Patterns of diet-related practices and prevalence of gastro-esophageal reflux disease.

PubMed

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.

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…

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…

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,…

Assessment of Vestibular Rehabilitation Therapy Training and Practice Patterns

PubMed Central

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

Modeling study on the flow patterns of gas-liquid flow for fast decarburization during the RH process

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.

TCM Pattern Questionnaire for Lateral Elbow Pain: Development of an Instrument via a Delphi Process

PubMed Central

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

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,…

Pre- and postdoctoral dental education compared to practice patterns in special care dentistry.

PubMed

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.

Effects of practice schedule and task specificity on the adaptive process of motor learning.

PubMed

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.

Allowing Learners to Choose: Self-Controlled Practice Schedules for Learning Multiple Movement Patterns

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…

The impact of a general practice group intervention on prescribing costs and patterns.

PubMed Central

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

Correlation between practice location as a surrogate for UV exposure and practice patterns to prevent corneal haze after photorefractive keratectomy (PRK).

PubMed

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.

Patterns of Yoga Practice and Physical Activity Following a Yoga Intervention for Adults With or at Risk for Type 2 Diabetes

PubMed Central

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

Patterns of yoga practice and physical activity following a yoga intervention for adults with or at risk for type 2 diabetes.

PubMed

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.

Physiological patterns during practice of the Transcendental Meditation technique compared with patterns while reading Sanskrit and a modern language.

PubMed

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.

Shifting patterns of practice: nurse practitioners in a managed care environment.

PubMed

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.

Hemodialysis practice patterns in the Russia Dialysis Outcomes and Practice Patterns Study (DOPPS), with international comparisons.

PubMed

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.

Variation in transfusion rates within a single institution: exploring the effect of differing practice patterns on the likelihood of blood product transfusion in patients undergoing cardiac surgery.

PubMed

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.

Influence of hospital-level practice patterns on variation in the application of minimally invasive surgery in United States pediatric patients.

PubMed

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.

Assessment of Vestibular Rehabilitation Therapy Training and Practice Patterns.

PubMed

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.

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.

The U.S. Pediatric Dermatology Workforce: An Assessment of Productivity and Practice Patterns.

PubMed

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.

Proactive transfer of learning depends on the evolution of prior learned task in memory.

PubMed

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.

Alignment of breast cancer screening guidelines, accountability metrics, and practice patterns.

PubMed

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.

Pregnancy After Bariatric Surgery: National Survey of Obstetrician's Comfort, Knowledge, and Practice Patterns.

PubMed

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.

Caregiving Practice Patterns of Asian, Hispanic, and Non-Hispanic White American Family Caregivers of Older Adults Across Generations.

PubMed

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.

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...

Correlates of parental feeding practices with pre-schoolers: Parental body image and eating knowledge, attitudes, and behaviours.

PubMed

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.

Linkage between Graduate Medical Education Training Practice Profiles in Psychiatry, Obstetrics/Gynecology, and Family Practice. Deliverable No. 5. Final Report.

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…

Comparison of urban and rural general surgeons: motivations for practice location, practice patterns, and education requirements.

PubMed

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.

Future Career Plans and Practice Patterns of Canadian Obstetrics and Gynaecology Residents in 2011.

PubMed

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.

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…

Communication performance analysis and comparison of two patterns for data exchange between nodes in WorldFIP fieldbus network.

PubMed

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.

Alcohol policies and practices among four-year colleges in the United States: prevalence and patterns.

PubMed

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.

Use of Simulators to Explore Specialty Recommendation for a Palpable Breast Mass

PubMed Central

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

Ethnic Differences in the Food Intake Patterns and Its Associated Factors of Adolescents in Kelantan, Malaysia.

PubMed

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.

Ethnic Differences in the Food Intake Patterns and Its Associated Factors of Adolescents in Kelantan, Malaysia

PubMed Central

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

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…

Evolution as represented through argumentation: A qualitative study on reasoning and argumentation in high school biology teaching practices

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.

Practice patterns of family physicians with 2-year residency v. 1-year internship training: do both roads lead to Rome?

PubMed Central

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

Goal setting education and counseling practices of diabetes educators.

PubMed

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.

Patterns of online abortion among teenagers

NASA Astrophysics Data System (ADS)

Wahyudi, A.; Jacky, M.; Mudzakkir, M.; Deprita, R.

2018-01-01

An on-going debate of whether or not to legalize abortion has not stopped the number of abortion cases decreases. New practices of abortion such as online abortion has been a growing trend among teenagers. This study aims to determine how teenagers use social media such as Facebook, YouTube and Wikipedia for the practice of abortion. This study adopted online research methods (ORMs), a qualitative approach 2.0 by hacking analytical perspective developed. This study establishes online teen abortion as a research subject. This study finds patterns of online abortions among teenagers covering characteristics of teenagers as perpetrators, styles of communication, and their implication toward policy, particularly Electronic Transaction Information (ETI) regulation. Implications for online abortion behavior among teenagers through social media. The potential abortion client especially girls find practical, fast, effective, and efficient solutions that keep their secret. One of prevention patterns that has been done by some people who care about humanity and anti-abortion in the online world is posting a anti-abortion text, video or picture, anti-sex-free (anti -free intercourse before marriage) in an interesting, educative, and friendly ways.

Community health centers employ diverse staffing patterns, which can provide productivity lessons for medical practices.

PubMed

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.

Gender differences in practice patterns for diagnosis and treatment of dental caries: Findings from The Dental PBRN

PubMed Central

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

Clinical Practices and Outcomes in Elderly Hemodialysis Patients: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS)

PubMed Central

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

A Survey of Optometry Graduates to Determine Practice Patterns: Part II: Licensure and Practice Establishment Experiences.

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)

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…

Patterns in Elementary School Students' Strategic Actions in Varying Learning Situations

ERIC Educational Resources Information Center

Malmberg, Jonna; Järvenoja, Hanna; Järvelä, Sanna

2013-01-01

This study uses log file traces to examine differences between high-and low-achieving students' strategic actions in varying learning situations. In addition, this study illustrates, in detail, what strategic and self-regulated learning constitutes in practice. The study investigates the learning patterns that emerge in learning situations…

Reproductive practices by patterns of marriage among Iranian women: study protocol for an explanatory sequential mixed methods design.

PubMed

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.

Need for intraoperative ultrasound and surgical recommendation for partial nephrectomy: correlation with tumor imaging features and urologist practice patterns.

PubMed

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.

AAN Epilepsy Quality Measures in clinical practice: a survey of neurologists.

PubMed

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.

A survey of Korean medicine doctors' clinical practice patterns for autism spectrum disorder: preliminary research for clinical practice guidelines.

PubMed

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.

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…

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…

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)

A practice pattern assessment of members of the Society of Pediatric Urology for evaluation and treatment of urinary tract dilation.

PubMed

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.

Media Use Patterns of Young Men: Findings from the Youth Attitude Tracking Study 2

DTIC Science & Technology

1990-08-01

advertising avenue for the Military. To use the media most effectively , however, requires knowledge of the attitudes and practices of youths regarding...OPP~ FILE COPY DEFENSE -MANPOWER DATA CENTER MEDIA USE PATTERNS OF YOUNG MEN FINDINGS FROM THE YOUTH ATTITUDE TRACKING STUDY If Market Research...cost- effective military advertising. Understanding media use patterns will provide information to aid in understanding how to target advertising

Family Planning Practice by Patterns of Marriage in the North of Iran.

PubMed

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.

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.

Adolescent Maltreatment in the Child Welfare System and Developmental Patterns of Sexual Risk Behaviors

PubMed Central

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

Expert panel on practice patterns in the management of cow's milk protein allergy and associated economic burden of disease on health service in Turkey.

PubMed

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.

Public Health Campaigns to Change Industry Practices that Damage Health: An Analysis of 12 Case Studies

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…

The Influence of Health Promoting Practices on the Quality of Life of Community Adults in Hong Kong

ERIC Educational Resources Information Center

Mo, Phoenix K. H.; Winnie, W. S. Mak

2010-01-01

The importance of a healthy lifestyle is receiving increasing attention due to its impact on health and well-being. However, very few studies have been done on health promoting practices of the general public in Hong Kong. The present study aimed to identify the patterns of health promoting practices of the general public in Hong Kong, to compare…

An innovative professional practice model: adaptation of Carper's patterns of knowing, patterns of research, and Aristotle's intellectual virtues.

PubMed

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.

Gender trends in dental practice patterns. A review of current U.S. literature.

PubMed

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.

Antimicrobials for the treatment of urinary tract infection in pregnancy: practices in southern India.

PubMed

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.

Practice Patterns and Job Satisfaction of Mohs Surgeons.

PubMed

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.

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.

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…

Patterns of Racial Socialization and Psychological Adjustment: Can Parental Communications about Race Reduce the Impact of Racial Discrimination?

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,…

Sleep Practices of University Students Living in Residence

ERIC Educational Resources Information Center

Qin, Pei; Brown, Cary A.

2017-01-01

Sleep plays an important role in both students' academic and personal life. Despite widespread sleep problems among young adults, few studies focus on higher education students living in campus residence. This study investigated residence-living students' sleep patterns, sleep promoting practices, sources of help seeking, and preferred ways to…

A Systematic Scoping Literature Review of Publications Supporting Treatment Guidelines for Pediatric Atopic Dermatitis in Contrast to Clinical Practice Patterns.

PubMed

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.

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…

Patterns of Informal Reasoning in the Context of Socioscientific Decision Making

ERIC Educational Resources Information Center

Sadler, Troy D.; Zeidler, Dana L.

2005-01-01

The purpose of this study is to contribute to a theoretical knowledge base through research by examining factors salient to science education reform and practice in the context of socioscientific issues. The study explores how individuals negotiate and resolve genetic engineering dilemmas. A qualitative approach was used to examine patterns of…

Perceptions of Using Number Patterns to Manage Behaviors in Students with Autism

ERIC Educational Resources Information Center

Thomas, Miriam

2012-01-01

Studies have documented that an escalation in the phenomenon of aggression in autistic students reduces the potential for successful social inclusion. This qualitative case study examined the perceptions of certified professionals in education regarding implementing number patterns as a best practice to manage aggressive behaviors of students with…

Dietary intake practices associated with cardiovascular risk in urban and rural Ecuadorian adolescents: a cross-sectional study.

PubMed

Ochoa-Avilés, Angélica; Verstraeten, Roosmarijn; Lachat, Carl; Andrade, Susana; Van Camp, John; Donoso, Silvana; Kolsteren, Patrick

2014-09-09

Cardiovascular diseases (CVD) are amongst the leading causes of death worldwide. Risk factors of CVD develop during childhood and adolescence, and dietary quality has been linked to the development of CVD itself. This study examines the association between dietary patterns and cardiovascular risk in a group of urban and rural Ecuadorian adolescents from different socioeconomic backgrounds. A cross-sectional study was conducted from January 2008 to April 2009 among 606 adolescents from the 8th, 9th and 10th grade in an urban area (Cuenca), and 173 adolescents from a rural area (Nabón) in Ecuador. Data collection involved measuring anthropometric data (weight, height and waist circumference), blood pressure, dietary intake (2-day 24 h recall) and socio-demographic characteristics. Fasting blood lipids and glucose were measured in a subsample of 334 adolescents. Factor analysis was used to identify dietary patterns and linear regression models were used to (i) identify differences in food intake practices according to socioeconomic status and place of residence and (ii) establish relationships between dietary patterns and cardiovascular risk factors. Median energy intake was 1851 kcal/day. Overall, fiber, fish and fruit and vegetables were scarcely consumed, while added sugar, refined cereals and processed food were important constituents of the diet. Two dietary patterns emerged, one labelled as "rice-rich non-animal fat pattern" and the other one as "wheat-dense animal-fat pattern". The first pattern was correlated with a moderate increase in glucose in urban participants, while the second pattern was associated with higher LDL and cholesterol blood levels in rural participants. This group of adolescents presented various dietary practices conducive to CVD development. Effective strategies are needed to prevent CVD in the Ecuadorian population by encouraging a balanced diet, which contains less refined cereals, added sugar, and processed food, but has more fruits, vegetables and whole grain cereals.

Clinical Practice Patterns of Radiotherapy in Patients with Hepatocellular Carcinoma: A Korean Radiation Oncology Group Study (KROG 14-07)

PubMed Central

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

A Worldwide Survey on Peyronie's Disease Surgical Practice Patterns Among Surgeons.

PubMed

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.

Associations of land, cattle and food security with infant feeding practices among a rural population living in Manyara, Tanzania.

PubMed

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.

Practice Patterns of Dentist Anesthesiologists in North America.

PubMed

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.

Are There Patterns of Bruising in Childhood Which Are Diagnostic or Suggestive of Abuse? A Systematic Review

ERIC Educational Resources Information Center

Maguire, S.; Mann, M. K.; Sibert, J.; Kemp, A.

2005-01-01

Aims: To investigate what patterns of bruising are diagnostic or suggestive of child abuse by means of a systematic review. Methods: All language literature search 1951-2004. Included: studies that defined patterns of bruising in non-abused or abused children <18 years. Excluded: personal practice, review articles, single case reports, inadequate…

Practice patterns of black physicians: results of a survey of Howard University College of Medicine alumni.

PubMed

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.

Explore Care Pathways of Colorectal Cancer Patients with Social Network Analysis.

PubMed

Huo, Tianyao; George, Thomas J; Guo, Yi; He, Zhe; Prosperi, Mattia; Modave, François; Bian, Jiang

2017-01-01

Patients with colorectal cancer (CRC) often face treatment delays and the exact reasons have not been well studied. This study is to explore clinical workflow patterns for CRC patients using electronic health records (EHR). In particular, we modeled the clinical workflow (provider-provider interactions) of a CRC patient's workup period as a social network, and identified clusters of workflow patterns based on network characteristics. Understanding of these patterns will help guide healthcare policy-making and practice.

Telecollaboration in the Secondary Language Classroom: Case Study of Adolescent Interaction and Pedagogical Integration

ERIC Educational Resources Information Center

Ware, Paige; Kessler, Greg

2016-01-01

This study builds on research examining the in-school technology practices of adolescent language learners by exploring the patterns of classroom literacy practices that emerge when a telecollaborative project is introduced into a conventional secondary language classroom. We draw on the conceptual frameworks and discourse analytical tools…

Linking Research and Practice through Teacher Communities: A Place Where Formal and Practical Knowledge Meet?

ERIC Educational Resources Information Center

Pareja Roblin, Natalie N.; Ormel, Bart J. B.; McKenney, Susan E.; Voogt, Joke M.; Pieters, Jules M.

2014-01-01

This study characterises the links between research and practice across 12 projects concerned with the collaborative design of lesson plans by teacher communities (TCs). Analyses focused on sources of knowledge used to inform lesson design, participants' roles and knowledge generated by the teacher community. Three patterns emerged pertaining…

The use of noninvasive prenatal testing in obstetric care: educational resources, practice patterns, and barriers reported by a national sample of clinicians.

PubMed

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.

Patterns and Predictors of Disciplinary Exclusion over Time: An Analysis of the SEELS National Data Set

ERIC Educational Resources Information Center

Bowman-Perrott, Lisa; Benz, Michael R.; Hsu, Hsien-Yuan; Kwok, Oi-Man; Eisterhold, Leigh Ann; Zhang, Dalun

2013-01-01

Disciplinary exclusion practices are on the rise nationally, as are concerns about their disproportionate use and lack of effectiveness. This study used data from the Special Education Elementary Longitudinal Study to examine patterns and predictors of disciplinary exclusion over time. Students with emotional/behavioral disorders were most likely…

A shift in referral patterns for HIV/AIDS patients.

PubMed

Fournier, Phillip O; Savageau, Judith A; Baldor, Robert A

2008-02-01

With the rapid development (and complex prescribing patterns) of drugs for HIV/AIDS care, it is challenging for physicians to keep current. We conducted a follow-up study to a 1994 cohort study to see how care and referral patterns have changed over the last decade. In this study, we examined how family physicians in Massachusetts were caring for their HIV-infected patients, and to see whether FPs were referring more patients to specialists for care compared with a decade ago. We designed a cross-sectional survey as an 11-year follow-up to a previous study. It was mailed in 2005 to the active membership of the Massachusetts Academy of Family Physicians. Compared with the cohort of 1994, the number of HIV+ patients in individual practices remained about the same, but the number of practices with no AIDS patients was significantly higher. 85.3% of FPs noted that they were more likely to refer HIV/AIDS patients immediately compared with their own practice patterns a decade ago. In this study, 39.0% of current respondents referred HIV+ patients immediately, 57.0% co-managed patients, and 4.1% managed these patients alone (the data for the 1994 cohort was 7.0%, 45.8%, and 47.2%, respectively; P<.0001). Similar changes were seen in regard to care patterns for AIDS patients. Among the current cohort, 61.7% reported that they referred patients immediately, compared with only 18.3% in 1994; 36.8% noted that they co-managed these patients (vs 74.3% in 1994); and only 1.5% reported that they managed these patients alone (vs 7.4% in 1994; P<.0001). A significant shift amongst FPs with regard to their referral patterns for patients with HIV/AIDS has occurred over the last decade. The community health center has emerged as a resource for patients with HIV/AIDS. Funding for specific training programs on HIV/AIDS care should be targeted to community health centers.

Adolescent maltreatment in the child welfare system and developmental patterns of sexual risk behaviors.

PubMed

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.

Mandatory Nap Times and Group Napping Patterns in Child Care: An Observational Study.

PubMed

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.

Thinking in clinical nursing practice: a study of critical care nurses' thinking applying the think-aloud, protocol analysis method.

PubMed

Han, Kyung-Ja; Kim, Hesook Suzie; Kim, Mae-Ja; Hong, Kyung-Ja; Park, Sungae; Yun, Soon-Nyoung; Song, Misoon; Jung, Yoenyi; Kim, Haewon; Kim, Dong-Oak Debbie; Choi, Heejung; Kim, Kyungae

2007-06-01

The purpose of the paper is to discover the patterns and processes of decision-making in clinical nursing practice. A set of think-aloud data from five critical care nurses during 40 to 50 minutes of caregiving in intensive care units were obtained and analyzed by applying the procedures recommended by Ericsson and Simon for protocol analysis. Four thinking processes before acting were identified to constitute various sorts of thoughts in which the nurses were engaged during patient care: reviewing, validation, consideration, rationalization, and action. In addition, three patterns of sequential streaming of thinking (short, intermediate, long) were identified to reveal various ways the nurses dealt with clinical situations involving nursing tasks and responsibilities. This study specifies the initial categories of thoughts for each of the processes and various patterns with which these processes are sequentially combined, providing insights into the ways nurses think about problems and address their concerns. The findings suggest that the thinking in clinical practice involves more than focused decision-making and reasoning, and needs to be examined from a broader perspective.

The teacher's role in the establishment of whole-class dialogue in a fifth grade science classroom using argument-based inquiry

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.

Student-Teachers' Verbal Communication Patterns during Their Teaching Practice in "Studies for the Environment" Subject in Early Greek Primary Classes

ERIC Educational Resources Information Center

Malandrakis, George; Karagianni, Aggeliki; Pani, Dimitra

2016-01-01

This study explores the quality of student-teachers' (STs') verbal communication during their teaching practice on the "Studies for the Environment" subject, and identifies potential factors affecting it. Forty-one teaching sessions were analysed revealing that STs dominate classroom talking by having almost an equal number of utterances…

[Discussion on theory and indes system of Chinese material medical regionalization].

PubMed

Zhang, Xiaobo; Guo, Lanping; Zhou, Tao; Huang, Luqi

2010-09-01

The paper discusses the theory regarding to the Chinese material medical (CMM) regionalization. It is based on the studying of papers and practical experience in the field of CMM regionalization. The basic theories of CMM regionalization are laws of territorial differentiation and location theory. The basic principles are excellent quality of CMM, difference, similarity and practicability. The study objects are CMM resources, natural environment and social environment. The definition of CMM regionalization is that study on the laws of spatial pattern of resources and regional system in the field of CMM,then regionalize it based on this kind of spatial pattern and law. The index system is built based on the study of the theory,principle,object and index of CMM regionalization.

Endophthalmitis Prophylaxis in Cataract Surgery: Overview of Current Practice Patterns Around the World.

PubMed

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.

Practice patterns and organizational commitment of inpatient nurse practitioners.

PubMed

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.

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)

Public-on-private dual practice among physicians in public hospitals of Tigray National Regional State, North Ethiopia: perspectives of physicians, patients and managers.

PubMed

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.

Etching-free patterning method for electrical characterization of atomically thin MoSe2 films grown by chemical vapor deposition

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

Sequential Research Needs in Evolving Disciplines of Social Practice.

ERIC Educational Resources Information Center

Knowles, Malcolm S.

The author suggests that the emerging fields of social practice (such as recreation, social work, and adult education) must all go through a sequential pattern of research needs, first superficially, and then in ever deeper cycles. The six phases of these research needs are: definition of the field (survey and descriptive studies, census studies,…

Home Literacy Beliefs and Practices among Low-Income Latino Families

ERIC Educational Resources Information Center

Davis, Heather S.; Gonzalez, Jorge E.; Pollard-Durodola, Sharolyn; Saenz, Laura M.; Soares, Denise A.; Resendez, Nora; Zhu, Leina; Hagan-Burke, Shanna

2016-01-01

The aim of this study was to explore within-group patterns of variability in the home literacy environments (HLEs) of low-income Latino families using latent profile analysis. Participants were (N = 193) families of Latino preschoolers enrolled in a larger study. In the fall of 2012, mothers filled out a family literacy practices inventory, a…

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…

Pattern of Drug Use and Associated Behaviors Among Female Injecting Drug Users From Northeast India: A Multi-Centric, Cross-Sectional, Comparative Study.

PubMed

Ambekar, Atul; Rao, Ravindra; Agrawal, Alok; Goyal, Shrigopal; Mishra, Ashwani; Kishore, Kunal; Mukherjee, Debashis; Albertin, Cristina

2015-01-01

Studies from developed countries document the presence of injecting drug use among females and significantly higher vulnerabilities and risks as compared with male injecting drug users (IDUs). Studies comparing vulnerabilities and drug use patterns between female and male IDUs are not available for developing countries. The aim of the study was to assess the drug use pattern and related HIV vulnerabilities among female IDUs and compare these findings with those from male IDUs from four states of Northeast India. The study used data collected as part of a nationwide study of drug use pattern and related HIV vulnerabilities among IDUs. Ninety-eight female and 202 male IDUs accessing services from harm reduction sites across the four states of Northeast region of India were chosen through random sampling methodology. Drug use pattern, injecting practices, and knowledge of HIV were assessed using a structured questionnaire. Significantly higher proportion of female IDUs was uneducated, unemployed, reported their occupation as sex workers, and switched to injecting drug use faster as compared with male IDUs. Female IDUs practicing sex work differed significantly from those who did not with respect to frequency of daily injections, choice of drugs injected, and concomitant use of non-injecting drugs. More than half of female IDUs initiated sharing within the first month of injecting. The study demonstrates that female IDUs differ from male IDUs in their drug use pattern, initiation into injection as well as injecting behavior, which would be an important consideration during designing of female-specific interventions.

Practice pattern and professional issues of nurse practitioners in mechanical circulatory support programs in the United States: a survey report.

PubMed

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.

Pedagogical Implications of Score Distribution Pattern and Learner Satisfaction in an Intensive TOEIC Course

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…

Effect of Health Lifestyle Pattern on Dietary Change.

ERIC Educational Resources Information Center

O'Halloran, Peggy; Lazovich, DeAnn; Patterson, Ruth E.; Harnack, Lisa; French, Simone; Curry, Sue J.; Beresford, Shirley A. A.

2001-01-01

Examined the impact of lifestyle on the effectiveness of a low-intensity dietary intervention. Analysis of data from the Eating Patterns Study indicated that people who practiced certain combinations of health behaviors responded differently to the low-intensity dietary intervention. People with high-risk behaviors were the least successful in…

Specification Theory, Patterns, and Models in Information Systems Domains: An Exploratory Investigation

ERIC Educational Resources Information Center

Woolridge, Richard William

2010-01-01

Application and project domain specifications are an important aspect of Information Systems (IS) development. Observations of over thirty IS projects suggest dimly perceived structural patterns in specifications that are unaccounted for in research and practice. This investigation utilizes a theory building with case studies methodology to…

Maternal Dietary Patterns and Practices and Birth Weight in Northern Ghana

PubMed Central

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

The Meal Pattern Questionnaire: A psychometric evaluation using the Eating Disorder Examination.

PubMed

Alfonsson, S; Sewall, A; Lidholm, H; Hursti, T

2016-04-01

Meal pattern is an important variable in both obesity treatment and treatment for eating disorders. Momentary assessment and eating diaries are highly valid measurement methods but often cumbersome and not always feasible to use in clinical practice. The aim of this study was to design and evaluate a self-report instrument for measuring meal patterns. The Pattern of eating item from the Eating Disorder Examination (EDE) interview was adapted to self-report format to follow the same overall structure as the Eating Disorder Examination Questionnaire. The new instrument was named the Meal Patterns Questionnaire (MPQ) and was compared with the EDE in a student sample (n=105) and an obese sample (n=111). The individual items of the MPQ and the EDE showed moderate to high correlations (rho=.63-89) in the two samples. Significant differences between the MPQ and EDE were only found for two items in the obese sample. The total scores correlated to a high degree (rho=.87/.74) in both samples and no significant differences were found in this variable. The MPQ can provide an overall picture of a person's eating patterns and is a valid way to collect data regarding meal patterns. The MPQ may be a useable tool in clinical practice and research studies when more extensive instruments cannot be used. Future studies should evaluate the MPQ in diverse cultural populations and with more ecological assessment methods. Copyright © 2015 Elsevier Ltd. All rights reserved.

The dialysis outcomes and practice patterns study phase 5 in the Gulf Cooperation Council countries: Design and study methods.

PubMed

Pisoni, Ronald L; Bieber, Brian A; Al Wakeel, Jamal; Al Arrayed, Sameer; Alkandari, Naser; Hassan, Mohamed; Karkar, Ayman; Al Lawati, Nabil M; Al Ali, Fadwa; Albert, Justin M; Robinson, Bruce M

2016-11-01

The Dialysis Outcomes and Practice Patterns Study (DOPPS) is an international prospective cohort study of the relationships between hemodialysis (HD) care practices and HD patient outcomes. The DOPPS began in 1996, in the United States, and has since expanded to 21 countries, collecting detailed data from >75,000 HD patients, with >200 scientific publications, focused on describing HD practices associated with improved HD patient outcomes. The goal of DOPPS is to help HD patients "live better and live longer." Starting in 2012, the DOPPS was able to expand to all six of the Gulf Cooperation Council (GCC) countries, namely, Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. The DOPPS study design consists of selecting HD facilities for study participation in each country to represent the different types of HD facilities and geographic regions within each GCC country. Within each study site, HD patients were randomly selected for detailed data collection to represent the HD practices within each participating HD facility. Altogether, 41 HD facilities have participated in the GCC-DOPPS Phase 5 study including 20 facilities from Saudi Arabia, nine from the United Arab Emirates, four each from Kuwait and Oman, two from Qatar, and one from Bahrain. Herein, we provide a detailed description of the study design and methods, data collection, study management, scientific investigator oversight and guidance, and study governance and support for the GCCDOPPS Phase 5 study.

Innovative physical therapy practice: a qualitative verification of factors that support diffusion of innovation in outpatient physical therapy practice

PubMed Central

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

Innovative physical therapy practice: a qualitative verification of factors that support diffusion of innovation in outpatient physical therapy practice.

PubMed

Sabus, Carla; Spake, Ellen

2016-01-01

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. 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. 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. 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. 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.

The role and functions of Clinical Nurse Consultants, an Australian advanced practice role: a descriptive exploratory cohort study.

PubMed

Baldwin, Richard; Duffield, Christine Margaret; Fry, Margaret; Roche, Michael; Stasa, Helen; Solman, Annette

2013-03-01

The NSW Health Policy Directive (NSW Department of Health, 2000) lists clinical service and consultancy; clinical leadership; research; education; clinical services planning and management as the five domains of practice for nurses appointed as Clinical Nurse Consultants (CNCs), an Australian advanced practice nurse (APN) role. However, there is no clear definition of what is meant by advanced practice in the Australian nursing context. Nowhere is this more evident than in differentiating between the roles of Clinical Nurse Consultants (CNCs) and Nurse Practitioners (NP) in NSW. To date, limited empirical research has been done to characterise or delineate CNC role activity and responsibility. To investigate (i) the nature of CNC roles, activities and responsibilities, (ii) differentiate between CNCs by their work patterns and activities, and (iii) empirically conceptualize and differentiate ways CNCs practice in terms of an APN typology. The study sample was 56 CNCs at one tertiary level public hospital in Australia. A descriptive exploratory cohort study was conducted to explore CNC role characteristics and patterns of activity. Data were triangulated using an online survey, a follow-up survey, and semi-structured interviews. The data were analysed using descriptive statistics to examine differences between CNC work patterns and role activities. The survey data and the individual reports were thematically analysed to investigate for difference across the population of CNCs. Interpretation of survey and interview data led to an analyst-developed CNC typology of four CNC categories based on the work patterns and activities of Sole Practitioner, Clinic Coordinator, Clinical Team Coordinator and Clinical Leader. The typology was based on the themes interprofessional, role focus, clinical focus and setting as these themes distinguished and differentiated CNC roles. The study provides evidence of great diversity and prioritization within CNC roles. The CNC typology identified in this study is similar to the categorisation of the roles of APNs reported by other researchers. With further testing, the CNC typology could be useful to service managers and policy makers in making decision on the category of CNC required for a position and may also be able to be applied to other APN roles. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS): Unifying Efforts to Inform Practice and Improve Global Outcomes in Peritoneal Dialysis

PubMed Central

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

The Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS): Unifying Efforts to Inform Practice and Improve Global Outcomes in Peritoneal Dialysis.

PubMed

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

♦ 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. ♦ 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. ♦ 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. ♦ 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. Copyright © 2016 International Society for Peritoneal Dialysis.

Practice Patterns of School-Based Occupational Therapists Targeting Handwriting: A Knowledge-to-Practice Gap

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…

Clinical Practice Patterns and Beliefs in the Management of Hamstrings Strain Injuries.

PubMed

Di Trani Lobacz, Andrea; Glutting, Joseph; Kaminski, Thomas W

2016-02-01

Hamstrings strain injuries (HSIs) are among the most commonly occurring injuries in sport and are top causes of missed playing time. Lingering symptoms, prolonged recovery, and a high reinjury rate (12%-34%) make HSI management a frustrating and challenging process for the athletic trainer (AT). The clinical practice patterns and opinions of ATs regarding HSI treatment and rehabilitation are unknown. To examine the frequency of method use and opinions about current HSI management among ATs. Cross-sectional study. Survey administered to registrants at the 2013 National Athletic Trainers' Association Clinical Symposia and AT Expo. A total of 1356 certified ATs (691 men, 665 women; age = 35.4 ± 10.5 years, time certified = 11.92 ± 9.75 years). A survey was distributed electronically to 7272 registrants and on paper to another 700 attendees. Validity and reliability were established before distribution. Participants reported demographic information and rated their frequency of treatment and rehabilitation method use and agreement with questions assessing confidence, satisfaction, and desire for better clinical practice guidelines. Exploratory factor analysis and principal axis factor analysis were used. We also calculated descriptive statistics and χ(2) tests to assess practice patterns. The response rate was 17% (n = 1356). A 2-factor solution was accepted for factor analysis (r = 0.76, r = 0.70), indicating that ATs follow either a contemporary or traditional management style. Various practice patterns were evident across employment settings and years of clinical experience. Satisfaction with the current HSI management plan was high (73.6%), whereas confidence in returning an athlete to play was lower (62.0%). Rates of use were associated with belief in effectiveness for all methods assessed (P < .001). Higher confidence levels were associated with high use of several methods; we observed increased satisfaction (χ(2)2 = 22.5, P = .002) but not increased confidence levels in more experienced ATs. Our study demonstrated the lack of consensus in HSI treatment and rehabilitation and the ATs' desire for better clinical practice guidelines. Future research in which multimodal strategies, including both traditional and contemporary methods, are studied is warranted for effective management of HSI.

A Descriptive Study of the Practice Patterns of Massage New Zealand Massage Therapists

PubMed Central

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

Practice variation on use of antibiotics: An international survey among pediatric urologists.

PubMed

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.

Applications of Ontology Design Patterns in Biomedical Ontologies

PubMed Central

Mortensen, Jonathan M.; Horridge, Matthew; Musen, Mark A.; Noy, Natalya F.

2012-01-01

Ontology design patterns (ODPs) are a proposed solution to facilitate ontology development, and to help users avoid some of the most frequent modeling mistakes. ODPs originate from similar approaches in software engineering, where software design patterns have become a critical aspect of software development. There is little empirical evidence for ODP prevalence or effectiveness thus far. In this work, we determine the use and applicability of ODPs in a case study of biomedical ontologies. We encoded ontology design patterns from two ODP catalogs. We then searched for these patterns in a set of eight ontologies. We found five patterns of the 69 patterns. Two of the eight ontologies contained these patterns. While ontology design patterns provide a vehicle for capturing formally reoccurring models and best practices in ontology design, we show that today their use in a case study of widely used biomedical ontologies is limited. PMID:23304337

Meal patterns and cooking practices in Southern France and Central England.

PubMed

Pettinger, Clare; Holdsworth, Michelle; Gerber, Mariette

2006-12-01

To evaluate whether meal patterns and cooking practices in Central England and Mediterranean France conform to popular stereotypes, eating together as a household, preparation of meals, food purchasing patterns, cooking practices and eating out were investigated. Cross-sectional studies conducted simultaneously in April 2001 using self-administered postal questionnaires. England (Nottingham, East Midlands) and France (Montpellier, Languedoc-Roussillon). A stratified random sample of 1000 males and 1000 females aged 18-65 years was generated from the electoral roll in each country. The final sample comprised 826 subjects in England (58% males, 42% females; mean age 44 years) and 766 subjects in France (42% males, 58% females; mean age 42 years). Analyses were conducted on samples standardised for sociodemographic differences. The French cooked from raw ingredients most often (P<0.001), ate together as a household more regularly (P<0.001) and were most likely to follow a regular meal pattern of three meals a day. On the other hand, the English relied more on ready-prepared (P<0.001) and take-away (P<0.001) meals, as well as on energy-dense snack foods such as crisps (P<0.001). Females in both countries reported having most responsibility for preparing meals. Some of the study's findings confirm popular stereotypes of French and English food cultures, as the importance of the convivial aspects of eating, as well as more traditional practices such as cooking meals from basic ingredients, structured mealtimes and less between-meal snacking, remain more prominent within the French population. This may contribute to the differences in prevalence of obesity seen between the two countries.

Interaction order and anxiety disorder: A 'Batesonian' heuristic of speaking patterns during psychotherapy.

PubMed

Streeck, Jürgen

2011-01-01

This paper describes speaking practices enacted by young female in-patients during psychotherapy sessions. The patients are in treatment for anxiety and panic disorders (social phobias). The practices involve prosodic, lexical and pragmatic aspects of utterance construction. An effect that they share is that the speaker's embodied presence in her talk and her epistemic commitment to it are reduced as the utterance progresses. The practices are interpreted in light of Bateson's interactional theory of character formation: as elements of a self-sustaining system Angst (anxiety). The study has grown out of an interdisciplinary effort to explore possible relationships between types of anxiety and the communicative and linguistic patterns by which patients describe panic attacks and other highly emotional experiences.

The Association of Music Experience, Pattern of Practice and Performance Anxiety with Playing-Related Musculoskeletal Problems (PRMP) in Children Learning Instrumental Music

ERIC Educational Resources Information Center

Ranelli, Sonia; Smith, Anne; Straker, Leon

2015-01-01

There is evidence supporting the social and cognitive benefits of music education. However aspects of music practice, such as an increase in frequency and intensity of practice, are associated with playing-related musculoskeletal problems in adult musicians, though with limited evidence in children. The aim of this study was to describe the music…

Imaging Practice Patterns: Referral Network Analysis of a Single State of Origination.

PubMed

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.

An Overview and Analysis of Journal Operations, Journal Publication Patterns, and Journal Impact in School Psychology and Related Fields

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…

Implications of current resident work-hour guidelines on the future practice of surgery in Canada.

PubMed

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.

Diabetes and Diabetic Retinopathy: Knowledge, Attitude, Practice (KAP) among Diabetic Patients in A Tertiary Eye Care Centre

PubMed Central

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

Optimizing students' motivation in inquiry-based learning environments: The role of instructional practices

NASA Astrophysics Data System (ADS)

Kempler, Toni M.

The influence of inquiry science instruction on the motivation of 1360 minority inner-city seventh graders was examined. The project-based curriculum incorporates motivating features like real world questions, collaboration, technology, and lesson variety. Students design investigations, collect and analyze data, and create artifacts; challenging tasks require extensive use of learning and metacognitive strategies. Study 1 used Structural Equation Modeling to investigate student perceptions of the prevalence of project-based features, including real world connections, collaboration, academic press, and work norms, and their relation to interest, efficacy, cognitive engagement, and achievement. Perceptions of features related to different motivational outcomes, indicating the importance of using differentiated rather than single measures to study motivation in context. Cognitive engagement was enhanced by interest and efficacy but did not influence achievement, perhaps because students were not proficient strategy users and were new to inquiry. Study 2 examined the relationship between instructional practices and motivation. The 23 teachers in study 1 were observed six times during one unit. Observations focused on curriculum congruence, content accuracy, contextualization, sense making, and management and climate. A majority of teacher enactment was congruent with the curriculum, indicating that students experienced motivating features of project-based science. Hierarchical Linear Modeling showed that contextualization accounted for between-teacher variance in student interest, efficacy, and cognitive engagement; Teachers encouraged motivation through extended real world examples that related material to students' experiences. Cluster analysis was used to determine how patterns of practice affected motivation. Unexpectedly these patterns did not differentially relate to cognitive engagement. Findings showed that interest and efficacy were enhanced when teachers used particular sense making practices. These teachers provided explicit scaffolding for accomplishing complex tasks with questioning and feedback that highlighted key points. Teachers also used effective management practices and maintained a positive classroom climate. In contrast, a pattern of practice where teachers used questioning and feedback to press students to make connections and synthesize concepts without scaffolding support diminished motivation, because students may have needed more help to deal with challenge. Implications from both studies suggest inquiry teachers need to use explicit scaffolding and academic press together, with effective management practices, to support motivation.

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

PubMed

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

2017-05-17

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

Diabetes eye exams

MedlinePlus

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- ...

Patterns of Care for Craniopharyngioma: Survey of members of the American Association of Neurological Surgeons

PubMed Central

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

Early Career Patterns for Social Work Graduates

ERIC Educational Resources Information Center

Choi, Mi Jin; Urbanski, Paul; Fortune, Anne E.; Rogers, Crystal

2015-01-01

This study examines master's of social work graduates' early careers. Six cohorts graduating from 2002 through 2007 (N = 246) completed a questionnaire 9-15 months after graduation. Most reported adequate or exceptional preparation on both generalist and advanced concentration practice behaviors. Almost all direct practice graduates and 2/3 of…

Referral Rates of Senior Family Practice Residents in an Ambulatory Care Clinic.

ERIC Educational Resources Information Center

Lawler, Frank H.

1987-01-01

A study of patterns in second- and third-year family practice residents' requests for referrals found higher rates for the senior students, suggesting possible differences in approach to case management, lack of experience in referral among younger students, and differences in case mix. (MSE)

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…

School Climate: Research, Policy, Practice, and Teacher Education

ERIC Educational Resources Information Center

Cohen, Jonathan; McCabe, Libby; Michelli, Nicholas M.; Pickeral, Terry

2009-01-01

Background/Context: Educators have written about and studied school climate for 100 years. School climate refers to the quality and character of school life. School climate is based on patterns of people's experiences of school life and reflects norms, goals, values, interpersonal relationships, teaching and learning practices, and organizational…

Teaching Practices and Elementary Classroom Peer Ecologies

ERIC Educational Resources Information Center

Gest, Scott D.; Rodkin, Philip C.

2011-01-01

Teachers and students in 39 1st, 3rd and 5th grade classrooms participated in a study of teaching practices and classroom peer networks. Teachers reported on their attitudes towards aggression and withdrawal, provided rationales for their seating arrangements, and were observed on patterns of emotional and instructional support and classroom…

Extracting patterns of database and software usage from the bioinformatics literature

PubMed Central

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

Practice patterns among entrants and incumbents in the home health market after the prospective payment system was implemented.

PubMed

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.

Pulmonary function outcomes for assessing cystic fibrosis care.

PubMed

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.

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.

Changes in trait brainwave power and coherence, state and trait anxiety after three-month transcendental meditation (TM) practice.

PubMed

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.

Handbuch fur einen aktiven Sprachunterricht (Handbook for Active Language Instruction). Teaching Languages to Adults, Eurocentres Publication No. 2.

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)…

Evaluation of a practice-based intervention to improve the management of pediatric asthma.

PubMed

Ragazzi, Helen; Keller, Adrienne; Ehrensberger, Ryan; Irani, Anne-Marie

2011-02-01

Pediatric asthma remains a significant burden upon patients, families, and the healthcare system. Despite the availability of evidence-based best practice asthma management guidelines for over a decade, published studies suggest that many primary care physicians do not follow them. This article describes the Provider Quality Improvement (PQI) intervention with six diverse community-based practices. A pediatrician and a nurse practitioner conducted the year-long intervention, which was part of a larger CDC-funded project, using problem-based learning within an academic detailing model. Process and outcome assessments included (1) pre- and post-intervention chart reviews to assess eight indicators of quality care, (2) post-intervention staff questionnaires to assess contact with the intervention team and awareness of practice changes, and (3) individual semi-structured interviews with physician and nurse champions in five of the six practices. The chart review indicated that all six practices met predefined performance improvement criteria for at least four of eight indicators of quality care, with two practices meeting improvement criteria for all eight indicators. The response rate for the staff questionnaires was high (72%) and generally consistent across practices, demonstrating high staff awareness of the intervention team, the practice "asthma champions," and changes in practice patterns. In the semi-structured interviews, several respondents attributed the intervention's acceptability and success to the expertise of the PQI team and expressed the belief that sustaining changes would be critically dependent on continued contact with the team. Despite significant limitations, this study demonstrated that interventions that are responsive to individual practice cultures can successfully change practice patterns.

Patterns of Informal Reasoning in the Context of Socioscientific Decision-Making.

ERIC Educational Resources Information Center

Sadler, Troy D.; Zeidler, Dana L.

The purpose of this article is to contribute to a theoretical knowledge base through research by examining factors salient to science education reform and practice in the context of socioscientific issues. The study explores how individuals negotiate and resolve genetic engineering dilemmas. A mixed-methods approach was used to examine patterns of…

Student Teachers' Patterns of Reflection in the Context of Teaching Practice

ERIC Educational Resources Information Center

Toom, Auli; Husu, Jukka; Patrikainen, Sanna

2015-01-01

This study clarifies the basic structure of student teachers' reflective thinking. It presents a constructivist account of teacher knowledge through a detailed analysis of various patterns of reflection in student teacher portfolios. We aim to gain a greater understanding of the process and outcomes of portfolio writing in the context of teaching…

Vascular Access Practice Patterns in Canada: A National Survey

PubMed Central

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

Institutional patterns in the Austrian space sector

NASA Astrophysics Data System (ADS)

Wong, Annie; Burg, Elco van; Giannopapa, Christina

2018-01-01

This paper employs the institutional logics perspective to understand how space policies and regulations influences entrepreneurship and innovation. We conducted interviews with entrepreneurs, ESA policy makers and governmental representatives in Austria and identified six prevailing institutional practices: geographical return, the SME-initiatives, the national support pattern, the size pattern, the consortium pattern and the experience pattern. Together, these patterns make up the semi-governmental logic of the space sector. We find that space actors adhere to these patterns to earn legitimacy, which is a condition for support and access to resources. This study adds to our understanding in the consequences of policies and contributes to the design of new space policies and programmes.

Emergency physician evaluation of PA and NP practice patterns.

PubMed

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.

Predicting Forearm Physical Exposures During Computer Work Using Self-Reports, Software-Recorded Computer Usage Patterns, and Anthropometric and Workstation Measurements.

PubMed

Huysmans, Maaike A; Eijckelhof, Belinda H W; Garza, Jennifer L Bruno; Coenen, Pieter; Blatter, Birgitte M; Johnson, Peter W; van Dieën, Jaap H; van der Beek, Allard J; Dennerlein, Jack T

2017-12-15

Alternative techniques to assess physical exposures, such as prediction models, could facilitate more efficient epidemiological assessments in future large cohort studies examining physical exposures in relation to work-related musculoskeletal symptoms. The aim of this study was to evaluate two types of models that predict arm-wrist-hand physical exposures (i.e. muscle activity, wrist postures and kinematics, and keyboard and mouse forces) during computer use, which only differed with respect to the candidate predicting variables; (i) a full set of predicting variables, including self-reported factors, software-recorded computer usage patterns, and worksite measurements of anthropometrics and workstation set-up (full models); and (ii) a practical set of predicting variables, only including the self-reported factors and software-recorded computer usage patterns, that are relatively easy to assess (practical models). Prediction models were build using data from a field study among 117 office workers who were symptom-free at the time of measurement. Arm-wrist-hand physical exposures were measured for approximately two hours while workers performed their own computer work. Each worker's anthropometry and workstation set-up were measured by an experimenter, computer usage patterns were recorded using software and self-reported factors (including individual factors, job characteristics, computer work behaviours, psychosocial factors, workstation set-up characteristics, and leisure-time activities) were collected by an online questionnaire. We determined the predictive quality of the models in terms of R2 and root mean squared (RMS) values and exposure classification agreement to low-, medium-, and high-exposure categories (in the practical model only). The full models had R2 values that ranged from 0.16 to 0.80, whereas for the practical models values ranged from 0.05 to 0.43. Interquartile ranges were not that different for the two models, indicating that only for some physical exposures the full models performed better. Relative RMS errors ranged between 5% and 19% for the full models, and between 10% and 19% for the practical model. When the predicted physical exposures were classified into low, medium, and high, classification agreement ranged from 26% to 71%. The full prediction models, based on self-reported factors, software-recorded computer usage patterns, and additional measurements of anthropometrics and workstation set-up, show a better predictive quality as compared to the practical models based on self-reported factors and recorded computer usage patterns only. However, predictive quality varied largely across different arm-wrist-hand exposure parameters. Future exploration of the relation between predicted physical exposure and symptoms is therefore only recommended for physical exposures that can be reasonably well predicted. © The Author 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Results of a survey regarding irradiation of internal mammary chain in patients with breast cancer: practice is culture driven rather than evidence based.

PubMed

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.

Is Reading Instruction Evidence-Based? Analyzing Teaching Practices Using T-Patterns.

PubMed

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.

Is Reading Instruction Evidence-Based? Analyzing Teaching Practices Using T-Patterns

PubMed Central

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

Pericentral retinopathy and racial differences in hydroxychloroquine toxicity.

PubMed

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.

The Practice of Hatha Yoga for the Treatment of Pain Associated with Endometriosis.

PubMed

Gonçalves, Andrea Vasconcelos; Barros, Nelson Filice; Bahamondes, Luis

2017-01-01

The aim of this study was to compare chronic pelvic pain, menstrual patterns, and quality of life (QoL) in two groups of women with endometriosis: those who did and those who did not participate in a specific 8-week yoga intervention. This was a randomized controlled trial. It was conducted at the University of Campinas Medical School, Campinas, SP, Brazil. Forty women were randomly divided into two groups: an intervention group of women who practiced yoga (n = 28), and a control group of women who did not practice yoga (n = 12). Participants attended 90-min scheduled yoga sessions twice a week for 8 weeks. Additionally, an Endometriosis Health Profile (EHP)-30 questionnaire was applied to evaluate women's QoL at admission and 2 months later upon completion of the yoga program. Menstrual and daily pain patterns were evaluated through a daily calendar (visual analog scale). The degree of daily pain was significantly lower among the women who practiced yoga compared with the non-yoga group (p = 0.0007). There was an improvement of QoL in both groups between baseline and the end of the study evaluation. In relation to EHP-30 domains, pain (p = 0.0046), impotence (p = 0.0006), well-being (p = 0.0009), and image (p = 0.0087) from the central questionnaire, and work (p = 0.0027) and treatment (p = 0.0245) from the modular questionnaire were significantly different between the study groups over time. There was no significant difference between the two groups regarding the diary of menstrual patterns (p = 0.96). Yoga practice was associated with a reduction in levels of chronic pelvic pain and an improvement in QoL in women with endometriosis.

Mothers' restrictive eating and food neophobia and fathers' dietary quality are associated with breast-feeding duration and introduction of solid foods: the STEPS study.

PubMed

Vaarno, Jenni; Niinikoski, Harri; Kaljonen, Anne; Aromaa, Minna; Lagström, Hanna

2015-08-01

The purpose of the present study was to examine the association between parental eating behaviours and dietary patterns and feeding practices of infants and young children. Data on infant-feeding practices were collected from each infant's birth via parentally self-administered follow-up diaries. Three questionnaires, the Three-Factor Eating Questionnaire, the Food Neophobia Scale and the Index of Diet Quality, were administered when the children were aged 4 and 13 months. South-western Finland. Families participating in the STEPS longitudinal cohort study (n 1797). Mean duration of exclusive breast-feeding was 2.4 months and total duration of breast-feeding averaged 8.1 months. The first solid food was introduced into children's diets at the age of 3.9 months, on average. Mothers with highly restrictive eating were more likely to introduce solid foods sooner than mothers who ranked lower in these behaviours (3.8 months v. 4.0 months, P = 0.012). Neophobic mothers breast-fed exclusively (2.0 v. 2.6 months, P = 0.038) and in total (7.2 v. 8.5 months, P = 0.039) for shorter times than average mothers, even after adjusting for various demographic characteristics. Fathers' diet quality was associated with total breast-feeding duration and with introduction of complementary foods in unadjusted analyses and with total breast-feeding duration also after adjusting for confounding factors. Mothers' and fathers' eating patterns and practices are associated with the feeding practices of infants and young children. Health promotion interventions seeking to improve parents' eating patterns might lead to more favourable feeding practices for infants and young children.

Ménière's Disease: A CHEER Database Study of Local and Regional Patient Encounter and Procedure Patterns.

PubMed

Crowson, Matthew G; Schulz, Kristine; Parham, Kourosh; Vambutas, Andrea; Witsell, David; Lee, Walter T; Shin, Jennifer J; Pynnonen, Melissa A; Nguyen-Huynh, Anh; Ryan, Sheila E; Langman, Alan

2016-07-01

(1) Integrate practice-based patient encounters using the Dartmouth Atlas Medicare database to understand practice treatments for Ménière's disease (MD). (2) Describe differences in the practice patterns between academic and community providers for MD. Practice-based research database review. CHEER (Creating Healthcare Excellence through Education and Research) network academic and community providers. MD patient data were identified with ICD-9 and CPT codes. Demographics, unique visits, and procedures per patient were tabulated. The Dartmouth Atlas of Health Care was used to reference regional health care utilization. Statistical analysis included 1-way analyses of variance, bivariate linear regression, and Student's t tests, with significance set at P < .05. A total of 2071 unique patients with MD were identified from 8 academic and 10 community otolaryngology-head and neck surgery provider centers nationally. Average age was 56.5 years; 63.9% were female; and 91.4% self-reported white ethnicity. There was an average of 3.2 visits per patient. Western providers had the highest average visits per patient. Midwest providers had the highest average procedures per patient. Community providers had more visits per site and per patient than did academic providers. Academic providers had significantly more operative procedures per site (P = .0002) when compared with community providers. Health care service areas with higher total Medicare reimbursements per enrollee did not report significantly more operative procedures being performed. This is the first practice-based clinical research database study to describe MD practice patterns. We demonstrate that academic otolaryngology-head and neck surgery providers perform significantly more operative procedures than do community providers for MD, and we validate these data with an independent Medicare spending database. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Pediatricians' knowledge, attitudes, and practice patterns regarding special education and individualized education programs.

PubMed

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.

Higher theta and alpha1 coherence when listening to Vedic recitation compared to coherence during Transcendental Meditation practice.

PubMed

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.

Professional nursing burnout and irrational thinking: a replication study.

PubMed

Balevre, Park S; Cassells, Julie; Buzaianu, Elena

2012-01-01

This expanded (n = 648) replication study examines job-related burnout in practicing nurses in relation to five maladaptive thinking patterns at eight northeast Florida hospitals. Data supported the hypothesis that maladaptive thinking patterns may be related to nurses' burnout thoughts and behaviors. The focus of this research spotlights the individual nurse's thoughts, emotions, and actions and suggests that these burnout tendencies can be mitigated if not changed.

Patterns And Determinants Of Breast Feeding Among Mother Infant Pairs In Dera Ghazi Khan, Pakistan.

PubMed

Khan, Moazzam Ali; Qureshi, Zubia; Khan, Kauser Aftab; Gill, Fouzia Nadeem

2016-01-01

Proper breastfeeding practices are effective ways for reducing childhood morbidity and mortality. The objective of the present study was to determine the patterns and explore the determinants associated with breast feeding practices among the nursing women in Dera Ghazi Khan. A cross sectional study was conducted on randomly selected lactating mother infant pairs in Dera Ghazi Khan. Structured questionnaire was used for data collection. Analysis was done by using SPSS, chi square test was applied to see the association between breast feeding practices and its determinants such as knowledge of breast feeding practices. Majority 372 (93%) of mothers mentioned that they had ever breastfed the youngest child. About 292 (73%) mothers gave colostrum to the child, and 48 (12%) exclusively breastfed. Weaning babies before four month of age was practiced by 84 (21%) of the mothers, 120 (55%) mothers started weaning at 4-6 months of child age, while 72 (18%) started to give additional food after baby turned six months old. Out of total 276 (69%) mothers reported that they had knowledge regarding breast feeding. Significant association was found between knowledge of breastfeeding and initiation and Exclusive Breast Feeding (EBF) practices (p-values <0.05). Income, family type, mode of delivery and assistance for child were significantly associated with initiation of breastfeeding within one hour after birth (p-value <0.001). Breast feeding practices in the studied area were not up to the mark. There is a strong need to improve the breastfeeding practices by Behavior Change Communication.

From Professional Practice to Practical Leader: Teacher Leadership in Professional Learning Communities

ERIC Educational Resources Information Center

Wilson, Adrianne

2016-01-01

The primary purpose of this research is to illuminate perceptions and lived experiences of secondary teachers through their involvement in a Professional Learning Community (PLC). Teachers' experiences within a PLC were examined for patterns of cultivated leadership. The second purpose of the study was to identify variables that either promote or…

Evidence-Based Speech-Language Pathology Practices in Schools: Findings from a National Survey

ERIC Educational Resources Information Center

Hoffman, LaVae M.; Ireland, Marie; Hall-Mills, Shannon; Flynn, Perry

2013-01-01

Purpose: This study documented evidence-based practice (EBP) patterns as reported by speech-language pathologists (SLPs) employed in public schools during 2010-2011. Method: Using an online survey, practioners reported their EBP training experiences, resources available in their workplaces, and the frequency with which they engage in specific EBP…

Committed, Face-Value, Hybrid or Mutual Adaptation? The Experiences of International Students in Australian Higher Education

ERIC Educational Resources Information Center

Tran, Ly Thi

2011-01-01

This paper explores the adaptation patterns of international Chinese and Vietnamese students in relation to academic writing practices in a higher education context. The study utilises a trans-disciplinary framework for interpreting students' and lecturers' practices within institutional structures. This framework has been developed by infusing a…

Child Abuse and Neglect in Cambodian Refugee Families: Characteristics and Implications for Practice

ERIC Educational Resources Information Center

Chang, Janet; Rhee, Siyon; Berthold, S. Megan

2008-01-01

This study examines the characteristics and patterns of child maltreatment among Cambodian refugee families in Los Angeles and assesses the implications for child welfare practice with Cambodian refugee families. Data were extracted from 243 active Cambodian case files maintained by the Los Angeles County Department of Children and Family Services…

Emerging Patterns in Transferring Assessment Practices from F2f to Online Environments

ERIC Educational Resources Information Center

Beebe, Ronald; Vonderwell, Selma; Boboc, Marius

2010-01-01

This study explores the transfer of assessment practices from f2f to online environments by college instructors, with a particular interest in the factors influencing assessment in online learning settings. Assessment is a critical aspect of the learning environment, and considerable research has suggested various methods of formative and…

Informing the Discussion on Evaluator Training: A Look at Evaluators' Course Taking and Professional Practice

ERIC Educational Resources Information Center

Christie, Christina A.; Quiñones, Patricia; Fierro, Leslie

2014-01-01

This classification study examines evaluators' coursework training as a way of understanding evaluation practice. Data regarding courses that span methods and evaluation topics were collected from evaluation practitioners. Using latent class analysis, we establish four distinct classes of evaluator course-taking patterns: quantitative,…

Practice Patterns for Chronic Respiratory Diseases in the Asia-Pacific Region: A Cross-Sectional Observational Study.

PubMed

Wang, De Yun; Cho, Sang-Heon; Lin, Horng-Chyuan; Ghoshal, Aloke Gopal; Bin Abdul Muttalif, Abdul Razak; Thanaviratananich, Sanguansak; Tunceli, Kaan; Urdaneta, Eduardo; Zhang, Dongmu; Faruqi, Rab

2018-06-06

Allergic rhinitis (AR), asthma, chronic obstructive pulmonary disease (COPD), and rhinosinusitis are common and little studied in the Asia-Pacific region. We sought to investigate real-world practice patterns for these respiratory diseases in India, Korea, Malaysia, Singapore, Taiwan, and Thailand. This cross-sectional observational study enrolled adults (age ≥18 years) presenting to general practitioners (GP) or specialists for physician-diagnosed AR, asthma, COPD, or rhinosinusitis. Physicians and patients completed study-specific surveys at one visit, recording patient characteristics, health-related quality of life (QoL), work impairment, and healthcare resource use. Findings by country and physician category (GP or specialist) were summarized. Of the 13,902 patients screened, 7,243 (52%) presented with AR (18%), asthma (18%), COPD (7%), or rhinosinusitis (9%); 5,250 of the 7,243 (72%) patients were eligible for this study. Most eligible patients (70-100%) in India, Korea, Malaysia, and Singapore attended GP, while most (83-85%) in Taiwan and Thailand attended specialists. From 42% (rhinosinusitis) to 67% (AR) of new diagnoses were made by GP. On average, patients with COPD reported the worst health-related QoL, particularly to GP. Median losses of work productivity for each condition and activity impairment, except for asthma, were numerically greater for patients presenting to GP vs. specialists. GP prescribed more antibiotics for AR and asthma, and fewer intranasal corticosteroids for AR, than specialists (p < 0.001 for all comparisons). Our findings, albeit mostly descriptive and influenced by between-country differences, suggest that practice patterns differ between physician types, and the disease burden may be substantial for patients presenting in general practice. © 2018 S. Karger AG, Basel.

Imbalanced target prediction with pattern discovery on clinical data repositories.

PubMed

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.

Patterns in Japanese Comparative Education Practices: A Contrast with North America and Greater China

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…

ACCULTURATION AS A PREDICTOR OF HEALTH PROMOTING AND LIFESTYLE PRACTICES OF ARAB AMERICANS: A DESCRIPTIVE STUDY.

PubMed

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.

Winter movements of Louisiana pine snakes (Pituophis ruthveni) in Texas and Louisiana

Treesearch

Josh B. Pierce; D. Craig Rudolph; Shirley J. Burgdorf; Richard R. Schaefer; Richard N. Conner; John G. Himes; C. Mike Duran; Laurence M. Hardy; Robert R. Fleet

2014-01-01

Despite concerns that the Louisiana Pine Snake (Pituophis ruthveni) has been extirpated from large portions of its historic range, only a limited number of studies on their movement patterns have been published. Winter movement patterns are of particular interest since it has been hypothesized that impacts of management practices would be reduced during the winter....

Changing Throwing Pattern: Instruction and Control Parameter

ERIC Educational Resources Information Center

Southard, Dan

2006-01-01

The purpose of this study was to determine the effects of instruction and scaling up a control parameter (velocity of throw) on changes in throwing pattern. Sixty adult female throwers (ages 20-26 years) were randomly placed into one of four practice conditions: (a) scale up on velocity with no instruction, (b) maintain constant velocity with no…

A Preliminary Study: Is the Metronome Harmful or Helpful?

ERIC Educational Resources Information Center

Arthur, Patricia; Khuu, Sieu; Blom, Diana

2016-01-01

The metronome is a frequently used time-keeping tool in music instrument practice. However, if its speed is set beyond a comfortable level for the performer, their eye movement (EM) patterns can betray pressure that might have been placed on the visual processing system. The patterns of the eyes moving forward or back, (saccades); when the eye…

A survey of UK practice patterns in the delivery of intravitreal injections.

PubMed

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.

Oropharyngeal dysphagia: surveying practice patterns of the speech-language pathologist.

PubMed

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.

Allergen-specific immunotherapy prescription patterns in veterinary practice: a US population-based cohort study.

PubMed

Tater, Kathy Chu; Cole, William Elliott; Pion, Paul David

2017-08-01

Poor adherence to continuing allergen-specific immunotherapy treatment (ASIT) may be an issue in veterinary medicine. No studies describe how allergen tests are used in general veterinary practice, including the percentage of patients that receive ASIT after allergen testing. Assess veterinary ASIT patterns in United States general practices. Dogs (n = 2,557) and 121 cats allergen-tested at 177 hospitals (173 general practice and four specialty practices) in 44 states. Invoiced service descriptions of allergen tests and ASIT orders were retrieved from an aggregated database of veterinary practices. In general practice, 42% (992 of 2,360) of patients did not begin ASIT after allergen testing. ASIT was not refilled for 29% (398 of 1,368) of patients after the initial order. ASIT was initiated and refilled more often in dogs (56.6%, 71.4%, respectively) than cats (38%, 67.4%). Specialty practice patients had the highest ASIT initiation (94.4%) and refill (92.7%) percentages in comparison to general practices (P < 0.001). Size, age, geographical region and type of practice were associated with whether dogs were started on ASIT. Geographical region was also associated with refilling a prescription for ASIT, which was considered to be evidence of adherence to continuing treatment. Almost one third of clients failed to continue ASIT beyond the initial order, which is a much shorter duration of therapy than the 12 months recommended for determining ASIT efficacy. A large number of general practice patients did not begin ASIT after allergen testing, likely due to differences in how clinicians in general and dermatology practices use allergen tests. © 2017 ESVD and ACVD.

Patterns of Chemotherapy Use in a U.S.-Based Cohort of Patients with Metastatic Pancreatic Cancer.

PubMed

Abrams, Thomas A; Meyer, Gary; Meyerhardt, Jeffrey A; Wolpin, Brian M; Schrag, Deborah; Fuchs, Charles S

2017-08-01

Few population studies have examined patterns of systemic therapy administration in metastatic pancreatic cancer (MPC) or the predictors associated with specific treatment choices. We assessed 4,011 consecutive MPC patients who received chemotherapy between January 2005 and December 2015 at academic, private, and community-based oncology practices subscribing to a U.S.-wide chemotherapy order entry system capturing disease, patient, provider, and treatment data. Multivariate analyses of these prospectively recorded characteristics identified significant predictors of specific therapeutic choices. Overall, 100 different regimens were used in first-line treatment of MPC. First-line gemcitabine monotherapy usage fell steadily from 72% in 2006 to 16% in 2015. This steep decline mirrored increases in first-line usage of both 5 fluorouracil, leucovorin, irinotecan and oxaliplatin (FOLFIRINOX) and gemcitabine + nab-paclitaxel. Younger male patients were more likely to receive FOLFIRINOX as first-line treatment, whereas patients treated at community practices and by oncologists with lower MPC patient volume were more likely to receive gemcitabine plus nab-paclitaxel (all p  ≤ .05). Among all patients receiving first-line chemotherapy for MPC, 49% went on to receive second-line therapy and 19% received third-line therapy; administration of second- and third-line therapies increased steadily over the time course of follow-up. Younger patients and those treated by oncologists with higher MPC patient volume were more likely to receive second- and third-line therapies. This population-based study provides insight into treatment patterns of MPC in the U.S. Usage patterns varied greatly according to patient and provider characteristics. This study examined real world metastatic pancreatic cancer treatment patterns in the United States with the goals of understanding changes in chemotherapy treatment frequencies over time and determining the individual predictors that underlie the chemotherapy choices oncologists make for their patients. Our data set is unique in that it captured not only patient-level data, but also oncologist-level data. It also captured data from private and community practices as well as academic centers. To our knowledge, this is the only data set that can give this degree of insight into oncologist decision making practices. © AlphaMed Press 2017.

Hand therapist management of the lateral epicondylosis: a survey of expert opinion and practice patterns.

PubMed

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.

Spending patterns in region of residency training and subsequent expenditures for care provided by practicing physicians for Medicare beneficiaries.

PubMed

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.

Changing patterns of brain activation during maze learning.

PubMed

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.

The demography, career pattern, and motivation of locum tenens physicians in the United States.

PubMed

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.

Actual versus desired initiation patterns among a sample of college men: tapping disjunctures within traditional male sexual scripts.

PubMed

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.

Change the management of patients with heart failure: Rationale and design of the CHAMP-HF registry.

PubMed

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.

Constructivism in Practice: an Exploratory Study of Teaching Patterns and Student Motivation in Physics Classrooms in Finland, Germany and Switzerland

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.

What makes it likeable? A study on the reactions to messages in a digital social network: the case of Facebook in Farsi.

PubMed

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.

Profile of advanced nursing practice in Spain: A cross-sectional study.

PubMed

Sevilla Guerra, Sonia; Miranda Salmerón, Josep; Zabalegui, Adelaida

2018-03-01

In this study, we described the profile of advanced nursing practice in Spain. A cross-sectional study design was used to explore the extent and patterns of advanced nursing practice activity within the domains of expert care planning, integrated care, interprofessional collaboration, education, research, evidence-based practice, and professional leadership. Data were collected in 2015/2016. Purposive sampling yielded a sample of 165 specialist and expert nurses employed by a dual tertiary and community hospital in an urban setting. The study included specialist and expert nurses who had a higher practice profile than registered general nurses. The performance of activities according to age, current position, years of experience, nursing grade, and education was compared. Practice domains were more strongly influenced by the predictors of nursing position and professional career ladder. Age and experience predictors were found to be weak predictors of advanced practice domains. This study offers essential information of the nursing workforce, and clarifies both the advanced nursing practice profile and nomenclature in the context of study. © 2017 John Wiley & Sons Australia, Ltd.

Constructivism in Practice: An Exploratory Study of Teaching Patterns and Student Motivation in Physics Classrooms in Finland, Germany and Switzerland

ERIC Educational Resources Information Center

Beerenwinkel, Anne; von Arx, Matthias

2017-01-01

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…

I spy with my little eye: Analysis of airline pilots' gaze patterns in a manual instrument flight scenario.

PubMed

Haslbeck, Andreas; Zhang, Bo

2017-09-01

The aim of this study was to analyze pilots' visual scanning in a manual approach and landing scenario. Manual flying skills suffer from increasing use of automation. In addition, predominantly long-haul pilots with only a few opportunities to practice these skills experience this decline. Airline pilots representing different levels of practice (short-haul vs. long-haul) had to perform a manual raw data precision approach while their visual scanning was recorded by an eye-tracking device. The analysis of gaze patterns, which are based on predominant saccades, revealed one main group of saccades among long-haul pilots. In contrast, short-haul pilots showed more balanced scanning using two different groups of saccades. Short-haul pilots generally demonstrated better manual flight performance and within this group, one type of scan pattern was found to facilitate the manual landing task more. Long-haul pilots tend to utilize visual scanning behaviors that are inappropriate for the manual ILS landing task. This lack of skills needs to be addressed by providing specific training and more practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sleeping, dreaming, and health in rural Indonesia and the urban U.S.: a cultural and experiential approach.

PubMed

Hollan, Douglas

2013-02-01

Sleeping, dreaming, and health or well-being are all closely related phenomena from an experiential and cultural point of view, and yet all three are often studied in isolation from one another. In this paper, I use an ethnographic and clinical lens to compare and contrast patterns of sleeping and dreaming and their relationship to health in a rural Indonesian society and among urban middle class people in the US. I demonstrate how culturally shaped patterns of sleeping and dreaming become linked through social practice and the implication of these practices for health and well being. I underscore, in particular, the seamless connection between waking and non-waking life, how daytime activities affect patterns of sleeping and dreaming, but also how the emotional and behavioral residues of the night affect daytime life and experience. Data for the Indonesia case were collected during extended fieldwork in 1981-1983, while the U.S. data come from my ongoing part-time private practice of psychotherapy and psychoanalysis. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

PubMed Central

2014-01-01

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

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

PubMed

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

2014-01-17

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

Dialysis outcomes and analysis of practice patterns suggests the dialysis schedule affects day-of-week mortality

PubMed Central

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

Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives.

PubMed

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.

Demographics, training, and practice patterns of practitioners of folk medicine in Taiwan: a survey of the Taipei metropolitan area.

PubMed

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.

Validating an instrument for selecting interventions to change physician practice patterns: a Michigan Consortium for Family Practice Research study.

PubMed

Green, Lee A; Gorenflo, Daniel W; Wyszewianski, Leon

2002-11-01

The goal of this study was to develop a psychometric instrument that classified physiciansamprsquo response styles to new information as seekers, receptives, traditionalists, or pragmatists. This classification was based on specific combinations of 3 scales: (a) belief in evidence vs experience as the basis of knowledge, (b) willingness to diverge from common or previous practice, and (c) sensitivity to pragmatic concerns of practice. The instrument will help focus efforts to change practice more accurately. This was a cross-sectional study of physician responses to a psychometric instrument. Paper-and-pencil survey forms were distributed to 3 waves of physicians, with revision for improved internal consistency at each iteration. Participants were 1393 primary care physicians at continuing education events in the Midwest or at primary care clinic sites in the Veteransamprsquo Health Administration system. Internal consistency was measured by factor analysis with orthogonal rotation and Cronbachamprsquos alpha. A total of 1287 usable instruments were returned (106, 1120, and 61 in the 3 iterations, respectively), representing approximately three fourths of distributed forms. Final scale internal consistencies were a = 0.79, b = 0.74, and c = 0.68. The patterns of scores on the 3 scales were consistent with the predictions of the theoretical scheme of physician types. The "seeker" type was the rarest, at fewer than 3%. It is possible to reliably classify physicians into categories that a theoretical framework predicts will respond differently to different interventions for implementing guidelines and translating research findings into practice. The next step is to demonstrate that the classification predicts physician practice behavior.

Effects of lauric acid on ruminal protozoal numbers and fermentation pattern and milk production in lactating dairy cows

USDA-ARS?s Scientific Manuscript database

The objectives of this study were to evaluate lauric acid (LA) as a practical agent to suppress ruminal protozoa (RP), and to assess the effects of RP suppression on fermentation patterns and milk production in dairy cows. In experiment 1, six Holstein cows fitted with ruminal cannulae were used in ...

Relationships of dead wood patterns with biophysical characteristics and ownership according to scale in Coastal Oregon, USA

Treesearch

Rebecca S.H. Kennedy; Thomas A. Spies; Matthew J. Gregory

2008-01-01

Dead wood patterns and dynamics vary with biophysical factors, disturbance history, ownership, and management practices; the relative importance of these factors is poorly understood, especially at landscape to regional scales. This study examined current dead wood amounts in the Coastal Province of Oregon, USA, at multiple spatial scales. Objectives were to: (1)...

Diversity of commercial sex among men and male-born trans people in three Peruvian cities.

PubMed

Nureña, César R; Zúñiga, Mario; Zunt, Joseph; Mejía, Carolina; Montano, Silvia; Sánchez, Jorge L

2011-11-01

In Peru, commercial sex involving men and male-born travestis, transgenders and transsexuals (CSMT) is usually represented as a dangerous practice carried out on the streets by people experiencing economic hardship and social exclusion. However, in reality little is known about the complexities of this practice in Peru. This paper presents findings from an ethnographic study of the characteristics, patterns and sociocultural aspects of CSMT in three Peruvian cities. The study included participant observation in sex work venues and interviews with 42 sex workers and 25 key informants. We found that CSMT in Peru takes many forms (some not previously described in the country) and is practised in different places by people from various socioeconomic levels. In many cases, the practice appears linked to ideals of social mobility, migratory experiences and other economic activities. In addition, the increasing use of the Internet and mobile phones has changed patterns of sex work in Peru. We review the implications of these findings for future research and public health interventions.

Qualitative Studies of Infant and Young Child Feeding in Lower-Income Countries: A Systematic Review and Synthesis of Dietary Patterns

PubMed Central

Kaji, Aiko; Felker-Kantor, Erica; Bazzano, Lydia A.; Potts, Kaitlin S.

2017-01-01

Continued high rates of both under- and over-nutrition in low- and low-middle-income countries highlight the importance of understanding dietary practices such as early and exclusive breastfeeding, and dietary patterns such as timely, appropriate complementary feeding—these behaviors are rooted in complex cultural ecologies. A systematic review and synthesis of available qualitative research related to infant and young child dietary patterns and practices from the perspective of parents and families in low income settings is presented, with a focus on barriers and facilitators to achieving international recommendations. Data from both published and grey literature from 2006 to 2016 was included in the review. Quality assessment consisted of two phases (Critical Appraisal Skills Program (CASP) guidelines and assessment using GRADE-CERQual), followed by synthesis of the studies identified, and subsequent thematic analysis and interpretation. The findings indicated several categories of both barriers and facilitators, spanning individual and system level factors. The review informs efforts aimed at improving child health and nutrition, and represents the first such comprehensive review of the qualitative literature, uniquely suited to understanding complex behaviors leading to infant and young child dietary patterns. PMID:29057842

New entrants' practice patterns in Medicare home health care after the prospective payment system revision in 2008.

PubMed

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.

Sparking Thinking: Studying Modern Precision Medicine Will Accelerate the Progression of Traditional Chinese Medicine Patterns.

PubMed

Liu, Bao-Cheng; Ji, Guang

2017-07-01

Incorporating "-omics" studies with environmental interactions could help elucidate the biological mechanisms responsible for Traditional Chinese Medicine (TCM) patterns. Based on the authors' own experiences, this review outlines a model of an ideal combination of "-omics" biomarkers, environmental factors, and TCM pattern classifications; provides a narrative review of the relevant genetic and TCM studies; and lists several successful integrative examples. Two integration tools are briefly introduced. The first is the integration of modern devices into objective diagnostic methods of TCM patterning, which would improve current clinical decision-making and practice. The second is the use of biobanks and data platforms, which could broadly support biological and medical research. Such efforts will transform current medical management and accelerate the progression of precision medicine.

Anticoagulation for nonvalvular atrial fibrillation: effects of type of practice on physicians' self-reported behavior.

PubMed

Bush, D; Tayback, M

1998-02-01

This study examines whether social and economic factors affect physician practice and attitude with regard to warfarin anticoagulation in patients with nonvalvular atrial fibrillation. We identified physicians in Baltimore City, Baltimore County, and Prince George's County who (1) had written one or more prescriptions for a digitalis compound during the preceding year, and (2) were classified as general practitioners, family practice specialists, internists, or cardiologists. All 358 physicians fulfilling these criteria were surveyed by questionnaire. The overall response rate was 43%. Physicians who wrote 15% or more of their digitalis prescriptions for Medicaid patients said they used warfarin at significantly lower rates for patients with nonvalvular AF than other (66% versus 79%, P <0.01). The opposite pattern was seen with regard to aspirin. There were no significant differences in practice pattern between physicians located in urban vs. suburban counties. In our sample, self-reported anticoagulant practices for patients with nonvalvular AF were associated with the percentage of digitalis prescriptions written for Medicaid patients. In this metropolitan area, anticoagulant therapy was reportedly prescribed for approximately 75% of patients with nonvalvular atrial fibrillation.

[A comparison of paying patients in private practice and in public dental service--found from the Harstad-study 1974].

PubMed

Heloe, L A; Heloe, B

1975-09-01

Since 1950, the Public Dental Service (PDS) has gradually been developed in Norway. In addition to rendering free and systematic treatment to children aged 6--17 years, which has priority, the PDS also offers treatment to other categories of patients at fixed fees, generally lower than those in private practice. The purpose of the present study was to elucidate the impact made by PDS on the dental treatment pattern within one particular area (the district of Harstad with a population of approximately 29,000). Furthermore, the study included a description of the clientele in the PDS, excluding the "free clientele" aged 6--17, in relation to that treated in private practice. During a limited period in February--March 1974, all the 9 dentists in the PDS treating "paying clientele" and all the 9 private practitioners in the district, filled in a questionnaire by each patient visit (course of treatment) (Fig. 1). In addition to the information on social and demographic characteristics, data were also collected on dental treatment pattern, the treatment presently rendered, and the presence of teeth and possible dentures (Fig. 1). Four--fifths of the visits made by "paying clientele" were made in private practice, only one--fifth in the PDS. In private practice, rural people, women and people of young age were underrepresented. Children under 6 years of age comprised 3% of the clientele in private practice and 9% in the PDS. No significant difference was found between the two types of practice regarding the social class composition of the clientele. Dental status as measured by the occurrence of teeth and dentures was generally poorer among the PDS patients, seemingly due to the overweight of rural people and of those with an irregular or occasional treatment pattern. Totally 40% of all visits were made by regular treatment attenders. 20% of the services delivered were prophylaxes and/or periodontics, 56% were conservative and/or endodontic treatments. The introduction of the FDS in the district some 10--15 years ago has conceivably contributed to an overall increase in the demand for dental services, and to an improvement of denial treatment patterns. During this period, the number of public dentists has increased from 2--3 to a total of 12. Correspondingly, the number of private practitioners has increased from 5 to 9, of whom 2 work part time. The treatment attendance of some population subgroups is, however, still lagging behind: rural people, small children and persons over 50 years of age, and particularly people belonging to lower socio-economic brackets.

Patterns of daily duration and frequency of breastfeeding among exclusively breastfed infants in Shiraz, Iran, a 6-month follow-up study using Bayesian generalized linear mixed models.

PubMed

Saki, Azadeh; Eshraghian, Mohammad Reza; Tabesh, Hamed

2012-12-19

Despite numerous studies on the benefits of exclusive breastfeeding during the first half year of life, little information is available on actual breastfeeding practices in terms of daily duration and frequency of suckling. This study proposes to determine daily breastfeeding patterns among exclusively breastfed infants from birth to six months. An observational prospective follow-up study of daily feeding practices among exclusively breastfed infants was conducted in 2007/2008. Mothers were recruited and interviewed during their first month postpartum health center visit. A total of 287 mothers were recruited into the study. Primary outcome measures were suckling duration and frequency of breastfeeding during daytime and nighttime. Mothers were asked at each healthcare visit to report the daily duration in minutes and the daily number of breastfeeding sessions. Mixed models were used to determine breastfeeding patterns and predictors. Of 287 mothers selected for this study, 174 (61%) exclusively breastfeeding until six months after delivery. Mixed modeling showed that as the infant's age increased duration of one suckling, cumulative duration and frequency of breastfeeding during daytime, nighttime and a twenty four hour period all gradually decreased. Infants gender and receiving professional advice about breastfeeding were also significant factors in breastfeeding patterns (p<0.05). The one suckling duration and frequency of feeds in this study population were considerably higher than values reported in other populations. The variation of feeding patterns between exclusively breastfed infants was very wide. The distributions of one suckling duration, frequency of breastfeeding and cumulative duration of feeds were right-skewed. The current professional advices about breastfeeding are not appropriate because they do not consider unique condition within specific populations.

Type 1 and type 2 diabetes mellitus in childhood in the United States: practice patterns by pediatric endocrinologists.

PubMed

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.

Using History to Analyze the Learning by Observing and Pitching In Practices of Contemporary Mesoamerican Societies.

PubMed

Flores, Rubén; Urrieta, Luis; Chamoux, Marie-Noëlle; Fernández, David Lorente; López, Angélica

2015-01-01

The analysis of Indigenous learning practices in Mexico and the United States typically relies on ethnography, oral history, and participant observation as the methodology for understanding the socialization processes of Mesoamerican societies. In this chapter, we consider the importance of using historical analysis as an added methodology for understanding the Indigenous learning practices by considering three case studies of Indigenous communities in Mexico, where a consideration of historical patterns have proven fruitful for understanding the contemporary Learning by Observing and Pitching In (LOPI) practices. These communities include the Nahua people of the state of Puebla, the P'urhépecha communities of the state of Michoacán, and the Nahua people of the Texcoco area to the southeast of Mexico City. We conclude that a consideration of the cultural patterns that have developed in Mesoamerican societies across time would benefit contemporary researchers as one component of their LOPI research. © 2015 Elsevier Inc. All rights reserved.

Status Report on Speech Research: A Report on the Status and Progress of Studies on the Nature of Speech, Instrumentation for Its Investigation, and Practical Applications, July 1 - December 31, 1977).

ERIC Educational Resources Information Center

Haskins Labs., New Haven, CT.

This report is one of a regular series about the status and progress of studies on the nature of speech, instrumentation for its investigation, and practical applications. The 17 papers discuss the identification of sine-wave analogues of speech sounds; prosodic information for vowel identity; progressive changes in articulatory patterns in verbal…

Management Trends in Prenatally-Detected Hydronephrosis: A National Survey of Pediatrician Practice Patterns and Antibiotic Use

PubMed Central

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

Determinants of leisure-time physical activity and future intention to practice in Spanish college students.

PubMed

Molina-García, Javier; Castillo, Isabel; Pablos, Carlos

2009-05-01

Few studies analyze determinants and patterns of physical activity among college students, so it has not been possible to carry out effective interventions to promote this practice. The aim of this study was to analyze the associations between some personal, social, and environmental determinants, practice of physical activity and future intention to practice in a sample of 639 university students (321 men and 318 women), mean age 21.43 years (+/- 2.78). Physical fitness self-perception, physical activity history, and coach's support to practice physical activity have a direct effect on the practice of physical activity and an indirect effect on future intention to practice, both in men and women. The practice of physical activity has also a direct effect on future intention to practice. Likewise, the participation in sport competitions predicts practice of physical activity and future intention in men, whereas being a member of a sports club predicts practice and future intention in women.

Unpacking Docent Practice in Free Choice Science Learning Settings: A Qualitative Study Documenting the What and Whys of Docent Interpretive Practice

NASA Astrophysics Data System (ADS)

Good, Laura H.

Museum settings including aquariums, zoos and science centers rely heavily on their volunteer docent populations to interact with and communicate science and conservation concepts to the visiting public. The interactions docents have with museum visitors are important to meeting the educational expectations of museums and improving public science literacy as a whole, yet research to date is limited around docent practice, docents' reflections on that practice nor the sources for docents to learn that practice. Thus, we have little understanding of the interpretive practice docents actually undertake whilst interacting with visitors, why they choose to enact particular strategies, and how they came to learn those practices. Using a grounded qualitative approach within a framework of mediated action and cultural historical activity theory, this case study utilized video observations of docent practice at a science center, pre and post observation interviews, and focus groups to 1) document docent practices for engaging visitors, 2) explain those practices from the docents' own perspectives, and 3) examine those practices from the point of view of how they align with teaching and learning theories and interpretive practice. Thematic analysis using constant comparative methods demonstrate four claims about docent practice: 1) docents view teaching in the museum as opportunities to spark interest with these new experiences. Practices are chosen to engage visitors in these experiences. Docents choose to highlight these experiences as they believe they are reasons to be engaged; 2) docents as teachers are perceptive about their audience. They pay attention to patterns and provide information in response to those patterns. Docents utilize a shared repertoire of practice and information in their community developed from understanding visitor patterns of interest; 3) docents care about their setting and the exhibits within it. They also care about the visitor experience as a whole, and have to be flexible when working with different types of learners. They believe that being a docent means balancing potentially conflicting roles; and 4) docents use interpretation as a pedagogy to engage visitors with science and create personally meaningful experiences. Analysis of significant interactions between docents and visitors shows that such practices are mediated through a variety of discursive and physical tools and implemented by docents as a means of engaging visitors with science and conservation. Moreover, most of these skills appear to be learned on-the-job within their communities of practice, and while specific docent actions and skills may be different across contexts, member checks with docents working in other museum settings demonstrate the resonance of the findings across contexts. The findings of the study are placed in the context of interpretation theories of communication as well as research on docents as lifelong, free-choice learners both facilitating and participating in societal STEM learning activity. Findings and methods of research from this study are valuable to the greater understanding of how docents learn and enact interpretive practice and the development of more effective professional development for docents in museum settings.

Minimal perceptrons for memorizing complex patterns

NASA Astrophysics Data System (ADS)

Pastor, Marissa; Song, Juyong; Hoang, Danh-Tai; Jo, Junghyo

2016-11-01

Feedforward neural networks have been investigated to understand learning and memory, as well as applied to numerous practical problems in pattern classification. It is a rule of thumb that more complex tasks require larger networks. However, the design of optimal network architectures for specific tasks is still an unsolved fundamental problem. In this study, we consider three-layered neural networks for memorizing binary patterns. We developed a new complexity measure of binary patterns, and estimated the minimal network size for memorizing them as a function of their complexity. We formulated the minimal network size for regular, random, and complex patterns. In particular, the minimal size for complex patterns, which are neither ordered nor disordered, was predicted by measuring their Hamming distances from known ordered patterns. Our predictions agree with simulations based on the back-propagation algorithm.

Practice patterns and job satisfaction in fellowship-trained endocrine surgeons.

PubMed

Tsinberg, Michael; Duh, Quan-Yang; Cisco, Robin M; Gosnell, Jessica E; Scholten, Anouk; Clark, Orlo H; Shen, Wen T

2012-12-01

Debates about the difficult job market for young endocrine surgeons are ongoing. This study aimed to analyze the practice patterns and work-related satisfaction levels of recently trained endocrine surgeons. An anonymous survey was utilized. Participants were divided into 3 groups: "Young" (<3 years in practice), "middle" (3-5 years), and "older" (>5 years). Fifty-six of 78 surgeons (72%) responded to the survey. Time in practice ranged from 1 to 9 years (mean, 3.9 ± 0.28). Forty-five (80%) described their practice as academic. Participants performed 244.1 ± 17.8 operations within the last year; 75.4 ± 3.3% were endocrine cases. More surgeons in the "young" group have academic practices (92%) and joined established endocrine surgery groups (54%) versus older surgeons (67% and 42%; P = .05). Of surgeons in the "young" group, 4% started their own practice versus 33% in the "older" group (P = .04). Level of satisfaction with financial compensation (3.2 on a 4-point scale versus 2.9) and lifestyle (3.6 vs 3.1) was also higher in the younger group (P = .009). Despite widespread speculation about scarcity of academic jobs after fellowship, recently trained endocrine surgeons are more likely to practice in academic settings and join established endocrine surgery practices when compared with older surgeons. Overall satisfaction level is higher among recently trained surgeons. Copyright © 2012 Mosby, Inc. All rights reserved.

Pattern and determinants of breast feeding and contraceptive practices among mothers within six months postpartum.

PubMed

Kunwar, Shipra; Faridi, Mohammad M A; Singh, Shivani; Zahra, Fatima; Alizaidi, Zeashan

2010-08-01

The present study aims to determine the patterns of breast feeding, return of menstruation, and contraceptive practices in the first six months postpartum in women visiting the outpatient department at a teaching hospital in Lucknow, Northern India. Mothers of infants between six to eight months of age visiting the outpatient department of Era's Lucknow Medical College were interviewed regarding breast feeding practices, return of menstruation, sexual activity, and contraceptive practices within the first six months postpartum using a structured questionnaire. Of all women interviewed only 75.8% practiced exclusive breast feeding with the mean duration of exclusive breast feeding (EBF) being 3.5 months with only 41% practicing EBF for six months, 28% were sexually active within six weeks postpartum, 64.5% women had a return of menstruation within six months. Contraception was practiced by only 54.4% women with a barrier method such as a condom, being the most common. Better education was the only factor significantly affecting EBF (p < 0.004) and use of contraception (p < 0.027). There were a total of 10 pregnancies within six months postpartum. In conclusion, optimal breast feeding practices are poor in this part of the country and lactational amenorrhoea cannot be effectively and reliably used as a method of contraception. Therefore, optimal breast feeding practices, timely introduction of contraception and institutional delivery need to be encouraged.

Sexual practices and their development pattern among jimma university students.

PubMed

Ambaw, Fentie; Mossie, Andualem; Gobena, Teshome

2010-11-01

Traditional views of sexual behaviors are frequently changing as the factors influencing them are changing. Therefore, assessing sexual practices that are not part of the tradition would be necessary. The objective of this study was to identify the types of sexual practices, their development pattern and how these development patterns expose students to sexually transmitted infections and unplanned pregnancy. A cross-sectional survey was conducted on a sample of 1986 (1612 males, 365 females, and with 9 subjects' gender not indicated) Jimma university students in August 2009 with their age ranging from 17-45 years (median = 20). Quantitative data was collected using a piloted, precoded questionnaire and qualitative data was collected from six focus group discussions. Logistic regression and descriptive statistics were computed and qualitative findings were triangulated with quantitative findings. P-value less than 0.05 was considered significant. Practice of penile to vaginal intercourse, masturbation, kissing, oral sex, and anal sex were reported by 567 (28.9%), 688 (36.7%), 840 (42.4%), 179 (9.2%) and 83 (4.3%) of the respondents, respectively. Respondents had two years (one year with and one year without condom) of sexual experience before marriage. Sixty percent of those who had sexual experience were exposed to sexually transmitted infections and 46.6% were exposed to both unplanned pregnancy and sexually transmitted infections. Forty seven percent of those who practiced oral sex and 29% of those who practiced anal sex did not consider their acts as sexual intercourse. University students are high risk groups that need more focused research and concerted health care. The term 'sexual intercourse' should be consciously defined for its future use in Ethiopia. Furthermore, Service providers and researchers should address all types of sexual practices.

Effect of NHS reforms on general practitioners' referral patterns.

PubMed Central

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

The Role of Professional Identity in Patterns of Use of Multiple-Choice Assessment Tools

ERIC Educational Resources Information Center

Johannesen, Monica; Habib, Laurence

2010-01-01

This article uses the notion of professional identity within the framework of actor network theory to understand didactic practices within three faculties in an institution of higher education. The study is based on a series of interviews with lecturers in each faculty and diaries of their didactic practices. The article focuses on the use of a…

Parental Practices and Achievement of Mexican and Chinese Immigrant Children in the USA: Assimilation Patterns?

ERIC Educational Resources Information Center

Bodovski, Katerina; Durham, Rachel E.

2010-01-01

The authors used the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K) data to examine the mathematics and science achievement of two immigrant groups in the United States--Chinese and Mexican students. The authors also assessed variation in parental practices and fifth-grade achievement according to ethnicity and the age…

Patterns of Food Parenting Practices and Children's Intake of Energy-Dense Snack Foods.

PubMed

Gevers, Dorus W M; Kremers, Stef P J; de Vries, Nanne K; van Assema, Patricia

2015-05-27

Most previous studies of parental influences on children's diets included just a single or a few types of food parenting practices, while parents actually employ multiple types of practices. Our objective was to investigate the clustering of parents regarding food parenting practices and to characterize the clusters in terms of background characteristics and children's intake of energy-dense snack foods. A sample of Dutch parents of children aged 4-12 was recruited by a research agency to fill out an online questionnaire. A hierarchical cluster analysis (n = 888) was performed, followed by k-means clustering. ANOVAs, ANCOVAs and chi-square tests were used to investigate associations between cluster membership, parental and child background characteristics, as well as children's intake of energy-dense snack foods. Four distinct patterns were discovered: "high covert control and rewarding", "low covert control and non-rewarding", "high involvement and supportive" and "low involvement and indulgent". The "high involvement and supportive" cluster was found to be most favorable in terms of children's intake. Several background factors characterized cluster membership. This study expands the current knowledge about parental influences on children's diets. Interventions should focus on increasing parental involvement in food parenting.

Differences in gay men's AIDS risk knowledge and behavior patterns in high and low AIDS prevalence cities.

PubMed

St Lawrence, J S; Hood, H V; Brasfield, T; Kelly, J A

1989-01-01

Several studies have found reductions in acquired immunodeficiency syndrome (AIDS) risk practices among gay men in high AIDS-prevalence cities since the start of the AIDS crisis. Much less is known about risk behavior patterns among gay men in smaller cities, where AIDS cases are less common and the prevalence of human immunodeficiency virus infection is relatively lower. In the study, men entering gay bars in three cities, one large and two small, completed anonymous surveys of sexual practices and AIDS risk knowledge. Men in high AIDS-prevalence areas were found to have had a greater number of sexual partners, were more knowledgeable about AIDS, were much more likely to engage in low-risk practices (such as mutual masturbation or body rubbing), and had unprotected anal intercourse less frequently than gay men in smaller cities. The most common sexual activity among gay men in the larger city was mutual masturbation, a low-risk practice. The most common sexual activity among gay men in the smaller cities was unprotected anal intercourse. Increased efforts are needed to educate gay men and to promote risk behavior changes among those living in smaller cities and in communities outside the prominent AIDS epicenters.

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

PubMed

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

2017-08-01

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

'It was not just a walking experience': reflections on the role of care in dog-walking.

PubMed

Degeling, Chris; Rock, Melanie

2013-09-01

Research into physical activity and human health has recently begun to attend to dog-walking. This study extends the literature on dog-walking as a health behaviour by conceptualizing dog-walking as a caring practice. It centres on qualitative interviews with 11 Canadian dog-owners. All participants resided in urban neighbourhoods identified through previous quantitative research as conducive to dog-walking. Canine characteristics, including breed and age, were found to influence people's physical activity. The health of the dog and its position in the life-course influenced patterns of dog-walking. Frequency, duration and spatial patterns of dog-walking all depended on relationships and people's capacity to tap into resources. In foregrounding networks of care, inclusive of pets and public spaces, a relational conceptualization of dog-walking as a practice of caring helps to make sense of heterogeneity in patterns of physical activity among dog-owners.

Scheduling observational and physical practice: influence on the coding of simple motor sequences.

PubMed

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.

Management implications of recent changes in spatial patterns of interior northwest forests.

Treesearch

Paul. F. Hessburg; Bradley G. Smith

1999-01-01

Declining health of forest ecosystems in the interior West has been the subject of much study, concern and controversy in recent years (e.g., Everett et al. 1994, Harvey et al. 1995, Lehmkuhl et al. 1994, O'Laughlin et al. 1993, Wickman 1992). Land-use practices of this century have altered disturbance regimes and spatial and temporal patterns of vegetation, and...

Interactions of glyphosate use with farm characteristics and cropping patterns in Central Europe.

PubMed

Wiese, Armin; Schulte, Michael; Theuvsen, Ludwig; Steinmann, Horst-Henning

2018-05-01

Although glyphosate is the most widely used herbicide in the European Union, little is known about the patterns of its usage in arable farming. Therefore, a nationwide survey of 2026 German farmers was analysed to obtain further knowledge about glyphosate applications in conventional European arable farming. Given its broad range of agri-environmental and farm-type conditions, Germany can be regarded as a suitable study region to represent Central European farming. The growing season 2013/2014 was set as a reference. Farmers who participated in the survey employ diverse patterns of glyphosate use. While 23% stated that they did not use glyphosate in the season in question, others applied glyphosate to their total arable area. However, most applications occurred on specific parts of the farm. Application patterns of oilseed rape, winter wheat, maize and sugar beet were studied in detail, and U-shaped distributions of glyphosate use intensity were observed. The effects of farm type and management practices on glyphosate use patterns were mixed in the various crops. Motivation for glyphosate use differs widely within the farming community. Agricultural researchers, extension services and policy makers are recommended to mitigate vulnerabilities associated with glyphosate use, such as routine spraying and practices that increase selection pressure for the evolution of glyphosate-resistant weeds. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

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.

Blood Pressure Levels and Mortality Risk among Hemodialysis Patients: Results from the Dialysis Outcomes and Practice Patterns Study

PubMed Central

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

The social media: its impact on a vascular surgery practice.

PubMed

Turnipseed, William D

2013-04-01

Social media has revolutionized interpersonal communication and has become a commonly used public informational resource. This study evaluates the impact of intranet informatics on a specialty practice of vascular surgery. Referral patterns for patients with chronic compartment syndrome (CCS) and popliteal entrapment syndrome (PAES) between 2008 and 2011 were analyzed. Demographics included referral source (physicians, nonphysicians), media resource, and case volume change. Prior to 2008, referrals came from local or regional sports medicine practices (100%). Since 2008 this pattern has changed; local/regional (80%), national (15%), and international (5%). Physician referrals dropped from 97% to 70%, and nonphysician referrals increased from 3% to 30%. Both CCS procedures and PAES procedures increased as remote geographic and public referrals increased. Referral change was associated with social media searches using applications such as PubMed and Google. Social media is an evolving source of medical information and patient referrals which physicians should cautiously embrace.

Income, productivity, and satisfaction of breast surgeons.

PubMed

Bendorf, David C; Helmer, Stephen D; Osland, Jacqueline S; Tenofsky, Patty L

2010-03-01

The purpose of this study was to assess how the practice patterns of breast surgeons affect their income and job satisfaction. A 19-question survey regarding practice patterns and income and job satisfaction was mailed to all active US members of the American Society of Breast Surgeons. There were 772 responses. An increasing percentage of breast care was associated with lower incomes (P=.0001) and similar income satisfaction (P=.4517) but higher job satisfaction (P=.0001). The increasing proportion of breast care was also associated with fewer hours worked per week (P=.0001). Although incomes were lower in surgeons with a higher proportion of their practice in breast care, income satisfaction was not affected. Although cause and effect relationships between income and breast surgery are difficult to establish, several trends do emerge. Most significantly, we found that dedicated breast surgeons have higher job satisfaction ratings and similar income satisfaction despite lower incomes. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Employment of Dental Hygienists as Dental Educators.

ERIC Educational Resources Information Center

Fong, Cynthia; Odrich, Johanna

1987-01-01

A study of the use of dental hygienists to teach periodontics, preventive dentistry, community dentistry, and public health courses looked at employment patterns and practices and the qualifications of the teachers. (MSE)

Update on imbalanced distribution of endodontists: 1995-2006.

PubMed

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).

Rural Idaho family physicians' scope of practice.

PubMed

Baker, Ed; Schmitz, David; Epperly, Ted; Nukui, Ayaka; Miller, Carissa Moffat

2010-01-01

Scope of practice is an important factor in both training and recruiting rural family physicians. To assess rural Idaho family physicians' scope of practice and to examine variations in scope of practice across variables such as gender, age and employment status. A survey instrument was developed based on a literature review and was validated by physician educators, practicing family physicians and executives at the state hospital association. This survey was mailed to rural family physicians practicing in Idaho counties with populations of less than 50,000. Descriptive, bivariate and multivariate analyses were employed to describe and compare scope of practice patterns. Responses were obtained from 92 of 248 physicians (37.1% response rate). Idaho rural family physicians reported providing obstetrical services in the areas of prenatal care (57.6%), vaginal delivery (52.2%) and C-sections (37.0%); other operating room services (43.5%); esophagogastroduodenoscopy (EGD) or colonoscopy services (22.5%); emergency room coverage (48.9%); inpatient admissions (88.9%); mental health services (90.1%); nursing home services (88.0%); and supervision to midlevel care providers (72.5%). Bivariate analyses showed differences in scope of practice patterns across gender, age group and employment status. Binomial logistic regression models indicated that younger physicians were roughly 3 times more likely to provide prenatal care and perform vaginal deliveries than older physicians in rural areas. Idaho practicing rural family physicians report a broad scope of practice. Younger, employed and female rural family medicine physicians are important subgroups for further study.

Methodological standards and interpretation of video-electroencephalography in adult control rodents. A TASK1-WG1 report of the AES/ILAE Translational Task Force of the ILAE.

PubMed

Kadam, Shilpa D; D'Ambrosio, Raimondo; Duveau, Venceslas; Roucard, Corinne; Garcia-Cairasco, Norberto; Ikeda, Akio; de Curtis, Marco; Galanopoulou, Aristea S; Kelly, Kevin M

2017-11-01

In vivo electrophysiological recordings are widely used in neuroscience research, and video-electroencephalography (vEEG) has become a mainstay of preclinical neuroscience research, including studies of epilepsy and cognition. Studies utilizing vEEG typically involve comparison of measurements obtained from different experimental groups, or from the same experimental group at different times, in which one set of measurements serves as "control" and the others as "test" of the variables of interest. Thus, controls provide mainly a reference measurement for the experimental test. Control rodents represent an undiagnosed population, and cannot be assumed to be "normal" in the sense of being "healthy." Certain physiological EEG patterns seen in humans are also seen in control rodents. However, interpretation of rodent vEEG studies relies on documented differences in frequency, morphology, type, location, behavioral state dependence, reactivity, and functional or structural correlates of specific EEG patterns and features between control and test groups. This paper will focus on the vEEG of standard laboratory rodent strains with the aim of developing a small set of practical guidelines that can assist researchers in the design, reporting, and interpretation of future vEEG studies. To this end, we will: (1) discuss advantages and pitfalls of common vEEG techniques in rodents and propose a set of recommended practices and (2) present EEG patterns and associated behaviors recorded from adult rats of a variety of strains. We will describe the defining features of selected vEEG patterns (brain-generated or artifactual) and note similarities to vEEG patterns seen in adult humans. We will note similarities to normal variants or pathological human EEG patterns and defer their interpretation to a future report focusing on rodent seizure patterns. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

Variation in intravenous iron use internationally and over time: the Dialysis Outcomes and Practice Patterns Study (DOPPS).

PubMed

Bailie, George R; Larkina, Maria; Goodkin, David A; Li, Yun; Pisoni, Ronald L; Bieber, Brian; Mason, Nancy; Tong, Lin; Locatelli, Francesco; Marshall, Mark R; Inaba, Masaki; Robinson, Bruce M

2013-10-01

To examine patterns of intravenous (IV) iron use across 12 countries from 1999 to 2011. Trends in iron use are described among 32 192 hemodialysis (HD) patients in the Dialysis Outcomes and Practice Patterns Study. Adjusted associations of IV iron dose with serum ferritin and transferrin saturation (TSAT) values were also studied. IV iron was administered to 50% of patients over 4 months in 1999, increasing to 71% during 2009-11, with increasing use in most countries. Among patients receiving IV iron, the mean monthly dose increased from 232 ± 167 to 281 ± 211 mg. Most countries used 3 to 4 doses/month, but Canada used about 2 doses/month, Italy increased from 3 to almost 6 doses/month and Germany used 5 to 6 doses/month. The USA and most European countries predominantly used iron sucrose and sodium ferric gluconate. A significant use of iron dextran was limited to Canada and France; iron polymaltose was used in Australia and New Zealand; and Japan used ferric oxide saccharate, chondroitin polysulfate iron complex and cideferron. Ferritin values rose in most countries: 22% of patients had ≥ 800 ng/mL in the recent years of study. TSAT levels increased to a lesser degree over time. Japan had much lower IV iron dosing and ferritin levels, but similar TSAT levels. In adjusted analyses, serum ferritin and TSAT levels increased signifcantly by 14 ng/mL and 0.16%, respectively, for every 100 mg/month higher mean monthly iron dose. IV iron prescription patterns varied between countries and changed over time from 1999 to 2011. IV iron use and dose increased in most countries, with notable increases in ferritin but not TSAT levels. With rising cumulative IV iron doses, studies of the effects of changing IV iron dosing and other anemia management practices on clinical outcomes should be a high priority.

Towards evenly distributed grazing patterns: including social context in sheep management strategies.

PubMed

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.

Influence of Obstetric Practice on Workload and Practice Patterns of Family Physicians and Obstetrician-Gynecologists

PubMed Central

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

A 2013 European survey of clinical practice patterns in the management of Graves' disease.

PubMed

Bartalena, L; Burch, H B; Burman, K D; Kahaly, G J

2016-01-01

Management of Graves' disease (GD) in Europe was published in 1987. Aim of this survey was to provide an update on clinical practice in Europe, and to compare it with a 2011 American survey. Members of the European Thyroid Association (ETA) were asked to participate in a survey on management of GD, using the same questionnaire of a recent American survey. A total of 147 ETA members participated. In addition to serum TSH and free T4 assays, most respondents would request TSH-receptor autoantibody (TRAb) measurement (85·6%) and thyroid ultrasound (70·6%) to confirm aetiology, while isotopic studies were selected by 37·7%. Antithyroid drug (ATD) therapy was the preferred first-line treatment (83·8%). Compared to the previous European survey, Europeans currently more frequently use TRAb measurement and thyroid ultrasound for diagnosis and evaluation, but first-line treatment remains ATDs in a similar percentage of respondents. Current clinical practice patterns differ from those in North America, where isotopic studies are more frequently used, and radioiodine (RAI) still is first-line treatment. When RAI treatment is selected in the presence of mild Graves' orbitopathy and/or associated risk factors for its occurrence/exacerbation, steroid prophylaxis is frequently used. The preferred ATD in pregnancy is propylthiouracil in the first trimester and methimazole in the second and third trimesters, similar to North America. Significant changes in clinical practice patterns in Europe were noted compared to the previous European survey, as well as persisting differences in diagnosis and therapy between Europe and North America. © 2015 John Wiley & Sons Ltd.

Home Health Chains and Practice Patterns: Evidence of 2008 Medicare Reimbursement Revision.

PubMed

Huang, Sean Shenghsiu; Kim, Hyunjee

2017-10-01

Home health agencies (HHAs) are known to exploit the Medicare reimbursement schedule by targeting a specific number of therapy visits. These targeting behaviors cause unnecessary medical spending. The Centers for Medicare & Medicaid Services estimates that during fiscal year 2015, Medicare made more than $10 billion in improper payments to HHAs. Better understanding of heterogeneous gaming behaviors among HHAs can inform policy makers to more effectively oversee the home health care industry. This article aims to study how home health chains adjust and adopt new targeting behaviors as compared to independent agencies under the new reimbursement schedule. The analytic data are constructed from: (1) 5% randomly sampled Medicare home health claim data, and (2) HHA chain information extracted from the Medicare Cost Report. The study period spans from 2007 to 2010, and the sample includes 7800 unique HHAs and 380,118 treatment episodes. A multivariate regression model is used to determine whether chain and independent agencies change their practice patterns and adopt different targeting strategies after the revision of the reimbursement schedule in 2008. This study finds that independent agencies are more likely to target 6 and 14 visits, while chain agencies are more likely to target 20 visits. Such a change of practice patterns is more significant among for-profit HHAs. The authors expect these findings to inform policy makers that organizational structures, especially the combination of for-profit status and chain affiliation, should be taken into the consideration when detecting medical fraud and designing the reimbursement schedule.

When kinesthetic information is neglected in learning a Novel bimanual rhythmic coordination.

PubMed

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.

Benchmarking Curriculum Content in Entry-Level Health Professional Education with Special Reference to Health Promotion Practice in Physical Therapy: A Multi-Institutional International Study

ERIC Educational Resources Information Center

Bodner, Michael E.; Rhodes, Ryan E.; Miller, William C.; Dean, Elizabeth

2013-01-01

Health promotion (HP) warrants being a clinical competency for health professionals given the global burden of lifestyle-related conditions; these are largely preventable with lifestyle behavior change. Physical therapists have a practice pattern conducive to HP, including lifestyle behavior change. The extent to which HP content is included in…

Adherence to quality indicators and surveillance guidelines in the management of Barrett's esophagus: a retrospective analysis.

PubMed

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.

The Teacher's Role in the Establishment of Whole-Class Dialogue in a Fifth Grade Science Classroom Using Argument-Based Inquiry

ERIC Educational Resources Information Center

Benus, Matthew J.

2011-01-01

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…

Is the rearfoot pattern the most frequently foot strike pattern among recreational shod distance runners?

PubMed

de Almeida, Matheus Oliveira; Saragiotto, Bruno Tirotti; Yamato, Tiê Parma; Lopes, Alexandre Dias

2015-02-01

To determine the distribution of the foot strike patterns among recreational shod runners and to compare the personal and training characteristics between runners with different foot strike patterns. Cross-sectional study. Areas of running practice in São Paulo, Brazil. 514 recreational shod runners older than 18 years and free of injury. Foot strike patterns were evaluated with a high-speed camera (250 Hz) and photocells to assess the running speed of participants. Personal and training characteristics were collected through a questionnaire. The inter-rater reliability of the visual foot strike pattern classification method was 96.7% and intra-rater reliability was 98.9%. 95.1% (n = 489) of the participants were rearfoot strikers, 4.1% (n = 21) were midfoot strikers, and four runners (0.8%) were forefoot strikers. There were no significant differences between strike patterns for personal and training characteristics. This is the first study to demonstrate that almost all recreational shod runners were rearfoot strikers. The visual method of evaluation seems to be a reliable and feasible option to classify foot strike pattern. Copyright © 2014 Elsevier Ltd. All rights reserved.

Etching-free patterning method for electrical characterization of atomically thin MoSe2 films grown by chemical vapor deposition.

PubMed

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.

The attitudes and beliefs of oncology nurse practitioners regarding direct-to-consumer advertising of prescription medications.

PubMed

Viale, Pamela Hallquist; Sanchez Yamamoto, Deanna

2004-07-01

To obtain information about the knowledge and attitudes of oncology nurse practitioners (ONPs) concerning the effect of direct-to-consumer (DTC) advertising of prescription medications on prescribing patterns. Exploratory survey. Oncology Nursing Society Nurse Practitioner Special Interest Group members in the United States. 221 of 376 ONPs completed the survey (58%). Researcher-developed 12-question postal survey. Knowledge and attitudes of ONPs on DTC advertising effects on prescribing patterns. The findings were similar to those of previous studies of physicians regarding the number of visits when patients requested DTC-advertised medications. Major differences were the positive attitudes of ONPs toward potentially longer patient visits to explain and educate patients regarding medication requests based on DTC advertising and smaller percentages of ONPs who felt "pressured" to prescribe requested medications. ONPs have mixed opinions regarding the practice of DTC advertising but do not believe that they are influenced heavily by advertising with regard to prescriptive practices. ONPs consider patient encounters for education purposes as appropriate and include information about requested DTC-advertised medications in their approach to patient care. This is an exploratory survey of a specialty group of ONPs. More research is needed to further explore the practice of DTC advertising and potential influences on the prescribing patterns of ONPs. DTC advertising of prescription medications is increasing; ONPs need to increase their knowledge base about the potential for influences of prescriptive practices.

Lifestyle Patterns and Weight Status in Spanish Adults: The ANIBES Study.

PubMed

Pérez-Rodrigo, Carmen; Gianzo-Citores, Marta; Gil, Ángel; González-Gross, Marcela; Ortega, Rosa M; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Aranceta-Bartrina, Javier

2017-06-14

Limited knowledge is available on lifestyle patterns in Spanish adults. We investigated dietary patterns and possible meaningful clustering of physical activity, sedentary behavior, sleep time, and smoking in Spanish adults aged 18-64 years and their association with obesity. Analysis was based on a subsample ( n = 1617) of the cross-sectional ANIBES study in Spain. We performed exploratory factor analysis and subsequent cluster analysis of dietary patterns, physical activity, sedentary behaviors, sleep time, and smoking. Logistic regression analysis was used to explore the association between the cluster solutions and obesity. Factor analysis identified four dietary patterns, " Traditional DP ", " Mediterranean DP ", " Snack DP " and " Dairy-sweet DP ". Dietary patterns, physical activity behaviors, sedentary behaviors, sleep time, and smoking in Spanish adults aggregated into three different clusters of lifestyle patterns: " Mixed diet-physically active-low sedentary lifestyle pattern ", " Not poor diet-low physical activity-low sedentary lifestyle pattern " and " Poor diet-low physical activity-sedentary lifestyle pattern ". A higher proportion of people aged 18-30 years was classified into the " Poor diet-low physical activity-sedentary lifestyle pattern ". The prevalence odds ratio for obesity in men in the " Mixed diet-physically active-low sedentary lifestyle pattern " was significantly lower compared to those in the " Poor diet-low physical activity-sedentary lifestyle pattern ". Those behavior patterns are helpful to identify specific issues in population subgroups and inform intervention strategies. The findings in this study underline the importance of designing and implementing interventions that address multiple health risk practices, considering lifestyle patterns and associated determinants.

A qualitative study exploring medicines use pattern and practice among general public in Malaysia.

PubMed

Dawood, Omar T; Hassali, Mohamed A; Saleem, Fahad

2016-01-01

The objective of this study is to explore the pattern and practice of medicine use among the general public; and to explore the key factors influencing medicine use among medicine users. A qualitative approach using focus group discussions was conducted to get in-depth information about medicines use pattern and practice from the general public. Adult people who reported using medicines at the time of study or in the previous month were approached. Two focus group discussions were audio-recorded and transcribed verbatim. The obtained data were analysed using thematic content analysis. This study found that there are some misunderstanding about the appropriate use of medicines. The majority of the participants reported that they were complying with their medication regimen. However, forgetting to take medicines was stated by 4 participants while 2 participants stopped taking medicines when they felt better. In addition, 10 participants reporting using medicines according to their own knowledge and past experience. Whereas 4 participants took medicines according to other informal resources such as family, friends or the media. Seven participants have experienced side effects with using medicines, 4 of them informed their doctor while 3 participants stopped taking medicines without informing their doctor. There was a misunderstanding about medicines use in terms of medication compliance, self-management of the illness and the resources of information about using medicines. Many efforts are still needed from health care professionals to provide sufficient information about medicines use in order to decrease the risk of inappropriate use of medicines and to achieve better therapeutic outcome.

Tramadol prescription patterns in patients followed by general practitioners and orthopedists in Germany in the year 2015.

PubMed

Kostev, Karel; Von Vultée, Christian; Usinger, Diethard M; Reese, Jens-Peter

2018-01-01

The aim of this study was to analyze tramadol prescription patterns in acute pain patients followed by general practitioners and orthopedists in Germany. This study included patients ≥18 years diagnosed with acute pain who received at least one tramadol prescription each in one of 1,129 general or 179 orthopedic practices in Germany between January and December 2015 (index date). Patients were excluded if they had received a prescription for another analgesic in the year prior to the index date, had a follow-up of less than 15 months after the index date, or were prescribed tramadol for a period of more than three months. The main outcome of this retrospective study was the share of patients receiving tramadol in combination therapy. Combination therapy was defined as the prescription of tramadol in conjunction with at least one other analgesic during the same medical visit. The present study included a total of 8,766 individuals. Overall, 1,492 (22.0%) of tramadol patients seen by general practitioners and 370 (18.7%) of those seen by orthopedists received tramadol in combination with other analgesics. Although this proportion was similar throughout the different subgroups in orthopedic practices, it was considerably higher in patients >80 years and in those with private health insurance coverage in general practices. Approximately one of five tramadol patients was prescribed tramadol in combination therapy. Further research is needed to gain a better understanding of the demographic and clinical factors that have an effect on tramadol prescription patterns in Germany.

Message framing and defensive processing: a cultural examination.

PubMed

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.

Doctors' experience with handheld computers in clinical practice: qualitative study.

PubMed

McAlearney, Ann Scheck; Schweikhart, Sharon B; Medow, Mitchell A

2004-05-15

To examine doctors' perspectives about their experiences with handheld computers in clinical practice. Qualitative study of eight focus groups consisting of doctors with diverse training and practice patterns. Six practice settings across the United States and two additional focus group sessions held at a national meeting of general internists. 54 doctors who did or did not use handheld computers. 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. 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.

Parental practices and political violence: the protective role of parental warmth and authority-control in Jewish and Arab Israeli children.

PubMed

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.

Functional neuroanatomy of meditation: A review and meta-analysis of 78 functional neuroimaging investigations.

PubMed

Fox, Kieran C R; Dixon, Matthew L; Nijeboer, Savannah; Girn, Manesh; Floman, James L; Lifshitz, Michael; Ellamil, Melissa; Sedlmeier, Peter; Christoff, Kalina

2016-06-01

Meditation is a family of mental practices that encompasses a wide array of techniques employing distinctive mental strategies. We systematically reviewed 78 functional neuroimaging (fMRI and PET) studies of meditation, and used activation likelihood estimation to meta-analyze 257 peak foci from 31 experiments involving 527 participants. We found reliably dissociable patterns of brain activation and deactivation for four common styles of meditation (focused attention, mantra recitation, open monitoring, and compassion/loving-kindness), and suggestive differences for three others (visualization, sense-withdrawal, and non-dual awareness practices). Overall, dissociable activation patterns are congruent with the psychological and behavioral aims of each practice. Some brain areas are recruited consistently across multiple techniques-including insula, pre/supplementary motor cortices, dorsal anterior cingulate cortex, and frontopolar cortex-but convergence is the exception rather than the rule. A preliminary effect-size meta-analysis found medium effects for both activations (d=0.59) and deactivations (d=-0.74), suggesting potential practical significance. Our meta-analysis supports the neurophysiological dissociability of meditation practices, but also raises many methodological concerns and suggests avenues for future research. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Relation of Recent Tampon Use, Douching, Coitus, and Vaginal Medications for Reported Cervical Cytology Results

DTIC Science & Technology

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

Diversity of commercial sex among men and male-born trans people in three Peruvian cities

PubMed Central

Zúñiga, Mario; Zunt, Joseph; Mejía, Carolina; Montano, Silvia; Sánchez, Jorge L.

2011-01-01

In Peru, commercial sex involving men and male-born travestis, transgenders and transsexuals (CSMT) is usually represented as a dangerous practice carried out on the streets by people experiencing economic hardship and social exclusion. However, in reality little is known about the complexities of this practice in Peru. This paper presents findings from an ethnographic study of the characteristics, patterns and socio-cultural aspects of CSMT in three Peruvian cities. The study included participant observation in sex work venues and interviews with 42 sex workers and 25 key informants. We found that CSMT in Peru takes many forms (some not previously described in the country) and is practised in different places by people from various socioeconomic levels. In many cases, the practice appears linked to ideals of social mobility, migratory experiences and other economic activities. In addition, the increasing use of the internet and mobile phones has changed patterns of sex work in Peru. We review the implications of these findings for future research and public health interventions. PMID:21936651

Practice and transfer of the frequency structures of continuous isometric force.

PubMed

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.

Patterns of HIV testing practices among young gay and bisexual men living in Scotland: a qualitative study.

PubMed

Boydell, Nicola; Buston, Katie; McDaid, Lisa Margaret

2017-08-17

Increasing overall rates, and frequency, of HIV testing in populations at risk is a key public health objective and a critical dimension of HIV prevention efforts. In the UK, men who have sex with men (MSM) remain one of the communities most at risk of HIV and, within this, young gay men are a key risk group. Understanding HIV testing practices is important in the development of interventions to promote testing among young gay and bisexual men. Qualitative interviews were conducted with thirty young gay and bisexual men (aged 18-29) in Scotland. Thematic analysis of men's accounts of their approach to HIV testing identified three overarching patterns of testing: 'habitual', 'reactive' and ' ad hoc'. This qualitative study, the first to explore patterns of HIV testing practices among young gay and bisexual men in the UK, contributes novel findings around the role of social support and 'community' in shaping young men's approaches to HIV testing. The findings suggest that social support can play an important role in encouraging and facilitating HIV testing among young gay men, however, social norms of non-testing also have the potential to act as a barrier to development of a regular routine. Men with habitual testing practices framed HIV testing as both a personal and 'community' responsibility, and more effective than testing in response to risk events or emergent symptoms. Men who reported reactive testing practices described testing for HIV primarily in response to perceived exposure to sexual risk, along with 'transitional moments' such as starting, ending or changes to a relationship. Among young men who reported testing on an ad hoc basis, inconvenience and disruptions to HIV testing practices, particularly where men lacked social support, acted as a barrier to developing a routine of regular testing. Our findings suggest that interventions which seek to increase rates of HIV testing and testing frequency among young gay and bisexual men should include a specific focus on promoting and supporting positive testing practices within young men's friendship groups and wider gay communities.

Prospective study of trends in referral patterns in fundholding and non-fundholding practices in the Oxford region, 1990-4.

PubMed Central

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

Option generation in the treatment of unstable patients: An experienced-novice comparison study.

PubMed

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.

Frequency and patterns of contact with domestic poultry and potential risk of H5N1 transmission to humans living in rural Cambodia

PubMed Central

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

Non-steroidal anti-inflammatory drug prescribing patterns in general practice: comparison of a general practitioner-based survey and a pharmacy-based survey in France.

PubMed

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.

Breast interest group faculty of radiation oncology: Australian and New Zealand patterns of practice survey on breast radiotherapy.

PubMed

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.

A survey of views and practice patterns of dialysis medical directors toward end-of-life decision making for patients with end-stage renal disease.

PubMed

Fung, Enrica; Slesnick, Nate; Kurella Tamura, Manjula; Schiller, Brigitte

2016-07-01

Patients with end-stage renal disease report infrequent end-of-life discussions, and nephrology trainees report feeling unprepared for end-of-life decision making, but the views of dialysis medical directors have not been studied. Our objective is to understand dialysis medical directors' views and practice patterns on end-of-life decision making for patients with ESRD. We administered questionnaires to dialysis medical directors during medical director meetings of three different dialysis organizations in 2013. Survey questions corresponded to recommendations from the Renal Physicians Association clinical practice guidelines on initiation and withdrawal of dialysis. There were 121 medical director respondents from 28 states. The majority of respondents felt "very prepared" (66%) or "somewhat prepared" (29%) to participate in end-of-life decisions and most (80%) endorsed a model of shared decision making. If asked to do so, 70% of the respondents provided prognostic information "often" or "nearly always." For patients with a poor prognosis, 36% of respondents would offer a time-limited trial of dialysis "often" or "nearly always", while 56% of respondents would suggest withdrawal from dialysis "often" or "nearly always" for those with a poor prognosis currently receiving dialysis therapy. Patient resistance and fear of taking away hope were the most commonly cited barriers to end-of-life discussions. Views and reported practice patterns of medical directors are consistent with clinical practice guidelines for end-of-life decision making for patients with end-stage renal disease but inconsistent with patient perceptions. © The Author(s) 2016.

The Genetic Counseling Video Project (GCVP): Models of Practice

PubMed Central

Roter, D.; Ellington, L.; Erby, L. Hamby; Larson, S.; W, Dudley

2009-01-01

Genetic counseling is conceptualized as having both “teaching” and “counseling” functions; however, little is known about how these functions are articulated in routine practice. This study addresses the question by documenting, on videotape, the practices of a national sample of prenatal and cancer genetic counselors (GCs) providing routine pretest counseling to simulated clients (SCs). 177 GCs recruited at two annual conferences of the National Society of Genetic Counselors (NSGC) were randomly assigned to counsel one of six female SCs of varying ethnicity, with or without a spouse, in their specialty. 152 videotapes were coded with the Roter Interaction Analysis System (RIAS) and both GCs and SCs completed evaluative questionnaires. Two teaching and two counseling patterns of practice emerged from cluster analysis. The teaching patterns included: (1) Clinical teaching (31%) characterized by low psychosocial, emotional and facilitative talk, high levels of clinical exchange, and high verbal dominance; and (2) Psycho-educational teaching (27%) characterized by high levels of both clinical and psychosocial exchange, low levels of emotional and facilitative talk, and higher verbal dominance. The counseling patterns included: (1) Supportive counseling (33%) characterized by low psychosocial and clinical exchange, high levels of emotional and facilitative talk, and low verbal dominance; and (2) Psychosocial counseling (9%) with high emotional and facilitative talk, low clinical and high psychosocial exchange, and the lowest verbal dominance. SCs ratings of satisfaction with communication, the counselor’s affective demeanor, and the counselor’s use of nonverbal skills were highest for the counseling model sessions. Both the teaching and counseling models seem to be represented in routine practice and predict variation in client satisfaction. PMID:16941666

The Islamic tradition and health inequities: A preliminary conceptual model based on a systematic literature review of Muslim health-care disparities

PubMed Central

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

Differences in gay men's AIDS risk knowledge and behavior patterns in high and low AIDS prevalence cities.

PubMed Central

St Lawrence, J S; Hood, H V; Brasfield, T; Kelly, J A

1989-01-01

Several studies have found reductions in acquired immunodeficiency syndrome (AIDS) risk practices among gay men in high AIDS-prevalence cities since the start of the AIDS crisis. Much less is known about risk behavior patterns among gay men in smaller cities, where AIDS cases are less common and the prevalence of human immunodeficiency virus infection is relatively lower. In the study, men entering gay bars in three cities, one large and two small, completed anonymous surveys of sexual practices and AIDS risk knowledge. Men in high AIDS-prevalence areas were found to have had a greater number of sexual partners, were more knowledgeable about AIDS, were much more likely to engage in low-risk practices (such as mutual masturbation or body rubbing), and had unprotected anal intercourse less frequently than gay men in smaller cities. The most common sexual activity among gay men in the larger city was mutual masturbation, a low-risk practice. The most common sexual activity among gay men in the smaller cities was unprotected anal intercourse. Increased efforts are needed to educate gay men and to promote risk behavior changes among those living in smaller cities and in communities outside the prominent AIDS epicenters. PMID:2502813

Practice Patterns, Attitudes and Activities of Caucasian vs. Asian University of California-San Francisco PharmD Graduates.

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)

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…

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…

Prescription patterns in asthma patients initiating salmeterol in UK general practice: a retrospective cohort study using the General Practice Research Database (GPRD).

PubMed

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.

Knowing for Nursing Practice: Patterns of Knowledge and Their Emulation in Expert Systems

PubMed Central

Abraham, Ivo L.; Fitzpatrick, Joyce J.

1987-01-01

This paper addresses the issue of clinical knowledge in nursing, and the feasibility of emulating this knowledge into expert system technology. The perspective on patterns of knowing for nursing practice, advanced by Carper (1978), serves as point of departure. The four patterns of knowing -- empirics, esthetics, ethics, personal knowledge -- are evaluated as to the extent to which they can be emulated in clinical expert systems, given constraints imposed by the current technology of these systems.

Variation in CAD Secondary Prevention Prescription among Outpatient Cardiology Practices: Insights from the NCDR®

PubMed Central

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

Clinician adoption patterns and patient outcome results in use of evidence-based nursing plans of care.

PubMed

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.

Pattern of Visits to Older Family Physicians in Taiwan.

PubMed

Liu, Hao-Yen; Liu, Cheng-Chieh; Shen, Tzu-Hsiang; Wang, Yi-Jen; Liu, Jui-Yao; Chen, Tzeng-Ji; Chou, Li-Fang; Hwang, Shinn-Jang

2017-05-08

Many family physicians still practice at an old age. Nevertheless, their practice patterns have scarcely been studied. To address this lack of research, the current study analyzed claims data for a total of 2,018,440 visits to 171 family physicians in 2011 sourced from Taiwan's National Health Insurance Research Database. Family physicians aged 65 years and over had fewer patients (mean: 2330, standard deviation (SD): 2019) and visits (mean: 9220, SD: 8600) than younger physicians had. Furthermore, the average age of the patients who visited physicians aged 65 years and over was 51.9 (SD: 21.5) years, significantly higher than that of patients who visited younger physicians. However, the proportions of visits for upper respiratory tract infections, hypertension, diabetes mellitus, and dyslipidemia did not differ significantly among different age groups of physicians. In the future, the manpower planning of physicians should take into consideration the age structure and work profile of physicians.

Visualizing Article Similarities via Sparsified Article Network and Map Projection for Systematic Reviews.

PubMed

Ji, Xiaonan; Machiraju, Raghu; Ritter, Alan; Yen, Po-Yin

2017-01-01

Systematic Reviews (SRs) of biomedical literature summarize evidence from high-quality studies to inform clinical decisions, but are time and labor intensive due to the large number of article collections. Article similarities established from textual features have been shown to assist in the identification of relevant articles, thus facilitating the article screening process efficiently. In this study, we visualized article similarities to extend its utilization in practical settings for SR researchers, aiming to promote human comprehension of article distributions and hidden patterns. To prompt an effective visualization in an interpretable, intuitive, and scalable way, we implemented a graph-based network visualization with three network sparsification approaches and a distance-based map projection via dimensionality reduction. We evaluated and compared three network sparsification approaches and the visualization types (article network vs. article map). We demonstrated the effectiveness in revealing article distribution and exhibiting clustering patterns of relevant articles with practical meanings for SRs.

Do financial incentives linked to ownership of specialty hospitals affect physicians' practice patterns?

PubMed

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.

A case series study of the neurophysiological effects of altered states of mind during intense Islamic prayer.

PubMed

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.

Values Education as Perceived by Social Studies Teachers in Objective and Practice Dimensions

ERIC Educational Resources Information Center

Katilmis, Ahmet

2017-01-01

The purpose of this study was to reveal the objectives of values education in Turkey, values education-related activities performed in schools, and preferred approaches to values education according to the opinions of social studies teachers. This qualitative study used a phenomenological pattern. The participants of the study were selected from…

Guidelines on common cold for traditional Chinese medicine based on pattern differentiation.

PubMed

Jiao, Yang; Liu, Jianping; Jiang, Liangduo; Liu, Qingquan; Li, Xiaoli; Zhang, Shunan; Zhao, Baixiao; Wang, Tianfang

2013-08-01

To establish the guidelines on common cold treated with Traditional Chinese Medicine (TCM) in terms of pattern identification. The guidelines were formulated by using the basic patterns common cold in China Pharmacopeia integrated with findings from systematic literature review and the experts' consensus on the issue in question. Common cold was divided into four patterns in the guidelines. The medications were recommended respectively: Ganmaoqingre granule for wind-cold exterior syndrome, Yinqiaojiedu granule for wind-heat exterior syndrome, Huoxiangzhengqi Wan for summer-heat dampness exterior syndrome and Shensu Wan for wind-cold exterior syndrome accompanied with Qi deficiency. The guidelines were primarily derived from the practice experience of TCM and the experts' consensus. The process was not strictly evidence-based because of lacking enough clinical studies. Further refinement of the guidelines should be needed as more studies are available.

Influence of gender and other factors on medical student specialty interest.

PubMed

Boyle, Veronica; Shulruf, Boaz; Poole, Phillippa

2014-09-12

Medical schools must select and educate to meet anticipated health needs. Factors influencing career choice include those of the student and their background as well as subsequent experience. Women have comprised over 50% of medical classes for over 20 years. This study describes gender patterns of current specialty interest among medical students at the University of Auckland, and models the predictive effect of gender compared to other career influencing factors. The study analysed career intention survey data from 711 graduating medical students (response rate, 79%) from 2006 to 2011. Interest level was highest for medicine, followed by subspecialty surgery, general practice and paediatrics. There were differences by gender for most specialties, but not for general practice. Women were more likely than men to be interested in Obstetrics and Gynaecology, Paediatrics, Geriatrics, Public Health or General Medicine, and less interested in Surgery, Anaesthesia, Emergency Medicine or post graduate study. Each specialty had a different pattern of influencing factors with the most important factor being the experience on a clinical attachment. Factors in career choice are complex and vary by gender and specialty. General practice levels of interest are too low for workforce needs. Predictive models need to be validated in longer term studies but may help guide selection and curriculum design.

The roles of talent, physical precocity and practice in the development of soccer expertise.

PubMed

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.

Evaluation of Core Vocabulary Intervention for Treatment of Inconsistent Phonological Disorder: Three Treatment Case Studies

ERIC Educational Resources Information Center

McIntosh, Beth; Dodd, Barbara

2009-01-01

Children with unintelligible speech differ in severity, underlying deficit, type of surface error patterns and response to treatment. Detailed treatment case studies, evaluating specific intervention protocols for particular diagnostic groups, can identify best practice for children with speech disorder. Three treatment case studies evaluated the…

Case Study of a College Mathematics Instructor: Patterns of Classroom Discourse

ERIC Educational Resources Information Center

Tsay, Jenq-Jong; Judd, April B.; Hauk, Shandy; Davis, Mark K.

2011-01-01

In the United States, undergraduates--regardless of their field of study--generally must complete a mathematics course to meet breadth-of-study requirements. This report is aimed at providing a research foundation for practical efforts to improve teaching and learning in such college mathematics service courses (e.g., college algebra, liberal arts…

Practice patterns of post-radical prostatectomy incontinence surgery in Ontario

PubMed Central

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

Prevalence of renal stones in an Italian urban population: a general practice-based study.

PubMed

Croppi, Emanuele; Ferraro, Pietro Manuel; Taddei, Luca; Gambaro, Giovanni

2012-10-01

Kidney stones represent a common condition characterized by significant morbidity and economic costs. The epidemiology of kidney stones is not completely understood and may vary substantially based on geographic, socioeconomic and clinical factors; the present study aims at defining the prevalence and diagnostic patterns of kidney stones in a cohort representative of the general population in Florence, Italy. A sample of 1,543 adult subjects, all Caucasians, was randomly selected from a population of over 25,000 subjects followed by 22 general practitioners (GPs). Subjects were administered a questionnaire requesting the patient's age and sex, any history of kidney stones and/or colics and the prescription of kidney ultrasound (US) examination. GPs data-bases were also interrogated. Crude and adjusted prevalence proportions and ratios (PRs) with corresponding 95% confidence intervals (CIs) were computed. Furthermore, the association between the practice pattern of each physician with respect to US prescription and the prevalence of kidney stones was investigated. The overall prevalence of kidney stones was 7.5% (95% confidence interval 6.2, 8.9%), increasing with age until 55-60 years and then decreasing. About 50% reported recurrent disease. There were no significant differences in prevalence among males and females. GPs who tended to prescribe more US examinations were more likely to have more patients with kidney stones (adjusted PR 1.80, 95% CI 1.11, 2.94; p = 0.020). The present study confirms both the high prevalence and the regional variability of kidney stones. Practice patterns may be involved in such variability.

Women in dentistry in South Africa: a survey of their experiences and opinions.

PubMed

Naidoo, S

2005-08-01

Women form an increasingly important part of the dentally trained workforce in South Africa. However, little is known about the professional issues and work-related problems affecting women dentists. A postal survey was undertaken of registered female dental practitioners in the country, with the aim to document their experiences. The survey (i) ascertained their current pattern of work, (ii) identified factors influencing their work patterns and (iii) identified factors that would help women remain in the profession or re-enter it more easily after an absence. A self-administered 50-item questionnaire containing open and closed-ended questions was used. Questions related to professional status, working patterns, practice ownership, postgraduate qualifications and career satisfaction. Nine hundred and sixty questionnaires were sent out and 280 were returned (29% response rate). Although a significant majority were currently practicing (96%), about 20% were employed or worked part-time and 7 reported that they were not in practice at the time of the survey for various reasons including maternity leave, ill-health, retirement or that they were now working outside the dental field. Major factors identified in this study were the women's dual responsibility at home and at work. Few women find themselves in specialist practice, although 68% indicated that they would liked to have specialised. Home responsibilities and inflexible working conditions were commonly reported difficulties experienced with further studies. In addition, the lack of part-time training and the geographical location of training facilities also played a role. Women dentists need more flexible working schedules and conditions of employment. Part-time training and part-time career options should be extended. Retraining and refresher courses for Women dentists who have had a break in their careers should be available to enable them to return sooner and more easily to practice. Tertiary training dental facilities throughout the country should take up this challenge and run courses that are tailored to the local need and domestic commitments of the women involved.

CD-SEM metrology and OPC modeling for 2D patterning in advanced technology nodes (Conference Presentation)

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.

Relationship between Food Insecurity, Child Weight Status, and Parent-Reported Child Eating and Snacking Behaviors

PubMed Central

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

How much tumor surgery do early-career orthopaedic oncologists perform?

PubMed

Miller, Benjamin J; Rajani, Rajiv; Leddy, Lee; Carmody Soni, Emily E; White, Jeremy R

2015-02-01

There are few data on the types of procedures orthopaedic oncologists perform in their first years of practice. Because fellowships are graduating fellows each year and the number of tumor patients is limited, defining the practice patterns of early-career orthopaedic oncologists may help diminish early employment discontent and enhance workforce discussions. The aim of the study was to use the objective case log volumes of a cross-section of early career orthopaedic oncologists to describe (1) the number of operations performed annually; (2) the proportion of tumor, trauma, adult reconstruction, and other operations for individual participants, (3) individual practice characteristics that were associated with the number of tumor procedures; and (4) the sources of satisfaction and challenges in each individual's career and surgical practice. Fifteen fellowship-trained orthopaedic oncologists out of a potential pool of 33 (45%) in their first 4 years of practice responded to a survey by submitting complete operative case lists for a 2-year period. We recorded the type of procedure and determined associations between the annual number of tumor operations and total operative caseload, years in practice, and some details of individual practice patterns. Each participant completed a survey regarding practice-related sources of stress and satisfaction. A total of 5611 surgical cases were available for review. For the entire cohort, there were 3303 (59%) tumor procedures, 973 (17%) trauma, 890 (16%) adult reconstruction, and 445 (8%) other. The median annual number of total operations was 214 (range, 63-356) and median annual number of tumor operations was 135 (range, 47-216). The median proportion of tumor operations in an individual practice was 56% (range, 43%-94%). The annual number of tumor operations correlated with the total annual number of operations (r = 0.73, p < 0.001). Sources of stress and satisfaction were similar to the general membership of the Musculoskeletal Tumor Society (MSTS), apart from more early-career surgeons regarding case volume as important (29 of 104 [28%] of MSTS versus 11 of 15 [73%] of early-career, p < 0.001). The typical early-career orthopaedic tumor surgeon had fewer than 60% of his or her operative procedures directly related to the subject of his or her fellowship training in orthopaedic oncology. Overall, the challenges and rewards of clinical practice are similar to oncologic surgeons later in their career. This study is a first step in assessing early practice characteristics and may be of value to the prospective orthopaedic oncologist, fellowship educators, and the society in workforce discussions. Early-career practice patterns have not been previously presented, to our knowledge, for any subspecialty of orthopaedic surgery, and we hope that this study will stimulate similar efforts throughout the field. Level IV, economic and decision analyses. See Guidelines for Authors for a complete description of levels of evidence.

Trends in fire patterns in a southern African savanna under alternative land use practices

Treesearch

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...

Examining First Grade Teachers' Handwriting Instruction

ERIC Educational Resources Information Center

Arslan, Derya

2012-01-01

The purpose of this study is to examine the first grade teachers' practices of handwriting instructions in terms of teaching, evaluation and handwriting difficulties. From qualitative research patterns, phenomenology was used. The study was applied to the 54 First grade teachers who work at central Burdur and Burdur county centre primary education…

Heritage Language Literacy Maintenance: A Study of Korean-American Heritage Learners

ERIC Educational Resources Information Center

Kim, Catherine E.; Pyun, Danielle O.

2014-01-01

How heritage learners successfully maintain their heritage language (HL) and literacy is a significant topic of discussion in the field of bilingual education. This study examines what factors are most closely associated with literacy competence by inspecting Korean heritage learners' language and literacy practice patterns and their literacy…

Rapid Transfer of Abstract Rules to Novel Contexts in Human Lateral Prefrontal Cortex

PubMed Central

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

Social media use and impact on plastic surgery practice.

PubMed

Vardanian, Andrew J; Kusnezov, Nicholas; Im, Daniel D; Lee, James C; Jarrahy, Reza

2013-05-01

Social media platforms have revolutionized the way human beings communicate, yet there is little evidence describing how the plastic surgery community has adopted social media. In this article, the authors evaluate current trends in social media use by practicing plastic surgeons. An anonymous survey on the use of social media was distributed to members of the American Society of Plastic Surgeons. Prevalent patterns of social media implementation were elucidated. One-half of respondents were regular social media users. Reasons for using social media included the beliefs that incorporation of social media into medical practice is inevitable (56.7 percent), that they are an effective marketing tool (52.1 percent), and that they provide a forum for patient education (49 percent). Surgeons with a primarily aesthetic surgery practice were more likely to use social media. Most respondents (64.6 percent) stated that social media had no effect on their practice, whereas 33.8 percent reported a positive impact and 1.5 percent reported a negative impact. This study depicts current patterns of social media use by plastic surgeons, including motivations driving its implementation and impressions on its impact. Many feel that social media are an effective marketing tool that generates increased exposure and referrals. A small number of surgeons have experienced negative repercussions from social media involvement. Our study reveals the presence of a void. There is a definite interest among those surveyed in developing best practice standards and oversight to ensure ethical use of social media platforms throughout the plastic surgery community. Continuing discussion regarding these matters should be ongoing as our experience with social media in plastic surgery evolves.

Evidence-practice gap for dental sealant application: results from a dental practice-based research network in Japan.

PubMed

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.

Disparities persist in nutrition policies and practices in Minnesota secondary schools

PubMed Central

Caspi, Caitlin Eicher; Davey, Cynthia; Nelson, Toben F.; Larson, Nicole; Kubik, Martha Y.; Coombes, Brandon; Nanney, Marilyn S.

2014-01-01

Access to healthy foods among secondary school students is patterned by individual-level socioeconomic status, but few studies have examined how school nutrition policies and practices are patterned by school-level characteristics. The objective of this study was to examine school nutrition policies and practices by school characteristics (location, racial/ethnic composition and free/reduced priced lunch eligibility [FRPL]) in Minnesota secondary schools between 2008 and 2012. Data from the 2008 to 2012 Minnesota School Health Profiles survey were used to assess school nutrition policies and practices, and National Center for Educational Statistics (NCES) data were used for school characteristics (n = 505 secondary schools). Nutrition policies and practices included: 1) the availability of low-nutrient, energy dense (LNED) items, 2) strategies to engage students in healthy eating, and 3) restrictions on advertisements of LNED products in areas around the school. Among school-level characteristics, school location was most strongly related to school nutrition policies. Across all years, city schools were less likely than town/rural schools to have vending machines/school stores [prevalence difference (PD)=13.7, 95% confidence interval (CI) -25.0,-2.3], and less likely to sell sports drinks (PD= -36.3, 95% CI: -51.8, -20.7). City schools were also more likely to prohibit advertisements for LNED products in school buildings (PD=17.7, 95% CI: 5.5, 29.9) and on school grounds (PD=15.6, 95% CI: 1.7, 29.5). Between 2008 and 2012 the prevalence of some healthy eating policies/practices (limiting salty snacks, offering taste testing, banning unhealthy food advertisements in school publications) declined in city schools only, where these policies/practices had previously been more common. Monitoring of these trends is needed to understand the impact of these policies on student outcomes across school settings. PMID:25441964

Patterns of Early Childhood, Elementary, and Middle-Level Social Studies Teaching: An Interpretation of Illinois Social Studies Teachers' Practices and Beliefs

ERIC Educational Resources Information Center

Lucey, Thomas A.; Shifflet, Rena A.; Weilbacher, Gary A.

2014-01-01

Using data from a national social studies survey, the authors examined instructional trends among Illinois elementary and middle school social studies teachers. The authors found that teachers preferred whole-group and teacher-centered instructional strategies over more active, student-centered methods. While surveyed teachers predominately…

Measuring the impact of practice-based research networks on member dentists in the Collaboration on Networked Dental and Oral Health Research, CONDOR.

PubMed

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.

The effect of learning via module versus lecture teaching methods on the knowledge and practice of oncology nurses about safety standards with cytotoxic drugs in Shiraz University of Medical Sciences.

PubMed

Abbasi, Khadijeh; Hazrati, Maryam; Mohamadi, Nasrin Pourali; Rajaeefard, Abdolreza

2013-11-01

Several studies have established that all nurses need continuing education, especially those who are working in oncology wards. In the current programs, there are just two general patterns for teaching: Teacher-centered and student-centered patterns. In this study, the effect of teacher-centered (lecture) and student-centered (module) teaching methods in relation to safety standards with cytotoxic drugs on the knowledge and practice of oncology nurses was compared. This research was a quasi-experimental study with two intervention groups (module and lecture) and a control group. In this study, 86 nurses in Shiraz, Fars province in 2011, who participated in the prescription of cytotoxic drugs to patients were selected and randomly divided into three groups. The module group used a self-directed module, the lecture group was taught by an experienced lecturer in the classroom and the control group did not receive any intervention. Data in relation to knowledge and practice of oncology nurses in the three groups were collected before and 8 weeks after the intervention by using a questionnaire and checklist. To analyze the data paired-samples t-test and one way ANOVA analysis were used. Knowledge and practice scores increased significantly from baseline in both intervention groups, but there was no significant difference between the scores of the two groups. No considerable changes were observed in the control group. Both module and lecture methods have similar effects on improving the knowledge and practice of nurses in oncology wards. Therefore, considering the advantages of student-centered educational methods, the work load of nurses and the sensitivity of their jobs, we suggest using module.

Assessment of nonsteroidal anti-inflammatory drug use pattern using World Health Organization indicators: A cross-sectional study in a tertiary care teaching hospital of Chhattisgarh.

PubMed

R Vaishnavi, P R; Gaikwad, Nitin; Dhaneria, S P

2017-01-01

The objective of this study is to assess drug utilization pattern of nonsteroidal anti-inflammatory drugs (NSAIDs) in a tertiary care teaching hospital, Raipur, Chhattisgarh. A prospective, cross-sectional observational study was conducted in the outpatient department during 2-month period. After informed consent, the patients visiting pharmacy shop with a prescription were enrolled in the study. Their demographic details and prescription data were recorded in a case record form. The data were analyzed to determine the drug utilization pattern of NSAIDs, using the World Health Organization (WHO) prescribing indicators. A total of 600 prescriptions were analyzed. Of them, NSAIDs were prescribed in 30.83% encounters. In general, nonselective COX inhibitors were most commonly prescribed. The most commonly prescribed form of NSAID was paracetamol (39.45%). The percentage of NSAIDs prescribed with generic names were almost identical (91.15%), whereas the percentage of NSAIDs prescribed from the National List of Essential Medicine (India) - 2015 (49.72%) was not identical with the WHO standard (100%) which serves as an ideal. In 13.51% encounters, a fixed-dose combination (FDC) of NSAIDs was prescribed. Co-administration of gastroprotective agent with NSAIDs was observed in 24.32% encounters. The prescribing practices of NSAIDs indicate some deviation from the WHO standard. In addition, FDCs of NSAIDs with gastroprotective agents as well as other NSAIDs was also prescribed, which are irrational. This baseline data will be useful to plan further targeted research and to improve prescribing practices at the center. Various strategies such as face-to-face periodic training programs of prescribers, establishing drug and therapeutic committee; drug information centers; and drug bulletins can serve beneficial in improving prescribing practices.

The relationship between children's home food environment and dietary patterns in childhood and adolescence.

PubMed

Vereecken, Carine; Haerens, Leen; De Bourdeaudhuij, Ilse; Maes, Lea

2010-10-01

To identify the correlates of the home food environment (parents' intake, availability and food-related parenting practices) at the age of 10 years with dietary patterns during childhood and in adolescence. Primary-school children of fifty-nine Flemish elementary schools completed a questionnaire at school in 2002. Four years later they completed a questionnaire by e-mail or mail at home. Their parents completed a questionnaire on food-related parenting practices at baseline. Longitudinal study. The analyses included 609 matched questionnaires. Multi-level regression analyses were used to identify baseline parenting practices (pressure, reward, negotiation, catering on demand, permissiveness, verbal praise, avoiding negative modelling, availability of healthy/unhealthy food items and mothers' fruit and vegetable (F&V) and excess scores) associated with children's dietary patterns (F&V and excess scores). Mother's F&V score was a significant positive independent predictor for children's F&V score at baseline and follow-up, whereas availability of unhealthy foods was significantly negatively associated with both scores. Negotiation was positively associated with children's follow-up score of F&V, while permissiveness was positively associated with children's follow-up excess score. Availability of unhealthy foods and mother's excess score were positively related to children's excess score at baseline and follow-up. Parental intake and restricting the availability of unhealthy foods not only appeared to have a consistent impact on children's and adolescents' diets, but also negotiating and less permissive food-related parenting practices may improve adolescents' diets.

Time to pay attention: attentional performance time-stamped prefrontal cholinergic activation, diurnality and performance

PubMed Central

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

Time to pay attention: attentional performance time-stamped prefrontal cholinergic activation, diurnality, and performance.

PubMed

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.

Breathing simulator of workers for respirator performance test.

PubMed

Yuasa, Hisashi; Kumita, Mikio; Honda, Takeshi; Kimura, Kazushi; Nozaki, Kosuke; Emi, Hitoshi; Otani, Yoshio

2015-01-01

Breathing machines are widely used to evaluate respirator performance but they are capable of generating only limited air flow patterns, such as, sine, triangular and square waves. In order to evaluate the respirator performance in practical use, it is desirable to test the respirator using the actual breathing patterns of wearers. However, it has been a difficult task for a breathing machine to generate such complicated flow patterns, since the human respiratory volume changes depending on the human activities and workload. In this study, we have developed an electromechanical breathing simulator and a respiration sampling device to record and reproduce worker's respiration. It is capable of generating various flow patterns by inputting breathing pattern signals recorded by a computer, as well as the fixed air flow patterns. The device is equipped with a self-control program to compensate the difference in inhalation and exhalation volume and the measurement errors on the breathing flow rate. The system was successfully applied to record the breathing patterns of workers engaging in welding and reproduced the breathing patterns.

Towards evenly distributed grazing patterns: including social context in sheep management strategies

PubMed Central

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

Patterns and Variations in Microvascular Decompression for Trigeminal Neuralgia

PubMed Central

TODA, Hiroki; GOTO, Masanori; IWASAKI, Koichi

2015-01-01

Microvascular decompression (MVD) is a highly effective surgical treatment for trigeminal neuralgia (TN). Although there is little prospective clinical evidence, accumulated observational studies have demonstrated the benefits of MVD for refractory TN. In the current surgical practice of MVD for TN, there have been recognized patterns and variations in surgical anatomy and various decompression techniques. Here we provide a stepwise description of surgical procedures and relevant anatomical characteristics, as well as procedural options. PMID:25925756

Evidence-based practice guideline of Chinese herbal medicine for primary open-angle glaucoma (qingfeng -neizhang).

PubMed

Yang, Yingxin; Ma, Qiu-Yan; Yang, Yue; He, Yu-Peng; Ma, Chao-Ting; Li, Qiang; Jin, Ming; Chen, Wei

2018-03-01

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. 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. 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. CHM therapy alone or combined with other conventional treatment reported in clinical studies together with Expert consensus were recommended for clinical practice.

Assessment of prescribing practices among urban and rural general practitioners in Tamil Nadu.

PubMed

Gopalakrishnan, Sekharan; Ganeshkumar, Parasuraman; Katta, Ajitha

2013-01-01

Studying drug use pattern among medical practitioners is of vital importance in the present scenario where irrational drug use and development of drug resistance is becoming rampant. To assess, the pattern of prescribing practices among the general practitioners in a defined rural and urban area of Tamil Nadu. A community based descriptive study was conducted to collect 600 prescriptions from the catchment areas of rural and urban health training centers of a medical college using prescribing indicators as per the WHO "How to investigate drug use in health facilities" tool. This prescription study revealed that multivitamins (19.5%), antibiotics (19.3%), drugs for gastro-intestinal tract (GIT) (18%), analgesic non-steroidal anti-inflammatory drugs/ (NSAID's) (15.1%), and antihistaminic (12.5%) were prescribed frequently. Among the antibiotics, amoxicillin (49.2%) was the most commonly prescribed followed by gentamicin (31.7%). Percentage of prescriptions with an antibiotic was 55% and nearly 62% of the practitioners prescribed drugs by their generic names. As a practice of poly-pharmacy, it was observed that the average number of drugs prescribed in urban and rural area was nearly 5 and 4, respectively. Nearly 80% of the urban and rural practitioners were prescribing at least one injection. Study of the quality of prescriptions revealed that there was poor legibility, high usage of abbreviations, inadequate details of the drugs, and absence of signature by practitioners in the prescriptions. This study clearly highlights the practice of poly-pharmacy, low usage of generic drugs, injudicious usage of antibiotics and injections and low usage of drugs prescribed from essential drugs list.

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.

The role of family communication and parents' feeding practices in children's food preferences.

PubMed

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.

European cardiac nurses' current practice and knowledge on anticoagulation therapy.

PubMed

Oterhals, Kjersti; Deaton, Christi; De Geest, Sabina; Jaarsma, Tiny; Lenzen, Mattie; Moons, Philip; Mårtensson, Jan; Smith, Karen; Stewart, Simon; Strömberg, Anna; Thompson, David R; Norekvål, Tone M

2014-06-01

Successful management of warfarin, new anti-thrombotic agents and self-monitoring devices requires that health care professionals effectively counsel and educate patients. Previous studies indicate that health care professionals do not always have the knowledge to provide patients with the correct information. The purpose of this study was to investigate European cardiovascular nurses' knowledge on the overall management of anticoagulation therapy and examine if this knowledge was influenced by level of education and years in clinical practice. A questionnaire including 47 items on practice patterns and knowledge on warfarin, new anticoagulants, warfarin-drug and warfarin-food interactions, and self-management of International Normalized Ratio (INR) was distributed to the attendants at a European conference in 2012. The response rate was 32% (n=206), of whom 84% reported having direct patient contact. Warfarin was the most common used oral anticoagulation in daily practice. One third offered their patients both patient self-testing and patient self-management of INR. The mean total score on the knowledge questions was 28±6 (maximum possible score 53). Nurses in direct patient care had a higher mean score (p=0.011). Knowledge on warfarin and medication-interactions were low, but knowledge on warfarin-diet interactions and how to advise patients on warfarin as somewhat better. European cardiac nurses need to improve their knowledge and practice patterns on oral anticoagulation therapy. This area of knowledge is important in order to deliver optimal care to cardiac patients and to minimise adverse effects of the treatment.

Doctors' experience with handheld computers in clinical practice: qualitative study

PubMed Central

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

PUFA and LC-PUFA intake during the first year of life: can dietary practice achieve a guideline diet?

PubMed

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.

Patterned-wettability-induced alteration of electro-osmosis over charge-modulated surfaces in narrow confinements.

PubMed

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.

Gulf Cooperation Council-dialysis outcomes and practice patterns study: An overview of anemia management trends at the regional and country specific levels in the Gulf Cooperation Council countries.

PubMed

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.

Task delegation to physician extenders--some comparisons.

PubMed Central

Glenn, J K; Goldman, J

1976-01-01

This study uses a task delegation questionnaire to compare 1973 physician extender practices in seven primary care-oriented sites with a physician attitude survey made in 1969. One additional site using no physician extenders was included as a control. The study involves both major types of physician extenders (physician assistants and nurse practitioners) in ambulatory practices with at least one year of experience in using such personnel. With minor exceptions, actual task delegation patterns conform with the 1969 attitudes of physicians as to which tasks "could and should" be delegated to physician extenders. PMID:2022

The social construction of copyright ethics and values.

PubMed

Slaughter, Sheila; Rhoades, Gary

2010-06-01

This study is based on analysis of copyright policies and 26 interviews with science and engineering faculty at three research universities on the topic of copyright beliefs, values, and practices, with emphasis on copyright of instructional materials, courseware, tools, and texts. Given that research universities now emphasize increasing external revenue flows through marketing of intellectual property, we expected copyright to follow the path of patents and lead to institutional emphasis of policies and practices that enhanced universities' intellectual property portfolios, accompanied by an increase in copyrighting by professors. Although this pattern occurred with regard to institutions, professors offered a more varied pattern, with some fully participating in commercialization of copyright and embracing entrepreneurial values, while others resisted or subverted commercial activity in favor of traditional science and engineering values.

Personnel resources in physical therapy: an analysis of supply, career patterns, and methods to enhance availability.

PubMed

Gwyer, J

1995-01-01

Describing the ever-changing supply and demand for physical therapy personnel in the United States is an intricate, complex, and profoundly significant task for the profession. In this article, a review of data relating to the supply of physical therapy personnel in the work force and their typical career patterns is presented. The estimates of the numbers of physical therapists and physical therapist assistants are discussed, as are problems associated with such estimates. Studies of career patterns of physical therapists are compared. Changes in the participation rates of women in the physical therapy work force over the last three decades are described. Career expectations, defined as both length and pattern of work-force participation, of entering physical therapy professionals are presented. Strategies to adjust the work-force participation of personnel through changes in the educational process, career patterns, and practice patterns are discussed.

AAHSL Twitter Use From 2007 to 2014: An Exploratory Analysis.

PubMed

Stellrecht, Elizabeth; Hendrix, Dean

2016-01-01

Twitter is a popular social media platform used by organizations for communication and marketing purposes. Many libraries, including members of the Association of Academic Health Sciences Libraries (AAHSL), have Twitter accounts, but how do these libraries use Twitter to communicate with their constituents and are they using it effectively? This study is a large-scale observational study of Twitter use within AAHSL libraries and reflects on the usage patterns present in the context of social media best practices. This study also aims to expand upon best practices for implementing and maintaining a Twitter account in a health sciences library setting.

Patterns in artisanal coral reef fisheries revealed through local monitoring efforts

PubMed Central

Teneva, Lida T.; Ogawa, Tom; Friedlander, Alan M.

2017-01-01

Sustainable fisheries management is key to restoring and maintaining ecological function and benefits to people, but it requires accurate information about patterns of resource use, particularly fishing pressure. In most coral reef fisheries and other data-poor contexts, obtaining such information is challenging and remains an impediment to effective management. We developed the most comprehensive regional view of shore-based fishing effort and catch published to date, to show detailed fishing patterns from across the main Hawaiian Islands (MHI). We reveal these regional patterns through fisher “creel” surveys conducted by local communities, state agencies, academics, and/or environmental organizations, at 18 sites, comprising >10,000 h of monitoring across a range of habitats and human influences throughout the MHI. All creel surveys included in this study except for one were previously published in some form (peer-reviewed articles or gray literature reports). Here, we synthesize these studies to document spatial patterns in nearshore fisheries catch, effort, catch rates (i.e., catch-per-unit-effort (CPUE)), and catch disposition (i.e., use of fish after catch is landed). This effort provides for a description of general regional patterns based on these location-specific studies. Line fishing was by far the dominant gear type employed. The most efficient gear (i.e., highest CPUE) was spear (0.64 kg h−1), followed closely by net (0.61 kg h−1), with CPUE for line (0.16 kg h−1) substantially lower than the other two methods. Creel surveys also documented illegal fishing activity across the studied locations, although these activities were not consistent across sites. Overall, most of the catch was not sold, but rather retained for home consumption or given away to extended family, which suggests that cultural practices and food security may be stronger drivers of fishing effort than commercial exploitation for coral reef fisheries in Hawai‘i. Increased monitoring of spatial patterns in nearshore fisheries can inform targeted management, and can help communities develop a more informed understanding of the drivers of marine resource harvest and the state of the resources, in order to maintain these fisheries for food security, cultural practices, and ecological value. PMID:29226033

Pattern of prescription drug use in Nigerian army hospitals.

PubMed

Adebayo, E T; Hussain, N A

2010-01-01

Most health expenditure of developing countries is on drugs and medical sundries but inappropriate use of such resources is common. To our knowledge, only few studies have been done in Africa on this issue , with inadequate consideration of the sociological context of the knowledge, attitude and practice of the prescribers especially doctors. This study presents the pooled data of the pattern of prescription drug use from three Nigerian Army hospitals using some WHO criteria, and the knowledge and attitude underlying doctors' prescribing practices in these hospitals. Retrospective cross-sectional survey of one year (March 2006-February 2007). Systematic random sample of general out patient case notes from three hospitals were collected using WHO criteria. The knowledge, attitude and practice survey of doctors at each study site towards the concept of rational drug use (RDU) were assessed using a self-administered questionnaire. Data collected from 660 case notes showed that average number of drugs per encounter was 2.8 while 49.3% of drugs were prescribed in the generic form. An average of 28.1% of patients encountered antibiotics. From the knowledge, attitude and practice survey, it is evident that 90.5% of 74 prescribers were aware of the existence of national essential drugs list but 58.1% of them did not use it as basis of prescriptions. In describing types of medicines preferred, 56.7% of prescribers claimed they prescribed a mixture of generic and branded drugs. Only 12.1% of prescribers could accurately detail the 5 steps of rational prescribing. The pattern of prescription drug use in Nigerian Army hospitals is unsatisfactory. It is characterised by high number of drugs per prescription, high rate of antibiotic usage and unscientific prescription by doctors. There is a need for further education and research on rational drug use among prescribers in Nigerian military health facilities.

Leak location using the pattern of the frequency response diagram in pipelines: a numerical study

NASA Astrophysics Data System (ADS)

Lee, Pedro J.; Vítkovský, John P.; Lambert, Martin F.; Simpson, Angus R.; Liggett, James A.

2005-06-01

This paper presents a method of leak detection in a single pipe where the behaviour of the system frequency response diagram (FRD) is used as an indicator of the pipe integrity. The presence of a leak in a pipe imposes a pattern on the resonance peaks of the FRD that can be used as a clear indication of leakage. Analytical expressions describing the pattern of the resonance peaks are derived. Illustrations of how this pattern can be used to individually locate and size multiple leaks within the system are presented. Practical issues with the technique, such as the procedure for frequency response extraction, the impact of measurement position, noise- and frequency-dependent friction are also discussed.

Assessing the uptake of persistent identifiers by research infrastructure users

PubMed Central

Maull, Keith E.

2017-01-01

Significant progress has been made in the past few years in the development of recommendations, policies, and procedures for creating and promoting citations to data sets, software, and other research infrastructures like computing facilities. Open questions remain, however, about the extent to which referencing practices of authors of scholarly publications are changing in ways desired by these initiatives. This paper uses four focused case studies to evaluate whether research infrastructures are being increasingly identified and referenced in the research literature via persistent citable identifiers. The findings of the case studies show that references to such resources are increasing, but that the patterns of these increases are variable. In addition, the study suggests that citation practices for data sets may change more slowly than citation practices for software and research facilities, due to the inertia of existing practices for referencing the use of data. Similarly, existing practices for acknowledging computing support may slow the adoption of formal citations for computing resources. PMID:28394907

The Genetic Counseling Video Project (GCVP): models of practice.

PubMed

Roter, D; Ellington, L; Erby, L Hamby; Larson, S; Dudley, W

2006-11-15

Genetic counseling is conceptualized as having both "teaching" and "counseling" functions; however, little is known about how these functions are articulated in routine practice. This study addresses the question by documenting, on videotape, the practices of a national sample of prenatal and cancer genetic counselors (GCs) providing routine pre-test counseling to simulated clients (SCs). One hundred and seventy-seven GCs recruited at two annual conferences of the National Society of Genetic Counselors (NSGC) were randomly assigned to counsel one of six female SCs of varying ethnicity, with or without a spouse, in their specialty. One hundred and fifty-two videotapes were coded with the Roter Interaction Analysis System (RIAS) and both GCs and SCs completed evaluative questionnaires. Two teaching and two counseling patterns of practice emerged from cluster analysis. The teaching patterns included: (1) clinical teaching (31%) characterized by low psychosocial, emotional and facilitative talk, high levels of clinical exchange, and high verbal dominance; and (2) psycho-educational teaching (27%) characterized by high levels of both clinical and psychosocial exchange, low levels of emotional and facilitative talk, and higher verbal dominance. The counseling patterns included: (1) supportive counseling (33%) characterized by low psychosocial and clinical exchange, high levels of emotional and facilitative talk, and low verbal dominance; and (2) psychosocial counseling (9%) with high emotional and facilitative talk, low clinical and high psychosocial exchange, and the lowest verbal dominance. SCs ratings of satisfaction with communication, the counselor's affective demeanor, and the counselor's use of non-verbal skills were highest for the counseling model sessions. Both the teaching and counseling models seem to be represented in routine practice and predict variation in client satisfaction, affective demeanor, and nonverbal effectiveness. (c) 2006 Wiley-Liss, Inc.

Perceived outcomes of web-based modules designed to enhance athletic trainers' knowledge of evidence-based practice.

PubMed

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

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. 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. Qualitative study. Individual telephone interviews. A total of 25 ATs (12 educators, 13 clinicians; experience as an AT = 16.00 ± 9.41 years) were interviewed. 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. 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. 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.

Perceived Outcomes of Web-Based Modules Designed to Enhance Athletic Trainers' Knowledge of Evidence-Based Practice

PubMed Central

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

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…

Patterns and Rates of Learning in Two Problem-Based Learning Courses Using Outcome Based Assessment and Elaboration Theory

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…

Optimization of landscape pattern [Chapter 8

Treesearch

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...

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.

A Study of the Effects of Child Rearing Patterns on Test Anxiety in Late Adolescence.

ERIC Educational Resources Information Center

Mine, Hiroshi; And Others

This study of Japanese families postulated that positive and negative parental attitudes may affect the degree of test anxiety experienced by children in the families. The study used translations of the Reactions to Tests (RTT) inventory and parental attitude tests to identify relationships between child rearing practices and the child's…

A naturalistic study of changes in pharmacological prescription for borderline personality disorder in clinical practice: from APA to NICE guidelines.

PubMed

Pascual, Juan C; Martín-Blanco, Ana; Soler, Joaquim; Ferrer, Alicia; Tiana, Thais; Alvarez, Enrique; Pérez, Víctor

2010-11-01

Although no psychotropic agents are specifically licensed for the management of borderline personality disorder (BPD), pharmacological treatment appears to be common. This study aimed to examine the drug prescriptions for patients with BPD in clinical practice, analyze the prescription patterns from the appearance of the American Psychiatric Association guidelines in 2001 until the National Institute for Health and Clinical Excellence guidelines in 2009, and identify the factors associated with such prescription of each type of drug. Naturalistic study on 226 consecutive BPD patients admitted to an outpatient BPD program. Socio-demographic, clinical and pharmacological treatment information was collected; factors associated with drug prescription were examined using logistic regression analyses for dichotomous outcomes measures. Changes in prescription patterns over time were also evaluated. Patients received an average of 2.7 drugs; only 6% were drug-free; 56% were taking ≥3 drugs and 30% ≥4 drugs. Over the past 8 years, prescription of antidepressants has remained stable; there has been a significant reduction in prescription of benzodiazepines and an increase in the use of mood stabilizers and atypical antipsychotics. Comorbidity with Axis I disorders was the main factor associated with drug prescription. Drug prescription and polypharmacy are common in the management of BPD in clinical practice.

Blood/Brain Biomarkers of Inflammation After Stroke and Their Association With Outcome: From C-Reactive Protein to Damage-Associated Molecular Patterns.

PubMed

Bustamante, Alejandro; Simats, Alba; Vilar-Bergua, Andrea; García-Berrocoso, Teresa; Montaner, Joan

2016-10-01

Stroke represents one of the most important causes of disability and death in developed countries. However, there is a lack of prognostic tools in clinical practice to monitor the neurological condition and predict the final outcome. Blood biomarkers have been proposed and studied in this indication; however, no biomarker is currently used in clinical practice. The stroke-related neuroinflammatory processes have been associated with a poor outcome in stroke, as well as with poststroke complications. In this review, we focus on the most studied blood biomarkers of this inflammatory processes, cytokines, and C-reactive protein, evaluating its association with outcome and complications in stroke through the literature, and performing a systematic review on the association of C-reactive protein and functional outcome after stroke. Globally, we identified uncertainty with regard to the association of the evaluated biomarkers with stroke outcome, with little added value on top of clinical predictors such as age or stroke severity, which makes its implementation unlikely in clinical practice for global outcome prediction. Regarding poststroke complications, despite being more practical scenarios in which to make medical decisions following a biomarker prediction, not many studies have been performed, although there are now some candidates for prediction of poststroke infections. Finally, as potential new candidates, we reviewed the pathophysiological actions of damage-associated molecular patterns as triggers of the neuroinflammatory cascade of stroke, and their possible use as biomarkers.

The Costs and Benefits of Testing and Guessing on Recognition Memory

PubMed Central

Huff, Mark J.; Balota, David A.; Hutchison, Keith A.

2016-01-01

We examined whether two types of interpolated tasks (i.e., retrieval-practice via free recall or guessing a missing critical item) improved final recognition for related and unrelated word lists relative to restudying or completing a filler task. Both retrieval-practice and guessing tasks improved correct recognition relative to restudy and filler tasks, particularly when study lists were semantically related. However, both retrieval practice and guessing also generally inflated false recognition for the non-presented critical words. These patterns were found when final recognition was completed during a short delay within the same experimental session (Experiment 1) and following a 24-hr delay (Experiment 2). In Experiment 3, task instructions were presented randomly after each list to determine whether retrieval-practice and guessing effects were influenced by task-expectancy processes. In contrast to Experiments 1 and 2, final recognition following retrieval practice and guessing was equivalent to restudy, suggesting that the observed retrieval-practice and guessing advantages were in part due to preparatory task-based processing during study. PMID:26950490

A User-Centered Framework for Deriving A Conceptual Design From User Experiences: Leveraging Personas and Patterns to Create Usable Designs

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.

The development and validation of the Dormitory Observation Report: a behavioral rating instrument for juvenile delinquents in residential care.

PubMed

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.

The efficacy of using human myoelectric signals to control the limbs of robots in space

NASA Technical Reports Server (NTRS)

Clark, Jane E.; Phillips, Sally J.

1988-01-01

This project was designed to investigate the usefulness of the myoelectric signal as a control in robotics applications. More specifically, the neural patterns associated with human arm and hand actions were studied to determine the efficacy of using these myoelectric signals to control the manipulator arm of a robot. The advantage of this approach to robotic control was the use of well-defined and well-practiced neural patterns already available to the system, as opposed to requiring the human operator to learn new tasks and establish new neural patterns in learning to control a joystick or mechanical coupling device.

[Practice patterns in Mexican allergologists about specific immunotherapy with allergens].

PubMed

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.

Histological Pattern Of Endometrial Samples In Postmenopausal Women With Abnormal Uterine Bleeding.

PubMed

Deeba, Farhat; Shaista; Khan, Bushra

2016-01-01

Abnormal uterine bleeding is one of the most common clinical problems in gynaecological practice and is an indicator of various underlying disorders. An endometrial biopsy should be done in all women over 35 years with AUB to rule out endometrial cancer or pre-malignant lesion and to initiate treatment. However, wide range of histological patterns on endometrial biopsy offer a diagnostic challenge to practicing pathologists. The objective of this study was to determine histological patterns of endometrium in postmenopausal women with abnormal uterine bleeding. This cross-sectional study was conducted in the department of obstetrics and gynaecology, Benazir Bhutto Shaheed women and children teaching hospital, Abbottabad from 15/11/2014 to 14/05/2015. This study involved 110 postmenopausal women presenting with abnormal uterine bleeding. A written informed consent was obtained from every patient. The mean age of the patients was 61.60±6.17 years and the mean duration of AUB was 5.20±2.80 years. Most of the patients were para 6 (28.2%) and para 5 (28.2%) followed by para 4 (18.2%) and para 3 (17.3%) while only 8.2% were para 1. The most common histological pattern observed was complex hyperplasia without atypia (30.9%) followed by atrophic endometrium (24.5%), simple hyperplasia (23.6%), malignancy (12.7%), complex hyperplasia with atypia (4.5%) and benign endometrial polyp (3.6%). When stratified the data, there was no significant difference of histological patterns across various age groups (p=.673), duration of AUB (p=.064) and parity (p=.242). The most common histological pattern observed in postmenopausal women with AUB was complex hyperplasia without atypia (30.9%) followed by atrophic endometrium (24.5%), simple hyperplasia (23.6%), malignancy (12.7%), complex hyperplasia with atypia (4.5%) and benign endometrial polyp (3.6%).

Using Wise Interventions to Motivate Deliberate Practice

PubMed Central

Eskreis-Winkler, Lauren; Shulman, Elizabeth P.; Young, Victoria; Tsukayama, Eli; Brunwasser, Steven M.; Duckworth, Angela L.

2015-01-01

Deliberate practice leads to world-class excellence across domains. In the current investigation, we examined whether psychologically “wise” interventions targeting expectancies and values—stock antecedents of ordinary effortful behaviors—could motivate non-experts to engage in deliberate practice and improve their achievement. As a preliminary, we developed and validated a novel task measure of deliberate practice and confirmed its association with (a) expectancy-value beliefs and (b) achievement in the non-expert setting (Study 1). Next, across four longitudinal, randomized-controlled, field experiments, we intervened. Among lower-achievers, wise deliberate practice interventions improved math performance for fifth and sixth graders (Study 2), end-of-semester grades for undergraduates (Study 3), and end-of-quarter grades for sixth graders (Study 4); the same pattern of results emerged in end-of-quarter grades for seventh graders (Study 5). Following the intervention, expectancy-value beliefs and deliberate practice improved for one month (Study 4), but not four (Study 5). Treatment proved beneficial over and above two control conditions, one that taught standard study skills (Studies 2 and 3), and one that discussed deep interests, generalized motivation, and high achievement (Studies 4 and 5). Collectively, these findings provide preliminary support for the heretofore untested hypothesis that deliberate practice submits to the same laws that govern typical forms of effortful behavior, and that wise interventions that tap into these laws can spur short-term gains in adaptive beliefs, deliberate practice, and objectively-measured achievement. PMID:27762575

A Comparative Study Concerning Administrative Aspects of Elementary Off-Campus Student Teaching Programs: Current Practices and Proposed Patterns.

ERIC Educational Resources Information Center

Armstrong, Robert J.

A study was made to determine the current status of selected administrative areas of student teaching programs in Massachusetts and cooperative student teaching programs throughout the nation, the desirability of establishing cooperative programs in Massachusetts, and the organization and impelementation of these programs. Specific administrative…

Examination of Resource Allocation in Education: Connecting Spending to Student Performance. Research Report.

ERIC Educational Resources Information Center

Pan, Diane; Rudo, Zena H.; Schneider, Cynthia L.; Smith-Hansen, Lotte

This document reports on a study on the relationship between resources and student performance. The study examined district-level patterns of resource allocation, district and school resource practices implemented to improve student performance, and barriers and challenges to efficient resource allocation faced by districts and schools. The study…

Do Premarital Education Programs Really Work? A Meta-Analytic Study

ERIC Educational Resources Information Center

Fawcett, Elizabeth B.; Hawkins, Alan J.; Blanchard, Victoria L.; Carroll, Jason S.

2010-01-01

Previous studies (J. S. Carroll & W. J. Doherty, 2003) have asserted that premarital education programs have a positive effect on program participants. Using meta-analytic methods of current best practices to look across the entire body of published and unpublished evaluation research on premarital education, we found a more complex pattern of…

Cultural Diversity and the Experiences of Alaska Native Nursing Students

ERIC Educational Resources Information Center

Gilmon, Margaret E.

2012-01-01

The purpose of this ethnonursing research study was to discover, describe, and systematically analyze the care expressions, practices, and patterns of Alaska Native nurses within the context of their nursing school experience. The goals of this study were to identify generic and professional care factors that promote the academic success of Alaska…

Opening Up the Black Box: Literacy Instruction in Schools Participating in Three Comprehensive School Reform Programs

ERIC Educational Resources Information Center

Correnti, Richard; Rowan, Brian

2007-01-01

This study examines patterns of literacy instruction in schools adopting three of America's most widely disseminated comprehensive school reform (CSR) programs (the Accelerated Schools Project, America's Choice, and Success for All). Contrary to the view that educational innovations seldom affect teaching practices, the study found large…

Conifer root proliferation after 20 years of soil compaction

Treesearch

Matt D. Busse; Gary O. Fiddler; Carol J. Shestak

2017-01-01

Soil compaction is known to limit plant growth by reducing soil macroporosity and restricting gas, water, and root movement. Recent evidence from study sites across the United States and Canada, however, suggests that tree growth is not universally affected by soil compaction from forest harvesting practices. Our observational study examined rooting patterns in mixed...

What Do Mothers Say? Korean Mothers' Perceptions of Children's Participation in Extra-Curricular Musical Activities

ERIC Educational Resources Information Center

Cho, Eun

2015-01-01

A recent study of Korean middle-class mothers' perceptions and parenting practices associated with children's participation in musical activities reported unique forms of musical parenting, which closely correspond with previous studies of concerted cultivation in Western middle-class families. Are these unique patterns exclusive to middle-class…

Portraits of Principal Practice: Time Allocation and School Principal Work

ERIC Educational Resources Information Center

Sebastian, James; Camburn, Eric M.; Spillane, James P.

2018-01-01

Purpose: The purpose of this study was to examine how school principals in urban settings distributed their time working on critical school functions. We also examined who principals worked with and how their time allocation patterns varied by school contextual characteristics. Research Method/Approach: The study was conducted in an urban school…

Whither British general practice after the 2004 GMS contract? Stories and realities of change in four UK general practices.

PubMed

Huby, Guro; Guthrie, Bruce; Grant, Suzanne; Watkins, Francis; Checkland, Kath; McDonald, Ruth; Davies, Huw

2008-01-01

The purpose of this article is to provide answers to two questions: what has been the impact of nGMS on practice organisation and teamwork; and how do general practice staff perceive the impact? The article is based on comparative in-depth case studies of four UK practices. There was a discrepancy between changes observed and the way practice staff described the impact of the contract. Similar patterns of organisational change were apparent in all practices. Decision-making became concentrated in fewer hands. Formally or informally constituted "elite" multidisciplinary groups monitored and controlled colleagues' behaviour for maximum performance and remuneration. This convergence of organisational form was not reflected in the dominant "story" each practice constructed about its unique ethos and style. The "stories" also failed to detect negative consequences to the practice flowing from its adaptation to the contract. The paper highlights how collective "sensemaking" in practices may fail to detect and address key organisational consequences from the nGMS.

Power, uncertainty, self-transcendence, and quality of life in breast cancer survivors.

PubMed

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.

Interdisciplinary team communication among forensic nurses and rape victim advocates.

PubMed

Patterson, Debra

2014-01-01

Victim advocates and forensic nurses provide integrated care to address the complex legal, medical, and mental health needs of rape survivors. Research suggests that conflict exists between nurses and advocates, but it remains unknown how their communication patterns contribute to or resolve these conflicts. Utilizing a qualitative case study approach, the current study interviewed 24 nurses and advocates from a Midwest organization to better understand team communication patterns when addressing conflicts. The findings suggest that most nurses communicate concerns directly while advocates avoid direct communication. Factors that influenced direct and indirect communication and their implications for practice will be discussed.

How often do neuroradiologists perform sonography of the carotid arteries? A survey of academic and nonacademic radiology practices, with implications for fellowship training.

PubMed

Friedman, David P; Maitino, Andrea J

2003-08-01

Debate in the neuroradiology community surrounds the amount of formal training in sonography of the carotid arteries that should be provided to fellows. This study was designed to assess current practice patterns at both academic and nonacademic practices regarding the performance of carotid sonography. A neurovascular radiology survey was sent to all 102 program directors of neuroradiology fellowships in the United States and Canada (academic practices). The survey was also sent to 146 randomly selected senior members of the ASNR (three per state, except one each for Alaska and Vermont) who were not affiliated with fellowship programs (nonacademic practices). Fifty-seven surveys from academic practices and 70 surveys from nonacademic practices were returned. Radiologists at academic practices performed approximately 42% of studies (general radiologists or sonography specialists, 36%; neuroradiologists, 5%; cardiovascular radiologists, 1%). Nonradiologists performed approximately 58% of studies (vascular surgeons, 47%; neurologists, 10%; cardiologists, 1%; neurosurgeons, <1%). Neuroradiologists performed carotid sonography at 11% (6/57) of academic practices. On average, radiologists at nonacademic practices performed approximately 62% of studies (general radiologists or sonography specialists, 38%; neuroradiologists, 15%; cardiovascular radiologists, 9%). Nonradiologists performed approximately 38% of studies (vascular surgeons, 25%; neurologists, 6%; cardiologists or internists, 6%). Neuroradiologists performed carotid sonography at 53% (37/70) of nonacademic practices. At most academic practices, neuroradiologists do not perform sonography of the carotid arteries. This may explain the reluctance of some fellowships to provide formal training in this technique. In contrast, although neuroradiologists perform carotid sonography at a majority of the nonacademic practices, the percentage of studies that they perform is small; moreover, neuroradiologists perform far fewer studies than do general radiologists or sonography specialists.

Effects of holistic nursing course: a paradigm shift for holistic health practices.

PubMed

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.

Meditation has stronger relationships with mindfulness, kundalini, and mystical experiences than yoga or prayer.

PubMed

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.

Dietary patterns in infancy are associated with child diet and weight outcomes at 6 years.

PubMed

Rose, C M; Birch, L L; Savage, J S

2017-05-01

To assess whether patterns of dietary exposures at 9 months are associated with child diet and weight at 6 years. Data for this study were from the Infant Feeding Practices Study II and Year 6 Follow-Up Studies. All data were self-reported monthly. Results of a previous latent class analysis revealed five dietary patterns varying in milk and solid food intake. These five infant dietary patterns were used in the current study to predict child diet and weight outcomes at 6 years, while controlling for confounding variables. Infants with dietary patterns higher in fruit and vegetable intake at 9 months had higher fruit and vegetable intake at 6 years. Similarly, infants with the dietary pattern characterized by foods high in energy density (that is, French Fries and sweet desserts) continued to have higher consumption of these foods at 6 years, and had a higher prevalence of overweight at 6 years (43%) compared with the other classes. Formula-fed infants had higher sugar-sweetened beverage intake and fewer met the dietary guidelines for fruit and vegetable intake at 6 years than breastfed infants, controlling for factors such as income. Early decisions about milk-feeding, and the types of solid foods offered in infancy can foreshadow dietary patterns and obesity risk later in childhood. Infants who were offered energy-dense foods had higher intake of these foods at 6 years of age.

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.

Practice patterns of graduates of 2- and 3-year family medicine programs: in Ontario, 1996 to 2004.

PubMed

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.

Practice patterns of academic general thoracic and adult cardiac surgeons.

PubMed

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

2014-10-01

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

Parenting Practices and Child Misbehavior: A Mixed Method Study of Italian Mothers and Children

PubMed Central

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

An audit of clinical practice, referral patterns, and appropriateness of clinical indications for brain MRI examinations: A single-centre study in Ghana.

PubMed

Piersson, A D; Nunoo, G; Gorleku, P N

2018-05-01

The aim of this study was to investigate current brain MRI practice, pattern of brain MRI requests, and their appropriateness using the American College of Radiology (ACR) Appropriateness Criteria. We used direct observation and questionnaires to obtain data concerning routine brain MRI practice. We then retrospectively analyzed (i) demographic characteristics, (ii) clinical history, and (iii) appropriateness of brain MRI requests against published criteria. All patients were administered the screening questionnaire; however, no reviews were undertaken directly with patients, and no signature of the radiographer was recorded. Apart from routine brain protocol, there were dedicated protocols for epilepsy and stroke. Brain MRI images from 161 patients (85 Males; 76 Females) were analyzed. The age group with most brain MRI requests were from 26 to 45 year olds. The commonest four clinical indications for imaging were brain tumour, headache, seizure, and stroke. Using the ACR Appropriateness Criteria, almost 43% of the brain MRI scans analyzed were found to be "usually appropriate", 38% were "maybe appropriate" and 19% were categorized as "usually not appropriate". There was knowledge gap with regards to MRI safety in local practice, thus there is the utmost need for MRI safety training. Data on the commonest indications for performing brain MRI in this study should be used to inform local neuroradiological practice. Dedicated stroke and epilepsy MRI protocols require additional sequences i.e. MRA and 3D T1 volume acquisition, respectively. The ACR Appropriateness Criteria is recommended for use by the referring practitioners to improve appropriateness of brain MRI requests. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Dentist practice patterns and therapeutic confidence in the treatment of pain related to temporomandibular disorders in a dental practice-based research network

PubMed Central

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

A study of National Health Service management of chronic osteoarthritis and low back pain.

PubMed

Hart, Oliver R; Uden, Ruth M; McMullan, James E; Ritchie, Mark S; Williams, Timothy D; Smith, Blair H

2015-04-01

To describe treatment and referral patterns and National Health Service resource use in patients with chronic pain associated with low back pain or osteoarthritis, from a Primary Care perspective. Osteoarthritis and low back pain are the two commonest debilitating causes of chronic pain, with high health and social costs, and particularly important in primary care. Understanding current practice and resource use in their management will inform health service and educational requirements and the design and optimisation of future care. Multi-centre, retrospective, descriptive study of adults (⩾18 years) with chronic pain arising from low back pain or osteoarthritis, identified through primary care records. Five general practices in Scotland, England (two), Northern Ireland and Wales. All patients with a diagnosis of low back pain or osteoarthritis made on or before 01/09/2006 who had received three or more prescriptions for pain medication were identified and a sub-sample randomly selected then consented to an in-depth review of their medical records (n=264). Data on management of chronic pain were collected retrospectively from patients' records for three years from diagnosis ('newly diagnosed' patients) or for the most recent three years ('established' patients). Patients received a wide variety of pain medications with no overall common prescribing pattern. GP visits represented the majority of the resource use and 'newly diagnosed' patients were significantly more likely to visit their GP for pain management than 'established' patients. Although 'newly diagnosed' patients had more referrals outside the GP practice, the number of visits to secondary care for pain management was similar for both groups. This retrospective study confirmed the complexity of managing these causes of chronic pain and the associated high resource use. It provides an in-depth picture of prescribing and referral patterns and of resource use.

Patterns of Radiotherapy Practice for Pancreatic Cancer in Japan: Results of the Japanese Radiation Oncology Study Group (JROSG) Survey

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

Self-Reported Dietary Restrictions and Dietary Patterns in Polish Girls: A Short Research Report (GEBaHealth Study).

PubMed

Galinski, Grzegorz; Lonnie, Marta; Kowalkowska, Joanna; Wadolowska, Lidia; Czarnocinska, Jolanta; Jezewska-Zychowicz, Marzena; Babicz-Zielinska, Ewa

2016-12-19

Dietary restraint is a commonly reported practice observed among young females. The practice remains controversial and can be interpreted as a beneficial self-regulating behavior or the opposite, an eating disorder that may have a detrimental effect on health. The aim of this short report was to investigate if dietary restrictions are associated with dietary patterns in a representative sample of Polish girls. Analyses were carried out on data from the Girls' Eating Behavior and Health (GEBaHealth) study. The sample included 1107 girls, ranging in age from 13 to 21 years old. Restrictions regarding food quantities and selected food groups were assessed using a standardized interview. Dietary patterns were identified with Principal Component Analysis (PCA), based on dietary data collected with Food Frequency Questionnaires (FFQs). Logistic regression analysis was used to study the associations between self-reported restrictions and each dietary pattern. In the total sample, 30.5% of girls reported following some food restrictions. The most common restrictions regarded consumption of sugar and/or sweets (23.7%), high-fat foods (22.4%), and fats (21.3%). Girls who declared following any restrictions, restrictions in food quantity and restrictions in the consumption of sugar and/or sweets, high-fat foods, fats, cereals and/or bread and/or potatoes were more likely to adhere to the "fruit and vegetables" (considered pro-healthy) dietary pattern (adjusted odds ratios (ORs): 1.55, 95% CI: 1.14-2.12; 1.61, 95% CI: 1.17-2.21; 1.81, 95% CI: 1.30-2.52; 1.46, 95% CI: 1.04-2.06; 1.96, 95% CI: 1.38-2.80 and 3.25, 95% CI: 1.97-5.37, respectively), and less likely to adhere to the "fast foods and sweets" (unhealthy) and "traditional Polish" (rather unhealthy) patterns, compared to girls who declared no restrictions. Declared restrictions in the consumption of foods high in sugar, fat, and starch were observed in girls in the "fruit and vegetables" pattern and were uncommon in girls with unhealthy dietary patterns. Although cautious interpretation is needed when considering restrictions in the overall quantity of food consumed, the results indicate that dietary restrictions of sugar, high-fat foods, fats, and starch may be considered predictors of both pro-healthy and unhealthy dietary patterns in the population of Polish girls.

Practice patterns for the use of iodinated i.v. contrast media for pediatric CT studies: a survey of the Society for Pediatric Radiology.

PubMed

Callahan, Michael J; Servaes, Sabah; Lee, Edward Y; Towbin, Alexander J; Westra, Sjirk J; Frush, Donald P

2014-04-01

There are limited data available on the use of i.v. contrast media for CT studies in the pediatric population. The purpose of this study is to determine the practice patterns of i.v. contrast media usage for pediatric CT by members of the Society for Pediatric Radiology (SPR). SPR members were surveyed regarding the use of i.v. contrast media for pediatric CT studies. Questions pertained to information required before administering i.v. contrast media, types of central catheters for injecting i.v. contrast media, injection rates based on angiocatheter size and study type, and management of i.v. contrast media extravasation. The response rate of 6% (88/1545) represented practice patterns of 26% (401/1545) of the SPR membership. Most respondents thought the following clinical information was mandatory before i.v. contrast media administration: allergy to i.v. contrast media (97%), renal insufficiency (97%), current metformin use (72%), significant allergies (61%), diabetes (54%), and asthma (52%). Most administered i.v. contrast media through nonimplanted central venous catheters (78%), implanted venous ports (78%), and peripherally inserted central catheters (72%). The most common maximum i.v. contrast media injection rates were 5.0 mL/s or greater for a 16-gauge angiocatheter, 4.0 mL/s for an 18-gauge angiocatheter, 3.0 mL/s for a 20-gauge angiocatheter, and 2.0 mL/s for a 22-gauge angiocatheter. For soft-tissue extravasation of i.v. contrast media, 95% elevate the affected extremity, 76% use ice, and 45% use heat. The results of this survey illustrate the collective opinion of a subset of SPR members relating to the use of i.v. contrast media in pediatric CT, providing guidelines for clinical histories needed before i.v. contrast media, maximum i.v. contrast injection rates for standard angiocatheters, contrast media injection rates for specific CT studies, and management of i.v. contrast media soft-tissue extravasation.

Human growth hormone treatment: synthesis of literature on product delivery systems and administration practices.

PubMed

Bhosle, Monali; Klingman, David; Aagren, Mark; Wisniewski, Tami; Lee, Won Chan

2011-01-01

To synthesize current literature on recombinant human growth hormone (rhGH) use and to identify areas of research that have received little to no attention in light of administration practice and patient perception/behavior. Relevant articles for a systematic review were identified through PubMed. A total of 43 articles were identified: 9 (15.9%) studies on product administration practices and 34 (84.1%) on patient behavior patterns. Patients primarily preferred simple, convenient, and easy-to-use delivery devices. However, literature addressing the effect of convenient product administration practices on treatment outcomes using real-world patient/caregiver data is lacking. Better understanding of real-world product administration practices will help nurses identify areas of improvement in patient education and training. © 2010, Wiley Periodicals, Inc.

The relationship between the number of cardiologists and clinical practice patterns in acute heart failure: a cross-sectional observational study

PubMed Central

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

Do Parents Treat Siblings Similarly or Differently with Regard to Feeding Practices, Weight-Related Conversations, and Support for Physical Activity? An Exploratory Analysis

PubMed Central

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

General surgery workloads and practice patterns in the United States, 2007 to 2009: a 10-year update from the American Board of Surgery.

PubMed

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.

Using classification tree modelling to investigate drug prescription practices at health facilities in rural Tanzania.

PubMed

Kajungu, Dan K; Selemani, Majige; Masanja, Irene; Baraka, Amuri; Njozi, Mustafa; Khatib, Rashid; Dodoo, Alexander N; Binka, Fred; Macq, Jean; D'Alessandro, Umberto; Speybroeck, Niko

2012-09-05

Drug prescription practices depend on several factors related to the patient, health worker and health facilities. A better understanding of the factors influencing prescription patterns is essential to develop strategies to mitigate the negative consequences associated with poor practices in both the public and private sectors. A cross-sectional study was conducted in rural Tanzania among patients attending health facilities, and health workers. Patients, health workers and health facilities-related factors with the potential to influence drug prescription patterns were used to build a model of key predictors. Standard data mining methodology of classification tree analysis was used to define the importance of the different factors on prescription patterns. This analysis included 1,470 patients and 71 health workers practicing in 30 health facilities. Patients were mostly treated in dispensaries. Twenty two variables were used to construct two classification tree models: one for polypharmacy (prescription of ≥3 drugs) on a single clinic visit and one for co-prescription of artemether-lumefantrine (AL) with antibiotics. The most important predictor of polypharmacy was the diagnosis of several illnesses. Polypharmacy was also associated with little or no supervision of the health workers, administration of AL and private facilities. Co-prescription of AL with antibiotics was more frequent in children under five years of age and the other important predictors were transmission season, mode of diagnosis and the location of the health facility. Standard data mining methodology is an easy-to-implement analytical approach that can be useful for decision-making. Polypharmacy is mainly due to the diagnosis of multiple illnesses.

Behavioral Patterns in Special Education. Good Teaching Practices

PubMed Central

Rodríguez-Dorta, Manuela; Borges, África

2017-01-01

Providing quality education means to respond to the diversity in the classroom. The teacher is a key figure in responding to the various educational needs presented by students. Specifically, special education professionals are of great importance as they are the ones who lend their support to regular classroom teachers and offer specialized educational assistance to students who require it. Therefore, special education is different from what takes place in the regular classroom, demanding greater commitment by the teacher. There are certain behaviors, considered good teaching practices, which teachers have always been connected with to achieve good teaching and good learning. To ensure that these teachers are carrying out their educational work properly it is necessary to evaluate. This means having appropriate instruments. The Observational Protocol for Teaching Functions in Primary School and Special Education (PROFUNDO-EPE, v.3., in Spanish) allows to capture behaviors from these professionals and behavioral patterns that correspond to good teaching practices. This study evaluates the behavior of two special education teachers who work with students from different educational stages and educational needs. It reveals that the analyzed teachers adapt their behavior according the needs and characteristics of their students to the students responding more adequately to the needs presented by the students and showing good teaching practices. The patterns obtained indicate that they offer support, help and clear guidelines to perform the tasks. They motivate them toward learning by providing positive feedback and they check that students have properly assimilated the contents through questions or non-verbal supervision. Also, they provide a safe and reliable climate for learning. PMID:28512437

Behavioral Patterns in Special Education. Good Teaching Practices.

PubMed

Rodríguez-Dorta, Manuela; Borges, África

2017-01-01

Providing quality education means to respond to the diversity in the classroom. The teacher is a key figure in responding to the various educational needs presented by students. Specifically, special education professionals are of great importance as they are the ones who lend their support to regular classroom teachers and offer specialized educational assistance to students who require it. Therefore, special education is different from what takes place in the regular classroom, demanding greater commitment by the teacher. There are certain behaviors, considered good teaching practices, which teachers have always been connected with to achieve good teaching and good learning. To ensure that these teachers are carrying out their educational work properly it is necessary to evaluate. This means having appropriate instruments. The Observational Protocol for Teaching Functions in Primary School and Special Education (PROFUNDO-EPE, v.3., in Spanish) allows to capture behaviors from these professionals and behavioral patterns that correspond to good teaching practices. This study evaluates the behavior of two special education teachers who work with students from different educational stages and educational needs. It reveals that the analyzed teachers adapt their behavior according the needs and characteristics of their students to the students responding more adequately to the needs presented by the students and showing good teaching practices. The patterns obtained indicate that they offer support, help and clear guidelines to perform the tasks. They motivate them toward learning by providing positive feedback and they check that students have properly assimilated the contents through questions or non-verbal supervision. Also, they provide a safe and reliable climate for learning.

Challenges in economic evaluation of new drugs: experience with rituximab in Hungary.

PubMed

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.

Factors influencing contraceptive behavior of single college students.

PubMed

Maxwell, J W; Sack, A R; Frary, R B; Keller, J F

1977-01-01

This study investigated the premarital contraceptive behavior of 222 male and female college students. Contraceptive practice was examined in relation to dating patterns, level of emotional involvement with the sex partner was heightened, the intercourse was planned, and the individual and prior sexual experience.

Technology and Youth

ERIC Educational Resources Information Center

Mesch, Gustavo S.

2012-01-01

Long-term studies monitoring the process of young people adopting new media patterns of social interaction and communication with parents and peers are needed to better understand how young people cope with perpetual peer communication, how parents and adolescents deal with intergenerational conflicts, and the outcomes of these practices and…

Residents' responses to wildland fire programs: a review of cognitive and behavioral studies

Treesearch

James D. Absher; Jerry J. Vaske; Lori B. Shelby

2009-01-01

A compilation and summary of four research studies is presented. They were aimed at developing a theoretical and practical understanding of homeowners’ attitudes and behaviors in the wildland-urban interface (WUI) in relation to the threat from wildland fires. Individual studies focused on models and methods that measured (1) value orientations (patterns of basic...

Use of culture care theory with Anglo- and African American elders in a long-term care setting.

PubMed

McFarland, M R

1997-01-01

The purpose of this study was to discover the care expressions, practices, and patterns of elderly Anglo- and African American elders. The domain of inquiry was the cultural care of elderly residents within the environmental context of a long-term care institution. The ethnonursing qualitative research method was used to conduct the study which was conceptualized within Leininger's theory of culture care diversity and universality. Four major themes were discovered: (a) Residents expressed and lived generic care to maintain their preadmission lifeways; (b) The nursing staff provided aspects of professional care to support satisfying lifeways for residents; (c) Institutional care patterns and expressions were viewed as a continuing life experience but with major differences between the apartment section and nursing home units; and (d) An institutional culture of the retirement home was discovered which reflected unique lifeways and shared care and health expressions and practices. These themes substantiated the culture care theory and revealed new modes of care for the elderly in an institutional setting.

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…

The malleability of infant motor development: cautions based on studies of child-rearing practices in Yucatan.

PubMed

Solomons, H C

1978-11-01

Tests with the Bayley Motor Scale were given to 288 infants, equally divided by sex, in Yucatan, Mexico. These were 2 to 54 weeks in age and came from three sociocultural levels. In comparison to USA infants, early acceleration of motor development was followed by a marked downward trend. This phenomenon, if observed in a single child, may indicate progressive neurologic disease. Child-rearing practices would appear to account for the difference in pattern of test performance.

Modifiers: Increasing Richness and Nuance of Design Pattern Languages

NASA Astrophysics Data System (ADS)

Kolfschoten, Gwendolyn L.; Briggs, Robert O.; Lukosch, Stephan

One of the challenges when establishing and maintaining a pattern language is to balance richness with simplicity. On the one hand, designers need a variety of useful design patterns to increase the speed of their design efforts and to reduce design risk. On the other hand, the greater the variety of design patterns in a language, the higher the cognitive load to remember and select among them. One solution to this problem is the concept of a modifier design pattern, a design pattern for pattern languages. A modifier pattern is a named, documented variation that can be applied to some set of other design patterns. They create similar, useful changes and refinements to the solutions derived from any pattern to which they are applied. The modifier concept, described in this paper emerged in a relatively new design pattern language for collaborative work practices in which the design patterns are called thinkLets. When analyzing the thinkLet pattern language, we found that many of the patterns we knew were variations and refinements of other patterns. However, we also found patterns in these variations; we found variations that could be applied to different patterns, with similar effects. We document these variations as modifiers. In this paper, we introduce the concept of modifier design patterns and illustrate the use of modifiers with two case studies.

Healthcare improvement as planned system change or complex responsive processes? a longitudinal case study in general practice

PubMed Central

2013-01-01

Background Interest in how to implement evidence-based practices into routine health care has never been greater. Primary care faces challenges in managing the increasing burden of chronic disease in an ageing population. Reliable prescriptions for translating knowledge into practice, however, remain elusive, despite intense research and publication activity. This study seeks to explore this dilemma in general practice by challenging the current way of thinking about healthcare improvement and asking what can be learned by looking at change through a complexity lens. Methods This paper reports the local level of an embedded case study of organisational change for better chronic illness care over more than a decade. We used interviews, document review and direct observation to explore how improved chronic illness care developed in one practice. This formed a critical case to compare, using pattern matching logic, to the common prescription for local implementation of best evidence and a rival explanation drawn from complexity sciences interpreted through modern sociology and psychology. Results The practice changed continuously over more than a decade to deliver better chronic illness care in line with research findings and policy initiatives – re-designing care processes, developing community linkages, supporting patient self-management, using guidelines and clinical information systems, and integrating nurses into the practice team. None of these improvements was designed and implemented according to an explicit plan in response to a documented gap in chronic disease care. The process that led to high quality chronic illness care exhibited clear complexity elements of co-evolution, non-linearity, self-organisation, emergence and edge of chaos dynamics in a network of agents and relationships where a stable yet evolving way of organizing emerged from local level communicative interaction, power relating and values based choices. Conclusions The current discourse of implementation science as planned system change did not match organisational reality in this critical case of improvement in general practice. Complexity concepts translated in human terms as complex responsive processes of relating fit the pattern of change more accurately. They do not provide just another fashionable blueprint for change but inform how researchers, policymakers and providers participate in improving healthcare. PMID:23617833

Pattern and Process in the Comparative Study of Convergent Evolution.

PubMed

Mahler, D Luke; Weber, Marjorie G; Wagner, Catherine E; Ingram, Travis

2017-08-01

Understanding processes that have shaped broad-scale biodiversity patterns is a fundamental goal in evolutionary biology. The development of phylogenetic comparative methods has yielded a tool kit for analyzing contemporary patterns by explicitly modeling processes of change in the past, providing neontologists tools for asking questions previously accessible only for select taxa via the fossil record or laboratory experimentation. The comparative approach, however, differs operationally from alternative approaches to studying convergence in that, for studies of only extant species, convergence must be inferred using evolutionary process models rather than being directly measured. As a result, investigation of evolutionary pattern and process cannot be decoupled in comparative studies of convergence, even though such a decoupling could in theory guard against adaptationist bias. Assumptions about evolutionary process underlying comparative tools can shape the inference of convergent pattern in sometimes profound ways and can color interpretation of such patterns. We discuss these issues and other limitations common to most phylogenetic comparative approaches and suggest ways that they can be avoided in practice. We conclude by promoting a multipronged approach to studying convergence that integrates comparative methods with complementary tests of evolutionary mechanisms and includes ecological and biogeographical perspectives. Carefully employed, the comparative method remains a powerful tool for enriching our understanding of convergence in macroevolution, especially for investigation of why convergence occurs in some settings but not others.

Learning alternative movement coordination patterns using reinforcement feedback.

PubMed

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.

Intercountry prevalences and practices of betel-quid use in south, southeast and eastern Asia regions and associated oral preneoplastic disorders: an international collaborative study by Asian betel-quid consortium of south and east Asia.

PubMed

Lee, Chien-Hung; Ko, Albert Min-Shan; Warnakulasuriya, Saman; Yin, Bang-Liang; Sunarjo; Zain, Rosnah Binti; Ibrahim, Salah Osman; Liu, Zhi-Wen; Li, Wen-Hui; Zhang, Shan-Shan; Kuntoro; Utomo, Budi; Rajapakse, Palandage Sunethra; Warusavithana, Supun Amila; Razak, Ishak Abdul; Abdullah, Norlida; Shrestha, Prashanta; Kwan, Aij-Lie; Shieh, Tien-Yu; Chen, Mu-Kuan; Ko, Ying-Chin

2011-10-01

Health risks stemming from betel-quid (BQ) chewing are frequently overlooked by people. Updated epidemiological data on the increased BQ use among Asian populations using comparable data collection methods have not been widely available. To investigate the prevalence, patterns of practice and associated types of oral preneoplastic disorders, an intercountry Asian Betel-quid Consortium study (the ABC study) was conducted for Taiwan, Mainland China, Malaysia, Indonesia, Nepal and Sri Lanka. A random sample of 8,922 subjects was recruited, and the data were analyzed using survey-data modules adjusted for the complex survey design. Chewing rates among men (10.7-43.6%) were significantly higher than women (1.8-34.9%) in Taiwan, Mainland China, Nepal and Sri Lanka, while women's rates (29.5-46.8%) were higher than that for men (9.8-12.0%) in Malaysia and Indonesia. An emerging, higher proportion of new-users were identified for Hunan in Mainland China (11.1-24.7%), where Hunan chewers have the unique practice of using the dried husk of areca fruit rather than the solid nut universally used by others. Men in the Eastern and South Asian study communities were deemed likely to combine chewing with smoking and drinking (5.6-13.6%). Indonesian women who chewed BQ exhibited the highest prevalence of oral lichen planus, oral submucous fibrosis and oral leukoplakia (9.1-17.3%). Lower schooling, alcohol drinking and tobacco smoking were identified as being associated with BQ chewing. In conclusion, the ABC study reveals the significant cultural and demographic differences contributing to practice patterns of BQ usage and the great health risks that such practices pose in the Asian region. Copyright © 2010 UICC.

Breathing simulator of workers for respirator performance test

PubMed Central

YUASA, Hisashi; KUMITA, Mikio; HONDA, Takeshi; KIMURA, Kazushi; NOZAKI, Kosuke; EMI, Hitoshi; OTANI, Yoshio

2014-01-01

Breathing machines are widely used to evaluate respirator performance but they are capable of generating only limited air flow patterns, such as, sine, triangular and square waves. In order to evaluate the respirator performance in practical use, it is desirable to test the respirator using the actual breathing patterns of wearers. However, it has been a difficult task for a breathing machine to generate such complicated flow patterns, since the human respiratory volume changes depending on the human activities and workload. In this study, we have developed an electromechanical breathing simulator and a respiration sampling device to record and reproduce worker’s respiration. It is capable of generating various flow patterns by inputting breathing pattern signals recorded by a computer, as well as the fixed air flow patterns. The device is equipped with a self-control program to compensate the difference in inhalation and exhalation volume and the measurement errors on the breathing flow rate. The system was successfully applied to record the breathing patterns of workers engaging in welding and reproduced the breathing patterns. PMID:25382381

Precipitation Based Malaria Patterns in the Amazon -- Will Deforestation Alter Risk?

NASA Astrophysics Data System (ADS)

Olson, S. H.; Durieux, L.; Elguero, E.; Foley, J.; Gagnon, R.; Guegan, J.; Patz, J.

2007-12-01

The World Health Organization, estimates that forty-two percent of malaria cases are "associated with policies and practices regarding land use, deforestation, water resource management, settlement siting and modified house design". This estimate was drawn from expert opinion and studies performed at local scales, but little research has investigated the cumulative impacts of land use and land cover changes occurring in the Amazon Basin on malaria. Much less is understood about the impact of changing land use and subsequent precipitation regimes on malaria risk. To understand how land use practices may alter malaria patterns in the Basin we present an analysis of municipio (n=755) malaria case data and monthly precipitation patterns between 1996 and 1999. Climate data originated from the CRU TS 2.1 half-degree grid resolution climate data set. We present a hierarchical (random coefficients) log-linear Poisson model relating malaria incidence to precipitation for both municipos and states. At the Basin scale precipitation and cases show strong relationships. Precipitation and cases are asynchronous across the period of observation, but detailed inspection of states and individual municipios reveal geographic dependencies of precipitation and malaria incidence. Future research will link the patterns of precipitation and malaria to anticipated changes in climate from deforestation in the Basin.

Evidence-based practice guideline of Chinese herbal medicine for primary open-angle glaucoma (qingfeng -neizhang)

PubMed Central

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

Prescribing pattern of psychotropic medications in child psychiatric practice in a mental referral hospital in Botswana

PubMed Central

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

Analysis of sex-specific injury patterns and risk factors in young high-level athletes.

PubMed

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.

Prospective-pricing strategies for hospital and departmental effectiveness: the physician's response.

PubMed

Shapleigh, C

1985-10-01

Physician-practice patterns are discussed, and programs of decentralization designed to reduce ancillary use are described. The New England Medical Center (NEMC) conducted a study with two other major hospitals in Boston comparing physician-practice patterns for patients who had had carotid endarterectomies. The indications for surgery for these patients did not appear to be different among the hospitals; however, average charges and length of stay varied considerably. Operating-room time and postoperative management also varied substantially. Strategies to change physician-practice patterns must address the issues of incentives to physicians and hospitals. At NEMC, a program of decentralization is being implemented that involves physician participation in budgeting hospital resources. A program of product pricing has been developed, whereby the NEMC offers an HMO a fixed price for certain kinds of cases upon admission. A daily use report was started to report resource use for specific cases compared with annual medians for that type of case. Case types from many different surgical specialties are involved. The reports show physicians the difference between the actual and expected costs in terms of variances. The NEMC has reoriented its budgeting process to include clinical divisions. Clinical services are planning to budget the use of intermediate products across different cost centers. The clinical budgeting program makes the planning process more objective, lowers the use of ancillary services, and reduces costs.

Foods served in child care facilities participating in the Child and Adult Care Food Program: Menu match and agreement with the new meal patterns and best practices

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...

HemoVision: An automated and virtual approach to bloodstain pattern analysis.

PubMed

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.

The Effects of Aging on the Neural Basis of Implicit Associative Learning in a Probabilistic Triplets Learning Task

ERIC Educational Resources Information Center

Simon, Jessica R.; Vaidya, Chandan J.; Howard, James H., Jr.; Howard, Darlene V.

2012-01-01

Few studies have investigated how aging influences the neural basis of implicit associative learning, and available evidence is inconclusive. One emerging behavioral pattern is that age differences increase with practice, perhaps reflecting the involvement of different brain regions with training. Many studies report hippocampal involvement early…

Effects of experimental canopy manipulation on amphibian egg deposition

Treesearch

Zachary I. Felix; Yong Wang; Callie J. Schweitzer

2010-01-01

Although effects of forest management on amphibians are relatively well studied, few studies have examined how these practices affect egg deposition by adults, which can impact population recruitment. We quantified the effects of 4 canopy tree-retention treatments on amphibian oviposition patterns in clusters of 60-L aquatic mesocosms located in each treatment. We also...

Language Policy and Literacy Practices in the Family: The Case of Ethiopian Parental Narrative Input

ERIC Educational Resources Information Center

Stavans, Anat

2012-01-01

The present study analyses the Family Language Policy (FLP) in regards language literacy development of children in Ethiopian immigrant families. Bridging the gap between linguistic literacy at home and at school hinders a smooth societal integration and a normative literacy development. This study describes the home literacy patterns shaped by…

A COMPARISON OF MATHEMATICS PROGRAMS FOR ABLE JUNIOR HIGH SCHOOL STUDENTS, VOLUME 1 - FINAL REPORT.

ERIC Educational Resources Information Center

GOLDBERG, MIRIAM L.; AND OTHERS

THE TALENTED YOUTH PROJECT (TYP) MATHEMATICS STUDY WAS DESIGNED AS A STUDY TO COMPARE THE EFFECTIVENESS OF VARIOUS CURRICULUM PATTERNS AND PRACTICES IN MATHEMATICS EDUCATION CURRENTLY USED WITH ACADEMICALLY TALENTED JUNIOR HIGH SCHOOL STUDENTS. THE SAMPLE CONSISTED OF 51 CLASSES AND 6 MATHEMATICS PROGRAMS. THE LORGE-THORNDIKE VERBAL INTELLIGENCE…

Information-Seeking Behaviour of Prospective Geography Teachers at the National University of Lesotho

ERIC Educational Resources Information Center

Bitso, Constance; Fourie, Ina

2014-01-01

Introduction: This paper reports a study on information-seeking behaviour of prospective geography teachers at the National University of Lesotho based on their experiences during teaching practice. It is part of a larger doctoral study on information needs and information-seeking patterns of secondary level geography teachers in Lesotho. Method:…

Aneurysm treatment practice patterns for newly appointed dual-trained cerebrovascular/endovascular neurosurgeons: Comparison of open surgical to neuroendovascular procedures in the first 2 years of academic practice.

PubMed

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

The practice patterns of a hybrid open cerebrovascular/neuroendovascular (CVNV) neurosurgeon in early academic practice is unknown. 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. 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. 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.

Critical thinking: Reported enhancers and barriers by nurses in long-term care: implications for staff development.

PubMed

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.

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.

Evaluation of the American college of surgeons thyroid and parathyroid ultrasound course: Results of a web-based survey.

PubMed

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.

Understanding the primary care paradigm: an experiential learning focus of the early veterinary graduate.

PubMed

Dixon, William H R; Kinnison, Tierney; May, Stephen A

2017-11-01

At a time where high levels of stress are reported in the veterinary profession, this study explores the challenges that veterinary graduates encounter when they enter general (first opinion) practice. Participants had written reflective accounts of their 'Most Puzzling Cases' for the postgraduate Professional Key Skills module of the Certificate in Advanced Veterinary Practice, offered by the Royal Veterinary College. Reasons that a case was puzzling, or became challenging, were thematically analysed. Fifteen summaries were analysed. Three core themes were identified: 'clinical reasoning', centred on the limitations of pattern recognition and the methods used to overcome this; the 'veterinary healthcare system', focusing on the need for continuity of care, time pressure and support in the transition to practice; and the 'owner', looking at the broader clinical skills needed to succeed in general practice. Clinical reasoning was raised as an issue; discussion of when pattern recognition is not appropriate and what to do in these cases was common. A lack of experience in general practice case types, and how to best operate in the resource-constrained environment in which they present, is the likely cause of this, suggesting that a greater focus on the primary care paradigm is needed within veterinary education. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Patterns of public participation.

PubMed

Slutsky, Jean; Tumilty, Emma; Max, Catherine; Lu, Lanting; Tantivess, Sripen; Hauegen, Renata Curi; Whitty, Jennifer A; Weale, Albert; Pearson, Steven D; Tugendhaft, Aviva; Wang, Hufeng; Staniszewska, Sophie; Weerasuriya, Krisantha; Ahn, Jeonghoon; Cubillos, Leonardo

2016-08-15

Purpose - The paper summarizes data from 12 countries, chosen to exhibit wide variation, on the role and place of public participation in the setting of priorities. The purpose of this paper is to exhibit cross-national patterns in respect of public participation, linking those differences to institutional features of the countries concerned. Design/methodology/approach - The approach is an example of case-orientated qualitative assessment of participation practices. It derives its data from the presentation of country case studies by experts on each system. The country cases are located within the historical development of democracy in each country. Findings - Patterns of participation are widely variable. Participation that is effective through routinized institutional processes appears to be inversely related to contestatory participation that uses political mobilization to challenge the legitimacy of the priority setting process. No system has resolved the conceptual ambiguities that are implicit in the idea of public participation. Originality/value - The paper draws on a unique collection of country case studies in participatory practice in prioritization, supplementing existing published sources. In showing that contestatory participation plays an important role in a sub-set of these countries it makes an important contribution to the field because it broadens the debate about public participation in priority setting beyond the use of minipublics and the observation of public representatives on decision-making bodies.

Describing spatial pattern in stream networks: A practical approach

USGS Publications Warehouse

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.

Diffuse nitrogen loss simulation and impact assessment of stereoscopic agriculture pattern by integrated water system model and consideration of multiple existence forms

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.

The Association between Acculturation and Dietary Patterns of South Asian Immigrants

PubMed Central

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

The association between acculturation and dietary patterns of South Asian immigrants.

PubMed

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.

Clinical reports of pulmonary metastasectomy for colorectal cancer: a citation network analysis

PubMed Central

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

Observation of Communication by Physical Education Teachers: Detecting Patterns in Verbal Behavior

PubMed Central

García-Fariña, Abraham; Jiménez-Jiménez, F.; Anguera, M. Teresa

2018-01-01

The aim of this study was to analyze the verbal behavior of primary school physical education teachers in a natural classroom setting in order to investigate patterns in social constructivist communication strategies before and after participation in a training program designed to familiarize teachers with these strategies. The participants were three experienced physical education teachers interacting separately with 65 students over a series of classes. Written informed consent was obtained from all the students' parents or legal guardians. An indirect observation tool (ADDEF) was designed specifically for the study within the theoretical framework, and consisted of a combined field format, with three dimensions, and category systems. Each dimension formed the basis for building a subsequent system of exhaustive and mutually exclusive categories. Twenty-nine sessions, grouped into two separate modules, were coded using the Atlas.ti 7 program, and a total of 1991 units (messages containing constructivist discursive strategies) were recorded. Analysis of intraobserver reliability showed almost perfect agreement. Lag sequential analysis, which is a powerful statistical technique based on the calculation of conditional and unconditional probabilities in prospective and retrospective lags, was performed in GSEQ5 software to search for verbal behavior patterns before and after the training program. At both time points, we detected a pattern formed by requests for information combined with the incorporation of students' contributions into the teachers' discourse and re-elaborations of answers. In the post-training phase, we detected new and stronger patterns in certain sessions, indicating that programs combining theoretical and practical knowledge can effectively increase teachers' repertoire of discursive strategies and ultimately promote active engagement in learning. This has important implications for the evaluation and development of teacher effectiveness in practice and formal education programs. PMID:29615943

Observation of Communication by Physical Education Teachers: Detecting Patterns in Verbal Behavior.

PubMed

García-Fariña, Abraham; Jiménez-Jiménez, F; Anguera, M Teresa

2018-01-01

The aim of this study was to analyze the verbal behavior of primary school physical education teachers in a natural classroom setting in order to investigate patterns in social constructivist communication strategies before and after participation in a training program designed to familiarize teachers with these strategies. The participants were three experienced physical education teachers interacting separately with 65 students over a series of classes. Written informed consent was obtained from all the students' parents or legal guardians. An indirect observation tool (ADDEF) was designed specifically for the study within the theoretical framework, and consisted of a combined field format, with three dimensions, and category systems. Each dimension formed the basis for building a subsequent system of exhaustive and mutually exclusive categories. Twenty-nine sessions, grouped into two separate modules, were coded using the Atlas.ti 7 program, and a total of 1991 units (messages containing constructivist discursive strategies) were recorded. Analysis of intraobserver reliability showed almost perfect agreement. Lag sequential analysis, which is a powerful statistical technique based on the calculation of conditional and unconditional probabilities in prospective and retrospective lags, was performed in GSEQ5 software to search for verbal behavior patterns before and after the training program. At both time points, we detected a pattern formed by requests for information combined with the incorporation of students' contributions into the teachers' discourse and re-elaborations of answers. In the post-training phase, we detected new and stronger patterns in certain sessions, indicating that programs combining theoretical and practical knowledge can effectively increase teachers' repertoire of discursive strategies and ultimately promote active engagement in learning. This has important implications for the evaluation and development of teacher effectiveness in practice and formal education programs.

Relilgious beliefs and practices of Taiwanese parents of pediatric patients with cancer.

PubMed

Yeh, C H

2001-12-01

The aim of this study was to increase understanding of religious beliefs and practices among Taiwanese parents of pediatric patients. Parents of 63 pediatric patients with cancer were interviewed to explore their related religious beliefs and practices, ie, worship at temple, drawing Chien, and divinations. Rituals were used to diminish the harmful effects of the child's disease, such as temple ceremonies, changing the child's name, and taking "Fu" water. Such practices were generally undertaken with a lack of medical guidance from oncologists largely because of poor interactions between parents and oncologists. The findings suggest that discovering a caregiver's worldview and cultural values is important to establish holistic nursing practices. Because immigrants increasingly move around the world, Taiwanese parents become a culturally diverse clientele for healthcare professionals who have to be aware of the existing cultural differences in healthcare values, patterns, and practices, particularly between Western and Eastern cultures.

Self-controlled practice enhances motor learning in introverts and extroverts.

PubMed

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.

The Rising Landscape: A Visual Exploration of Superstring Revolutions in Physics.

ERIC Educational Resources Information Center

Chen, Chaomei; Kuljis, Jasna

2003-01-01

Discussion of knowledge domain visualization focuses on practical issues concerning modeling and visualizing scientific revolutions. Studies growth patterns of specialties derived from citation and cocitation data on string theory in physics, using the general framework of Thomas Kuhn's structure of scientific revolutions. (Author/LRW)

Rural Practitioners' Involvement in Response to Intervention

ERIC Educational Resources Information Center

Cahill, Susan M.; McGuire, Beatriz; Krumdick, Nathaniel D.; Lee, Michelle M.

2015-01-01

Objective: This study describes perceived levels of involvement in school-based Response to Intervention (RtI) initiatives as reported by occupational therapy (OT) practitioners from different types of communities (i.e., rural, suburban, and urban). In addition, it identifies differences among practice patterns of rural OT practitioners, compared…

"Geriatricizing" Hospitalists: Identifying Educational Opportunities

ERIC Educational Resources Information Center

Friedman, Susan M.; Gillespie, Suzanne M.; Medina-Walpole, Annette M.; Caprio, Thomas V.; Karuza, Jurgis; McCann, Robert M.

2013-01-01

The objective of this study was to identify differences between geriatricians and hospitalists in caring for hospitalized older adults, so as to inform faculty development programs that have the goal of improving older patient care. Eleven hospitalists and 13 geriatricians were surveyed regarding knowledge, confidence, and practice patterns in…

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…

The numerical model of multi-layer insulation with a defined wrapping pattern immersed in superfluid helium

NASA Astrophysics Data System (ADS)

Malecha, Ziemowit; Lubryka, Eliza

2017-11-01

The numerical model of thin layers, characterized by a defined wrapping pattern can be a crucial element of many computational problems related to engineering and science. A motivating example is found in multilayer electrical insulation, which is an important component of superconducting magnets and other cryogenic installations. The wrapping pattern of the insulation can significantly affect heat transport and the performance of the considered instruments. The major objective of this study is to develop the numerical boundary conditions (BC) needed to model the wrapping pattern of thin insulation. An example of the practical application of the proposed BC includes the heat transfer of Rutherford NbTi cables immersed in super-fluid helium (He II) across thin layers of electrical insulation. The proposed BC and a mathematical model of heat transfer in He II are implemented in the open source CFD toolbox OpenFOAM. The implemented mathematical model and the BC are compared in the experiments. The study confirms that the thermal resistance of electrical insulation can be lowered by implementing the proper wrapping pattern. The proposed BC can be useful in the study of new patterns for wrapping schemes. The work has been supported by statutory funds from Polish Ministry for Science and Higher Education for the year of 2017.

Patients with persistent medically unexplained physical symptoms: a descriptive study from Norwegian general practice.

PubMed

Aamland, Aase; Malterud, Kirsti; Werner, Erik L

2014-05-29

Further research on effective interventions for patients with peristent Medically Unexplained Physical Symptoms (MUPS) in general practice is needed. Prevalence estimates of such patients are conflicting, and other descriptive knowledge is needed for development and evaluation of effective future interventions. In this study, we aimed to estimate the consultation prevalence of patients with persistent MUPS in general practice, including patients' characteristics and symptom pattern, employment status and use of social benefits, and the general practitioners' (GPs) management strategy. During a four-week period the participating Norwegian GPs (n=84) registered all consultations with patients who met a strict definition of MUPS (>3 months duration and function loss), using a questionnaire with simple tick-off questions. Analyses were performed with descriptive statistics for all variables and split analysis on gender and age. The GPs registered 526 patients among their total of 17 688 consultations, giving a consultation prevalence of persistent MUPS of 3%. The mean age of patients was 46 years, and 399 (76%) were women. The most frequent group of symptoms was musculoskeletal problems, followed by asthenia/fatigue. There was no significant gender difference in symptom pattern. Almost half of the patients were currently working (45%), significantly more men. The major GP management strategy was supportive counseling. A consultation prevalence rate of 3% implies that patients with persistent MUPS are common in general practice. Our study disclosed heterogeneity among the patients such as differences in employment status, which emphasizes the importance of personalized focus rather than unsubstantiated stereotyping of "MUPS patients" as a group.

Utilisation of a direct access echocardiography service by general practitioners in a remote and rural area--distance and rurality are not barriers to referral.

PubMed

Choo, Wai K; McGeary, Katie; Farman, Colin; Greyling, Andre; Cross, Stephen J; Leslie, Stephen J

2014-01-01

This study aimed to examine whether general practitioner (GP) practice locations in remote and rural areas affected the pattern of direct access echocardiography referral and to assess any variations in echocardiographic findings. All referrals made by all GP practices in the Scottish Highlands over a 36-month period were analysed. Referral patterns were examined according to distance and rurality based on the Scottish Government's Urban-Rural Classification. Reasons for referral and cardiac abnormality detection rates were also examined. In total, 1188 referrals were made from 49 different GP practices; range of referral rates was 0.3-20.1 per 1000 population with a mean of 6.5 referrals per 1000 population. Referral rates were not significantly different between urban and rural practices after correction for population size. There was no correlation between the referral rates and the distance from the centre (r2=0.004, p=0.65). The most common reason for referral was the presence of new murmur (46%). The most common presenting symptom was breathlessness (44%). Overall, 28% of studies had significant abnormal findings requiring direct input from a cardiologist. There was no clear relationship between referral rates and cardiac abnormality detection rates (r2=0.07, p=0.37). The average cardiac abnormality detection rate was 56%, (range 52-60%), with no variation based on rurality (p=0.891). In this cohort, rurality and distance were not barriers to an equitable direct access echocardiography service. Cardiac abnormality detection rates are consistent with that of other studies.

Simulating Spatial Growth Patterns in Developing Countries: A Case of Shama in the Western Region of Ghana.

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.

Factors Associated with the Economic Sustainability of the Registered Dental Hygienist in Alternative Practice.

PubMed

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.

Practice Patterns in the Treatment and Monitoring of Acute T Cell-Mediated Kidney Graft Rejection in Canada.

PubMed

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.

Comorbidity in ADHD: implications for research, practice, and DSM-V.

PubMed

Jensen, P S; Martin, D; Cantwell, D P

1997-08-01

Since the introduction of DSM-III/III-R, clinicians and investigators have shown increasing interest in the study of conditions comorbid with attention-deficit hyperactivity disorder (ADHD). Better understanding ADHD comorbidity patterns is needed to guide treatment, research and future classification approaches. The ADHD literature from the past 15 years was reviewed to (1) explore the most prevalent patterns of ADHD comorbidity; (2) examine the correlates and longitudinal predictors of comorbidity; and (3) determine the extent to which comorbid patterns convey unique information concerning ADHD etiology, treatment and outcomes. To identify potential new syndromes, the authors examined comorbid patterns based on eight validational criteria. The largest available body of literature concerned the comorbidity with ADHD and conduct disorder/aggression, with a substantially smaller amount of data concerning other comorbid conditions. In many areas the literature was sparse, and pertinent questions concerning comorbidity patterns remain unexplored. Nonetheless available data warrant the delineation of two new subclassifications of ADHD: (1) ADHD aggressive subtype, and (2) ADHD, anxious subtype. Additional studies of the frequency of comorbidity and associated factors are greatly needed to include studies of differential effects of treatment of children with various comorbid ADHD disorders, as well as of ADHD children who differ on etiological factors.

Macroscale patterns of synchrony identify complex relationships among spatial and temporal ecosystem drivers

USGS Publications Warehouse

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.

The Pattern and Loci of Training-Induced Brain Changes in Healthy Older Adults Are Predicted by the Nature of the Intervention

PubMed Central

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

A real-time, practical sensor fault-tolerant module for robust EMG pattern recognition.

PubMed

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.

Food avoidance and restriction in adults: a cross-sectional pilot study comparing patients from an immunology clinic to a general practice.

PubMed

Fitzgerald, Michael; Frankum, Brad

2017-01-01

With the introduction of avoidant/restrictive food intake disorder (ARFID) in the Diagnostic and Statistical Manual - fifth edition, there is an increased need to understand the prevalence and pattern of food avoidance and restriction in adults. High rates of food allergy and intolerance in immunology clinic populations, and subsequent high rates of elimination diets, place these individuals at a greater risk of developing pathological eating behaviours. This descriptive cross sectional pilot study aims to provide preliminary data on the prevalence and nature of food avoidance and restriction in an adult population, and to explore the reasons for this behaviour. A self-administered questionnaire was designed and distributed to adults presenting to an immunology clinic and a general practice over the course of 6 months to describe the prevalence and nature of avoidant and restrictive eating behaviours in this population. Pearson's chi square test was used to examine the strength of a potential link to a formal diagnosis of avoidant restrictive food intake disorder in these patients. A total of 102 completed questionnaires were used for data analysis. Food avoidance or restriction was detected in 81 respondents (79%), with rates not significantly higher in the immunology clinic group compared to the general practice group ( p  = .242). Food allergy and intolerance were the most common reasons for disturbed eating patterns. Life impact secondary to food avoidance and restriction was reported by 26% of respondents, with significantly higher rates observed in the immunology clinic cohort compared to the general practice ( p  = .011). Eating disturbances similar to those characteristic of ARFID are very common in adults. Food avoidance and restriction due to perceived food allergy and intolerance are significant reasons for such disordered eating patterns, particularly in an immunology clinic population. Further investigation is needed to determine if such eating behaviours are pathological and whether they qualify for a diagnosis of ARFID.

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...

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.…

Waiting to see the doctor. The impact of organizational structure on medical practice.

PubMed

Wolinsky, F D; Marder, W D

1983-05-01

In this article it is assessed whether or not the scheduling and office visit queues a patient faces depend upon the organizational structure of the physician's practice (i.e., does the physician practice in the fee-for-service system or in a health maintenance organization [HMO], and if in an HMO, in what type of an HMO). Data pooled from two national studies (N = 2448) reveal two major findings. First, although scheduling queues may be predicted from the organizational structure of physicians' practices and other factors, office queues appear to be more of a random phenomenon. Second, a distinct pattern emerges among the effects of the organizational structure of physicians' practices on patient queues, including 1) physicians in solo practice offer their patients the shortest queues, 2) physicians in group model HMOs maximize scheduling queues but minimize waiting room queues, 3) patient queues for physicians practicing in IPAs are no different from those of their counterparts in group-practice fee-for-service settings, and 4) patient queues for salaried physicians practicing in a predominantly salaried environment are among the longest. The implications of these findings are discussed with special reference to extent and future studies of the effects of organizational structure on medical practice.

A systematic review on the neural effects of music on emotion regulation: implications for music therapy practice.

PubMed

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.

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…

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…

Food for thought: an exploratory study of how physicians experience poor workplace nutrition

PubMed Central

2011-01-01

Background Nutrition is often a casualty of the busy work day for physicians. We aimed to explore physicians' views of their nutrition in the workplace including their perceptions of the impact of inadequate nutrition upon their personal wellness and their professional performance. Methods This is a qualitative study of a sample of 20 physicians practicing in a large urban teaching hospital. Semi-structured open ended interviews were conducted to explore physicians' views of workplace nutrition. The same physicians had agreed to participate in a related nutrition based wellness intervention study that compared nutritional intake and cognitive function during a day of usual nutrition patterns against another day with scheduled nutrition breaks. A second set of interviews was conducted after the intervention study to explore how participation in the intervention impacted these views. Detailed interview content notes were transcribed and analyzed independently with differences reconciled by discussion. Results At initial interview, participants reported difficulty accessing adequate nutrition at work, linking this deficit with emotional (irritable and frustrated), physical (tired and hungry), and cognitive (difficulty concentrating and poor decision making) symptoms. In addition to identifying practical barriers such as lack of time to stop and eat, inconvenient access to food and poor food choices, the physicians described how their sense of professionalism and work ethic also hinder their work nutrition practices. After participating in the intervention, most physicians reported heightened awareness of their nutrition patterns and intentions to improve their workplace nutrition. Conclusions Physicians report that inadequate workplace nutrition has a significant negative impact on their personal wellness and professional performance. Given this threat to health care delivery, health care organizations and the medical profession need to address both the practical and professional barriers identified. PMID:21333008

Dilemmas of reform: An exploration of science teachers' collective sensemaking of formative assessment practices

NASA Astrophysics Data System (ADS)

Heredia, Sara Catherine

Current reform efforts in science education call for significant shifts in how science is taught and learned. Teachers are important gatekeepers for reform, as they must enact these changes with students in their own classrooms. As such, professional development approaches need to be developed and studied to understand how teachers interpret and make instructional plans to implement these reforms. However, traditional approaches to studying implementation of reforms often draw on metrics such as time allotted to new activities, rather than exploring the ways in which teachers make sense of these reforms. In this dissertation I draw upon a body of work called sensemaking that has focused on locating learning in teachers' conversations in departmental work groups. I developed a conceptual and analytic framework to analyze how teachers make sense of reform given their local contexts and then used this framework to perform a case study of one group of teachers that participated in larger professional development project that examined the impact of a learning progression on science teachers' formative assessment practices. I draw upon videotapes of three years of monthly professional development meetings as my primary source of data, and used an ethnographic approach to identify dilemmas surfaced by teachers, sources of ambiguity and uncertainty, and patterns of and resources for teacher sensemaking. The case study reveals relationships between the type of dilemma surfaced by the teachers and different patterns of sensemaking for modification of teaching practices. When teachers expressed concerns about district or administrative requirements, they aligned their work in the professional development to those external forces. In contrast, teachers were able to develop and try out new practices when they perceived coherence between the professional development and school or district initiatives. These results underscore the importance of coherence between various components of teachers' work environments.

Disparities persist in nutrition policies and practices in Minnesota secondary schools.

PubMed

Caspi, Caitlin E; Davey, Cynthia; Nelson, Toben F; Larson, Nicole; Kubik, Martha Y; Coombes, Brandon; Nanney, Marilyn S

2015-03-01

Access to healthy foods among secondary school students is patterned by individual-level socioeconomic status, but few studies have examined how school nutrition policies and practices are patterned by school-level characteristics. The objective of our study was to examine school nutrition policies and practices by school characteristics (eg, location, racial/ethnic composition, and free/reduced priced lunch eligibility) in Minnesota secondary schools between 2008 and 2012. Data from the 2008 to 2012 Minnesota School Health Profiles survey were used to assess school nutrition policies and practices, and National Center for Educational Statistics data were used for school characteristics (n=505 secondary schools). Nutrition policies and practices included the availability of low-nutrient, energy dense (LNED) items, strategies to engage students in healthy eating, and restrictions on advertisements of LNED products in areas around the school. Among school-level characteristics, school location was most strongly related to school nutrition policies. Across all years, city schools were less likely than town/rural schools to have vending machines/school stores (prevalence difference [PD] -13.7, 95% CI -25.0 to -2.3), and less likely to sell sport drinks (PD -36.3, 95% CI -51.8 to -20.7). City schools were also more likely to prohibit advertisements for LNED products in school buildings (PD 17.7, 95% CI 5.5 to 29.9) and on school grounds (PD 15.6, 95% CI 1.7 to 29.5). Between 2008 and 2012, the prevalence of some healthy eating policies/practices (eg, limiting salty snacks, offering taste testing, and banning unhealthy food advertisements in school publications) declined in city schools only, where these policies/practices had previously been more common. Monitoring of these trends is needed to understand the influence of these policies on student outcomes across school settings. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Disassortative mixing patterns of drug-using and sex networks on HIV risk behaviour among young drug users in Yunnan, China.

PubMed

Li, J; Luo, J; Li, J; Liu, H

2015-09-01

The dominant mode of HIV transmission in China has changed from injection drug use to sexual contact. The objectives of this study were to describe the disassortative and assortative mixing patterns of drug-using and sex networks among young drug users in China. Cross-sectional study. Respondent-driven sampling (RDS) was used to recruit young drug users in an egocentric network study in Yunnan, China. Egos were categorized as having disassortative mixing network patterns if they reported both sex and drug-using networks. Egos who only had a sex network (no drug-using network), or only a drug-using network (no sex network) were categorized as having assortative mixing network patterns. Multiple logistic regression was performed to analyze the relationships between disassortative patterns with risky sexual behaviour and drug-using practices. A total of 426 participants were recruited into the study. Two hundred forty-two egos reported disassortative mixing patterns and 139 egos had assortative patterns. The RDS-adjusted proportion of having a disassortative pattern was 53.2%. Participants with disassortative patterns were more likely to engage in HIV risk behaviour compared to those with assortative patterns. Specifically, drug users with disassortative patterns reported more multiple sex partners (31.4% vs 19.6%), concurrent partnerships (52.1% vs 39.0%), non-regular sex partners (12.0% vs 4.3%), and sex partners who were IDUs (24.9% vs 12.5%). Consistent condom use with regular or non-regular partners was low (between 18.9% and 47.2%) regardless of the mixing pattern. However, parenteral risk for HIV transmission was relatively low in both groups. The transition of the HIV epidemic in China from injection drug use to sexual contact may be attributed to disassortative mixing in drug-use and sexual networks. HIV programs should consider disassortative mixing patterns when designing new behavioural interventions. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

A descriptive study of employment patterns and work environment outcomes of specialist nurses in Canada.

PubMed

Doran, Diane; Duffield, Christine; Rizk, Paul; Nahm, Sang; Chu, Charlene H

2014-01-01

The purpose was to describe the number, demographic characteristics, work patterns, exit rates, and work perceptions of nurses in Ontario, Canada, in 4 specialty classifications: advanced practice nurse (APN)-clinical nurse specialist (CNS), APN-other, primary healthcare nurse practitioner [RN(extended class [EC])], and registered nurse (RN) with specialty certification. The objectives were to (1) describe how many qualified nurses are available by specialty class; (2) create a demographic profile of specialist nurses; (3) determine the proportions of specialist and nonspecialist nurses who leave (a) direct patient care and (b) nursing practice annually; (4) determine whether specialist and nonspecialist nurses differ in their self-ratings of work environment, job satisfaction, and intention to remain in nursing. Employment patterns refer to nurses' employment status (eg, full-time, part-time, casual), work duration (ie, length of employment in nurses and in current role), and work transitions (ie, movement in and out of the nursing workforce, and movement out of current role). A longitudinal analysis of the Ontario nurses' registration database from 2005 to 2010 and a survey of specialist nurses in Canada was conducted. The setting was Canada. The database sample consisted of 3 specialist groups, consisting of RN(EC), CNS, and APN-other, as well as 1 nonspecialist RN staff nurse group. The survey sample involved 359 nurses who were classified into groups based on self-reported job title and RN specialty-certification status. Data sources included College of Nurses of Ontario registration database and survey data. The study measures were the Nursing Work Index, a 4-item measure of job satisfaction, and 1-item measure of intent to leave current job. Nurses registered with the College of Nurses of Ontario were tracked over the study period to identify changes in their employment status with comparisons made between nurses employed in specialist roles and those registered as general staff nurses. Analysis involved descriptive summaries, mean comparisons with independent-samples t test, and χ(2) tests for categorical data. Exit rates from direct practice were highest for APN-other (7.6%) and CNS (6.2%) and lowest for RN(EC) (1.0%) and staff nurses (1.2%). χ(2) Tests indicated yearly exit rates of both APN-other and CNS nurse groups were significantly higher than those of staff nurses in all years evaluated (α = .025). Every specialist employment group scored significantly higher than staff nurses on measures of work environment and satisfaction outcomes. We provided a description of specialist nurses in Ontario and examined the relationship between specialization and employment patterns of nurses to inform nurse retention strategies in the future. Employment in specialist nursing positions is significantly associated with differences in transitions or exits from nursing among the specialist and nonspecialist groups. Registered nurses (EC) displayed improved retention characteristics compared with staff nurses. Advanced practice nurse-other and APN-CNS exit rates from nursing practice in Ontario were comparable to staff nurses, but exit rates from direct clinical practice roles were higher than those of staff nurses. Targeted strategies are required to retain CNS and APN-other in direct clinical practice roles.

Dental family stress and coping patterns.

PubMed

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.

Smartphone Usage Patterns by Canadian Neurosurgery Residents: A National Cross-Sectional Survey.

PubMed

Kameda-Smith, Michelle Masayo; Iorio-Morin, Christian; Winkler-Schwartz, Alexander; Ahmed, Uzair S; Bergeron, David; Bigder, Mark; Dakson, Ayoub; Elliott, Cameron A; Guha, Daipayan; Lavergne, Pascal; Makarenko, Serge; Taccone, Michael S; Tso, Michael; Wang, Bill; Fortin, David

2018-03-01

Smartphones and their apps are used ubiquitously in medical practice. However, in some cases their use can be at odds with current patient data safety regulations such as Canada's Personal Health Information Protection Act of 2004. To assess current practices and inform mobile application development, we sought to better understand mobile device usage patterns among Canadian neurosurgery residents. Through the Canadian Neurosurgery Research Collaborative, an online survey characterizing smartphone ownership and usage patterns was developed and sent to all Canadian neurosurgery resident in April of 2016. Questionnaires were collected and completed surveys analyzed. Of 146 eligible residents, 76 returned completed surveys (52% response rate). Of these 99% of respondents owned a smartphone, with 79% running on Apple's iOS. Four general mobile uses were identified: 1) communication between members of the medical team, 2) decision support, 3) medical reference, and 4) documentation through medical photography. Communication and photography were areas where the most obvious breaches in the Canadian Personal Health Information Protection Act were noted, with 89% of respondents taking pictures of patients' radiologic studies and 75% exchanging them with Short Message System. Hospital policies had no impact on user behaviors. Smartphones are used daily by most neurosurgery residents. Identified usage patterns are associated with perceived gains in efficacy and challenges in privacy and data reliability. We believe creating and improving workflows that address these usage patterns has a greater potential to improve privacy than changing policies and enforcing regulations. Copyright © 2017 Elsevier Inc. All rights reserved.

Physicians' opinions and clinical practice patterns for actinic keratosis management in Italy.

PubMed

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.

Post-task Effects on EEG Brain Activity Differ for Various Differential Learning and Contextual Interference Protocols

PubMed Central

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

Changes in pathology test ordering by early career general practitioners: a longitudinal study.

PubMed

Magin, Parker J; Tapley, Amanda; Morgan, Simon; Henderson, Kim; Holliday, Elizabeth G; Davey, Andrew R; Ball, Jean; Catzikiris, Nigel F; Mulquiney, Katie J; van Driel, Mieke L

2017-07-17

To assess the number of pathology tests ordered by general practice registrars during their first 18-24 months of clinical general practice. Longitudinal analysis of ten rounds of data collection (2010-2014) for the Registrar Clinical Encounters in Training (ReCEnT) study, an ongoing, multicentre, cohort study of general practice registrars in Australia. The principal analysis employed negative binomial regression in a generalised estimating equations framework (to account for repeated measures on registrars).Setting, participants: General practice registrars in training posts with five of 17 general practice regional training providers in five Australian states. The registrar participation rate was 96.4%. Number of pathology tests requested per consultation. The time unit for analysis was the registrar training term (the 6-month full-time equivalent component of clinical training); registrars contributed data for up to four training terms. 876 registrars contributed data for 114 584 consultations. The number of pathology tests requested increased by 11% (95% CI, 8-15%; P < 0.001) per training term. Contrary to expectations, pathology test ordering by general practice registrars increased significantly during their first 2 years of clinical practice. This causes concerns about overtesting. As established general practitioners order fewer tests than registrars, test ordering may peak during late vocational training and early career practice. Registrars need support during this difficult period in the development of their clinical practice patterns.

Innovative gait robot for the repetitive practice of floor walking and stair climbing up and down in stroke patients

PubMed Central

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

Innovative gait robot for the repetitive practice of floor walking and stair climbing up and down in stroke patients.

PubMed

Hesse, Stefan; Waldner, Andreas; Tomelleri, Christopher

2010-06-28

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. 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. 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. 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.

Clinician Adoption Patterns and Patient Outcome Results in Use of Evidence-Based Nursing Plans of Care

PubMed Central

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

The costs of parental pressure to express emotions: conditional regard and autonomy support as predictors of emotion regulation and intimacy.

PubMed

Roth, Guy; Assor, Avi

2012-08-01

This research focuses on offspring's perceptions of their parents' usage of conditional regard and autonomy-supportive practices in response to the offspring's experiences of negative emotion. Participants were 174 college students (60% were females). As predicted from self-determination theory (Ryan & Deci, 2000), students' perceptions of parents as hinging their regard on students' expression or suppression of negative emotions predicted a maladaptive pattern of emotion regulation and intimacy capacity. In contrast, autonomy-supportive parenting predicted more adaptive emotion regulation and intimacy patterns. Also as predicted, emotion-regulation mode mediated the relations between parental practices and intimacy capacity. The innovative aspect of the study is the finding that parents who use conditional regard to encourage children's expression (sharing) of negative emotions may actually undermine their children's socioemotional capacities. Copyright © 2011 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Factors Influencing Contraceptive Behavior of Single College Students

ERIC Educational Resources Information Center

Maxwell, Joseph W.; And Others

1977-01-01

This study investigates the premarital contraceptive behavior of 222 male and female college students. Contraceptive practice was examined in relation to dating patterns, level of emotional involvement with sex partners, types of birth control used, number of different sex partners, and reasons for failure to use birth control. (Author)

Longitudinal Variability in Streamwater Chemistry and Carbon and Nitrogen Fluxes in Restored and Degraded Urban Stream Networks

EPA Science Inventory

Stream restoration has increasingly been used as a best management practice for improving water quality in urbanizing watersheds, yet few data exist to assess restoration effectiveness. This study examined the longitudinal patterns in carbon and nitrogen concentrations and mass ...

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…

Classroom Groups in Theory and Practice.

ERIC Educational Resources Information Center

Boydell, Deanne

1979-01-01

This article examines some British classroom studies and raises further research questions on small group instruction (SGI) as a teaching tool. Considered are teachers' use of SGI; its efficacy for cognitive, language, and social development; and student-to-student interaction patterns in relation to seating, sex, and ability mix. (SJL)

Status Report on Speech Research, January-June 1989.

ERIC Educational Resources Information Center

Studdert-Kennedy, Michael, Ed.

One of a series of semiannual reports, this publication contains 14 articles which report the status and progress of studies on the nature of speech, instrumentation for its investigation, and practical applications. The titles of the articles and their authors are as follows: "Gestural Structure and Phonological Patterns" (Catherine P.…

Integrating space and time: A case for phenological context in grazing studies and management

USDA-ARS?s Scientific Manuscript database

In water-limited landscapes, patterns in primary production are highly variable across space and time. Livestock grazing is a common agricultural practice worldwide and a concern is localized overuse of specific pasture resources that can exacerbate grass losses and soil erosion. On a research ranch...

Kindergarten Children's Interactions with Touchscreen Mathematics Virtual Manipulatives: An Innovative Mixed Methods Analysis

ERIC Educational Resources Information Center

Tucker, Stephen I.; Lommatsch, Christina W.; Moyer-Packenham, Patricia S.; Anderson-Pence, Katie L.; Symanzik, Jürgen

2017-01-01

The purpose of this study was to examine patterns of mathematical practices evident during children's interactions with touchscreen mathematics virtual manipulatives. Researchers analyzed 33 Kindergarten children's interactions during activities involving apps featuring mathematical content of early number sense or quantity in base ten, recorded…

Theory, Method and Practice of Neuroscientific Findings in Science Education

ERIC Educational Resources Information Center

Liu, Chia-Ju; Chiang, Wen-Wei

2014-01-01

This report provides an overview of neuroscience research that is applicable for science educators. It first offers a brief analysis of empirical studies in educational neuroscience literature, followed by six science concept learning constructs based on the whole brain theory: gaining an understanding of brain function; pattern recognition and…

Changes in Teachers' Beliefs and Practices in Technology-Rich Classrooms.

ERIC Educational Resources Information Center

Dwyer, David C.; And Others

1991-01-01

The Apple Classrooms of Tomorrow (ACOT) project is a flexible consortium of researchers, educators, students, and parents who have worked collaboratively to create and study innovative learning environments since 1985. ACOT classrooms are true multimedia environments where students move from competitive work patterns toward collaborative ones. (10…

Maternal Socialization and Kindergarten Children's Behaviors from Jordanian Mothers' and Teachers' Perspectives

ERIC Educational Resources Information Center

Abu Al Rub, Majedah Fawzy; Rababaeh, Ebtesam Qasim; Mustafa, Intisar Ghazy

2017-01-01

This study investigated whether Jordanian mothers' self-reported parenting practices were associated with their kindergarten children's prosocial or anti-social behavior based on three parental patterns: nurturance, respect, and power assertion. The participants were 95 mothers with children in the kindergarten level in Jordan. Additionally, 13…

Nordic Walking Practice Might Improve Plantar Pressure Distribution

ERIC Educational Resources Information Center

Perez-Soriano, Pedro; Llana-Belloch, Salvador; Martinez-Nova, Alfonso; Morey-Klapsing, G.; Encarnacion-Martinez, Alberto

2011-01-01

Nordic walking (NW), characterized by the use of two walking poles, is becoming increasingly popular (Morgulec-Adamowicz, Marszalek, & Jagustyn, 2011). We studied walking pressure patterns of 20 experienced and 30 beginner Nordic walkers. Plantar pressures from nine foot zones were measured during trials performed at two walking speeds (preferred…

Influence of shifting cultivation practices on soil-plant-beetle interactions.

PubMed

Ibrahim, Kalibulla Syed; Momin, Marcy D; Lalrotluanga, R; Rosangliana, David; Ghatak, Souvik; Zothansanga, R; Kumar, Nachimuthu Senthil; Gurusubramanian, Guruswami

2016-08-01

Shifting cultivation (jhum) is a major land use practice in Mizoram. It was considered as an eco-friendly and efficient method when the cycle duration was long (15-30 years), but it poses the problem of land degradation and threat to ecology when shortened (4-5 years) due to increased intensification of farming systems. Studying beetle community structure is very helpful in understanding how shifting cultivation affects the biodiversity features compared to natural forest system. The present study examines the beetle species diversity and estimates the effects of shifting cultivation practices on the beetle assemblages in relation to change in tree species composition and soil nutrients. Scarabaeidae and Carabidae were observed to be the dominant families in the land use systems studied. Shifting cultivation practice significantly (P < 0.05) affected the beetle and tree species diversity as well as the soil nutrients as shown by univariate (one-way analysis of variance (ANOVA), correlation and regression, diversity indices) and multivariate (cluster analysis, principal component analysis (PCA), detrended correspondence analysis (DCA), canonical variate analysis (CVA), permutational multivariate analysis of variance (PERMANOVA), permutational multivariate analysis of dispersion (PERMDISP)) statistical analyses. Besides changing the tree species composition and affecting the soil fertility, shifting cultivation provides less suitable habitat conditions for the beetle species. Bioindicator analysis categorized the beetle species into forest specialists, anthropogenic specialists (shifting cultivation habitat specialist), and habitat generalists. Molecular analysis of bioindicator beetle species was done using mitochondrial cytochrome oxidase subunit I (COI) marker to validate the beetle species and describe genetic variation among them in relation to heterogeneity, transition/transversion bias, codon usage bias, evolutionary distance, and substitution pattern. The present study revealed the fact that shifting cultivation practice significantly affects the beetle species in terms of biodiversity pattern as well as evolutionary features. Spatiotemporal assessment of soil-plant-beetle interactions in shifting cultivation system and their influence in land degradation and ecology will be helpful in making biodiversity conservation decisions in the near future.

International Differences in the Location and Use of Arteriovenous Accesses Created for Hemodialysis: Results From the Dialysis Outcomes and Practice Patterns Study (DOPPS).

PubMed

Pisoni, Ronald L; Zepel, Lindsay; Fluck, Richard; Lok, Charmaine E; Kawanishi, Hideki; Süleymanlar, Gültekin; Wasse, Haimanot; Tentori, Francesca; Zee, Jarcy; Li, Yun; Schaubel, Douglas; Burke, Steven; Robinson, Bruce

2018-04-01

Vascular access practice is strongly associated with clinical outcomes. There is substantial international variation in the use of arteriovenous fistulas (AVFs) and grafts (AVGs), as well as AVF maturation time and location. Prospective cohort study. Hemodialysis patients participating in the prospective Dialysis Outcomes and Practice Patterns Study (DOPPS) from the United States, Japan, and Europe/ANZ (Belgium, France, Germany, Italy, Spain, Sweden, United Kingdom, Australia, and New Zealand), including 3,850 patients receiving 4,247 new AVFs and 842 patients receiving 1,129 new AVGs in 2009 to 2015. AVF location trends were based on 38,868 AVFs recorded in DOPPS 1 to 5 cross-sections (1996-2015). Demographics, comorbid conditions, dialysis vintage, body mass index, facility percentage AVF use, median blood flow rate, and AVF location. AVF location; successful AVF/AVG use (≥30 days of continuous use); time-to-first successful AVF/AVG use (maturation). During DOPPS 1 to 5, the percentage of AVFs created in the lower arm was consistently ≥93% in Japan and 65% to 77% in Europe/ANZ, but in the United States, this value declined from 70% (DOPPS 1) to 32% (DOPPS 5). Patient characteristics associated with AVF location differed by region. Successful AVF use was 87% in Japan, 67% in Europe/ANZ, and 64% in the United States, whereas successful AVG use was 86%, 75%, and 78%, respectively. Successful AVF use was greater for upper- versus lower-arm AVFs in the United States, with little difference in Europe/ANZ and the opposite pattern in Japan. Median time until first successful AVF use was 10 days in Japan, 46 days in Europe/ANZ, and 82 days in United States; until first successful AVG use: 6, 24, and 29 days, respectively. Potential measurement error related to chart data abstraction in multiple hemodialysis facilities. Large international differences exist in AVF location, predictors of AVF location, successful use of AVFs, and time to first AVF/AVG use, challenging what constitutes best practice. The large US shift from lower- to upper-arm AVFs raises serious concerns about long-term health implications for some patients and how policies and practices aimed at increasing AVF use have affected AVF placement location. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

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…

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.

Patterns of functional vision loss in glaucoma determined with archetypal analysis

PubMed Central

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

Pattern Recognition Using Artificial Neural Network: A Review

NASA Astrophysics Data System (ADS)

Kim, Tai-Hoon

Among the various frameworks in which pattern recognition has been traditionally formulated, the statistical approach has been most intensively studied and used in practice. More recently, artificial neural network techniques theory have been receiving increasing attention. The design of a recognition system requires careful attention to the following issues: definition of pattern classes, sensing environment, pattern representation, feature extraction and selection, cluster analysis, classifier design and learning, selection of training and test samples, and performance evaluation. In spite of almost 50 years of research and development in this field, the general problem of recognizing complex patterns with arbitrary orientation, location, and scale remains unsolved. New and emerging applications, such as data mining, web searching, retrieval of multimedia data, face recognition, and cursive handwriting recognition, require robust and efficient pattern recognition techniques. The objective of this review paper is to summarize and compare some of the well-known methods used in various stages of a pattern recognition system using ANN and identify research topics and applications which are at the forefront of this exciting and challenging field.

Factors affecting self-regulatory driving practices among older adults.

PubMed

Molnar, Lisa J; Charlton, Judith L; Eby, David W; Langford, Jim; Koppel, Sjaan; Kolenic, Giselle E; Marshall, Shawn

2014-01-01

The primary objective of this study was to better understand how self-regulatory driving practices at multiple levels of driver decision making are influenced by various factors. Specifically, the study investigated patterns of tactical and strategic self-regulation among a sample of 246 Australian older drivers. Of special interest was the relative influence of several variables on the adoption of self-regulation, including self-perceptions of health, functioning, and abilities for safe driving and driving confidence and comfort. The research was carried out at the Monash University Accident Research Centre, as part of its Ozcandrive study, a partnership with the Canadian Driving Research Initiative for Vehicular Safety in the Elderly (Candrive), and in conjunction with the University of Michigan Transportation Research Institute (UMTRI). Candrive/Ozcandrive represents the first study to follow a large group of older drivers over several years and collect comprehensive self-reported and objectively derived data on health, functioning, and driving. This study used a subset of data from the Candrive/Ozcandrive study. Upon enrolling in the study, participants underwent a comprehensive clinical assessment during which data on visual, cognitive, and psychomotor functioning were collected. Approximately 4 months after study enrollment, participants completed the Advanced Driving Decisions and Patterns of Travel (ADDAPT) questionnaire, a computer-based self-regulation instrument developed and pilot-tested at UMTRI. Self-regulation among older adults was found to be a multidimensional concept. Rates of self-regulation were tied closely to specific driving situations, as well as level of decision making. In addition, self-regulatory practices at the strategic and tactical levels of decision making were influenced by different sets of factors. Continuing efforts to better understand the self-regulatory practices of older drivers at multiple levels of driver performance and decision making should provide important insights into how the transition from driving to nondriving can be better managed to balance the interdependent needs of public safety and personal mobility.

Single-room usage patterns and allocation decision-making in an Australian public hospital: a sequential exploratory study.

PubMed

Bloomer, Melissa J; Lee, Susan F; Lewis, David P; Biro, Mary Anne; Moss, Cheryle

2016-08-01

The aims are to (1) measure occupancy rates of single and shared rooms; (2) compare single room usage patterns and (3) explore the practice, rationale and decision-making processes associated with single rooms; across one Australian public health service. There is a tendency in Australia and internationally to increase the proportion of single patient rooms in hospitals. To date there have been no Australian studies that investigate the use of single rooms in clinical practice. This study used a sequential exploratory design with data collected in 2014. A descriptive survey was used to measure the use of single rooms across a two-week time frame. Semi-structured interviews were undertaken with occupancy decision-makers to explore the practices, rationale decision-making process associated with single-room allocation. Total bed occupancy did not fall below 99·4% during the period of data collection. Infection control was the primary reason for patients to be allocated to a single room, however, the patterns varied according to ward type and single-room availability. For occupancy decision-makers, decisions about patient allocation was a complex and challenging process, influenced and complicated by numerous factors including occupancy rates, the infection status of the patient/s, funding and patient/family preference. Bed moves were common resulting from frequent re-evaluation of need. Apart from infection control mandates, there was little tangible evidence to guide decision-making about single-room allocation. Further work is necessary to assist nurses in their decision-making. There is a trend towards increasing the proportion of single rooms in new hospital builds. Coupled with the competing clinical demands for single room care, this study highlights the complexity of nursing decision-making about patient allocation to single rooms, an issue urgently requiring further attention. © 2016 John Wiley & Sons Ltd.

Study of menstrual patterns in adolescent girls with disabilities in a residential institution.

PubMed

Joshi, Ganesh Arun; Joshi, Prajakta Ganesh

2015-02-01

The gynecological health needs of girls with disabilities is an issue related to their rights as individuals. The objective of this study is to describe the menstrual pattern of girls with disabilities. A descriptive study was undertaken on thirty girls with different types of disabilities in a residential institution. The diagnosis, type of disability, secondary sexual characters, age at menarche, menstrual pattern and practice of menstrual hygiene was noted. The girls with intellectual disabilities had later age of menarche, irregular cycles and more behaviour problems. The girls with hearing impairment and locomotor disabilities had normal menstrual pattern. The girl with low vision had earlier menarche and regularized cycles. Girls with normal intelligence and mild intellectual disabilities were independent in maintaining menstrual hygiene. The menstrual disorders are managed conservatively in accordance with latest guidelines. Onset of menarche is towards the extremes of normal age range in girls with intellectual disabilities or visual impairment but not in girls with hearing impairments or locomotor disabilities. Girls with disabilities have potential for independent menstrual care. Menstrual disorders were managed conservatively.

Health spending in the 1980's: Integration of clinical practice patterns with management

PubMed Central

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

"It's Different Now:" How Exit Exams Are Affecting Teaching and Learning in Jackson and Austin

ERIC Educational Resources Information Center

Zabala, Dalia; Minnici, Angela; Kober, Nancy, Ed.

2007-01-01

Since much of the previous research on exit exams, including CEP's own work, has looked at national patterns of implementation and passing rates, this study aimed to benefit policy and practice by focusing on the local level. Specifically, case studies were conducted in Jackson, MS and Austin, TX that examined how classroom instruction and other…

Examining the Sustainability of Teacher Learning Following a Year-Long Science Professional Development Programme for Inservice Primary School Teachers

ERIC Educational Resources Information Center

Drits-Esser, Dina; Gess-Newsome, Julie; Stark, Louisa A.

2017-01-01

This two-year, mixed-methods study explored teacher learning during a year-long professional development programme and during the year following the programme. The study examined patterns of change in primary school teachers' inquiry practices, inquiry beliefs and physical science content knowledge during both years as well as the effects of…

Online Education: Analysis of Interaction and Knowledge Building Patterns among Foreign Language Teachers

ERIC Educational Resources Information Center

Celentin, Paola

2007-01-01

In this article we discuss findings from a case-study related to the distance education of teachers of Italian as a second/foreign language. This case-study has examined interactions among teachers during their discussions in a web-forum exploiting the model of content analysis proposed in the "Practical Inquiry Model" by Garrison, Anderson, and…

Comments from the Classroom: A Case Study of a Generation-1.5 Student in a University IEP and beyond

ERIC Educational Resources Information Center

Vasquez, Camilla

2007-01-01

This case study examines the patterns of participation of one US-educated refugee student in a university intensive English program (IEP). Specifically, I illustrate how the focal student used her advanced oral proficiency and prior experience with US educational norms and practices to engage in various interactional behaviours, such as shifting…

Teacher Enactment Patterns: How Can We Help Move All Teachers to Reform-Based Inquiry Practice through Professional Development?

ERIC Educational Resources Information Center

Lotter, Christine; Rushton, Gregory T.; Singer, Jonathan

2013-01-01

The purpose of this study was to investigate high school teachers' beliefs about inquiry instruction and determine how their beliefs influenced their use of inquiry after a professional development program. Thirty-six high school science teachers participated in this study. The professional development program consisted of a 2-week summer…

Diverse Pathways in Early Childhood Professional Development: An Exploration of Early Educators in Public Preschools, Private Preschools, and Family Child Care Homes

PubMed Central

Fuligni, Allison Sidle; Howes, Carollee; Lara-Cinisomo, Sandraluz; Karoly, Lynn

2009-01-01

This paper presents a naturalistic investigation of the patterns of formal education, early childhood education training, and mentoring of a diverse group of urban early childhood educators participating in the Los Angeles: Exploring Children's Early Learning Settings (LA ExCELS) study. A total of 103 preschool teachers and family child care providers serving primarily low-income 3- and 4-year-old children in Los Angeles County provided data on their education, training, and beliefs about teaching. This sample worked in public center based preschool programs including Head Start classrooms and State preschool classrooms (N=42), private non-profit preschools including community based organizations and faith-based preschools (N=42), and licensed family child care homes (N=19). This study uses a person-centered approach to explore patterns of teacher preparation, sources of support, supervision, and mentoring across these 3 types of education settings, and how these patterns are associated with early childhood educators' beliefs and practices. Findings suggest a set of linkages between type of early education setting, professional development, and supervision of teaching. Public preschools have the strongest mandates for formal professional development and typically less variation in levels of monitoring, whereas family child care providers on average have less formal education and more variability in their access to and use of other forms of training and mentorship. Four distinct patterns of formal education, child development training, and ongoing mentoring or support were identified among the educators in this study. Associations between professional development experiences and teachers' beliefs and practices suggested the importance of higher levels of formal training for enhancing the quality of teacher-child interactions. Implications of the findings for changing teacher behaviors are discussed with respect to considering the setting context. PMID:20072719

Opportunities for improvement in anti-thrombotic therapy and other strategies for the management of acute coronary syndromes: Insights from EPICOR, an international study of current practice patterns.

PubMed

Bueno, Héctor; Sinnaeve, Peter; Annemans, Lieven; Danchin, Nicolas; Licour, Muriel; Medina, Jesús; Pocock, Stuart; Sánchez-Covisa, Joaquín; Storey, Robert F; Jukema, J Wouter; Zeymer, Uwe; Van de Werf, Frans

2016-02-01

To describe international patterns and opportunities for improvement of pre- and in-hospital care of patients hospitalized for acute coronary syndromes (ACS), with special focus on anti-thrombotic therapy. EPICOR (long-tErm follow-uP of anti-thrombotic management patterns In acute CORonary syndrome patients), an international, cohort study, which enrolled 10,568 consecutive ACS survivors from 555 hospitals in 20 countries across Europe and Latin America (September 2010 to March 2011), prospectively registered detailed information on pre- and in-hospital management. Globally, 4738 (44.8%) were attended before hospitalization, 4241 (40.1%) had an ECG, 2119 (20%) received anti-platelet therapy and 101 STEMI patients (2%) fibrinolysis. In-hospital, 7944 patients (75.2%) received dual anti-platelet therapy, most often with clopidogrel (69.7%), and less with prasugrel (5.4%); 1705 (16.1%) had triple anti-platelet therapy, and 849 (8%) single anti-platelet therapy. STEMI patients more often received pre-hospital anti-thrombotics, and prasugrel, GP IIb/IIIa inhibitors and UFH in-hospital (all p < 0.001). More NSTE-ACS patients received clopidogrel, single anti-platelet therapy, and fondaparinux (all p < 0.001). As many as 33% of ACS patients were medically managed. A significant decreasing gradient was found between Northern, Southern and Eastern Europe and Latin America in use of more potent patterns of anti-platelet therapy, reperfusion therapy and invasive strategy. This large international study shows room for improvement in use of anti-thrombotic drugs and other strategies for optimal management of ACS, including pre-hospital ECG and anti-thrombotic therapy. Regional practice differences not based on evidence or conditioned by economic constraints should be reduced. © The European Society of Cardiology 2015.

Changes in the monitoring and oversight practices of not-for-profit hospital governing boards 1989-2005: evidence from three national surveys.

PubMed

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.

A survey of the advertising of nine new drugs in the general practice literature.

PubMed

Jones, M; Greenfield, S; Bradley, C

1999-12-01

To undertake a survey of the advertising of new drugs in the general practice literature as part of a larger study investigating the factors which influence the introduction of new drugs into clinical practice. The advertisements for nine new drugs from a range of therapeutic groups were monitored for 30 months in 12 journals, which are received by most GPs. The amount of prescribing, in defined daily doses, of each new drug by 50 GPs, selected as regular users of a teaching hospital, was also recorded during this period. Of the journals, 798 issues were surveyed (93% of the total published). The total number of advertisements was almost 33 000, of which 2163 (6.6%) were for the study drugs. The pattern of advertising of each study drug was very complex and varied from month to month and between journals. There was no consistent pattern in the way the drugs were advertised, with large variations in the amount and timing of advertisements. The prescribing data showed wide variations in the number of GPs prescribing each drug and in the amount prescribed. There was no clear relationship between the extent of the advertising of a drug and the amount of prescribing by the GPs. This suggests that advertising in journals is only one of many factors which are important in influencing GPs to prescribe new drugs. However, the study may have been insufficiently comprehensive to capture complex relationships between advertising and prescribing.

Prophylactic antibiotic use in pediatric patients undergoing urinary tract catheterization: a survey of members of the Society for Pediatric Urology.

PubMed

Glaser, Alexander P; Rosoklija, Ilina; Johnson, Emilie K; Yerkes, Elizabeth B

2017-09-06

Current organizational guidelines regarding use of antibiotics during urinary tract catheterization are based on limited evidence and are not directly applicable to the pediatric urology population. We seek to improve understanding of this population by first evaluating current practices. This study aims to investigate practice patterns and attitudes of pediatric urologists regarding the use of antibiotics in the setting of urinary tract catheterization. An online survey was sent to members of the Society for Pediatric Urology. Questionnaire sections included demographics, general questions about antibiotic use with catheterization, and specific clinical scenarios. Descriptive statistics were used, and chi-square analysis was performed to examine associations between demographics and specific responses. Of 448 pediatric urologists surveyed, 154 (34%) responded to the survey. A majority of surveyed urologists (78%) prescribe daily prophylactic antibiotics with a hypospadias stent in place, but extensive variation in use of antibiotics was reported with other catheters and tubes. Extensive variation in practice patterns was also reported for three case scenarios regarding antibiotic prophylaxis with catheterization. Urologists > 50 years of age and fellowship-trained urologists were more likely to prescribe antibiotics for hypospadias stents (p = 0.02, p = 0.03), but no other significant associations between demographic characteristics and antibiotic use were found. There is substantial variation in practice patterns among surveyed pediatric urologists regarding prophylactic antibiotic use with urinary catheterization. This variation, combined with a lack of objective data and increasing pressure to decrease infectious complications and combat antibiotic resistance, highlights the need for development of management guidelines for this unique population.

Perioperative glycaemic control in diabetic patients undergoing cataract surgery under local anaesthesia: a survey of practices of Singapore ophthalmologists and anaesthesiologists

PubMed Central

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

Perioperative glycaemic control in diabetic patients undergoing cataract surgery under local anaesthesia: a survey of practices of Singapore ophthalmologists and anaesthesiologists.

PubMed

Woo, Jyh Haur; Ng, Wei Di; Salah, Maaz Mohammad; Neelam, Kumari; Au Eong, Kah-Guan; Kumar, Chandra Mohan

2016-02-01

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. 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. 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%). 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. Copyright © Singapore Medical Association.

A Survey of Practice Patterns for Rehabilitation Post Elbow Fracture

PubMed Central

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