Student-Directed Video Validation of Psychomotor Skills Performance: A Strategy to Facilitate Deliberate Practice, Peer Review, and Team Skill Sets.

PubMed

DeBourgh, Gregory A; Prion, Susan K

2017-03-22

Background Essential nursing skills for safe practice are not limited to technical skills, but include abilities for determining salience among clinical data within dynamic practice environments, demonstrating clinical judgment and reasoning, problem-solving abilities, and teamwork competence. Effective instructional methods are needed to prepare new nurses for entry-to-practice in contemporary healthcare settings. Method This mixed-methods descriptive study explored self-reported perceptions of a process to self-record videos for psychomotor skill performance evaluation in a convenience sample of 102 pre-licensure students. Results Students reported gains in confidence and skill acquisition using team skills to record individual videos of skill performance, and described the importance of teamwork, peer support, and deliberate practice. Conclusion Although time consuming, the production of student-directed video validations of psychomotor skill performance is an authentic task with meaningful accountabilities that is well-received by students as an effective, satisfying learner experience to increase confidence and competence in performing psychomotor skills.

Barriers in implementing evidence-informed health decisions in rural rehabilitation settings: a mixed methods pilot study.

PubMed

Prakash, V; Hariohm, K; Balaganapathy, M

2014-08-01

Literature on the barriers to implementing research findings into physiotherapy practice are often urban centric, using self report based on the hypothetical patient scenario. The objective of this study was to investigate the occurrence of barriers, encountered by evidence informed practice-trained physiotherapists in the management of "real world" patients in rural rehabilitation settings. A mixed-methods research design was used. Physiotherapists working in rural outpatient rehabilitation settings participated in the study. In the first phase, we asked all participants (N = 5) to maintain a log book for a 4-week period to record questions that arose during their routine clinical encounters and asked them also to follow first four of the five steps of evidence-informed practice (ask, access, appraise and apply). In the second phase (after 4 weeks), we conducted a semistructured, direct interviews with the participants exploring their experiences involved in the process of implementing evidence-informed clinical decisions made during the study period. At the end of 4 weeks, 30 questions were recorded. For 17 questions, the participants found evidence but applied that evidence into their practice only in 9 instances. Being generalist practitioners, lack of outcomes specific to the patients were reported as barriers more so than time constraints in implementing evidence-informed practice. Practice setting, lack of patient-centered research and evidence-informed practice competency of physiotherapists can be significant barriers to implementing evidence-informed health decisions in rural rehabilitation setting. © 2014 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

The Scope of Practice of Occupational Therapy in U.S. Criminal Justice Settings.

PubMed

Muñoz, Jaime P; Moreton, Emily M; Sitterly, Audra M

2016-09-01

In the past 40 years, prison populations in the U.S. have nearly quadrupled while funding for rehabilitation, education and other programmes has been cut. Despite accounting for a small fraction of the world's population more than 20% of the worlds incarcerated population is in the U.S. and the rate of recidivism remains alarmingly high. Occupational therapists have the capability to play a significant role in addressing the needs of persons within the criminal justice system. However, the profession has been slow to delineate of the role occupational therapy within criminal justice settings. This study sought to provide a descriptive analysis of current occupational therapy roles and practices within the U.S. criminal justice system. Using survey research methods, the researchers collected data from respondents (N = 45; Response Rate + 51.7%) to establish a baseline of the scope of practices employed by occupational therapists working in the U.S. criminal justice system. U.S. practitioners work within institutional and community based criminal justice settings. Primary practice models, assessments and group interventions were catalogued. Respondents strongly valued the creation of networking to build the professions' presence within criminal justice settings. Occupational therapy in the criminal justice system remains an emerging practice arena. Understanding the current scope of practice in the U.S. and creating a mechanism for collaboration may help increase the depth, breadth and overall growth of the profession's role in these settings. The sampling method does not guarantee a representative sample of the population and is limited to practice within the United States. Survey design may not have allowed for respondents to fully describe their practice experiences. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The Objective Borderline Method (OBM): A Probability-Based Model for Setting up an Objective Pass/Fail Cut-Off Score in Medical Programme Assessments

ERIC Educational Resources Information Center

Shulruf, Boaz; Turner, Rolf; Poole, Phillippa; Wilkinson, Tim

2013-01-01

The decision to pass or fail a medical student is a "high stakes" one. The aim of this study is to introduce and demonstrate the feasibility and practicality of a new objective standard-setting method for determining the pass/fail cut-off score from borderline grades. Three methods for setting up pass/fail cut-off scores were compared: the…

Study on process evaluation model of students' learning in practical course

NASA Astrophysics Data System (ADS)

Huang, Jie; Liang, Pei; Shen, Wei-min; Ye, Youxiang

2017-08-01

In practical course teaching based on project object method, the traditional evaluation methods include class attendance, assignments and exams fails to give incentives to undergraduate students to learn innovatively and autonomously. In this paper, the element such as creative innovation, teamwork, document and reporting were put into process evaluation methods, and a process evaluation model was set up. Educational practice shows that the evaluation model makes process evaluation of students' learning more comprehensive, accurate, and fairly.

Best Practices. Premiere PD

ERIC Educational Resources Information Center

Brown, Ryan; Ernst, Jeremy; Clark, Aaron; DeLuca, Bill; Kelly, Daniel

2017-01-01

Educators who engage in best practices utilize a variety of instructional delivery methods to assist all learners in achieving success in concept mastery. Best practices help educators set expectations for completing activities/lessons/projects/units, differentiate instruction, integrate curricula, and provide active learning opportunities for…

On the Need for Practical Formal Methods

DTIC Science & Technology

1998-01-01

additional research and engineering that is needed to make the current set of formal methods more practical. To illustrate the ideas, I present several exam ...either a good violin or a highly talented violinist. Light-weight techniques o er software developers good violins . A user need not be a talented

Evidence-based Practices Addressed in Community-based Children’s Mental Health Clinical Supervision

PubMed Central

Accurso, Erin C.; Taylor, Robin M.; Garland, Ann F.

2013-01-01

Context Clinical supervision is the principal method of training for psychotherapeutic practice, however there is virtually no research on supervision practice in community settings. Of particular interest is the role supervision might play in facilitating implementation of evidence-based (EB) care in routine care settings. Objective This study examines the format and functions of clinical supervision sessions in routine care, as well as the extent to which supervision addresses psychotherapeutic practice elements common to EB care for children with disruptive behavior problems, who represent the majority of patients served in publicly-funded routine care settings. Methods Supervisors (n=7) and supervisees (n=12) from four publicly-funded community-based child mental health clinics reported on 130 supervision sessions. Results Supervision sessions were primarily individual in-person meetings lasting one hour. The most common functions included case conceptualization and therapy interventions. Coverage of practice elements common to EB treatments was brief. Discussion Despite the fact that most children presenting to public mental health services are referred for disruptive behavior problems, supervision sessions are infrequently focused on practice elements consistent with EB treatments for this population. Supervision is a promising avenue through which training in EB practices could be supported to improve the quality of care for children in community-based “usual care” clinics. PMID:24761163

Generalized Buneman Pruning for Inferring the Most Parsimonious Multi-state Phylogeny

NASA Astrophysics Data System (ADS)

Misra, Navodit; Blelloch, Guy; Ravi, R.; Schwartz, Russell

Accurate reconstruction of phylogenies remains a key challenge in evolutionary biology. Most biologically plausible formulations of the problem are formally NP-hard, with no known efficient solution. The standard in practice are fast heuristic methods that are empirically known to work very well in general, but can yield results arbitrarily far from optimal. Practical exact methods, which yield exponential worst-case running times but generally much better times in practice, provide an important alternative. We report progress in this direction by introducing a provably optimal method for the weighted multi-state maximum parsimony phylogeny problem. The method is based on generalizing the notion of the Buneman graph, a construction key to efficient exact methods for binary sequences, so as to apply to sequences with arbitrary finite numbers of states with arbitrary state transition weights. We implement an integer linear programming (ILP) method for the multi-state problem using this generalized Buneman graph and demonstrate that the resulting method is able to solve data sets that are intractable by prior exact methods in run times comparable with popular heuristics. Our work provides the first method for provably optimal maximum parsimony phylogeny inference that is practical for multi-state data sets of more than a few characters.

Video observation in HIT development: lessons learned on benefits and challenges.

PubMed

Høstgaard, Anna Marie; Bertelsen, Pernille

2012-08-22

Experience shows that the precondition for the development of successful health information technologies is a thorough insight into clinical work practice. In contemporary clinical work practice, clinical work and health information technology are integrated, and part of the practice is tacit. When work practice becomes routine, it slips to the background of the conscious awareness and becomes difficult to recognize without the context to support recall. This means that it is difficult to capture with traditional ethnographic research methods or in usability laboratories or clinical set ups. Observation by the use of the video technique within healthcare settings has proven to be capable of providing a thorough insight into the complex clinical work practice and its context - including parts of the tacit practice. The objective of this paper is 1) to argue for the video observation technique to inform and improve health-information-technology development and 2) to share insights and lessons learned on benefits and challenges when using the video observation technique within healthcare settings. A multiple case study including nine case studies conducted by DaCHI researchers 2004-2011 using audio-visual, non-participant video observation for data collection within different healthcare settings. In HIT development, video observation is beneficial for 1) informing and improving system design 2) studying changes in work practice 3) identifying new potentials and 4) documenting current work practices. The video observation technique used within healthcare settings is superior to other ethnographic research methods when it comes to disclosing the complexity in clinical work practice. The insights gained are far more realistic compared to traditional ethnographic studies or usability studies and studies in clinical set ups. Besides, the data generated through video recordings provide a solid basis for dialog between the health care professionals involved. The most important lessons learned are that a well considered methodology and clear formulated objectives are imperative, in order to stay focused during the data rich analysis phase. Additionally, the video observation technique is primarily recommended for studies of specific clinical work practices within delimited clinical settings. Overall, the video observation technique has proven to be capable of improving our understanding of the interwoven relation between clinical work practice and HIT and to inform us about user requirements and needs for HIT, which is a precondition for the development of more successful HIT systems in the future.

Developing a preliminary ‘never event’ list for general practice using consensus-building methods

PubMed Central

de Wet, Carl; O’Donnell, Catherine; Bowie, Paul

2014-01-01

Background The ‘never event’ concept has been implemented in many acute hospital settings to help prevent serious patient safety incidents. Benefits include increasing awareness of highly important patient safety risks among the healthcare workforce, promoting proactive implementation of preventive measures, and facilitating incident reporting. Aim To develop a preliminary list of never events for general practice. Design and setting Application of a range of consensus-building methods in Scottish and UK general practices. Method A total of 345 general practice team members suggested potential never events. Next, ‘informed’ staff (n =15) developed criteria for defining never events and applied the criteria to create a list of candidate never events. Finally, UK primary care patient safety ‘experts’ (n = 17) reviewed, refined, and validated a preliminary list via a modified Delphi group and by completing a content validity index exercise. Results There were 721 written suggestions received as potential never events. Thematic categorisation reduced this to 38. Five criteria specific to general practice were developed and applied to produce 11 candidate never events. The expert group endorsed a preliminary list of 10 items with a content validity index (CVI) score of >80%. Conclusion A preliminary list of never events was developed for general practice through practitioner experience and consensus-building methods. This is an important first step to determine the potential value of the never event concept in this setting. It is now intended to undertake further testing of this preliminary list to assess its acceptability, feasibility, and potential usefulness as a safety improvement intervention. PMID:24567655

A SAS Interface for Bayesian Analysis with WinBUGS

ERIC Educational Resources Information Center

Zhang, Zhiyong; McArdle, John J.; Wang, Lijuan; Hamagami, Fumiaki

2008-01-01

Bayesian methods are becoming very popular despite some practical difficulties in implementation. To assist in the practical application of Bayesian methods, we show how to implement Bayesian analysis with WinBUGS as part of a standard set of SAS routines. This implementation procedure is first illustrated by fitting a multiple regression model…

A checklist for health research priority setting: nine common themes of good practice.

PubMed

Viergever, Roderik F; Olifson, Sylvie; Ghaffar, Abdul; Terry, Robert F

2010-12-15

Health research priority setting processes assist researchers and policymakers in effectively targeting research that has the greatest potential public health benefit. Many different approaches to health research prioritization exist, but there is no agreement on what might constitute best practice. Moreover, because of the many different contexts for which priorities can be set, attempting to produce one best practice is in fact not appropriate, as the optimal approach varies per exercise. Therefore, following a literature review and an analysis of health research priority setting exercises that were organized or coordinated by the World Health Organization since 2005, we propose a checklist for health research priority setting that allows for informed choices on different approaches and outlines nine common themes of good practice. It is intended to provide generic assistance for planning health research prioritization processes. The checklist explains what needs to be clarified in order to establish the context for which priorities are set; it reviews available approaches to health research priority setting; it offers discussions on stakeholder participation and information gathering; it sets out options for use of criteria and different methods for deciding upon priorities; and it emphasizes the importance of well-planned implementation, evaluation and transparency.

A Metasynthesis of the Complementarity of Culturally Responsive and Inquiry-Based Science Education in K-12 Settings: Implications for Advancing Equitable Science Teaching and Learning

ERIC Educational Resources Information Center

Brown, Julie C.

2017-01-01

Employing metasynthesis as a method, this study examined 52 empirical articles on culturally relevant and responsive science education in K-12 settings to determine the nature and scope of complementarity between culturally responsive and inquiry-based science practices (i.e., science and engineering practices identified in the National Research…

Teledermatology in the United States: An Update in a Dynamic Era.

PubMed

Yim, Kaitlyn M; Florek, Aleksandra G; Oh, Dennis H; McKoy, Karen; Armstrong, April W

2018-01-22

Teledermatology is rapidly advancing in the United States. The last comprehensive survey of U.S. teledermatology programs was conducted in 2011. This article provides an update regarding the state of teledermatology programs in the United States. Active programs were identified and surveyed from November 2014 to January 2017. Findings regarding practice settings, consult volumes, payment methods, and delivery modalities were compared to those from the 2011 survey. Findings from the Veterans Affairs (VA) were reported as an aggregate. There were 40 active nongovernmental programs, amounting to a 48% increase and 30% discontinuation rate over five years. Academia remained the most common practice setting (50%). Median annual consultation volume was comparable with 263 consultations, but maximum annual consultation volume increased (range: 20-20,000). The most frequent payment method was self-pay (53%). Store-and-forward continued to be the most common delivery modality. In Fiscal Year 2016, the VA System consisted of 62 consultation sites and performed a total of 101,507 consultations. The limitations of this study were that consult volume and payment methods were not available from all programs. U.S. teledermatology programs have increased in number and annual consultation volume. Academia is the most prevalent practice setting, and self-pay is the dominant accepted payment method. Innovative platforms and the provision of direct-to-patient care are changing the practice of teledermatology.

Comparison of Web-Based and Face-to-Face Standard Setting Using the Angoff Method

ERIC Educational Resources Information Center

Katz, Irvin R.; Tannenbaum, Richard J.

2014-01-01

Web-based standard setting holds promise for reducing the travel and logistical inconveniences of traditional, face-to-face standard setting meetings. However, because there are few published reports of setting standards via remote meeting technology, little is known about the practical potential of the approach, including technical feasibility of…

Re-Conceptualization of Modified Angoff Standard Setting: Unified Statistical, Measurement, Cognitive, and Social Psychological Theories

ERIC Educational Resources Information Center

Iyioke, Ifeoma Chika

2013-01-01

This dissertation describes a design for training, in accordance with probability judgment heuristics principles, for the Angoff standard setting method. The new training with instruction, practice, and feedback tailored to the probability judgment heuristics principles was called the Heuristic training and the prevailing Angoff method training…

The Effectiveness of Concept Mapping and Retrieval Practice as Learning Strategies in an Undergraduate Physiology Course

ERIC Educational Resources Information Center

Burdo, Joseph; O'Dwyer, Laura

2015-01-01

Concept mapping and retrieval practice are both educational methods that have separately been reported to provide significant benefits for learning in diverse settings. Concept mapping involves diagramming a hierarchical representation of relationships between distinct pieces of information, whereas retrieval practice involves retrieving…

Efficient level set methods for constructing wavefronts in three spatial dimensions

NASA Astrophysics Data System (ADS)

Cheng, Li-Tien

2007-10-01

Wavefront construction in geometrical optics has long faced the twin difficulties of dealing with multi-valued forms and resolution of wavefront surfaces. A recent change in viewpoint, however, has demonstrated that working in phase space on bicharacteristic strips using eulerian methods can bypass both difficulties. The level set method for interface dynamics makes a suitable choice for the eulerian method. Unfortunately, in three-dimensional space, the setting of interest for most practical applications, the advantages of this method are largely offset by a new problem: the high dimension of phase space. In this work, we present new types of level set algorithms that remove this obstacle and demonstrate their abilities to accurately construct wavefronts under high resolution. These results propel the level set method forward significantly as a competitive approach in geometrical optics under realistic conditions.

Adolescent Girls' Reactions to Nutrition and Physical Activity Assessment Tools and Insight into Lifestyle Habits

ERIC Educational Resources Information Center

Metos, Julie; Gren, Lisa; Brusseau, Timothy; Moric, Endi; O'Toole, Karen; Mokhtari, Tahereh; Buys, Saundra; Frost, Caren

2018-01-01

Objective: The objective of this study was to understand adolescent girls' experiences using practical diet and physical activity measurement tools and to explore the food and physical activity settings that influence their lifestyle habits. Design: Mixed methods study using quantitative and qualitative methods. Setting: Large city in the western…

Modeling wildland fire propagation with level set methods

Treesearch

V. Mallet; D.E Keyes; F.E. Fendell

2009-01-01

Level set methods are versatile and extensible techniques for general front tracking problems, including the practically important problem of predicting the advance of a fire front across expanses of surface vegetation. Given a rule, empirical or otherwise, to specify the rate of advance of an infinitesimal segment of fire front arc normal to itself (i.e., given the...

Determinants in the development of advanced nursing practice: a case study of primary-care settings in Hong Kong.

PubMed

Twinn, Sheila; Thompson, David R; Lopez, Violeta; Lee, Diana T F; Shiu, Ann T Y

2005-01-01

Different factors have been shown to influence the development of models of advanced nursing practice (ANP) in primary-care settings. Although ANP is being developed in hospitals in Hong Kong, China, it remains undeveloped in primary care and little is known about the factors determining the development of such a model. The aims of the present study were to investigate the contribution of different models of nursing practice to the care provided in primary-care settings in Hong Kong, and to examine the determinants influencing the development of a model of ANP in such settings. A multiple case study design was selected using both qualitative and quantitative methods of data collection. Sampling methods reflected the population groups and stage of the case study. Sampling included a total population of 41 nurses from whom a secondary volunteer sample was drawn for face-to-face interviews. In each case study, a convenience sample of 70 patients were recruited, from whom 10 were selected purposively for a semi-structured telephone interview. An opportunistic sample of healthcare professionals was also selected. The within-case and cross-case analysis demonstrated four major determinants influencing the development of ANP: (1) current models of nursing practice; (2) the use of skills mix; (3) the perceived contribution of ANP to patient care; and (4) patients' expectations of care. The level of autonomy of individual nurses was considered particularly important. These determinants were used to develop a model of ANP for a primary-care setting. In conclusion, although the findings highlight the complexity determining the development and implementation of ANP in primary care, the proposed model suggests that definitions of advanced practice are appropriate to a range of practice models and cultural settings. However, the findings highlight the importance of assessing the effectiveness of such models in terms of cost and long-term patient outcomes.

Understanding Preservice Teachers' Development of Pedagogical Knowledge Practices When Co-Teaching Primary Science to Peers

ERIC Educational Resources Information Center

Hudson, Peter

2014-01-01

Preservice teachers articulate the need for more teaching experiences for developing their practices, however, extending beyond existing school arrangements may present difficulties. Thus, it is important to understand preservice teachers' development of pedagogical knowledge practices when in the university setting. This mixed-method study…

The effectiveness of concept mapping and retrieval practice as learning strategies in an undergraduate physiology course.

PubMed

Burdo, Joseph; O'Dwyer, Laura

2015-12-01

Concept mapping and retrieval practice are both educational methods that have separately been reported to provide significant benefits for learning in diverse settings. Concept mapping involves diagramming a hierarchical representation of relationships between distinct pieces of information, whereas retrieval practice involves retrieving information that was previously coded into memory. The relative benefits of these two methods have never been tested against each other in a classroom setting. Our study was designed to investigate whether or not concept mapping or retrieval practice produced a significant learning benefit in an undergraduate physiology course as measured by exam performance and, if so, was the benefit of one method significantly greater than the other. We found that there was a trend toward increased exam scores for the retrieval practice group compared with both the control group and concept mapping group, and that trend achieved statistical significance for one of the four module exams in the course. We also found that women performed statistically better than men on the module exam that contained a substantial amount of material relating to female reproductive physiology. Copyright © 2015 The American Physiological Society.

A practical material decomposition method for x-ray dual spectral computed tomography.

PubMed

Hu, Jingjing; Zhao, Xing

2016-03-17

X-ray dual spectral CT (DSCT) scans the measured object with two different x-ray spectra, and the acquired rawdata can be used to perform the material decomposition of the object. Direct calibration methods allow a faster material decomposition for DSCT and can be separated in two groups: image-based and rawdata-based. The image-based method is an approximative method, and beam hardening artifacts remain in the resulting material-selective images. The rawdata-based method generally obtains better image quality than the image-based method, but this method requires geometrically consistent rawdata. However, today's clinical dual energy CT scanners usually measure different rays for different energy spectra and acquire geometrically inconsistent rawdata sets, and thus cannot meet the requirement. This paper proposes a practical material decomposition method to perform rawdata-based material decomposition in the case of inconsistent measurement. This method first yields the desired consistent rawdata sets from the measured inconsistent rawdata sets, and then employs rawdata-based technique to perform material decomposition and reconstruct material-selective images. The proposed method was evaluated by use of simulated FORBILD thorax phantom rawdata and dental CT rawdata, and simulation results indicate that this method can produce highly quantitative DSCT images in the case of inconsistent DSCT measurements.

The Artificial Neural Networks Based on Scalarization Method for a Class of Bilevel Biobjective Programming Problem

PubMed Central

Chen, Zhong; Liu, June; Li, Xiong

2017-01-01

A two-stage artificial neural network (ANN) based on scalarization method is proposed for bilevel biobjective programming problem (BLBOP). The induced set of the BLBOP is firstly expressed as the set of minimal solutions of a biobjective optimization problem by using scalar approach, and then the whole efficient set of the BLBOP is derived by the proposed two-stage ANN for exploring the induced set. In order to illustrate the proposed method, seven numerical examples are tested and compared with results in the classical literature. Finally, a practical problem is solved by the proposed algorithm. PMID:29312446

What makes a sustainability tool valuable, practical and useful in real-world healthcare practice? A mixed-methods study on the development of the Long Term Success Tool in Northwest London

PubMed Central

Lennox, Laura; Doyle, Cathal; Reed, Julie E

2017-01-01

Objectives Although improvement initiatives show benefits to patient care, they often fail to sustain. Models and frameworks exist to address this challenge, but issues with design, clarity and usability have been barriers to use in healthcare settings. This work aimed to collaborate with stakeholders to develop a sustainability tool relevant to people in healthcare settings and practical for use in improvement initiatives. Design Tool development was conducted in six stages. A scoping literature review, group discussions and a stakeholder engagement event explored literature findings and their resonance with stakeholders in healthcare settings. Interviews, small-scale trialling and piloting explored the design and tested the practicality of the tool in improvement initiatives. Setting National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Northwest London (CLAHRC NWL). Participants CLAHRC NWL improvement initiative teams and staff. Results The iterative design process and engagement of stakeholders informed the articulation of the sustainability factors identified from the literature and guided tool design for practical application. Key iterations of factors and tool design are discussed. From the development process, the Long Term Success Tool (LTST) has been designed. The Tool supports those implementing improvements to reflect on 12 sustainability factors to identify risks to increase chances of achieving sustainability over time. The Tool is designed to provide a platform for improvement teams to share their own views on sustainability as well as learn about the different views held within their team to prompt discussion and actions. Conclusion The development of the LTST has reinforced the importance of working with stakeholders to design strategies which respond to their needs and preferences and can practically be implemented in real-world settings. Further research is required to study the use and effectiveness of the tool in practice and assess engagement with the method over time. PMID:28947436

Recruitment of private practices for primary care research: experience in a preventive services clinical trial.

PubMed

McBride, P E; Massoth, K M; Underbakke, G; Solberg, L I; Beasley, J W; Plane, M B

1996-10-01

Recruitment of community primary care practices for studies to improve health service delivery is important to many health care organizations. Prior studies have focused on individual physician recruitment or academic settings. This descriptive study evaluated the efficiency and utility of three different recruitment methods to encourage community practice participation in a preventive services research trial. Primary care practices in four midwestern states were recruited using different sources for initial mailings (physician lists, practice lists, and a managed care organization's primary care network) and different recruiting methods. Outcome measures included response rates, participation rates, and comparative costs of each method. Of the 86 eligible practices contacted, 52 (60%) consented to participate. Mailing to individual physicians was the most cumbersome and expensive method and had the lowest response rate. Initial contacts with practice medical directors increased the participation rate substantially, and practice recruitment meetings improved both study participation and practice-project communication. Experience with these three methods suggests that the most efficient way to recruit practices for participation in a preventive services research trial involves targeted mailings and phone calls to medical directors, followed by on-site practice meetings.

Stress management techniques in the prison setting.

PubMed

Kristofersson, Gisli Kort; Kaas, Merrie J

2013-01-01

The percentage of incarcerated individuals in the United States is currently close to an all time high, and more stressful places than prisons are hard to find. Because registered nurses and advance practice nurses are often the only healthcare providers readily available to prison inmates, nurses need a repertoire of effective strategies to minimize prisoners' stress-related symptoms and behaviors. The purpose of this critical literature review was to identify the state of knowledge about using stress management techniques (SMTs) in the prison setting for reducing psychological problems and/or behavioral problems in male and female adult prison populations. A comprehensive, systematic integrated literature search was performed using multiple relevant databases to identify studies using various SMTs for incarcerated adults. Although clinical practice recommendations for the use of SMTs in the prison setting cannot be made with strong certainty, nurses working in the prison setting should continue to incorporate muscle relaxation, Transcendental Meditation, and certain Eastern meditative practices in the care of their clients because of the safety and possible positive impacts and practicality these methods have in this setting.

Predicting the scope of practice of family physicians.

PubMed

Wong, Eric; Stewart, Moira

2010-06-01

To identify factors that are associated with the scope of practice of FPs and GPs who have office-based practices. Secondary univariable and multivariable analyses of cross-sectional data from the 2001 National Family Physician Workforce Survey conducted by the College of Family Physicians of Canada. Canada. General community of FPs and GPs who spent most of their clinical time in office settings. Demographic characteristics and scope of practice score (SPS), which was the number of 12 selected medical services provided by office-based FPs and GPs. The multivariable model explained 35.1% of the variation in the SPS among participants. Geographic factors of provincial division and whether or not the population served was rural explained 30.5% of the variation in the SPS. Male physician sex, younger physician age, being in group practice, greater access to hospital beds, less access to specialists, main practice setting of an academic teaching unit, mixed method physician payment, additional structured postresidency training, and greater number of different types of allied health professionals in the main practice setting were also associated with higher SPSs. Geographic factors were the strongest determinants of scope of practice; physician-related factors, availability of health care resources to the main practice setting, and practice organization factors were weaker determinants. It is important to understand how and why geographic factors influence scope of practice, and whether a broad scope of practice independent of population needs benefits the population. This study supports primary care renewal efforts that use mixed payment systems, incorporate allied health care professionals into family and general practices, and foster group practices.

A Comparison of different learning models used in Data Mining for Medical Data

NASA Astrophysics Data System (ADS)

Srimani, P. K.; Koti, Manjula Sanjay

2011-12-01

The present study aims at investigating the different Data mining learning models for different medical data sets and to give practical guidelines to select the most appropriate algorithm for a specific medical data set. In practical situations, it is absolutely necessary to take decisions with regard to the appropriate models and parameters for diagnosis and prediction problems. Learning models and algorithms are widely implemented for rule extraction and the prediction of system behavior. In this paper, some of the well-known Machine Learning(ML) systems are investigated for different methods and are tested on five medical data sets. The practical criteria for evaluating different learning models are presented and the potential benefits of the proposed methodology for diagnosis and learning are suggested.

Strong Similarity Measures for Ordered Sets of Documents in Information Retrieval.

ERIC Educational Resources Information Center

Egghe, L.; Michel, Christine

2002-01-01

Presents a general method to construct ordered similarity measures in information retrieval based on classical similarity measures for ordinary sets. Describes a test of some of these measures in an information retrieval system that extracted ranked document sets and discuses the practical usability of the ordered similarity measures. (Author/LRW)

[Teaching methods for clinical settings: a literature review].

PubMed

Brugnolli, Anna; Benaglio, Carla

2017-01-01

. Teaching Methods for clinical settings: a review. The teaching process during internship requires several methods to promote the acquisition of more complex technical skills such as relational, decisional and planning abilities. To describe effective teaching methods to promote the learning of relational, decisional and planning skills. A literature review of the teaching methods that have proven most effective, most appreciated by students, and most frequently used in Italian nursing schools. Clinical teaching is a central element to transform clinical experiences during internship in professional competences. The students are gradually brought to become more independent, because they are offered opportunities to practice in real contexts, to receive feedback, to have positive role models, to become more autonomous: all elements that facilitate and potentiate learning. Clinical teaching should be based on a variety of methods. The students value a gradual progression both in clinical experiences and teaching strategies from more supervised methods to methods more oriented towards reflecting on clinical practice and self-directed learning.

Scoring and setting pass/fail standards for an essay certification examination in nurse-midwifery.

PubMed

Fullerton, J T; Greener, D L; Gross, L J

1992-03-01

Examination for certification or licensure of health professionals (credentialing) in the United States is almost exclusively of the multiple choice format. The certification examination for entry into the practice of the profession of nurse-midwifery has, however, used a modified essay format throughout its twenty-year history. The examination has recently undergone a revision in the method for score interpretation and for pass/fail decision-making. The revised method, described in this paper, has important implications for all health professional credentialing agencies which use modified essay, oral or practical methods of competency assessment. This paper describes criterion-referenced scoring, the process of constructing the essay items, the methods for assuring validity and reliability for the examination, and the manner of standard setting. In addition, two alternative methods for increasing the validity of the pass/fail decision are evaluated, and the rationale for decision-making about marginal candidates is described.

Practical Child Safety Education in England: A National Survey of the Child Safety Education Coalition

ERIC Educational Resources Information Center

Mulvaney, Caroline A.; Watson, Michael C.; Walsh, Patrick

2013-01-01

Objective: To examine the provision of practical safety education by Child Safety Education Coalition (CSEC) organizations in England. Design: A postal survey. Setting: Providers of child practical safety education who were also part of CSEC. Methods: In February 2010 all CSEC organizations were sent a self-completion postal questionnaire which…

Determinants and Outcomes of Employee Participation in a Strategic Community of Practice: A Mixed-Method Approach

ERIC Educational Resources Information Center

Chang, Joohee; Jacobs, Ronald L.

2012-01-01

Despite increasing investment in building, supporting, and managing communities of practice that meet the strategic business needs of the organization, the literature indicates that little is known about strategic communities of practice in organizational work settings. The purpose of this study was to investigate determinants and outcomes of…

Algorithmic tools for interpreting vital signs.

PubMed

Rathbun, Melina C; Ruth-Sahd, Lisa A

2009-07-01

Today's complex world of nursing practice challenges nurse educators to develop teaching methods that promote critical thinking skills and foster quick problem solving in the novice nurse. Traditional pedagogies previously used in the classroom and clinical setting are no longer adequate to prepare nursing students for entry into practice. In addition, educators have expressed frustration when encouraging students to apply newly learned theoretical content to direct the care of assigned patients in the clinical setting. This article presents algorithms as an innovative teaching strategy to guide novice student nurses in the interpretation and decision making related to vital sign assessment in an acute care setting.

Understanding facilitators and barriers to reengineering the clinical research enterprise in community-based practice settings.

PubMed

Kukafka, Rita; Allegrante, John P; Khan, Sharib; Bigger, J Thomas; Johnson, Stephen B

2013-09-01

Solutions are employed to support clinical research trial tasks in community-based practice settings. Using the IT Implementation Framework (ITIF), an integrative framework intended to guide the synthesis of theoretical perspectives for planning multi-level interventions to enhance IT use, we sought to understand the barriers and facilitators to clinical research in community-based practice settings preliminary to implementing new informatics solutions for improving clinical research infrastructure. The studies were conducted in practices within the Columbia University Clinical Trials Network. A mixed-method approach, including surveys, interviews, time-motion studies, and observations was used. The data collected, which incorporates predisposing, enabling, and reinforcing factors in IT use, were analyzed according to each phase of ITIF. Themes identified in the first phase of ITIF were 1) processes and tools to support clinical trial research and 2) clinical research peripheral to patient care processes. Not all of the problems under these themes were found to be amenable to IT solutions. Using the multi-level orientation of the ITIF, we set forth strategies beyond IT solutions that can have an impact on reengineering clinical research tasks in practice-based settings. Developing strategies to target enabling and reinforcing factors, which focus on organizational factors, and the motivation of the practice at large to use IT solutions to integrate clinical research tasks with patient care processes, is most challenging. The ITIF should be used to consider both IT and non-IT solutions concurrently for reengineering of clinical research in community-based practice settings. © 2013.

"A golden opportunity": Exploring interprofessional learning and practice in rural clinical settings.

PubMed

Spencer, Judy; Woodroffe, Jessica; Cross, Merylin; Allen, Penny

2015-01-01

Little is known about interprofessional practice (IPP) and interprofessional learning (IPL) in rural health services, despite national funding and continuing emphasis on increasing students' clinical placements in rural areas. This short paper outlines a study in Tasmania, Australia, which investigated how and under what contexts and conditions IPP and IPL occur in rural clinical settings, and the enabling factors and strategies that promote this learning and practice. This study employed a mixed method design comprising focus group discussions and a survey involving health professionals from two rural health services. The findings demonstrate that formal and informal arrangements, the collaborative nature of small, close-knit healthcare teams and patient-centred models of care employed in rural practice settings, provide ideal contexts for IPP and IPL. The study has implications for promoting organisational readiness for IPP and IPL and harnessing the potential of rural services to promote and develop students' interprofessional capability.

Bridging theory and practice: Mixed methods approach to instruction of law and ethics within the pharmaceutical sciences.

PubMed

Wilby, Kyle John; Nasr, Ziad Ghantous

2016-11-01

Background: Professional responsibilities are guided by laws and ethics that must be introduced and mastered within pharmaceutical sciences training. Instructional design to teaching typically introduces concepts in a traditional didactic approach and requires student memorization prior to application within practice settings. Additionally, many centers rely on best practices from abroad, due to lack of locally published laws and guidance documents. Objectives: The aim of this paper was to summarize and critically evaluate a professional skills laboratory designed to enhance learning through diversity in instructional methods relating to pharmacy law and best practices regarding narcotics, controlled medications, and benzodiazepines. Setting: This study took place within the Professional Skills Laboratory at the College of Pharmacy at Qatar University. Method: A total of 25 students participated in a redesigned laboratory session administered by a faculty member, clinical lecturer, teaching assistant, and a professional skills laboratory technician. The laboratory consisted of eight independent stations that students rotated during the 3-h session. Stations were highly interactive in nature and were designed using non-traditional approaches such as charades, role-plays, and reflective drawings. All stations attempted to have students relate learned concepts to practice within Qatar. Main outcome measures: Student perceptions of the laboratory were measured on a post-questionnaire and were summarized descriptively. Using reflection and consensus techniques, two faculty members completed a SWOC (Strengths, Weaknesses, Opportunities, and Challenges) analysis in preparation for future cycles. Results: 100% (25/25) of students somewhat or strongly agreed that their knowledge regarding laws and best practices increased and that their learning experience was enhanced by a mixed-methods approach. A total of 96% (24/25) of students stated that the mixed-methods instructional approach should be continued in the future. The SWOC analysis identified the mixed methods approach and student feedback as strengths and opportunities, while resource shortages and lack of impact assessment were identified as weaknesses and challenges. Conclusion: Creative redesign of instructional methods pertaining to law and best practices was effective to achieve positive student perceptions regarding instructional methods and learning. Future cycles should include rigorous assessment methods to evaluate impact on student learning and practice.

Implementing change in primary care practices using electronic medical records: a conceptual framework.

PubMed

Nemeth, Lynne S; Feifer, Chris; Stuart, Gail W; Ornstein, Steven M

2008-01-16

Implementing change in primary care is difficult, and little practical guidance is available to assist small primary care practices. Methods to structure care and develop new roles are often needed to implement an evidence-based practice that improves care. This study explored the process of change used to implement clinical guidelines for primary and secondary prevention of cardiovascular disease in primary care practices that used a common electronic medical record (EMR). Multiple conceptual frameworks informed the design of this study designed to explain the complex phenomena of implementing change in primary care practice. Qualitative methods were used to examine the processes of change that practice members used to implement the guidelines. Purposive sampling in eight primary care practices within the Practice Partner Research Network-Translating Researching into Practice (PPRNet-TRIP II) clinical trial yielded 28 staff members and clinicians who were interviewed regarding how change in practice occurred while implementing clinical guidelines for primary and secondary prevention of cardiovascular disease and strokes. A conceptual framework for implementing clinical guidelines into primary care practice was developed through this research. Seven concepts and their relationships were modelled within this framework: leaders setting a vision with clear goals for staff to embrace; involving the team to enable the goals and vision for the practice to be achieved; enhancing communication systems to reinforce goals for patient care; developing the team to enable the staff to contribute toward practice improvement; taking small steps, encouraging practices' tests of small changes in practice; assimilating the electronic medical record to maximize clinical effectiveness, enhancing practices' use of the electronic tool they have invested in for patient care improvement; and providing feedback within a culture of improvement, leading to an iterative cycle of goal setting by leaders. This conceptual framework provides a mental model which can serve as a guide for practice leaders implementing clinical guidelines in primary care practice using electronic medical records. Using the concepts as implementation and evaluation criteria, program developers and teams can stimulate improvements in their practice settings. Investing in collaborative team development of clinicians and staff may enable the practice environment to be more adaptive to change and improvement.

Obesity Prevention Practices and Policies in Child Care Settings Enrolled and Not Enrolled in the Child and Adult Care Food Program.

PubMed

Liu, Sherry T; Graffagino, Cheryl L; Leser, Kendall A; Trombetta, Autumn L; Pirie, Phyllis L

2016-09-01

Objectives The United States Department of Agriculture's Child and Adult Care Food Program (CACFP) provides meals and snacks to low-income children in child care. This study compared nutrition and physical activity practices and policies as well as the overall nutrition and physical activity environments in a sample of CACFP and non-CACFP child care settings. Methods A random stratified sample of 350 child care settings in a large Midwestern city and its suburbs, was mailed a survey on obesity prevention practices and policies concerning menu offerings, feeding practices, nutrition and physical activity education, activity levels, training, and screen time. Completed surveys were obtained from 229 of 309 eligible child care settings (74.1 % response rate). Chi square tests were used to compare practices and policies in CACFP and non-CACFP sites. Poisson and negative binomial regression were used to examine associations between CACFP and total number of practices and policies. Results Sixty-nine percent of child care settings reported CACFP participation. A significantly higher proportion of CACFP sites reported offering whole grain foods daily and that providers always eat the same foods that are offered to the children. CACFP sites had 1.1 times as many supportive nutrition practices as non-CACFP sites. CACFP participation was not associated with written policies or physical activity practices. Conclusions for Practice There is room for improvement across nutrition and physical activity practices and policies. In addition to food reimbursement, CACFP participation may help promote child care environments that support healthy nutrition; however, additional training and education outreach activities may be needed.

Criteria for setting speed limits in urban and suburban areas in Florida

DOT National Transportation Integrated Search

2003-03-01

Current methods of setting speed limits include maximum statutory limits by road class and geometric characteristics and speed zoning practice for the roads where the legislated limit does not reflect local differences. Speed limits in speed zones ar...

Audiology Assistants in Private Practice

PubMed Central

Hamill, Teri A.; Andrews, Julia P.

2016-01-01

Using audiology assistants allows a practice to meet the expected increase in patient demand in a cost-effective manner, without compromise to quality of patient care. Assistants are particularly valuable in private practice settings that have an emphasis in amplification, as many of the tasks involved do not require the unique skills of the doctor of audiology. Regulatory considerations, methods of training, and scope of practice of the assistant are discussed. PMID:28028327

Simulated settings; powerful arenas for learning patient safety practices and facilitating transference to clinical practice. A mixed method study.

PubMed

Reime, Marit Hegg; Johnsgaard, Tone; Kvam, Fred Ivan; Aarflot, Morten; Breivik, Marit; Engeberg, Janecke Merethe; Brattebø, Guttorm

2016-11-01

Poor teamwork is an important factor in the occurrence of critical incidents because of a lack of non-technical skills. Team training can be a key to prevent these incidents. The purpose of this study was to explore the experience of nursing and medical students after a simulation-based interprofessional team training (SBITT) course and its impact on professional and patient safety practices, using a concurrent mixed-method design. The participants (n = 262) were organized into 44 interprofessional teams. The results showed that two training sequences the same day improved overall team performance. Making mistakes during SBITT appeared to improve the quality of patient care once the students returned to clinical practice as it made the students more vigilant. Furthermore, the video-assisted oral debriefing provided an opportunity to strengthen interprofessional teamwork and share situational awareness. SBITT gave the students an opportunity to practice clinical reasoning skills and to share professional knowledge. The students conveyed the importance of learning to speak up to ensure safe patient practices. Simulated settings seem to be powerful arenas for learning patient safety practices and facilitating transference of this awareness to clinical practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

Paving the COWpath: data-driven design of pediatric order sets

PubMed Central

Zhang, Yiye; Padman, Rema; Levin, James E

2014-01-01

Objective Evidence indicates that users incur significant physical and cognitive costs in the use of order sets, a core feature of computerized provider order entry systems. This paper develops data-driven approaches for automating the construction of order sets that match closely with user preferences and workflow while minimizing physical and cognitive workload. Materials and methods We developed and tested optimization-based models embedded with clustering techniques using physical and cognitive click cost criteria. By judiciously learning from users’ actual actions, our methods identify items for constituting order sets that are relevant according to historical ordering data and grouped on the basis of order similarity and ordering time. We evaluated performance of the methods using 47 099 orders from the year 2011 for asthma, appendectomy and pneumonia management in a pediatric inpatient setting. Results In comparison with existing order sets, those developed using the new approach significantly reduce the physical and cognitive workload associated with usage by 14–52%. This approach is also capable of accommodating variations in clinical conditions that affect order set usage and development. Discussion There is a critical need to investigate the cognitive complexity imposed on users by complex clinical information systems, and to design their features according to ‘human factors’ best practices. Optimizing order set generation using cognitive cost criteria introduces a new approach that can potentially improve ordering efficiency, reduce unintended variations in order placement, and enhance patient safety. Conclusions We demonstrate that data-driven methods offer a promising approach for designing order sets that are generalizable, data-driven, condition-based, and up to date with current best practices. PMID:24674844

Audit activity and quality of completed audit projects in primary care in Staffordshire.

PubMed Central

Chambers, R; Bowyer, S; Campbell, I

1995-01-01

OBJECTIVES--To survey audit activity in primary care and determine which practice factors are associated with completed audit; to survey the quality of completed audit projects. DESIGN--From April 1992 to June 1993 a team from the medical audit advisory group visited all general practices; a research assistant visited each practice to study the best audit project. Data were collected in structured interviews. SETTING--Staffordshire, United Kingdom. SUBJECTS--All 189 general practices. MAIN MEASURES--Audit activity using Oxford classification system. Quality of best audit project by assessing choice of topic; participation of practice staff; setting of standards; methods of data collection and presentation of results; whether a plan to make changes resulted from the audit; and whether changes led to the set standards being achieved. RESULTS--Audit information was available from 169 practices (89%). 44(26%) practices had carried out at least one full audit; 40(24%) had not started audit. Mean scores with the Oxford classification system were significantly higher with the presence of a practice manager (2.7(95% confidence interval 2.4 to 2.9) v 1.2(0.7 to 1.8), p < 0.0001) and with computerisation (2.8(2.5 to 3.1) v 1.4 (0.9 to 2.0), p < 0.0001), organised notes (2.6(2.1 to 3.0) v 1.7(7.2 to 2.2), p = 0.03), being a training practice (3.5(3.2 to 3.8) v 2.1(1.8 to 2.4), p < 0.0001), and being a partnership (2.8(2.6 to 3.0) v 1.5(1.1 to 2.0), p < 0.0001). Standards had been set in 62 of the 71 projects reviewed. Data were collected prospectively in 36 projects and retrospectively in 35. 16 projects entailed taking samples from a study population and 55 from the whole population. 50 projects had a written summary. Performance was less than the standards set or expected in 56 projects. 62 practices made changes as a result of the audit. 35 of the 53 that had reviewed the changes found that the original standards had been reached. CONCLUSIONS--Evaluation of audit in primary care should include evaluation of the methods used, whether deficiencies were identified, and whether changes were implemented to resolve any problems found. PMID:10153426

Organizational climate and hospital nurses' caring practices: a mixed-methods study.

PubMed

Roch, Geneviève; Dubois, Carl-Ardy; Clarke, Sean P

2014-06-01

Organizational climate in healthcare settings influences patient outcomes, but its effect on nursing care delivery remains poorly understood. In this mixed-methods study, nurse surveys (N = 292) were combined with a qualitative case study of 15 direct-care registered nurses (RNs), nursing personnel, and managers. Organizational climate explained 11% of the variation in RNs' reported frequency of caring practices. Qualitative data suggested that caring practices were affected by the interplay of organizational climate dimensions with patients and nurses characteristics. Workload intensity and role ambiguity led RNs to leave many caring practices to practical nurses and assistive personnel. Systemic interventions are needed to improve organizational climate and to support RNs' involvement in a full range of caring practices. © 2014 Wiley Periodicals, Inc.

Exploring the Degree of Support by PMOs for New Project Management Techniques and Methods

ERIC Educational Resources Information Center

Lopez, Kathleen P.

2012-01-01

An organization tends to seek out the best set of practices in order to achieve project success. Many organizations are implementing a Project Management Office (PMO) to serve as a central post for organizing and disseminating best practices. The PMO responsibilities in part is to examine all practices, old and new, to best determine which…

Critical Action Learning: A Method or Strategy for Peer Supervision of Coaching Practice

ERIC Educational Resources Information Center

Turner, Arthur; Tee, David; Crompton, Sally

2017-01-01

This paper deals with the on-going practice of a critical action learning set who come together to meet their needs for coaching supervision as a group of executive coaches working from, and within, the University sector in South Wales. The reasons for the successes of, and the challenges around, this practice of four years standing have been…

Enhancing Thinking through Cooperative Learning.

ERIC Educational Resources Information Center

Davidson, Neil, Ed.; Worsham, Toni, Ed.

This collection of papers provides a theoretical foundation on current practice in cooperative thinking. The papers offer many practical methods that can be applied to a full range of classroom settings. After an introduction, "HOTSICLE: Higher Order Thinking Skills in Cooperative Learning Environments" (Neil Davidson and Toni Worsham),…

Learning Music Literacies across Transnational School Settings

ERIC Educational Resources Information Center

Skerrett, Allison

2018-01-01

This article examines an adolescent's music literacy education across Caribbean and U.S. schools using qualitative research methods and theories of multimodality, transnationalism, and global cultural flows. Findings include that the youth's music literacy practices continuously shifted in response to the cultural practices and values of the…

Beam focal spot position determination for an Elekta linac with the Agility® head; practical guide with a ready-to-go procedure.

PubMed

Chojnowski, Jacek M; Taylor, Lee M; Sykes, Jonathan R; Thwaites, David I

2018-05-14

A novel phantomless, EPID-based method of measuring the beam focal spot offset of a linear accelerator was proposed and validated for Varian machines. In this method, one set of jaws and the MLC were utilized to form a symmetric field and then a 180 o collimator rotation was utilized to determine the radiation isocenter defined by the jaws and the MLC, respectively. The difference between these two isocentres is directly correlated with the beam focal spot offset of the linear accelerator. In the current work, the method has been considered for Elekta linacs. An Elekta linac with the Agility ® head does not have two set of jaws, therefore, a modified method is presented making use of one set of diaphragms, the MLC and a full 360 o collimator rotation. The modified method has been tested on two Elekta Synergy ® linacs with Agility ® heads and independently validated. A practical guide with instructions and a MATLAB ® code is attached for easy implementation. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Methods, metrics and research gaps around minimum data sets for nursing practice and fundamental care: A scoping literature review.

PubMed

Muntlin Athlin, Åsa

2018-06-01

To examine and map research on minimum data sets linked to nursing practice and the fundamentals of care. Another aim was to identify gaps in the evidence to suggest future research questions to highlight the need for standardisation of terminology around nursing practice and fundamental care. Addressing fundamental care has been highlighted internationally as a response to missed nursing care. Systematic performance measurements are needed to capture nursing practice outcomes. Overview of the literature framed by the scoping study methodology. PubMed and CINAHL were searched using the following inclusion criteria: peer-reviewed empirical quantitative and qualitative studies related to minimum data sets and nursing practice published in English. No time restrictions were set. Exclusion criteria were as follows: no available full text, reviews and methodological and discursive studies. Data were categorised into one of the fundamentals of care elements. The review included 20 studies published in 1999-2016. Settings were mainly nursing homes or hospitals. Of 14 elements of the fundamentals of care, 11 were identified as measures in the included studies, but their frequency varied. The most commonly identified elements concerned safety, prevention and medication (n = 11), comfort (n = 6) and eating and drinking (n = 5). Studies have used minimum data sets and included variables linked to nursing practices and fundamentals of care. However, the relations of these variables to nursing practice were not always clearly described and the main purpose of the studies was seldom to measure the outcomes of nursing interventions. More robust studies focusing on nursing practice and patient outcomes are warranted. Using minimum data sets can highlight the nurses' work and what impact it has on direct patient care. Appropriate models, systems and standardised terminology are needed to facilitate the documentation of nursing activities. © 2017 John Wiley & Sons Ltd.

Influence of Institutional Guidelines on Oral Hygiene Practices in Intensive Care Units.

PubMed

Kiyoshi-Teo, Hiroko; Blegen, Mary

2015-07-01

Maintaining oral hygiene is a key component of preventing ventilator-associated pneumonia; however, practices are inconsistent. To explore how characteristics of institutional guidelines for oral hygiene influence nurses' oral hygiene practices and perceptions of that practice. Oral hygiene section of a larger survey study on prevention of ventilator-associated pneumonia. Critical care nurses at 8 hospitals in Northern California that had more than 1000 ventilator days in 2009 were recruited to participate in the survey. Twenty-one questions addressed oral hygiene practices and practice perceptions. Descriptive statistics, analysis of variance, and Spearman correlations were used for analyses. A total of 576 critical care nurses (45% response rate) responded to the survey. Three types of institutional oral hygiene guidelines existed: nursing policy, order set, and information bulletin. Nursing policy provided the most detail about the oral hygiene care; however, adherence, awareness, and priority level were higher with order sets (P < .05). The content and method of disseminating these guidelines varied, and nursing practices were affected by these differences. Nurses assessed the oral cavity and used oral swabs more often when those practices were included in institutional guidelines. The content and dissemination method of institutional guidelines on oral hygiene do influence the oral hygiene practices of critical care nurses. Future studies examining how institutional guidelines could best be incorporated into routine workflow are needed. ©2015 American Association of Critical-Care Nurses.

Case study method and problem-based learning: utilizing the pedagogical model of progressive complexity in nursing education.

PubMed

McMahon, Michelle A; Christopher, Kimberly A

2011-08-19

As the complexity of health care delivery continues to increase, educators are challenged to determine educational best practices to prepare BSN students for the ambiguous clinical practice setting. Integrative, active, and student-centered curricular methods are encouraged to foster student ability to use clinical judgment for problem solving and informed clinical decision making. The proposed pedagogical model of progressive complexity in nursing education suggests gradually introducing students to complex and multi-contextual clinical scenarios through the utilization of case studies and problem-based learning activities, with the intention to transition nursing students into autonomous learners and well-prepared practitioners at the culmination of a nursing program. Exemplar curricular activities are suggested to potentiate student development of a transferable problem solving skill set and a flexible knowledge base to better prepare students for practice in future novel clinical experiences, which is a mutual goal for both educators and students.

Evaluation of the DIBELS (Sixth Edition) Diagnostic System for the Selection of Native and Proficient English Speakers at Risk of Reading Difficulties

ERIC Educational Resources Information Center

Smolkowski, Keith; Cummings, Kelli D.

2016-01-01

This comprehensive evaluation of the Dynamic Indicators of Basic Early Literacy Skills Sixth Edition (DIBELS6) set of measures gives a practical illustration of signal detection methods, the methods used to determine the value of screening and diagnostic systems, and offers an updated set of cut scores (decision thresholds). Data were drawn from a…

Some Practical Solutions to Standard-Setting Problems: The Georgia Teacher Certification Test Experience.

ERIC Educational Resources Information Center

Cramer, Stephen E.

A standard-setting procedure was developed for the Georgia Teacher Certification Testing Program as tests in 30 teaching fields were revised. A list of important characteristics of a standard-setting procedure was derived, drawing on the work of R. A. Berk (1986). The best method was found to be a highly formalized judgmental, empirical Angoff…

Variation in assessment and standard setting practices across UK undergraduate medicine and the need for a benchmark

PubMed Central

2015-01-01

Objectives The principal aim of this study is to provide an account of variation in UK undergraduate medical assessment styles and corresponding standard setting approaches with a view to highlighting the importance of a UK national licensing exam in recognizing a common standard. Methods Using a secure online survey system, response data were collected during the period 13 - 30 January 2014 from selected specialists in medical education assessment, who served as representatives for their respective medical schools. Results Assessment styles and corresponding choices of standard setting methods vary markedly across UK medical schools. While there is considerable consensus on the application of compensatory approaches, individual schools display their own nuances through use of hybrid assessment and standard setting styles, uptake of less popular standard setting techniques and divided views on norm referencing. Conclusions The extent of variation in assessment and standard setting practices across UK medical schools validates the concern that there is a lack of evidence that UK medical students achieve a common standard on graduation. A national licensing exam is therefore a viable option for benchmarking the performance of all UK undergraduate medical students. PMID:26520472

Pharmacogenomics in diverse practice settings: implementation beyond major metropolitan areas

PubMed Central

Dorfman, Elizabeth H; Trinidad, Susan Brown; Morales, Chelsea T; Howlett, Kevin; Burke, Wylie; Woodahl, Erica L

2015-01-01

Aim The limited formal study of the clinical feasibility of implementing pharmacogenomic tests has thus far focused on providers at large medical centers in urban areas. Our research focuses on small metropolitan, rural and tribal practice settings. Materials & methods We interviewed 17 healthcare providers in western Montana regarding pharmacogenomic testing. Results Participants were optimistic about the potential of pharmacogenomic tests, but noted unique barriers in small and rural settings including cost, adherence, patient acceptability and testing timeframe. Participants in tribal settings identified heightened sensitivity to genetics and need for community leadership approval as additional considerations. Conclusion Implementation differences in small metropolitan, rural and tribal communities may affect pharmacogenomic test adoption and utilization, potentially impacting many patients. PMID:25712186

Using evaluation theory in priority setting and resource allocation.

PubMed

Smith, Neale; Mitton, Craig; Cornelissen, Evelyn; Gibson, Jennifer; Peacock, Stuart

2012-01-01

Public sector interest in methods for priority setting and program or policy evaluation has grown considerably over the last several decades, given increased expectations for accountable and efficient use of resources and emphasis on evidence-based decision making as a component of good management practice. While there has been some occasional effort to conduct evaluation of priority setting projects, the literatures around priority setting and evaluation have largely evolved separately. In this paper, the aim is to bring them together. The contention is that evaluation theory is a means by which evaluators reflect upon what it is they are doing when they do evaluation work. Theories help to organize thinking, sort out relevant from irrelevant information, provide transparent grounds for particular implementation choices, and can help resolve problematic issues which may arise in the conduct of an evaluation project. A detailed review of three major branches of evaluation theory--methods, utilization, and valuing--identifies how such theories can guide the development of efforts to evaluate priority setting and resource allocation initiatives. Evaluation theories differ in terms of their guiding question, anticipated setting or context, evaluation foci, perspective from which benefits are calculated, and typical methods endorsed. Choosing a particular theoretical approach will structure the way in which any priority setting process is evaluated. The paper suggests that explicitly considering evaluation theory makes key aspects of the evaluation process more visible to all stakeholders, and can assist in the design of effective evaluation of priority setting processes; this should iteratively serve to improve the understanding of priority setting practices themselves.

Teaching trainers to incorporate evidence-based medicine (EBM) teaching in clinical practice: the EU-EBM project

PubMed Central

Thangaratinam, Shakila; Barnfield, Gemma; Weinbrenner, Susanne; Meyerrose, Berit; Arvanitis, Theodoros N; Horvath, Andrea R; Zanrei, Gianni; Kunz, Regina; Suter, Katja; Walczak, Jacek; Kaleta, Anna; Rengerink, Katrien Oude; Gee, Harry; Mol, Ben WJ; Khan, Khalid S

2009-01-01

Background Evidence based medicine (EBM) is considered an integral part of medical training, but integration of teaching various EBM steps in everyday clinical practice is uncommon. Currently EBM is predominantly taught through theoretical courses, workshops and e-learning. However, clinical teachers lack confidence in teaching EBM in workplace and are often unsure of the existing opportunities for teaching EBM in the clinical setting. There is a need for continuing professional development (CPD) courses that train clinical trainers to teach EBM through on-the-job training by demonstration of applied EBM real time in clinical practice. We developed such a course to encourage clinically relevant teaching of EBM in post-graduate education in various clinical environments. Methods We devised an e-learning course targeting trainers with EBM knowledge to impart educational methods needed to teach application of EBM teaching in commonly used clinical settings. The curriculum development group comprised experienced EBM teachers, clinical epidemiologists, clinicians and educationalists from institutions in seven European countries. The e-learning sessions were designed to allow participants (teachers) to undertake the course in the workplace during short breaks within clinical activities. An independent European steering committee provided input into the process. Results The curriculum defined specific learning objectives for teaching EBM by exploiting educational opportunities in six different clinical settings. The e-modules incorporated video clips that demonstrate practical and effective methods of EBM teaching in everyday clinical practice. The course encouraged focussed teaching activities embedded within a trainer's personal learning plan and documentation in a CPD portfolio for reflection. Conclusion This curriculum will help senior clinicians to identify and make the best use of available opportunities in everyday practice in clinical situations to teach various steps of EBM and demonstrate their applicability to clinical practice. Once fully implemented, the ultimate outcome of this pilot project will be a European qualification in teaching EBM, which will be used by doctors, hospitals, professional bodies responsible for postgraduate qualifications and continuing medical education. PMID:19744327

Bioethics education in clinical settings: theory and practice of the dilemma method of moral case deliberation.

PubMed

Stolper, Margreet; Molewijk, Bert; Widdershoven, Guy

2016-07-22

Moral Case Deliberation is a specific form of bioethics education fostering professionals' moral competence in order to deal with their moral questions. So far, few studies focus in detail on Moral Case Deliberation methodologies and their didactic principles. The dilemma method is a structured and frequently used method in Moral Case Deliberation that stimulates methodological reflection and reasoning through a systematic dialogue on an ethical issue experienced in practice. In this paper we present a case-study of a Moral Case Deliberation with the dilemma method in a health care institution for people with an intellectual disability, describing the theoretical background and the practical application of the dilemma method. The dilemma method focuses on moral experiences of participants concerning a concrete dilemma in practice. By an in-depth description of each of the steps of the deliberation process, we elucidate the educational value and didactics of this specific method. The didactics and methodical steps of the dilemma method both supported and structured the dialogical reflection process of the participants. The process shows that the participants learned to recognize the moral dimension of the issue at stake and were able to distinguish various perspectives and reasons in a systematic manner. The facilitator played an important role in the learning process of the participants, by assisting them in focusing on and exploring moral aspects of the case. The reflection and learning process, experienced by the participants, shows competency-based characteristics. The role of the facilitator is that of a Socratic teacher with specific knowledge and skills, fostering reflection, inquiry and dialogue. The specific didactics of the dilemma method is well suited for teaching bioethics in clinical settings. The dilemma method follows an inductive learning approach through a dialogical moral inquiry in which participants develop not only knowledge but also skills, attitude and character. The role of a trained facilitator and a specific view on teaching and practicing ethics are essential when using the dilemma method in teaching health care professionals how to reflect on their own moral issues in practice.

Sustaining School-Based Asthma Interventions through Policy and Practice Change

ERIC Educational Resources Information Center

Carpenter, Laurie M.; Lachance, Laurie; Wilkin, Margaret; Clark, Noreen M.

2013-01-01

Background: Schools are an ideal setting for implementation of asthma interventions for children; however, sustaining school-based programs can be challenging. This study illustrates policy and practice changes brought about through the Childhood Asthma Linkages in Missouri (CALM) program to sustain such programs. Methods: Researchers analyzed…

CPR: A Model for Effective Goal Setting.

ERIC Educational Resources Information Center

Bey, Theresa M.

The Complete Procedural Record (CPR) method provides an opportunity for the student teacher to: (1) review theories, practices, and experiences he or she encounters in teacher preparation courses; (2) rethink the various responsibilities and tasks one will have to assume during the practice teaching experience; (3) identify the concerns one has…

Teaching Light Compensation Point: A New Practical Approach.

ERIC Educational Resources Information Center

Aston, T. J.; Robinson, G.

1986-01-01

Describes a simple method for measuring respiration, net photosynthesis, and compensation points of plants in relation to light intensity. Outlines how the method can be used in teaching physiological adaptation. Includes a set of the experiment's results. (ML)

Employing Policy and Purchasing Levers to Increase the Use of Evidence-Based Practices in Community-Based Substance Abuse Treatment Settings: Reports from Single State Authorities

ERIC Educational Resources Information Center

Rieckmann, Traci R.; Kovas, Anne E.; Cassidy, Elaine F.; McCarty, Dennis

2011-01-01

State public health authorities are critical to the successful implementation of science based addiction treatment practices by community-based providers. The literature to date, however, lacks examples of state level policy strategies that promote evidence-based practices (EBPs). This mixed-methods study documents changes in two critical…

Setting Healthcare Priorities at the Macro and Meso Levels: A Framework for Evaluation

PubMed Central

Barasa, Edwine W.; Molyneux, Sassy; English, Mike; Cleary, Susan

2015-01-01

Background: Priority setting in healthcare is a key determinant of health system performance. However, there is no widely accepted priority setting evaluation framework. We reviewed literature with the aim of developing and proposing a framework for the evaluation of macro and meso level healthcare priority setting practices. Methods: We systematically searched Econlit, PubMed, CINAHL, and EBSCOhost databases and supplemented this with searches in Google Scholar, relevant websites and reference lists of relevant papers. A total of 31 papers on evaluation of priority setting were identified. These were supplemented by broader theoretical literature related to evaluation of priority setting. A conceptual review of selected papers was undertaken. Results: Based on a synthesis of the selected literature, we propose an evaluative framework that requires that priority setting practices at the macro and meso levels of the health system meet the following conditions: (1) Priority setting decisions should incorporate both efficiency and equity considerations as well as the following outcomes; (a) Stakeholder satisfaction, (b) Stakeholder understanding, (c) Shifted priorities (reallocation of resources), and (d) Implementation of decisions. (2) Priority setting processes should also meet the procedural conditions of (a) Stakeholder engagement, (b) Stakeholder empowerment, (c) Transparency, (d) Use of evidence, (e) Revisions, (f) Enforcement, and (g) Being grounded on community values. Conclusion: Available frameworks for the evaluation of priority setting are mostly grounded on procedural requirements, while few have included outcome requirements. There is, however, increasing recognition of the need to incorporate both consequential and procedural considerations in priority setting practices. In this review, we adapt an integrative approach to develop and propose a framework for the evaluation of priority setting practices at the macro and meso levels that draws from these complementary schools of thought. PMID:26673332

Testing Different Model Building Procedures Using Multiple Regression.

ERIC Educational Resources Information Center

Thayer, Jerome D.

The stepwise regression method of selecting predictors for computer assisted multiple regression analysis was compared with forward, backward, and best subsets regression, using 16 data sets. The results indicated the stepwise method was preferred because of its practical nature, when the models chosen by different selection methods were similar…

Mixed Methods in Intervention Research: Theory to Adaptation

ERIC Educational Resources Information Center

Nastasi, Bonnie K.; Hitchcock, John; Sarkar, Sreeroopa; Burkholder, Gary; Varjas, Kristen; Jayasena, Asoka

2007-01-01

The purpose of this article is to demonstrate the application of mixed methods research designs to multiyear programmatic research and development projects whose goals include integration of cultural specificity when generating or translating evidence-based practices. The authors propose a set of five mixed methods designs related to different…

Future methods in pharmacy practice research.

PubMed

Almarsdottir, A B; Babar, Z U D

2016-06-01

This article describes the current and future practice of pharmacy scenario underpinning and guiding this research and then suggests future directions and strategies for such research. First, it sets the scene by discussing the key drivers which could influence the change in pharmacy practice research. These are demographics, technology and professional standards. Second, deriving from this, it seeks to predict and forecast the future shifts in use of methodologies. Third, new research areas and availability of data impacting on future methods are discussed. These include the impact of aging information technology users on healthcare, understanding and responding to cultural and social disparities, implementing multidisciplinary initiatives to improve health care, medicines optimization and predictive risk analysis, and pharmacy as business and health care institution. Finally, implications of the trends for pharmacy practice research methods are discussed.

Practice Guidelines for Nutrition in Critically Ill Patients: A Relook for Indian Scenario

PubMed Central

Mehta, Yatin; Sunavala, J. D.; Zirpe, Kapil; Tyagi, Niraj; Garg, Sunil; Sinha, Saswati; Shankar, Bhuvaneshwari; Chakravarti, Sanghamitra; Sivakumar, M. N.; Sahu, Sambit; Rangappa, Pradeep; Banerjee, Tanmay; Joshi, Anshu; Kadhe, Ganesh

2018-01-01

Background and Aim: Intensive-care practices and settings may differ for India in comparison to other countries. While international guidelines are available to direct the use of enteral nutrition (EN), there are no recommendations specific to Indian settings. Advisory board meetings were arranged to develop the practice guidelines specific to Indian context, for the use of EN in critically ill patients and to overcome challenges in this field. Methods: Various existing guidelines, meta-analyses, randomized controlled trials, controlled trials, and review articles were reviewed for their contextual relevance and strength. A systematic grading of practice guidelines by advisory board was done based on strength of the supporting evidence. Wherever Indian studies were not available, references were taken from the international guidelines. Results: Based on the literature review, the recommendations for developing the practice guidelines were made as per the grading criteria agreed upon by the advisory board. The recommendations were to address challenges regarding EN versus parenteral nutrition; nutrition screening and assessment; nutrition in hemodynamically unstable; route of nutrition; tube feeding and challenges; tolerance; optimum calorie-protein requirements; selection of appropriate enteral feeding formula; micronutrients and immune-nutrients; standard nutrition in hepatic, renal, and respiratory diseases and documentation of nutrition practices. Conclusion: This paper summarizes the optimum nutrition practices for critically ill patients. The possible solutions to overcome the challenges in this field are presented as practice guidelines at the end of each section. These guidelines are expected to provide guidance in critical care settings regarding appropriate critical-care nutrition practices and to set up Intensive Care Unit nutrition protocols. PMID:29743765

Singularity computations. [finite element methods for elastoplastic flow

NASA Technical Reports Server (NTRS)

Swedlow, J. L.

1978-01-01

Direct descriptions of the structure of a singularity would describe the radial and angular distributions of the field quantities as explicitly as practicable along with some measure of the intensity of the singularity. This paper discusses such an approach based on recent development of numerical methods for elastoplastic flow. Attention is restricted to problems where one variable or set of variables is finite at the origin of the singularity but a second set is not.

A new IRT-based standard setting method: application to eCat-listening.

PubMed

García, Pablo Eduardo; Abad, Francisco José; Olea, Julio; Aguado, David

2013-01-01

Criterion-referenced interpretations of tests are highly necessary, which usually involves the difficult task of establishing cut scores. Contrasting with other Item Response Theory (IRT)-based standard setting methods, a non-judgmental approach is proposed in this study, in which Item Characteristic Curve (ICC) transformations lead to the final cut scores. eCat-Listening, a computerized adaptive test for the evaluation of English Listening, was administered to 1,576 participants, and the proposed standard setting method was applied to classify them into the performance standards of the Common European Framework of Reference for Languages (CEFR). The results showed a classification closely related to relevant external measures of the English language domain, according to the CEFR. It is concluded that the proposed method is a practical and valid standard setting alternative for IRT-based tests interpretations.

Risk Stratification Methods and Provision of Care Management Services in Comprehensive Primary Care Initiative Practices.

PubMed

Reddy, Ashok; Sessums, Laura; Gupta, Reshma; Jin, Janel; Day, Tim; Finke, Bruce; Bitton, Asaf

2017-09-01

Risk-stratified care management is essential to improving population health in primary care settings, but evidence is limited on the type of risk stratification method and its association with care management services. We describe risk stratification patterns and association with care management services for primary care practices in the Comprehensive Primary Care (CPC) initiative. We undertook a qualitative approach to categorize risk stratification methods being used by CPC practices and tested whether these stratification methods were associated with delivery of care management services. CPC practices reported using 4 primary methods to stratify risk for their patient populations: a practice-developed algorithm (n = 215), the American Academy of Family Physicians' clinical algorithm (n = 155), payer claims and electronic health records (n = 62), and clinical intuition (n = 52). CPC practices using practice-developed algorithm identified the most number of high-risk patients per primary care physician (282 patients, P = .006). CPC practices using clinical intuition had the most high-risk patients in care management and a greater proportion of high-risk patients receiving care management per primary care physician (91 patients and 48%, P =.036 and P =.128, respectively). CPC practices used 4 primary methods to identify high-risk patients. Although practices that developed their own algorithm identified the greatest number of high-risk patients, practices that used clinical intuition connected the greatest proportion of patients to care management services. © 2017 Annals of Family Medicine, Inc.

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

PubMed Central

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

2018-01-01

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

Controlled trials to improve antibiotic utilization: a systematic review of experience, 1984-2004.

PubMed

Parrino, Thomas A

2005-02-01

To review the effectiveness of interventions designed to improve antibiotic prescribing patterns in clinical practice and to draw inferences about the most practical methods for optimizing antibiotic utilization in hospital and ambulatory settings. A literature search using online databases for the years 1975-2004 identified controlled trials of strategies for improving antibiotic utilization. Due to variation in study settings and design, quantitative meta-analysis was not feasible. Therefore, a qualitative literature review was conducted. Forty-one controlled trials met the search criteria. Interventions consisted of education, peer review and feedback, physician participation, rewards and penalties, administrative methods, and combined approaches. Social marketing directed at patients and prescribers was effective in varying contexts, as was implementation of practice guidelines. Authorization systems with structured order entry, formulary restriction, and mandatory consultation were also effective. Peer review and feedback were more effective when combined with dissemination of relevant information or social marketing than when used alone. Several practices were effective in improving antibiotic utilization: social marketing, practice guidelines, authorization systems, and peer review and feedback. Online systems providing clinical information, structured order entry, and decision support may be the most promising approach. Further studies, including economic analyses, are needed to confirm or refute this hypothesis.

Developing a preliminary 'never event' list for general practice using consensus-building methods.

PubMed

de Wet, Carl; O'Donnell, Catherine; Bowie, Paul

2014-03-01

The 'never event' concept has been implemented in many acute hospital settings to help prevent serious patient safety incidents. Benefits include increasing awareness of highly important patient safety risks among the healthcare workforce, promoting proactive implementation of preventive measures, and facilitating incident reporting. To develop a preliminary list of never events for general practice. Application of a range of consensus-building methods in Scottish and UK general practices. A total of 345 general practice team members suggested potential never events. Next, 'informed' staff (n =15) developed criteria for defining never events and applied the criteria to create a list of candidate never events. Finally, UK primary care patient safety 'experts' (n = 17) reviewed, refined, and validated a preliminary list via a modified Delphi group and by completing a content validity index exercise. There were 721 written suggestions received as potential never events. Thematic categorisation reduced this to 38. Five criteria specific to general practice were developed and applied to produce 11 candidate never events. The expert group endorsed a preliminary list of 10 items with a content validity index (CVI) score of >80%. A preliminary list of never events was developed for general practice through practitioner experience and consensus-building methods. This is an important first step to determine the potential value of the never event concept in this setting. It is now intended to undertake further testing of this preliminary list to assess its acceptability, feasibility, and potential usefulness as a safety improvement intervention.

A Clinical Librarian-Nursing Partnership to Bridge Clinical Practice and Research in an Oncology Setting.

PubMed

Ginex, Pamela K; Hernandez, Marisol; Vrabel, Mark

2016-09-01

Nurses in clinical settings in which evidence-based, individualized care is expected are often the best resource to identify important clinical questions and gaps in practice. These nurses are frequently challenged by a lack of resources to fully develop their questions and identify the most appropriate methods to answer them. A strategic and ongoing partnership between medical library services and nursing can support nurses as they embark on the process of answering these questions and, ultimately, improving patient care and clinical outcomes

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.

77 FR 6879 - Rules of Practice for Trials Before the Patent Trial and Appeal Board and Judicial Review of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

...The United States Patent and Trademark Office (Office or USPTO) proposes new rules of practice to implement the provisions of the Leahy-Smith America Invents Act that provide for trials before the Patent Trial and Appeal Board (Board). The proposed rules would provide a consolidated set of rules relating to Board trial practice for inter partes review, post-grant review, the transitional program for covered business method patents, and derivation proceedings. The proposed rules would also provide a consolidated set of rules to implement the provisions of the Leahy-Smith America Invents Act related to seeking judicial review of Board decisions.

Maternal psychosocial well-being in Eritrea: application of participatory methods and tools of investigation and analysis in complex emergency settings.

PubMed Central

Almedom, Astier M.; Tesfamichael, Berhe; Yacob, Abdu; Debretsion, Zaïd; Teklehaimanot, Kidane; Beyene, Teshome; Kuhn, Kira; Alemu, Zemui

2003-01-01

OBJECTIVE: To establish the context in which maternal psychosocial well-being is understood in war-affected settings in Eritrea. METHOD: Pretested and validated participatory methods and tools of investigation and analysis were employed to allow participants to engage in processes of qualitative data collection, on-site analysis, and interpretation. FINDINGS: Maternal psychosocial well-being in Eritrea is maintained primarily by traditional systems of social support that are mostly outside the domain of statutory primary care. Traditional birth attendants provide a vital link between the two. Formal training and regular supplies of sterile delivery kits appear to be worthwhile options for health policy and practice in the face of the post-conflict challenges of ruined infrastructure and an overstretched and/or ill-mannered workforce in the maternity health service. CONCLUSION: Methodological advances in health research and the dearth of data on maternal psychosocial well-being in complex emergency settings call for scholars and practitioners to collaborate in creative searches for sound evidence on which to base maternity, mental health and social care policy and practice. Participatory methods facilitate the meaningful engagement of key stakeholders and enhance data quality, reliability and usability. PMID:12856054

Performing at the Top of One's Musical Game

PubMed Central

Hatfield, Johannes L.

2016-01-01

The purpose of the present mixed method study was to investigate personal benefits, perceptions, and the effect of a 15-week sport psychological skills training program adapted for musicians. The program was individually tailored for six music performance students with the objective of facilitating the participants' instrumental practice and performance. The participants learnt techniques such as goal setting, attentional focus, arousal regulation, imagery, and acceptance training/self-talk. Zimmerman's (1989) cyclical model of self-regulated learning was applied as a theoretical frame for the intervention. The present study's mixed-method approach (i.e., quan+ QUAL) included effect size, semi-structured interviews, a research log, and practice diaries of the participants (Creswell, 2009). Thematic analysis revealed that participants had little or no experience concerning planning and goal setting in regard to instrumental practice. Concentration, volition, and physical pain were additional issues that the participants struggled with at the time of pre-intervention. The study found that psychological skills training (with special emphasis on planning and goal setting) facilitated cyclical self-regulated learning patterns in the participants. In essence, the intervention was found to facilitate the participants' concentration, self-observation, self-efficacy, and coping in the face of failure. The appliance of practice journals facilitated the participants‘ self-observation, self-evaluation, and awareness of instrumental practice. Finally, the psychological skills intervention reduced participants' worry and anxiety in performance situations. An 8-month follow up interview revealed that the participants were still actively applying psychological skills. PMID:27679586

Alternative industrial carbon emissions benchmark based on input-output analysis

NASA Astrophysics Data System (ADS)

Han, Mengyao; Ji, Xi

2016-12-01

Some problems exist in the current carbon emissions benchmark setting systems. The primary consideration for industrial carbon emissions standards highly relate to direct carbon emissions (power-related emissions) and only a portion of indirect emissions are considered in the current carbon emissions accounting processes. This practice is insufficient and may cause double counting to some extent due to mixed emission sources. To better integrate and quantify direct and indirect carbon emissions, an embodied industrial carbon emissions benchmark setting method is proposed to guide the establishment of carbon emissions benchmarks based on input-output analysis. This method attempts to link direct carbon emissions with inter-industrial economic exchanges and systematically quantifies carbon emissions embodied in total product delivery chains. The purpose of this study is to design a practical new set of embodied intensity-based benchmarks for both direct and indirect carbon emissions. Beijing, at the first level of carbon emissions trading pilot schemes in China, plays a significant role in the establishment of these schemes and is chosen as an example in this study. The newly proposed method tends to relate emissions directly to each responsibility in a practical way through the measurement of complex production and supply chains and reduce carbon emissions from their original sources. This method is expected to be developed under uncertain internal and external contexts and is further expected to be generalized to guide the establishment of industrial benchmarks for carbon emissions trading schemes in China and other countries.

Interprofessional education in the clinical setting: A qualitative look at the preceptor's perspective in training advanced practice nursing students.

PubMed

Chen, Angel K; Rivera, Josette; Rotter, Nicole; Green, Emily; Kools, Susan

2016-11-01

With the shift towards interprofessional education to promote collaborative practice, clinical preceptors are increasingly working with trainees from various professions to provide patient care. It is unclear whether and how preceptors modify their existing precepting approach when working with trainees from other professions. There is little information on strategies for this type of precepting, and how preceptors may foster or impede interprofessional collaboration. The purpose of this qualitative description pilot study was to identify current methods preceptors use to teach trainees from other professions in the clinical setting, particularly advanced practice nursing and medical trainees, and to identify factors that support or impede this type of precepting. Data collected through observations and interviews were analyzed by the research team using thematic analysis procedures. Three major themes were identified: 1) a variety of teaching approaches and levels of engagement with trainees of different professions, 2) preceptor knowledge gaps related to curricula, goals, and scope of practice of trainees from other professions, and 3) administrative, structural and logistical elements that impact the success of precepting trainees from different professions in the clinical setting. This study has implications for faculty development and evaluation of current precepting practices in clinical settings. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

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…

Free selection: a silvicultural option

Treesearch

Russell T. Graham; Theresa B. Jain; Jonathan Sandquist

2007-01-01

Forest management objectives continue to evolve as the desires and needs of society change. The practice of silviculture has risen to the challenge by supplying silvicultural methods and systems to produce desired stand and forest structures and compositions to meet these changing objectives. For the most part, the practice of silviculture offers a robust set of...

Moving from Efficacy to Effectiveness in Cognitive Behavioral Therapy for Psychosis: A Randomized Clinical Practice Trial

ERIC Educational Resources Information Center

Lincoln, Tania M.; Ziegler, Michael; Mehl, Stephanie; Kesting, Marie-Luise; Lullmann, Eva; Westermann, Stefan; Rief, Winfried

2012-01-01

Objective: Randomized controlled trials have attested the efficacy of cognitive behavioral therapy (CBT) in reducing psychotic symptoms. Now, studies are needed to investigate its effectiveness in routine clinical practice settings. Method: Eighty patients with schizophrenia spectrum disorders who were seeking outpatient treatment were randomized…

An Empirical Comparison of Variable Standardization Methods in Cluster Analysis.

ERIC Educational Resources Information Center

Schaffer, Catherine M.; Green, Paul E.

1996-01-01

The common marketing research practice of standardizing the columns of a persons-by-variables data matrix prior to clustering the entities corresponding to the rows was evaluated with 10 large-scale data sets. Results indicate that the column standardization practice may be problematic for some kinds of data that marketing researchers used for…

Common Practice Lightning Strike Protection Characterization Technique to Quantify Damage Mechanisms on Composite Substrates

NASA Technical Reports Server (NTRS)

Szatkowski, George N.; Dudley, Kenneth L.; Koppen, Sandra V.; Ely, Jay J.; Nguyen, Truong X.; Ticatch, Larry A.; Mielnik, John J.; Mcneill, Patrick A.

2013-01-01

To support FAA certification airworthiness standards, composite substrates are subjected to lightning direct-effect electrical waveforms to determine performance characteristics of the lightning strike protection (LSP) conductive layers used to protect composite substrates. Test results collected from independent LSP studies are often incomparable due to variability in test procedures & applied practices at different organizations, which impairs performance correlations between different LSP data sets. Under a NASA supported contract, The Boeing Company developed technical procedures and documentation as guidance in order to facilitate a test method for conducting universal common practice lightning strike protection test procedures. The procedures obtain conformity in future lightning strike protection evaluations to allow meaningful performance correlations across data sets. This universal common practice guidance provides the manufacturing specifications to fabricate carbon fiber reinforced plastic (CFRP) test panels, including finish, grounding configuration, and acceptable methods for pretest nondestructive inspection (NDI) and posttest destructive inspection. The test operations guidance elaborates on the provisions contained in SAE ARP5416 to address inconsistencies in the generation of damage protection performance data, so as to provide for maximum achievable correlation across capable lab facilities. In addition, the guidance details a direct effects test bed design to aid in quantification of the multi-physical phenomena surrounding a lightning direct attachment supporting validation data requirements for the development of predictive computational modeling. The lightning test bed is designed to accommodate a repeatable installation procedure to secure the test panel and eliminate test installation uncertainty. It also facilitates a means to capture the electrical waveform parameters in 2 dimensions, along with the mechanical displacement and thermal heating parameters which occur during lightning attachment. Following guidance defined in the universal common practice LSP test documents, protected and unprotected CFRP panels were evaluated at 20, 40 and 100KAmps. This report presents analyzed data demonstrating the scientific usefulness of the common practice approach. Descriptions of the common practice CFRP test articles, LSP test bed fixture, and monitoring techniques to capture the electrical, mechanical and thermal parameters during lightning attachment are presented here. Two methods of measuring the electrical currents were evaluated, inductive current probes and a newly developed fiberoptic sensor. Two mechanical displacement methods were also examined, optical laser measurement sensors and a digital imaging correlation camera system. Recommendations are provided to help users implement the common practice test approach and obtain LSP test characterizations comparable across data sets.

Insightful practice: a reliable measure for medical revalidation

PubMed Central

Guthrie, Bruce; Sullivan, Frank M; Mercer, Stewart W; Russell, Andrew; Bruce, David A

2012-01-01

Background Medical revalidation decisions need to be reliable if they are to reassure on the quality and safety of professional practice. This study tested an innovative method in which general practitioners (GPs) were assessed on their reflection and response to a set of externally specified feedback. Setting and participants 60 GPs and 12 GP appraisers in the Tayside region of Scotland, UK. Methods A feedback dataset was specified as (1) GP-specific data collected by GPs themselves (patient and colleague opinion; open book self-evaluated knowledge test; complaints) and (2) Externally collected practice-level data provided to GPs (clinical quality and prescribing safety). GPs' perceptions of whether the feedback covered UK General Medical Council specified attributes of a ‘good doctor’ were examined using a mapping exercise. GPs' professionalism was examined in terms of appraiser assessment of GPs' level of insightful practice, defined as: engagement with, insight into and appropriate action on feedback data. The reliability of assessment of insightful practice and subsequent recommendations on GPs' revalidation by face-to-face and anonymous assessors were investigated using Generalisability G-theory. Main outcome measures Coverage of General Medical Council attributes by specified feedback and reliability of assessor recommendations on doctors' suitability for revalidation. Results Face-to-face assessment proved unreliable. Anonymous global assessment by three appraisers of insightful practice was highly reliable (G=0.85), as were revalidation decisions using four anonymous assessors (G=0.83). Conclusions Unlike face-to-face appraisal, anonymous assessment of insightful practice offers a valid and reliable method to decide GP revalidation. Further validity studies are needed. PMID:22653078

Governance of professional nursing practice in a hospital setting: a mixed methods study.

PubMed

dos Santos, José Luís Guedes; Erdmann, Alacoque Lorenzini

2015-01-01

To elaborate an interpretative model for the governance of professional nursing practice in a hospital setting. A mixed methods study with concurrent triangulation strategy, using data from a cross-sectional study with 106 nurses and a Grounded Theory study with 63 participants. The quantitative data were collected through the Brazilian Nursing Work Index - Revised and underwent descriptive statistical analysis. Qualitative data were obtained from interviews and analyzed through initial, selective and focused coding. Based on the results obtained with the Brazilian Nursing Work Index - Revised, it is possible to state that nurses perceived that they had autonomy, control over the environment, good relationships with physicians and organizational support for nursing governance. The governance of the professional nursing practice is based on the management of nursing care and services carried out by the nurses. To perform these tasks, nurses aim to get around the constraints of the organizational support and develop management knowledge and skills. It is important to reorganize the structures and processes of nursing governance, especially the support provided by the organization for the management practices of nurses.

Alternative Practice Dental Hygiene in California: Past, Present, and Future

PubMed Central

MERTZ, ELIZABETH; GLASSMAN, PAUL

2012-01-01

This study examines the development of the registered dental hygienist in alternative practice in California through an analysis of archival documents, stakeholder interviews, and two surveys of the registered dental hygienist in alternative practice. Designing, testing and implementing a new practice model for dental hygienists took 23 years. Today, registered dental hygienists in alternative practice have developed viable alternative methods for delivering preventive oral health care services in a range of settings with patients who often have no other source of access to care. PMID:21337961

Segmenting data sets for RIP.

PubMed

de Sanctis, Daniele; Nanao, Max H

2012-09-01

Specific radiation damage can be used for the phasing of macromolecular crystal structures. In practice, however, the optimization of the X-ray dose used to `burn' the crystal to induce specific damage can be difficult. Here, a method is presented in which a single large data set that has not been optimized in any way for radiation-damage-induced phasing (RIP) is segmented into multiple sub-data sets, which can then be used for RIP. The efficacy of this method is demonstrated using two model systems and two test systems. A method to improve the success of this type of phasing experiment by varying the composition of the two sub-data sets with respect to their separation by image number, and hence by absorbed dose, as well as their individual completeness is illustrated.

Integrating Science and Engineering to Implement Evidence-Based Practices in Health Care Settings.

PubMed

Wu, Shinyi; Duan, Naihua; Wisdom, Jennifer P; Kravitz, Richard L; Owen, Richard R; Sullivan, J Greer; Wu, Albert W; Di Capua, Paul; Hoagwood, Kimberly Eaton

2015-09-01

Integrating two distinct and complementary paradigms, science and engineering, may produce more effective outcomes for the implementation of evidence-based practices in health care settings. Science formalizes and tests innovations, whereas engineering customizes and optimizes how the innovation is applied tailoring to accommodate local conditions. Together they may accelerate the creation of an evidence-based healthcare system that works effectively in specific health care settings. We give examples of applying engineering methods for better quality, more efficient, and safer implementation of clinical practices, medical devices, and health services systems. A specific example was applying systems engineering design that orchestrated people, process, data, decision-making, and communication through a technology application to implement evidence-based depression care among low-income patients with diabetes. We recommend that leading journals recognize the fundamental role of engineering in implementation research, to improve understanding of design elements that create a better fit between program elements and local context.

Integrating Primary Sources, Artifacts, and Museum Visits into the Primary Years Program Inquiry Curriculum in an International Baccalaureate Elementary Setting

ERIC Educational Resources Information Center

Coppersmith, Sarah A.; Song, Kim H.

2017-01-01

Questions remain about inquiry instruction, while research confirms that using primary sources can aid students' inquiry learning processes. This study questioned: "How do second-grade teachers at an International Baccalaureate Organization/IBO language immersion setting incorporate inquiry methods in instructional practices?"; "How…

Provider, Patient, and Family Perspectives of Adolescent Alcohol Use and Treatment in Rural Settings

ERIC Educational Resources Information Center

Gordon, Adam J.; Ettaro, Lorraine; Rodriguez, Keri L.; Mocik, John; Clark, Duncan B.

2011-01-01

Purpose: We examined rural primary care providers' (PCPs) self-reported practices of screening, brief interventions, and referral to treatment (SBIRT) on adolescent alcohol use and examined PCPs', adolescents', and parents' attitudes regarding SBIRT on adolescent alcohol use in rural clinic settings. Methods: In 2007, we mailed surveys that…

Bringing Nature into Social Work Settings: Mother Earth's Presence

ERIC Educational Resources Information Center

Gana, Carolina

2011-01-01

In an urban location in the downtown core of Toronto, Ontario, the author provides both individual and group counselling to women impacted by trauma in a community-based setting. Various modalities and theoretical frameworks that include feminism and anti-oppressive methods inform her counselling practice. The approach that the author takes in the…

16 CFR § 1500.41 - Method of testing primary irritant substances.

Code of Federal Regulations, 2013 CFR

2013-01-01

... testing that does not require animals, are presented in the CPSC's animal testing policy set forth in 16... recommended to reduce the number of test animals. The method of testing the dermal corrosivity and primary... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Method of testing primary irritant...

Simplified Microarray Technique for Identifying mRNA in Rare Samples

NASA Technical Reports Server (NTRS)

Almeida, Eduardo; Kadambi, Geeta

2007-01-01

Two simplified methods of identifying messenger ribonucleic acid (mRNA), and compact, low-power apparatuses to implement the methods, are at the proof-of-concept stage of development. These methods are related to traditional methods based on hybridization of nucleic acid, but whereas the traditional methods must be practiced in laboratory settings, these methods could be practiced in field settings. Hybridization of nucleic acid is a powerful technique for detection of specific complementary nucleic acid sequences, and is increasingly being used for detection of changes in gene expression in microarrays containing thousands of gene probes. A traditional microarray study entails at least the following six steps: 1. Purification of cellular RNA, 2. Amplification of complementary deoxyribonucleic acid [cDNA] by polymerase chain reaction (PCR), 3. Labeling of cDNA with fluorophores of Cy3 (a green cyanine dye) and Cy5 (a red cyanine dye), 4. Hybridization to a microarray chip, 5. Fluorescence scanning the array(s) with dual excitation wavelengths, and 6. Analysis of the resulting images. This six-step procedure must be performed in a laboratory because it requires bulky equipment.

Identifying finite-time coherent sets from limited quantities of Lagrangian data.

PubMed

Williams, Matthew O; Rypina, Irina I; Rowley, Clarence W

2015-08-01

A data-driven procedure for identifying the dominant transport barriers in a time-varying flow from limited quantities of Lagrangian data is presented. Our approach partitions state space into coherent pairs, which are sets of initial conditions chosen to minimize the number of trajectories that "leak" from one set to the other under the influence of a stochastic flow field during a pre-specified interval in time. In practice, this partition is computed by solving an optimization problem to obtain a pair of functions whose signs determine set membership. From prior experience with synthetic, "data rich" test problems, and conceptually related methods based on approximations of the Perron-Frobenius operator, we observe that the functions of interest typically appear to be smooth. We exploit this property by using the basis sets associated with spectral or "mesh-free" methods, and as a result, our approach has the potential to more accurately approximate these functions given a fixed amount of data. In practice, this could enable better approximations of the coherent pairs in problems with relatively limited quantities of Lagrangian data, which is usually the case with experimental geophysical data. We apply this method to three examples of increasing complexity: The first is the double gyre, the second is the Bickley Jet, and the third is data from numerically simulated drifters in the Sulu Sea.

Identifying finite-time coherent sets from limited quantities of Lagrangian data

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

Williams, Matthew O.; Rypina, Irina I.; Rowley, Clarence W.

A data-driven procedure for identifying the dominant transport barriers in a time-varying flow from limited quantities of Lagrangian data is presented. Our approach partitions state space into coherent pairs, which are sets of initial conditions chosen to minimize the number of trajectories that “leak” from one set to the other under the influence of a stochastic flow field during a pre-specified interval in time. In practice, this partition is computed by solving an optimization problem to obtain a pair of functions whose signs determine set membership. From prior experience with synthetic, “data rich” test problems, and conceptually related methods basedmore » on approximations of the Perron-Frobenius operator, we observe that the functions of interest typically appear to be smooth. We exploit this property by using the basis sets associated with spectral or “mesh-free” methods, and as a result, our approach has the potential to more accurately approximate these functions given a fixed amount of data. In practice, this could enable better approximations of the coherent pairs in problems with relatively limited quantities of Lagrangian data, which is usually the case with experimental geophysical data. We apply this method to three examples of increasing complexity: The first is the double gyre, the second is the Bickley Jet, and the third is data from numerically simulated drifters in the Sulu Sea.« less

The perceived importance of anatomy and neuroanatomy in the practice of speech-language pathology.

PubMed

Martin, Kate; Bessell, Nicola J; Scholten, Ingrid

2014-01-01

The purpose of this study was to examine the application of anatomy and neuroanatomy knowledge to current practice of speech-language pathology (SLP), based on the perceptions of practicing SLPs, and to elicit information on participants' experiences of learning these subjects in their primary SLP degree with a view to inform potential curriculum development. A qualitative approach was taken to the collection of data. Eight practicing SLPs from four settings were interviewed. The critical incident technique, together with further probing, was used to elicit information. Interviews were transcribed and later thematically analyzed. This study found that knowledge of anatomy and neuroanatomy was perceived to be important by SLPs across all settings, to varying degrees, with a greater application in acute hospital settings. Negative experiences in studying this material were reported across all settings regardless of country of study. Participants discussed ways to increase students' motivation to learn this challenging material. Relevance of material demanded by students may be enhanced if active learning methods were used to teach anatomy/neuroanatomy, including case-based learning and with vertical and horizontal integration of material to provide a cohesive, spiral curriculum. © 2013 American Association of Anatomists.

Identification of an updated set of prescribing-safety indicators for GPs

PubMed Central

Spencer, Rachel; Bell, Brian; Avery, Anthony J; Gookey, Gill; Campbell, Stephen M

2014-01-01

Background Medication error is an important contributor to patient morbidity and mortality and is associated with inadequate patient safety measures. However, prescribing-safety tools specifically designed for use in general practice are lacking. Aim To identify and update a set of prescribing-safety indicators for assessing the safety of prescribing in general practice, and to estimate the risk of harm to patients associated with each indicator. Design and setting RAND/UCLA consensus development of indicators in UK general practice. Method Prescribing indicators were identified from a systematic review and previous consensus exercise. The RAND Appropriateness Method was used to further identify and develop the indicators with an electronic-Delphi method used to rate the risk associated with them. Twelve GPs from all the countries of the UK participated in the RAND exercise, with 11 GPs rating risk using the electronic-Delphi approach. Results Fifty-six prescribing-safety indicators were considered appropriate for inclusion (overall panel median rating of 7–9, with agreement). These indicators cover hazardous prescribing across a range of therapeutic indications, hazardous drug–drug combinations and inadequate laboratory test monitoring. Twenty-three (41%) of these indicators were considered high risk or extreme risk by 80% or more of the participants. Conclusion This study identified a set of 56 indicators that were considered, by a panel of GPs, to be appropriate for assessing the safety of GP prescribing. Twenty-three of these indicators were considered to be associated with high or extreme risk to patients and should be the focus of efforts to improve patient safety. PMID:24686882

Organizational contextual features that influence the implementation of evidence-based practices across healthcare settings: a systematic integrative review.

PubMed

Li, Shelly-Anne; Jeffs, Lianne; Barwick, Melanie; Stevens, Bonnie

2018-05-05

Organizational contextual features have been recognized as important determinants for implementing evidence-based practices across healthcare settings for over a decade. However, implementation scientists have not reached consensus on which features are most important for implementing evidence-based practices. The aims of this review were to identify the most commonly reported organizational contextual features that influence the implementation of evidence-based practices across healthcare settings, and to describe how these features affect implementation. An integrative review was undertaken following literature searches in CINAHL, MEDLINE, PsycINFO, EMBASE, Web of Science, and Cochrane databases from January 2005 to June 2017. English language, peer-reviewed empirical studies exploring organizational context in at least one implementation initiative within a healthcare setting were included. Quality appraisal of the included studies was performed using the Mixed Methods Appraisal Tool. Inductive content analysis informed data extraction and reduction. The search generated 5152 citations. After removing duplicates and applying eligibility criteria, 36 journal articles were included. The majority (n = 20) of the study designs were qualitative, 11 were quantitative, and 5 used a mixed methods approach. Six main organizational contextual features (organizational culture; leadership; networks and communication; resources; evaluation, monitoring and feedback; and champions) were most commonly reported to influence implementation outcomes in the selected studies across a wide range of healthcare settings. We identified six organizational contextual features that appear to be interrelated and work synergistically to influence the implementation of evidence-based practices within an organization. Organizational contextual features did not influence implementation efforts independently from other features. Rather, features were interrelated and often influenced each other in complex, dynamic ways to effect change. These features corresponded to the constructs in the Consolidated Framework for Implementation Research (CFIR), which supports the use of CFIR as a guiding framework for studies that explore the relationship between organizational context and implementation. Organizational culture was most commonly reported to affect implementation. Leadership exerted influence on the five other features, indicating it may be a moderator or mediator that enhances or impedes the implementation of evidence-based practices. Future research should focus on how organizational features interact to influence implementation effectiveness.

Practical Considerations for Optic Nerve Estimation in Telemedicine

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

Karnowski, Thomas Paul; Aykac, Deniz; Chaum, Edward

The projected increase in diabetes in the United States and worldwide has created a need for broad-based, inexpensive screening for diabetic retinopathy (DR), an eye disease which can lead to vision impairment. A telemedicine network with retina cameras and automated quality control, physiological feature location, and lesion / anomaly detection is a low-cost way of achieving broad-based screening. In this work we report on the effect of quality estimation on an optic nerve (ON) detection method with a confidence metric. We report on an improvement of the fusion technique using a data set from an ophthalmologists practice then show themore » results of the method as a function of image quality on a set of images from an on-line telemedicine network collected in Spring 2009 and another broad-based screening program. We show that the fusion method, combined with quality estimation processing, can improve detection performance and also provide a method for utilizing a physician-in-the-loop for images that may exceed the capabilities of automated processing.« less

Corporate working in health visiting: a concept analysis.

PubMed

Houston, A M; Clifton, J

2001-05-01

The aim of this paper is to examine individualized health visiting care and compare it to corporate working within a consensual management style. Corporate working has been discussed and used in many different ways since the idea first came to light at the end of the 1980s. Resource management makes it an appealing model, however, analysing how corporate working functions in the practice setting reveals the complexity of this method of service provision. This paper is based on a method of practice developed by health visitors in Haywards Heath, West Sussex, who implemented the process. The article examines individualized health visiting care and compares it to corporate working within a consensual management style. Important in this analysis are the elements of reflexivity, active listening, reflection and the application of 'praxis' within the corporate caseload approach. Rogers' evolutionary concept model was used to illuminate and explain the different ways of delivering the health visiting service. There are benefits in working corporately: shared workload, increased professional support and improved accountability. Alongside the integrated supervision of this model is the opportunity offered to practitioners to innovate. This offsets any initial difficulty experienced in setting up this method and makes it a worthwhile change of style in health visiting practice. Improved service delivery, enhanced professional growth and increased opportunity for public health work can be demonstrated as outcomes of this model. For professionals this method may prevent 'burn-out', enhance practice and increase innovation in health visiting practice. Using this method as a blueprint, practitioners can develop their own style of corporate working that offers a service that is equitable, proactive, efficient and accessible to clients.

Connecting the Dots and Merging Meaning: Using Mixed Methods to Study Primary Care Delivery Transformation

PubMed Central

Scammon, Debra L; Tomoaia-Cotisel, Andrada; Day, Rachel L; Day, Julie; Kim, Jaewhan; Waitzman, Norman J; Farrell, Timothy W; Magill, Michael K

2013-01-01

Objective. To demonstrate the value of mixed methods in the study of practice transformation and illustrate procedures for connecting methods and for merging findings to enhance the meaning derived. Data Source/Study Setting. An integrated network of university-owned, primary care practices at the University of Utah (Community Clinics or CCs). CC has adopted Care by Design, its version of the Patient Centered Medical Home. Study Design. Convergent case study mixed methods design. Data Collection/Extraction Methods. Analysis of archival documents, internal operational reports, in-clinic observations, chart audits, surveys, semistructured interviews, focus groups, Centers for Medicare and Medicaid Services database, and the Utah All Payer Claims Database. Principal Findings. Each data source enriched our understanding of the change process and understanding of reasons that certain changes were more difficult than others both in general and for particular clinics. Mixed methods enabled generation and testing of hypotheses about change and led to a comprehensive understanding of practice change. Conclusions. Mixed methods are useful in studying practice transformation. Challenges exist but can be overcome with careful planning and persistence. PMID:24279836

Exploration of the affordances of mobile devices in integrating theory and clinical practice in an undergraduate nursing programme.

PubMed

Willemse, Juliana J; Bozalek, Vivienne

2015-01-01

Promoting the quality and effectiveness of nursing education is an important factor, given the increased demand for nursing professionals. It is important to establish learning environments that provide personalised guidance and feedback to students about their practical skills and application of their theoretical knowledge. To explore and describe the knowledge and points of view of students and educators about introduction of new technologies into an undergraduate nursing programme. The qualitative design used Tesch's (1990) steps of descriptive data analysis to complete thematic analysis of the data collected in focus group discussions (FGDs) and individual interviews to identify themes. Themes identified from the students’ FGDs and individual interviews included: mobile devices as a communication tool; email, WhatsApp and Facebook as methods of communication; WhatsApp as a method of communication; nurses as role-models in the clinical setting; setting personal boundaries; and impact of mobile devices in clinical practice on professionalism. Themes identified from the FGD, individual interviews and a discussion session held with educators included: peer learning via mobile devices; email, WhatsApp and Facebook as methods of communication; the mobile device as a positive learning method; students need practical guidance; and ethical concerns in clinical facilities about Internet access and use of mobile devices. The research project established an understanding of the knowledge and points of view of students and educators regarding introduction of new technologies into an undergraduate nursing programme with the aim of enhancing integration of theory and clinical practice through use of mobile devices.

"Familias: Preparando La Nueva Generación": A Randomized Control Trial Testing the Effects on Positive Parenting Practices

ERIC Educational Resources Information Center

Marsiglia, Flavio F.; Williams, Lela Rankin; Ayers, Stephanie L.; Booth, Jaime M.

2014-01-01

Objectives: This article reports the effects of a culturally grounded parenting intervention to strengthen positive parenting practices. Method: The intervention was designed and tested with primarily Mexican origin parents in a large urban setting of the southwestern United States using an ecodevelopmental approach. Parents (N = 393) were…

MODELS AND METHODS IN PRACTICAL BIOLOGY FOR SECONDARY SCHOOLS.

ERIC Educational Resources Information Center

BELFIELD, W.

THIS BOOK WAS WRITTEN TO FUNCTION AS A STUDENT LABORATORY MANUAL OR AS TEACHER RESOURCE MATERIAL FOR DEVELOPING A LABORATORY-CENTERED COURSE IN PRACTICAL BIOLOGY FOR STUDENTS IN THE 13-16 AGE GROUP. IT WAS DESIGNED TO SUPPLY A COMPREHENSIVE SET OF EXPERIMENTS WHICH, WHEN CARRIED OUT IN CONJUNCTION WITH NORMAL THEORETICAL AND ANATOMICAL STUDIES,…

Impact of Long Farm Working Hours on Child Safety Practices in Agricultural Settings

ERIC Educational Resources Information Center

Marlenga, Barbara; Pahwa, Punam; Hagel, Louise; Dosman, James; Pickett, William

2010-01-01

Objectives: To characterize working hours of adult farm owner-operators and their spouses by season, and to examine associations between working hours and farm safety practices affecting children. Methods: We conducted a secondary analysis of cross-sectional survey data collected as part of an existing study of injury and its determinants.…

Research Priorities for Mental Health Counseling with Youth: Implications for Counselor Preparation, Professional Development, and Research

ERIC Educational Resources Information Center

Mellin, Elizabeth A.; Pertuit, Terry L.

2009-01-01

Counselors encounter the needs of youth (3-17 years) in a variety of settings; however, outside of school counseling, the profession faces a lack of preparation, professional development, and research focused on mental health practice with youth. Using the Delphi method, 12 counselor educators and 15 practicing counselors were polled regarding…

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.

A real-world approach to Evidence-Based Medicine in general practice: a competency framework derived from a systematic review and Delphi process.

PubMed

Galbraith, Kevin; Ward, Alison; Heneghan, Carl

2017-05-03

Evidence-Based Medicine (EBM) skills have been included in general practice curricula and competency frameworks. However, GPs experience numerous barriers to developing and maintaining EBM skills, and some GPs feel the EBM movement misunderstands, and threatens their traditional role. We therefore need a new approach that acknowledges the constraints encountered in real-world general practice. The aim of this study was to synthesise from empirical research a real-world EBM competency framework for general practice, which could be applied in training, in the individual pursuit of continuing professional development, and in routine care. We sought to integrate evidence from the literature with evidence derived from the opinions of experts in the fields of general practice and EBM. We synthesised two sets of themes describing the meaning of EBM in general practice. One set of themes was derived from a mixed-methods systematic review of the literature; the other set was derived from the further development of those themes using a Delphi process among a panel of EBM and general practice experts. From these two sets of themes we constructed a real-world EBM competency framework for general practice. A simple competency framework was constructed, that acknowledges the constraints of real-world general practice: (1) mindfulness - in one's approach towards EBM itself, and to the influences on decision-making; (2) pragmatism - in one's approach to finding and evaluating evidence; and (3) knowledge of the patient - as the most useful resource in effective communication of evidence. We present a clinical scenario to illustrate how a GP might demonstrate these competencies in their routine daily work. We have proposed a real-world EBM competency framework for general practice, derived from empirical research, which acknowledges the constraints encountered in modern general practice. Further validation of these competencies is required, both as an educational resource and as a strategy for actual practice.

Proposal of quality indicators for cardiac rehabilitation after acute coronary syndrome in Japan: a modified Delphi method and practice test.

PubMed

Ohtera, Shosuke; Kanazawa, Natsuko; Ozasa, Neiko; Ueshima, Kenji; Nakayama, Takeo

2017-01-27

Cardiac rehabilitation is underused and its quality in practice is unclear. A quality indicator is a measurable element of clinical practice performance. This study aimed to propose a set of quality indicators for cardiac rehabilitation following an acute coronary event in the Japanese population and conduct a small-size practice test to confirm feasibility and applicability of the indicators in real-world clinical practice. This study used a modified Delphi technique (the RAND/UCLA appropriateness method), a consensus method which involves an evidence review, a face-to-face multidisciplinary panel meeting and repeated anonymous rating. Evidence to be reviewed included clinical practice guidelines available in English or Japanese and existing quality indicators. Performance of each indicator was assessed retrospectively using medical records at a university hospital in Japan. 10 professionals in cardiac rehabilitation for the consensus panel. In the literature review, 23 clinical practice guidelines and 16 existing indicators were identified to generate potential indicators. Through the consensus-building process, a total of 30 indicators were assessed and finally 13 indicators were accepted. The practice test (n=39) revealed that 74% of patients underwent cardiac rehabilitation. Median performance of process measures was 93% (IQR 46-100%). 'Communication with the doctor who referred the patient to cardiac rehabilitation' and 'continuous participation in cardiac rehabilitation' had low performance (32% and 38%, respectively). A modified Delphi technique identified a comprehensive set of quality indicators for cardiac rehabilitation. The single-site, small-size practice test confirmed that most of the proposed indicators were measurable in real-world clinical practice. However, some clinical processes which are not covered by national health insurance in Japan had low performance. Further studies will be needed to clarify and improve the quality of care in cardiac rehabilitation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Improving quality of care through routine, successful implementation of evidence-based practice at the bedside: an organizational case study protocol using the Pettigrew and Whipp model of strategic change

PubMed Central

2007-01-01

Background Evidence-based practice (EBP) is an expected approach to improving the quality of patient care and service delivery in health care systems internationally that is yet to be realized. Given the current evidence-practice gap, numerous authors describe barriers to achieving EBP. One recurrently identified barrier is the setting or context of practice, which is likewise cited as a potential part of the solution to the gap. The purpose of this study is to identify key contextual elements and related strategic processes in organizations that find and use evidence at multiple levels, in an ongoing, integrated fashion, in contrast to those that do not. Methods The core theoretical framework for this multi-method explanatory case study is Pettigrew and Whipp's Content, Context, and Process model of strategic change. This framework focuses data collection on three entities: the Why of strategic change, the What of strategic change, and the How of strategic change, in this case related to implementation and normalization of EBP. The data collection plan, designed to capture relevant organizational context and related outcomes, focuses on eight interrelated factors said to characterize a receptive context. Selective, purposive sampling will provide contrasting results between two cases (departments of nursing) and three embedded units in each. Data collection methods will include quantitative tools (e.g., regarding culture) and qualitative approaches including focus groups, interviews, and documents review (e.g., regarding integration and “success”) relevant to the EBP initiative. Discussion This study should provide information regarding contextual elements and related strategic processes key to successful implementation and sustainability of EBP, specifically in terms of a pervasive pattern in an acute care hospital-based health care setting. Additionally, this study will identify key contextual elements that differentiate successful implementation and sustainability of EBP efforts, both within varying levels of a hospital-based clinical setting and across similar hospital settings interested in EBP. PMID:17266756

Personal information documents for people with dementia: Healthcare staff 's perceptions and experiences.

PubMed

Baillie, Lesley; Thomas, Nicola

2018-01-01

Person-centred care is internationally recognised as best practice for the care of people with dementia. Personal information documents for people with dementia are proposed as a way to support person-centred care in healthcare settings. However, there is little research about how they are used in practice. The aim of this study was to analyse healthcare staff 's perceptions and experiences of using personal information documents, mainly Alzheimer's Society's 'This is me', for people with dementia in healthcare settings. The method comprised a secondary thematic analysis of data from a qualitative study, of how a dementia awareness initiative affected care for people with dementia in one healthcare organisation. The data were collected through 12 focus groups (n = 58 participants) and 1 individual interview, conducted with a range of healthcare staff, both clinical and non-clinical. There are four themes presented: understanding the rationale for personal information documents; completing personal information documents; location for personal information documents and transfer between settings; impact of personal information documents in practice. The findings illuminated how healthcare staff use personal information documents in practice in ways that support person-centred care. Practical issues about the use of personal information documents were revealed and these may affect the optimal use of the documents in practice. The study indicated the need to complete personal information documents at an early stage following diagnosis of dementia, and the importance of embedding their use across care settings, to support communication and integrated care.

Clustering, Seriation, and Subset Extraction of Confusion Data

ERIC Educational Resources Information Center

Brusco, Michael J.; Steinley, Douglas

2006-01-01

The study of confusion data is a well established practice in psychology. Although many types of analytical approaches for confusion data are available, among the most common methods are the extraction of 1 or more subsets of stimuli, the partitioning of the complete stimulus set into distinct groups, and the ordering of the stimulus set. Although…

Treatment of Childhood and Adolescent Obesity: An Integrative Review of Recent Recommendations from Five Expert Groups

ERIC Educational Resources Information Center

Kirschenbaum, Daniel S.; Gierut, Kristen

2013-01-01

Objective: To compare and contrast 5 sets of expert recommendations about the treatment of childhood and adolescent obesity. Method: We reviewed 5 sets of recent expert recommendations: 2007 health care organizations' four stage model, 2007 Canadian clinical practice guidelines, 2008 Endocrine Society recommendations, 2009 seven step model, and…

Concordance of Patient-Physician Obesity Diagnosis and Treatment Beliefs in Rural Practice Settings

ERIC Educational Resources Information Center

Ely, Andrea Charbonneau; Greiner, K. Allen; Born, Wendi; Hall, Sandra; Rhode, Paula C.; James, Aimee S.; Nollen, Nicole; Ahluwalia, Jasjit S.

2006-01-01

Context: Although clinical guidelines recommend routine screening and treatment for obesity in primary care, lack of agreement between physicians and patients about the need for obesity treatment in the primary care setting may be an unexplored factor contributing to the obesity epidemic. Purpose and Methods: To better understand this dynamic, we…

Directions for Mind, Brain, and Education: Methods, Models, and Morality

ERIC Educational Resources Information Center

Stein, Zachary; Fischer, Kurt W.

2011-01-01

In this article we frame a set of important issues in the emerging field of Mind, Brain, and Education in terms of three broad headings: methods, models, and morality. Under the heading of methods we suggest that the need for synthesis across scientific and practical disciplines entails the pursuit of usable knowledge via a catalytic symbiosis…

Generalized Gaussian wave packet dynamics: Integrable and chaotic systems.

PubMed

Pal, Harinder; Vyas, Manan; Tomsovic, Steven

2016-01-01

The ultimate semiclassical wave packet propagation technique is a complex, time-dependent Wentzel-Kramers-Brillouin method known as generalized Gaussian wave packet dynamics (GGWPD). It requires overcoming many technical difficulties in order to be carried out fully in practice. In its place roughly twenty years ago, linearized wave packet dynamics was generalized to methods that include sets of off-center, real trajectories for both classically integrable and chaotic dynamical systems that completely capture the dynamical transport. The connections between those methods and GGWPD are developed in a way that enables a far more practical implementation of GGWPD. The generally complex saddle-point trajectories at its foundation are found using a multidimensional Newton-Raphson root search method that begins with the set of off-center, real trajectories. This is possible because there is a one-to-one correspondence. The neighboring trajectories associated with each off-center, real trajectory form a path that crosses a unique saddle; there are exceptions that are straightforward to identify. The method is applied to the kicked rotor to demonstrate the accuracy improvement as a function of ℏ that comes with using the saddle-point trajectories.

A masterclass to teach public health professionals to conduct practice-based research to promote evidence-based practice: a case study from The Netherlands.

PubMed

Jansen, Maria W J; Hoeijmakers, Marjan

2013-01-01

Public health professionals have a pivotal position in efforts to obtain more practice-based evidence about what people need and what works in real circumstances. Close collaboration with researchers should enable public health professionals to design and conduct research in practical settings to address today's complex public health problems and increase the external validity of results. This requires expanding the research competencies of public health professionals. We developed and implemented a masterclass for public health professionals, modeled on an existing scientific training course for general practitioners and rehabilitation physicians. The masterclass was evaluated using a multiple method design, involving quantitative and qualitative methods. Evaluation took place during, at the end of, and 9 months after the masterclass. Twenty-one candidates (mean age, 41 y) started the program, 66% of whom completed it. Teaching materials, lectures, organization, and facilities were favorably evaluated. At the end of the masterclass, participants were able to design and implement a research proposal in their daily work setting, write a draft article, and critically appraise scientific research for practice and policy purposes. Participants had become more confident about their research competence. Management support from their employer proved crucial. Results obtained with the different methods were consistent. The masterclass appeared to be an effective instrument to increase the practice-based research skills of public health professionals, provided the research is implemented in a supportive organization with management backing and supervision by senior university researchers. We recommend using masterclasses to contribute to the improvement of practice-based evidence for projects addressing current and future public health problems.

Predictors and enablers of mental health nurses' family-focused practice.

PubMed

Grant, Anne; Reupert, Andrea; Maybery, Darryl; Goodyear, Melinda

2018-06-27

Family-focused practice improves outcomes for families where parents have a mental illness. However, there is limited understanding regarding the factors that predict and enable these practices. This study aimed to identify factors that predict and enable mental health nurses' family-focused practice. A sequential mixed methods design was used. A total of 343 mental health nurses, practicing in 12 mental health services (in acute inpatient and community settings), throughout Ireland completed the Family Focused Mental Health Practice Questionnaire, measuring family-focused behaviours and other factors that impact family-focused activities. Hierarchical multiple regression identified 14 predictors of family-focused practice. The most important predictors noted were nurses' skill and knowledge, own parenting experience, and work setting (i.e. community). Fourteen nurses, who achieved high scores on the questionnaire, subsequently participated in semistructured interviews to elaborate on enablers of family-focused practice. Participants described drawing on their parenting experiences to normalize parenting challenges, encouraging service users to disclose parenting concerns, and promoting trust. The opportunity to visit a service user's home allowed them to observe how the parent was coping and forge a close relationship with them. Nurses' personal characteristics and work setting are key factors in determining family-focused practice. This study extends current research by clearly highlighting predictors of family-focused practice and reporting how various enablers promoted family-focused practice. The capacity of nurses to support families has training, organizational and policy implications within adult mental health services in Ireland and elsewhere. © 2018 Australian College of Mental Health Nurses Inc.

Effectiveness of automated notification and customer service call centers for timely and accurate reporting of critical values: a laboratory medicine best practices systematic review and meta-analysis.

PubMed

Liebow, Edward B; Derzon, James H; Fontanesi, John; Favoretto, Alessandra M; Baetz, Rich Ann; Shaw, Colleen; Thompson, Pamela; Mass, Diana; Christenson, Robert; Epner, Paul; Snyder, Susan R

2012-09-01

To conduct a systematic review of the evidence available in support of automated notification methods and call centers and to acknowledge other considerations in making evidence-based recommendations for best practices in improving the timeliness and accuracy of critical value reporting. This review followed the Laboratory Medicine Best Practices (LMBP) review methods (Christenson, et al. 2011). A broad literature search and call for unpublished submissions returned 196 bibliographic records which were screened for eligibility. 41 studies were retrieved. Of these, 4 contained credible evidence for the timeliness and accuracy of automatic notification systems and 5 provided credible evidence for call centers for communicating critical value information in in-patient care settings. Studies reporting improvement from implementing automated notification findings report mean differences and were standardized using the standard difference in means (d=0.42; 95% CI=0.2-0.62) while studies reporting improvement from implementing call centers generally reported criterion referenced findings and were standardized using odds ratios (OR=22.1; 95% CI=17.1-28.6). The evidence, although suggestive, is not sufficient to make an LMBP recommendation for or against using automated notification systems as a best practice to improve the timeliness of critical value reporting in an in-patient care setting. Call centers, however, are effective in improving the timeliness of critical value reporting in an in-patient care setting, and meet LMBP criteria to be recommended as an "evidence-based best practice." Copyright © 2012 The Canadian Society of Clinical Chemists. All rights reserved.

What makes a sustainability tool valuable, practical and useful in real-world healthcare practice? A mixed-methods study on the development of the Long Term Success Tool in Northwest London.

PubMed

Lennox, Laura; Doyle, Cathal; Reed, Julie E; Bell, Derek

2017-09-24

Although improvement initiatives show benefits to patient care, they often fail to sustain. Models and frameworks exist to address this challenge, but issues with design, clarity and usability have been barriers to use in healthcare settings. This work aimed to collaborate with stakeholders to develop a sustainability tool relevant to people in healthcare settings and practical for use in improvement initiatives. Tool development was conducted in six stages. A scoping literature review, group discussions and a stakeholder engagement event explored literature findings and their resonance with stakeholders in healthcare settings. Interviews, small-scale trialling and piloting explored the design and tested the practicality of the tool in improvement initiatives. National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Northwest London (CLAHRC NWL). CLAHRC NWL improvement initiative teams and staff. The iterative design process and engagement of stakeholders informed the articulation of the sustainability factors identified from the literature and guided tool design for practical application. Key iterations of factors and tool design are discussed. From the development process, the Long Term Success Tool (LTST) has been designed. The Tool supports those implementing improvements to reflect on 12 sustainability factors to identify risks to increase chances of achieving sustainability over time. The Tool is designed to provide a platform for improvement teams to share their own views on sustainability as well as learn about the different views held within their team to prompt discussion and actions. The development of the LTST has reinforced the importance of working with stakeholders to design strategies which respond to their needs and preferences and can practically be implemented in real-world settings. Further research is required to study the use and effectiveness of the tool in practice and assess engagement with the method over time. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Management of Dentin Hypersensitivity by National Dental Practice-Based Research Network practitioners: results from a questionnaire administered prior to initiation of a clinical study on this topic.

PubMed

Kopycka-Kedzierawski, Dorota T; Meyerowitz, Cyril; Litaker, Mark S; Chonowski, Sidney; Heft, Marc W; Gordan, Valeria V; Yardic, Robin L; Madden, Theresa E; Reyes, Stephanie C; Gilbert, Gregg H

2017-01-13

Dentin hypersensitivity (DH) is a common problem encountered in clinical practice. The purpose of this study was to identify the management approaches for DH among United States dentists. One hundred eighty five National Dental Practice-Based Research Network clinicians completed a questionnaire regarding their preferred methods to diagnose and manage DH in the practice setting, and their beliefs about DH predisposing factors. Almost all dentists (99%) reported using more than one method to diagnose DH. Most frequently, they reported using spontaneous patient reports coupled with excluding other causes of oral pain by direct clinical examination (48%); followed by applying an air blast (26%), applying cold water (12%), and obtaining patient reports after dentist's query (6%). In managing DH, the most frequent first choice was desensitizing, over-the-counter (OTC), potassium nitrate toothpaste (48%), followed by fluorides (38%), and glutaraldehyde/HEMA (3%). A total of 86% of respondents reported using a combination of products when treating DH, most frequently using fluoride varnish and desensitizing OTC potassium nitrate toothpaste (70%). The most frequent predisposing factor leading to DH, as reported by the practitioners, was recessed gingiva (66%), followed by abrasion, erosion, abfraction/attrition lesions (59%) and bruxism (32%). The majority of network practitioners use multiple methods to diagnose and manage DH. Desensitizing OTC potassium nitrate toothpaste and fluoride formulations are the most widely used products to manage DH in dental practice setting.

Management of intrathecal baclofen therapy for severe acquired brain injury: consensus and recommendations for good clinical practice.

PubMed

De Tanti, Antonio; Scarponi, Federico; Bertoni, Michele; Gasperini, Giulio; Lanzillo, Bernardo; Molteni, Franco; Posteraro, Federico; Vitale, Dino Francesco; Zanpolini, Mauro

2017-08-01

Although widespread in the treatment of generalised spasticity due to severe acquired brain injury, clinical use of intrathecal baclofen administered through an implanted catheter is not yet supported by full scientific evidence. The aim of the study is to provide recommendations for good clinical practice regarding intrathecal baclofen therapy. We used a modified RAND Delphi method to develop consensus-based medical guidelines, involving clinicians who use intrathecal baclofen therapy throughout Italy. The clinicians were asked 38 questions grouped in six areas (patient selection, contraindications for implant, tests prior to implant, method of implant and management of therapy, efficacy evaluation and goal setting, and management of complications). To establish consensus, 75% agreement was required in answers to every question. Consensus was reached on the second round of the Delphi process on 27/38 questions (71%), specifically those regarding identification of objectives, efficacy evaluation, and method of implant and management of therapy, whereas management of complications and contraindications for implant remained critical areas. Despite the limits of our method, a set of recommendations was drawn up for clinical practice in this sector. The study also revealed residual critical areas and indicated future lines of research necessary to reach evidence-based consensus.

Developing longitudinal qualitative designs: lessons learned and recommendations for health services research.

PubMed

Calman, Lynn; Brunton, Lisa; Molassiotis, Alex

2013-02-06

Longitudinal qualitative methods are becoming increasingly used in the health service research, but the method and challenges particular to health care settings are not well described in the literature.We reflect on the strategies used in a longitudinal qualitative study to explore the experience of symptoms in cancer patients and their carers, following participants from diagnosis for twelve months; we highlight ethical, practical, theoretical and methodological issues that need to be considered and addressed from the outset of a longitudinal qualitative study. Key considerations in undertaking longitudinal qualitative projects in health research, include the use of theory, utilizing multiple methods of analysis and giving consideration to the practical and ethical issues at an early stage. These can include issues of time and timing; data collection processes; changing the topic guide over time; recruitment considerations; retention of staff; issues around confidentiality; effects of project on staff and patients, and analyzing data within and across time. As longitudinal qualitative methods are becoming increasingly used in health services research, the methodological and practical challenges particular to health care settings need more robust approaches and conceptual improvement. We provide recommendations for the use of such designs. We have a particular focus on cancer patients, so this paper will have particular relevance for researchers interested in chronic and life limiting conditions.

Training in interprofessional collaboration: pedagogic innovation in family medicine units.

PubMed

Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien

2012-04-01

A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Based on adult learning theories, the program was divided into 3 phases--preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program's pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training.

6Cs and ten commitments: nurses' understanding and use of courage.

PubMed

Barchard, Fiona; Sixsmith, Judith; Neill, Sarah; Meurier, Clency

2017-02-27

Aim This article reports the initial findings of a study that explored nurses' understanding of courage, in the context of the 6Cs and the Leading Change, Adding Value framework. The aim was to explore how nurses' understanding of courage can inform future practice, thus enabling preparation and support for nurses' use of courage in practice settings, and to enhance understanding of their use of it in everyday professional practice. Method The study used unstructured interviews in a grounded-theory approach, in which a theory is constructed by analysing data, underpinned with epistemology of social constructionism, a theory that examines shared assumptions about reality. Twelve qualified nurses were interviewed in depth about their understanding of courage in professional practice. A literature review was also undertaken. Results Nurses discussed their understanding of courage in terms of being in a situation they do not want to be in, speaking up and taking risks. Conclusion Understanding nurses' view of courage and its influence on practice can inform future recruitment and retention policies and practice, thus preparing and supporting nurses in the use of courage in practice settings.

Dissemination and implementation of an educational tool for veterans on complementary and alternative medicine: a case study.

PubMed

Held, Rachel Forster; Santos, Susan; Marki, Michelle; Helmer, Drew

2016-09-02

We developed and disseminated an educational DVD to introduce U.S. Veterans to independently-practiced complementary and alternative medicine (CAM) techniques and encourage CAM experimentation. The project's goal was to determine optimal dissemination methods to facilitate implementation within the Veteran's Health Administration. In the first phase, the DVD was disseminated using four methods: passive, provider-mediated, active, and peer-mediated. In the second, implementation phase, "champion" providers who supported CAM integrated dissemination into clinical practice. Qualitative data came from Veteran focus groups and semi-structured provider interviews. Data from both phases was triangulated to identify common themes. Effective dissemination requires engaging patients. Providers who most successfully integrated the DVD into practice already had CAM knowledge, and worked in settings where CAM was accepted clinical practice, or with leadership or infrastructure that supported a culture of CAM use. Institutional buy-in allowed for provider networking and effective implementation of the tool. Providers were given autonomy to determine the most appropriate dissemination strategies, which increased enthusiasm and use. Many of the lessons learned from this project can be applied to dissemination of any new educational tool within a healthcare setting. Results reiterate the importance of utilizing best practices for introducing educational tools within the healthcare context and the need for thoughtful, multi-faceted dissemination strategies.

Developing self-regulation in early childhood☆

PubMed Central

Rothbart, Mary K.; Tang, Yiyuan

2014-01-01

Studies using fMRI at rest and during task performance have revealed a set of brain areas and their connections that can be linked to the ability of children to regulate their thoughts, actions and emotions. Higher self-regulation has also been related favorable outcomes in adulthood. These findings have set the occasion for methods of improving self-regulation via training. A tool kit of such methods is now available. It remains to be seen if educators will use these new findings and tools to forge practical methods for improving the lives of the world's children. PMID:24563845

Application of economic principles in healthcare priority setting.

PubMed

Bate, Angela; Mitton, Craig

2006-06-01

In healthcare, resources are often insufficient to meet all claims on them. In this respect, resources are considered scarce and have to be managed by prioritizing between competing claims. Economics as a discipline explicitly addresses this reality by acknowledging resource scarcity. However, the extent to which economics actually influences such prioritizing decisions in healthcare is unclear. The purpose of this paper is to review the use of economics in priority setting decision making. We outline the key principles of economics as they apply to priority setting and review the methods reported in the literature with respect to these. We find that these methods, even economic methods (e.g., those typically used in conducting economic evaluations such as cost-effectiveness analyses) do not tend to explicitly incorporate economic principles. We argue therefore that these methods, when applied to the context of priority setting, are not sufficient and that what is required is a broader framework that can incorporate the output from economic methods yet also be pragmatically applicable. We then go on to present an alternative approach - namely program budgeting and marginal analysis. Finally, we put forward our case for using program budgeting and marginal analysis in priority setting practice and set out some future research challenges.

Advanced Methods in Distance Education: Applications and Practices for Educators, Administrators and Learners

ERIC Educational Resources Information Center

Dooley, Kim E.; Lindner, James R.; Dooley, Larry M.

2005-01-01

Courses and programs being delivered at a distance require a unique set of professional competencies. Whether using synchronous or asynchronous methods of instruction, systematic instructional design can help stimulate motivation, increase interaction and social presence, and authenticate learning outcomes. Principles of adult learning, including…

ICIS and the Reduction of Paperback.

ERIC Educational Resources Information Center

Alvir, Howard P.

Methods by which campuses with similar information needs for similar decisions can set up a common data base are identified and discussed. Advantages and disadvantages of achieving the common data base by bulk paperwork, functional objectives, and piecemeal empiricism are considered. Practical suggestions for instituting each method are given. Use…

Upgrading in an Industrial Setting. Final Report.

ERIC Educational Resources Information Center

Russell, Wendell

The project objectives were: (1) to assess existing industrial upgrading practices in an Atomic Energy Commission contractor organization, (2) to design new alternative upgrading methods, (3) to experiment with new upgrading methods, (4) to plan for utilization of proven upgrading programs, and (5) to document and disseminate activities. A twelve…

A practical guide for the identification of major sulcogyral structures of the human cortex.

PubMed

Destrieux, Christophe; Terrier, Louis Marie; Andersson, Frédéric; Love, Scott A; Cottier, Jean-Philippe; Duvernoy, Henri; Velut, Stéphane; Janot, Kevin; Zemmoura, Ilyess

2017-05-01

The precise sulcogyral localization of cortical lesions is mandatory to improve communication between practitioners and to predict and prevent post-operative deficits. This process, which assumes a good knowledge of the cortex anatomy and a systematic analysis of images, is, nevertheless, sometimes neglected in the neurological and neurosurgical training. This didactic paper proposes a brief overview of the sulcogyral anatomy, using conventional MR-slices, and also reconstructions of the cortical surface after a more or less extended inflation process. This method simplifies the cortical anatomy by removing part of the cortical complexity induced by the folding process, and makes it more understandable. We then reviewed several methods for localizing cortical structures, and proposed a three-step identification: after localizing the lateral, medial or ventro-basal aspect of the hemisphere (step 1), the main interlobar sulci were located to limit the lobes (step 2). Finally, intralobar sulci and gyri were identified (step 3) thanks to the same set of rules. This paper does not propose any new identification method but should be regarded as a set of practical guidelines, useful in daily clinical practice, for detecting the main sulci and gyri of the human cortex.

Simulating Optical Fibers.

ERIC Educational Resources Information Center

Edgar, Dale

1988-01-01

Described is a demonstration of Snell's law using a laser beam and an optical fiber. Provided are the set-up method of the demonstration apparatus and some practical suggestions including "index matching" technique using vaseline. (YP)

Quantifying discipline practices using absolute versus relative frequencies: clinical and research implications for child welfare.

PubMed

Lindhiem, Oliver; Shaffer, Anne; Kolko, David J

2014-01-01

In the parent intervention outcome literatures, discipline practices are generally quantified as absolute frequencies or, less commonly, as relative frequencies. These differences in methodology warrant direct comparison as they have critical implications for study results and conclusions among treatments targeted at reducing parental aggression and harsh discipline. In this study, we directly compared the absolute frequency method and the relative frequency method for quantifying physically aggressive, psychologically aggressive, and nonaggressive discipline practices. Longitudinal data over a 3-year period came from an existing data set of a clinical trial examining the effectiveness of a psychosocial treatment in reducing parental physical and psychological aggression and improving child behavior (N = 139). Discipline practices (aggressive and nonaggressive) were assessed using the Conflict Tactics Scale. The two methods yielded different patterns of results, particularly for nonaggressive discipline strategies. We suggest that each method makes its own unique contribution to a more complete understanding of the association between parental aggression and intervention effects.

An efficient graph theory based method to identify every minimal reaction set in a metabolic network

PubMed Central

2014-01-01

Background Development of cells with minimal metabolic functionality is gaining importance due to their efficiency in producing chemicals and fuels. Existing computational methods to identify minimal reaction sets in metabolic networks are computationally expensive. Further, they identify only one of the several possible minimal reaction sets. Results In this paper, we propose an efficient graph theory based recursive optimization approach to identify all minimal reaction sets. Graph theoretical insights offer systematic methods to not only reduce the number of variables in math programming and increase its computational efficiency, but also provide efficient ways to find multiple optimal solutions. The efficacy of the proposed approach is demonstrated using case studies from Escherichia coli and Saccharomyces cerevisiae. In case study 1, the proposed method identified three minimal reaction sets each containing 38 reactions in Escherichia coli central metabolic network with 77 reactions. Analysis of these three minimal reaction sets revealed that one of them is more suitable for developing minimal metabolism cell compared to other two due to practically achievable internal flux distribution. In case study 2, the proposed method identified 256 minimal reaction sets from the Saccharomyces cerevisiae genome scale metabolic network with 620 reactions. The proposed method required only 4.5 hours to identify all the 256 minimal reaction sets and has shown a significant reduction (approximately 80%) in the solution time when compared to the existing methods for finding minimal reaction set. Conclusions Identification of all minimal reactions sets in metabolic networks is essential since different minimal reaction sets have different properties that effect the bioprocess development. The proposed method correctly identified all minimal reaction sets in a both the case studies. The proposed method is computationally efficient compared to other methods for finding minimal reaction sets and useful to employ with genome-scale metabolic networks. PMID:24594118

Mixed-methods research in pharmacy practice: basics and beyond (part 1).

PubMed

Hadi, Muhammad Abdul; Alldred, David Phillip; Closs, S José; Briggs, Michelle

2013-10-01

This is the first of two papers which explore the use of mixed-methods research in pharmacy practice. In an era of evidence-based medicine and policy, high-quality research evidence is essential for the development of effective pharmacist-led services. Over the past decade, the use of mixed-methods research has become increasingly common in healthcare, although to date its use has been relatively limited in pharmacy practice research. In this article, the basic concepts of mixed-methods research including its definition, typologies and advantages in relation to pharmacy practice research are discussed. Mixed-methods research brings together qualitative and quantitative methodologies within a single study to answer or understand a research problem. There are a number of mixed-methods designs available, but the selection of an appropriate design must always be dictated by the research question. Importantly, mixed-methods research should not be seen as a 'tool' to collect qualitative and quantitative data, rather there should be some degree of 'integration' between the two data sets. If conducted appropriately, mixed-methods research has the potential to generate quality research evidence by combining strengths and overcoming the respective limitations of qualitative and quantitative methodologies. © 2012 Royal Pharmaceutical Society.

Reading in NZ Schools: A Survey of Our Theory and Practice. Set Research Information for Teachers, Number Two, Item 2.

ERIC Educational Resources Information Center

Penton, John

Designed to provide information about reading in New Zealand, this report offers an overview of theory and practice in that area. Among the topics discussed are: the current concern about reading standards; developmental reading; effective methods of reading instruction; research into the nature of the reading process; preparation of teachers of…

Is Performance Feedback for Educators an Evidence-Based Practice? A Systematic Review and Evaluation Based on Single-Case Research

ERIC Educational Resources Information Center

Fallon, Lindsay M.; Collier-Meek, Melissa A.; Maggin, Daniel M.; Sanetti, Lisa M. H.; Johnson, Austin H.

2015-01-01

Optimal levels of treatment fidelity, a critical moderator of intervention effectiveness, are often difficult to sustain in applied settings. It is unknown whether performance feedback, a widely researched method for increasing educators' treatment fidelity, is an evidence-based practice. The purpose of this review was to evaluate the current…

Application of free selection in mixed forests of the inland northwestern United States

Treesearch

Russell T. Graham; Theresa B. Jain

2005-01-01

Forest management objectives continue to evolve as the desires and needs of society change. The practice of silviculture has risen to the challenge by supplying silvicultural methods and systems to produce desired stand and forest structures and compositions to meet these changing objectives. For the most part, the practice of silviculture offers a robust set of...

Online Learning from Input versus Offline Memory Evolution in Adult Word Learning: Effects of Neighborhood Density and Phonologically Related Practice

ERIC Educational Resources Information Center

Storkel, Holly L.; Bontempo, Daniel E.; Pak, Natalie S.

2014-01-01

Purpose: In this study, the authors investigated adult word learning to determine how neighborhood density and practice across phonologically related training sets influence online learning from input during training versus offline memory evolution during no-training gaps. Method: Sixty-one adults were randomly assigned to learn low- or…

The Teaching of Writing: Illinois Teachers Report on Research & Practices. Sentence Combining as a Composition Technique.

ERIC Educational Resources Information Center

Matthews, Dorothy, Ed.

1978-01-01

The ten articles in this journal report on research and practice in the teaching of writing. Topics covered include sentence combining as a composition technique, peer evaluation in a technical writing class, a plan for teaching paragraph construction, the use of literary humor in a writing class, methods for setting the scene, how students view…

The state of cell block variation and satisfaction in the era of molecular diagnostics and personalized medicine

PubMed Central

Crapanzano, John P.; Heymann, Jonas J.; Monaco, Sara; Nassar, Aziza; Saqi, Anjali

2014-01-01

Background: In the recent past, algorithms and recommendations to standardize the morphological, immunohistochemical and molecular classification of lung cancers on cytology specimens have been proposed, and several organizations have recommended cell blocks (CBs) as the preferred modality for molecular testing. Based on the literature, there are several different techniques available for CB preparation-suggesting that there is no standard. The aim of this study was to conduct a survey of CB preparation techniques utilized in various practice settings and analyze current issues, if any. Materials and Methods: A single E-mail with a link to an electronic survey was distributed to members of the American Society of Cytopathology and other pathologists. Questions pertaining to the participants’ practice setting and CBs-volume, method, quality and satisfaction-were included. Results: Of 95 respondents, 90/95 (94%) completed the survey and comprise the study group. Most participants practice in a community hospital/private practice (44%) or academic center (41%). On average, 14 CBs (range 0-50; median 10) are prepared by a laboratory daily. Over 10 methods are utilized: Plasma thrombin (33%), HistoGel (27%), Cellient automated cell block system (8%) and others (31%) respectively. Forty of 90 (44%) respondents are either unsatisfied or sometimes satisfied with their CB quality, with low-cellular yield being the leading cause of dissatisfaction. There was no statistical significance between the three most common CB preparation methods and satisfaction with quality. Discussion: Many are dissatisfied with their current method of CB preparation, and there is no consistent method to prepare CBs. In today's era of personalized medicine with an increasing array of molecular tests being applied to cytological specimens, there is a need for a standardized protocol for CB optimization to enhance cellularity. PMID:24799951

Effective Recruitment of Schools for Randomized Clinical Trials: Role of School Nurses.

PubMed

Petosa, R L; Smith, L

2017-01-01

In school settings, nurses lead efforts to improve the student health and well-being to support academic success. Nurses are guided by evidenced-based practice and data to inform care decisions. The randomized controlled trial (RCT) is considered the gold standard of scientific rigor for clinical trials. RCTs are critical to the development of evidence-based health promotion programs in schools. The purpose of this article is to present practical solutions to implementing principles of randomization to RCT trials conducted in school settings. Randomization is a powerful sampling method used to build internal and external validity. The school's daily organization and educational mission provide several barriers to randomization. Based on the authors' experience in conducting school-based RCTs, they offer a host of practical solutions to working with schools to successfully implement randomization procedures. Nurses play a critical role in implementing RCTs in schools to promote rigorous science in support of evidence-based practice.

Quantitative Imaging in Cancer Clinical Trials

PubMed Central

Yankeelov, Thomas E.; Mankoff, David A.; Schwartz, Lawrence H.; Lieberman, Frank S.; Buatti, John M.; Mountz, James M.; Erickson, Bradley J.; Fennessy, Fiona M.M.; Huang, Wei; Kalpathy-Cramer, Jayashree; Wahl, Richard L.; Linden, Hannah M.; Kinahan, Paul; Zhao, Binsheng; Hylton, Nola M.; Gillies, Robert J.; Clarke, Laurence; Nordstrom, Robert; Rubin, Daniel L.

2015-01-01

As anti-cancer therapies designed to target specific molecular pathways have been developed, it has become critical to develop methods to assess the response induced by such agents. While traditional, anatomic CT and MRI exams are useful in many settings, there is increasing evidence that these methods cannot answer the fundamental biological and physiological questions essential for assessment and, eventually, prediction of treatment response in the clinical trial setting, especially in the critical period soon after treatment is initiated. To optimally apply advances in quantitative imaging methods to trials of targeted cancer therapy, new infrastructure improvements are needed that incorporate these emerging techniques into the settings where they are most likely to have impact. In this review, we first elucidate the needs for therapeutic response assessment in the era of molecularly targeted therapy and describe how quantitative imaging can most effectively provide scientifically and clinically relevant data. We then describe the tools and methods required to apply quantitative imaging and provide concrete examples of work making these advances practically available for routine application in clinical trials. We conclude by proposing strategies to surmount barriers to wider incorporation of these quantitative imaging methods into clinical trials and, eventually, clinical practice. Our goal is to encourage and guide the oncology community to deploy standardized quantitative imaging techniques in clinical trials to further personalize care for cancer patients, and to provide a more efficient path for the development of improved targeted therapies. PMID:26773162

Fusion of visible and near-infrared images based on luminance estimation by weighted luminance algorithm

NASA Astrophysics Data System (ADS)

Wang, Zhun; Cheng, Feiyan; Shi, Junsheng; Huang, Xiaoqiao

2018-01-01

In a low-light scene, capturing color images needs to be at a high-gain setting or a long-exposure setting to avoid a visible flash. However, such these setting will lead to color images with serious noise or motion blur. Several methods have been proposed to improve a noise-color image through an invisible near infrared flash image. A novel method is that the luminance component and the chroma component of the improved color image are estimated from different image sources [1]. The luminance component is estimated mainly from the NIR image via a spectral estimation, and the chroma component is estimated from the noise-color image by denoising. However, it is challenging to estimate the luminance component. This novel method to estimate the luminance component needs to generate the learning data pairs, and the processes and algorithm are complex. It is difficult to achieve practical application. In order to reduce the complexity of the luminance estimation, an improved luminance estimation algorithm is presented in this paper, which is to weight the NIR image and the denoised-color image and the weighted coefficients are based on the mean value and standard deviation of both images. Experimental results show that the same fusion effect at aspect of color fidelity and texture quality is achieved, compared the proposed method with the novel method, however, the algorithm is more simple and practical.

Estimating a test's accuracy using tailored meta-analysis-How setting-specific data may aid study selection.

PubMed

Willis, Brian H; Hyde, Christopher J

2014-05-01

To determine a plausible estimate for a test's performance in a specific setting using a new method for selecting studies. It is shown how routine data from practice may be used to define an "applicable region" for studies in receiver operating characteristic space. After qualitative appraisal, studies are selected based on the probability that their study accuracy estimates arose from parameters lying in this applicable region. Three methods for calculating these probabilities are developed and used to tailor the selection of studies for meta-analysis. The Pap test applied to the UK National Health Service (NHS) Cervical Screening Programme provides a case example. The meta-analysis for the Pap test included 68 studies, but at most 17 studies were considered applicable to the NHS. For conventional meta-analysis, the sensitivity and specificity (with 95% confidence intervals) were estimated to be 72.8% (65.8, 78.8) and 75.4% (68.1, 81.5) compared with 50.9% (35.8, 66.0) and 98.0% (95.4, 99.1) from tailored meta-analysis using a binomial method for selection. Thus, for a cervical intraepithelial neoplasia (CIN) 1 prevalence of 2.2%, the post-test probability for CIN 1 would increase from 6.2% to 36.6% between the two methods of meta-analysis. Tailored meta-analysis provides a method for augmenting study selection based on the study's applicability to a setting. As such, the summary estimate is more likely to be plausible for a setting and could improve diagnostic prediction in practice. Copyright © 2014 Elsevier Inc. All rights reserved.

Mid-infrared spectroscopy combined with chemometrics to detect Sclerotinia stem rot on oilseed rape (Brassica napus L.) leaves.

PubMed

Zhang, Chu; Feng, Xuping; Wang, Jian; Liu, Fei; He, Yong; Zhou, Weijun

2017-01-01

Detection of plant diseases in a fast and simple way is crucial for timely disease control. Conventionally, plant diseases are accurately identified by DNA, RNA or serology based methods which are time consuming, complex and expensive. Mid-infrared spectroscopy is a promising technique that simplifies the detection procedure for the disease. Mid-infrared spectroscopy was used to identify the spectral differences between healthy and infected oilseed rape leaves. Two different sample sets from two experiments were used to explore and validate the feasibility of using mid-infrared spectroscopy in detecting Sclerotinia stem rot (SSR) on oilseed rape leaves. The average mid-infrared spectra showed differences between healthy and infected leaves, and the differences varied among different sample sets. Optimal wavenumbers for the 2 sample sets selected by the second derivative spectra were similar, indicating the efficacy of selecting optimal wavenumbers. Chemometric methods were further used to quantitatively detect the oilseed rape leaves infected by SSR, including the partial least squares-discriminant analysis, support vector machine and extreme learning machine. The discriminant models using the full spectra and the optimal wavenumbers of the 2 sample sets were effective for classification accuracies over 80%. The discriminant results for the 2 sample sets varied due to variations in the samples. The use of two sample sets proved and validated the feasibility of using mid-infrared spectroscopy and chemometric methods for detecting SSR on oilseed rape leaves. The similarities among the selected optimal wavenumbers in different sample sets made it feasible to simplify the models and build practical models. Mid-infrared spectroscopy is a reliable and promising technique for SSR control. This study helps in developing practical application of using mid-infrared spectroscopy combined with chemometrics to detect plant disease.

Environmental scan of infection prevention and control practices for containment of hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada.

PubMed

Ocampo, Wrechelle; Geransar, Rose; Clayden, Nancy; Jones, Jessica; de Grood, Jill; Joffe, Mark; Taylor, Geoffrey; Missaghi, Bayan; Pearce, Craig; Ghali, William; Conly, John

2017-10-01

Ward closure is a method of controlling hospital-acquired infectious diseases outbreaks and is often coupled with other practices. However, the value and efficacy of ward closures remains uncertain. To understand the current practices and perceptions with respect to ward closure for hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada. A Web-based environmental scan survey was developed by a team of infection prevention and control (IPC) experts and distributed to 235 IPC professionals at acute care sites across Canada. Data were analyzed using a mixed-methods approach of descriptive statistics and thematic analysis. A total of 110 completed responses showed that 70% of sites reported at least 1 outbreak during 2013, 44% of these sites reported the use of ward closure. Ward closure was considered an "appropriate," "sometimes appropriate," or "not appropriate" strategy to control outbreaks by 50%, 45%, and 5% of participants, respectively. System capacity issues and overall risk assessment were main factors influencing the decision to close hospital wards following an outbreak. Results suggest the use of ward closure for containment of hospital-acquired infectious disease outbreaks in Canadian acute care health settings is mixed, with outbreak control methods varying. The successful implementation of ward closure was dependent on overall support for the IPC team within hospital administration. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Evidence based general practice: a retrospective study of interventions in one training practice.

PubMed Central

Gill, P.; Dowell, A. C.; Neal, R. D.; Smith, N.; Heywood, P.; Wilson, A. E.

1996-01-01

OBJECTIVES--To estimate the proportion of interventions in general practice that are based on evidence from clinical trials and to assess the appropriateness of such an evaluation. DESIGN--Retrospective review of case notes. SETTING--One suburban training general practice. SUBJECTS--122 consecutive doctor-patient consultations over two days. MAIN OUTCOME MEASURES--Proportions of interventions based on randomised controlled trials (from literature search with Medline, pharmaceutical databases, and standard textbooks), on convincing non-experimental evidence, and without substantial evidence. RESULTS--21 of the 122 consultations recorded were excluded due to insufficient data; 31 of the interventions were based on randomised controlled trial evidence and 51 based on convincing non-experimental evidence. Hence 82/101 (81%) of interventions were based on evidence meeting our criteria. CONCLUSIONS--Most interventions within general practice are based on evidence from clinical trials, but the methods used in such trials may not be the most appropriate to apply to this setting. PMID:8608291

Informatics methodologies for evaluation research in the practice setting.

PubMed

Grant, A; Buteau, M; Richards, Y; Delisle, E; Laplante, P; Niyonsenga, T; Xhignesse, M

1998-06-01

A continuing challenge in health informatics and health evaluation is to enable access to the practice of health care so that the determinants of successful care and good health outcomes can be measured, evaluated and analysed. Furthermore the results of the analysis should be available to the health care practitioner or to the patient as might be appropriate, so that he or she can use this information for continual improvement of practice and optimisation of outcomes. In this paper we review two experiences, one in primary care, the FAMUS project, and the other in hospital care, the Autocontrol project. Each project demonstrates an informatics approach for evaluation research in the clinical setting and indicates ways in which useful information can be obtained which with appropriate feed-back and education can be used towards the achievement of better health. Emphasis is given to data collection methods compatible with practice and to high quality information feedback, particularly in the team context, to enable the formulation of strategies for practice improvement.

Rural Doctors’ Views on and Experiences with Evidence-Based Medicine: The FrEEDoM Qualitative Study

PubMed Central

Hisham, Ranita; Liew, Su May; Ng, Chirk Jenn; Mohd Nor, Kamaliah; Osman, Iskandar Firzada; Ho, Gah Juan; Hamzah, Nurazira; Glasziou, Paul

2016-01-01

Background Evidence-based medicine is the integration of individual clinical expertise, best external evidence and patient values which was introduced more than two decades ago. Yet, primary care physicians in Malaysia face unique barriers in accessing scientific literature and applying it to their clinical practice. Aim This study aimed to explore the views and experiences of rural doctors’ about evidence-based medicine in their daily clinical practice in a rural primary care setting. Methods Qualitative methodology was used. The interviews were conducted in June 2013 in two rural health clinics in Malaysia. The participants were recruited using purposive sampling. Four focus group discussions with 15 medical officers and three individual in-depth interviews with family medicine specialists were carried out. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked and analyzed using a thematic approach. Results Key themes identified were: (1) doctors viewed evidence-based medicine mainly as statistics, research and guidelines, (2) reactions to evidence-based medicine were largely negative, (3) doctors relied on specialists, peers, guidelines and non-evidence based internet sources for information, (4) information sources were accessed using novel methods such as mobile applications and (5) there are several barriers to evidence-based practice, including doctor-, evidence-based medicine-, patient- and system-related factors. These included inadequacies in knowledge, attitude, management support, time and access to evidence-based information sources. Participants recommended the use of online services to support evidence-based practice in the rural settings. Conclusion The level of evidence-based practice is low in the rural setting due to poor awareness, knowledge, attitude and resources. Doctors use non-evidence based sources and access them through new methods such as messaging applications. Further research is recommended to develop and evaluate interventions to overcome the identified barriers. PMID:27031700

Patients' perceptions of their roles in goal setting in a spinal cord injury regional rehabilitation program.

PubMed

Draaistra, Harriett; Singh, Mina D; Ireland, Sandra; Harper, Theresa

2012-01-01

Goal setting is a common practice in rehabilitation, yet there is a paucity of literature exploring patients' perceptions of their roles in this process. This study was conducted using a qualitative descriptive methodology to explore patients' perceptions of their roles in setting goals in a spinal cord injury regional rehabilitation program. Imogene King's theory of goal attainment was used to frame the study. Data were collected through interviews and analyzed using a content analysis. The results revealed four themes: Visioning, Redefining, Brainstorming, and Rebuilding Participants (n = 13) envisioned their roles as setting an overarching priority goal, defining detailed rehabilitation goals, sharing knowledge with the team, and rebuilding skills to attain goals. Implications for nursing practice include the need to understand patients' experiences and perceptions, share knowledge, and support effective communication to promote collaborative goal setting. A need to enhance health professionals' education to fully understand factors influencing patients' abilities to set rehabilitation goals, and future research in methods to promote patients' engagement in goal setting was also clearly indicated.

Concussion Assessment in California Community College Football: Athletic Trainers' Strides toward a Safer Return to Play

ERIC Educational Resources Information Center

Chinn, Nancy Resendes

2010-01-01

The purpose of this mixed method study was to compare current practices of athletic trainers in the management of concussion in football at California Community Colleges (CCC) with the concussion management guidelines set forth by the National Athletic Trainers Association (NATA). The study also set out to gain understanding of why some athletic…

76 FR 49737 - Takes of Marine Mammals Incidental to Specified Activities; Marine Geophysical Survey in the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-11

... stock(s) for subsistence uses (where relevant). The authorization must set forth the permissible methods... shooting a test pattern over an ocean bottom instrument in shallow water. This method is neither practical nor valid in water depths as great as 3,000 m (9,842.5 ft). The alternative method of conducting site...

16 CFR 1500.40 - Method of testing toxic substances.

Code of Federal Regulations, 2014 CFR

2014-01-01

... not require animals, are presented in the CPSC's animal testing policy set forth in 16 CFR 1500.232. A... test animals. The method of testing the toxic substances referred to in § 1500.3(c)(1)(ii)(C) and (c)(2... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Method of testing toxic substances. 1500.40...

"Theory Becoming Alive": The Learning Transition Process of Newly Graduated Nurses in Canada.

PubMed

Nour, Violet; Williams, Anne M

2018-01-01

Background Newly graduated nurses often encounter a gap between theory and practice in clinical settings. Although this has been the focus of considerable research, little is known about the learning transition process. Purpose The purpose of this study was to explore the experiences of newly graduated nurses in acute healthcare settings within Canada. This study was conducted to gain a greater understanding of the experiences and challenges faced by graduates. Methods Grounded theory method was utilized with a sample of 14 registered nurses who were employed in acute-care settings. Data were collected using in-depth interviews. Constant comparative analysis was used to analyze data. Results Findings revealed a core category, "Theory Becoming Alive," and four supporting categories: Entry into Practice, Immersion, Committing, and Evolving. Theory Becoming Alive described the process of new graduate nurses' clinical learning experiences as well as the challenges that they encountered in clinical settings after graduating. Conclusions This research provides a greater understanding of learning process of new graduate nurses in Canada. It highlights the importance of providing supportive environments to assist new graduate nurses to develop confidence as independent registered nurses in clinical areas. Future research directions as well as supportive educational strategies are described.

The client-centred approach as experienced by male neurological rehabilitation clients in occupational therapy. A qualitative study based on a grounded theory tradition.

PubMed

Van de Velde, Dominique; Devisch, Ignaas; De Vriendt, Patricia

2016-08-01

Purpose To explore the perspectives of male clients in a neurological rehabilitation setting with regard to the occupational therapy they have received and the client-centred approach. Method This study involved a qualitative research design based on the grounded theory tradition. Individual in-depth interviews were used to collect data. Data were analysed using a constant comparative method. Seven male participants from an inpatient neurological setting were included using a theoretical sampling technique. Results Three themes emerged to describe the approach of the therapists to client-centred practice: (a) a shared biomedical focus as the start of the rehabilitation process, (b) the un-simultaneous shift from a biomedical towards a psycho-social focus and (c) formal versus informal nature of gathering client information. Conclusion A client-centred approach entails a shift from the therapist focussing on recovery from the short-term neurological issues towards the long-term consequences of the disease. According to the client, this shift in reasoning must occur at a specific and highly subjective moment during the rehabilitation process. Identifying this moment could strengthen the client-centred approach. Implications for Rehabilitation Client-centred practice entails a shift from recovering the short-term neurological issues towards the long-term psycho-social consequences of the disease. To be effective in client-centred practice, the clients expect from the professional to be an authority with regard to biomedical issues and to be partner with regard to psycho-social issues. Client-centred practice is most likely to be successful when client is susceptible to discuss his psycho-social issues and finding this moment is a challenge for the professional. Using formal methods for goal setting do not necessarily cover all the information needed for a client-centred therapy programme. Rather, using informal methods could lead to a more valid image of the client.

Exploring the Perceptions of Newly Credentialed Athletic Trainers as They Transition to Practice

PubMed Central

Walker, Stacy E.; Thrasher, Ashley B.; Mazerolle, Stephanie M.

2016-01-01

Context: Research is limited on the transition to practice of newly credentialed athletic trainers (ATs). Understanding this transition could provide insight to assist employers and professional programs in developing initiatives to enhance the transition. Objective: To explore newly credentialed ATs' experiences and feelings during their transition from student to autonomous practitioner. Design: Qualitative study. Setting: Individual phone interviews. Patients or Other Participants: Thirty-four ATs certified between January and September 2013 participated in this study (18 women, 16 men; age = 23.8 ± 2.1 years; work settings were collegiate, secondary school, clinic, and other). Data saturation guided the number of participants. Data Collection and Analysis: Participants were interviewed via phone using a semistructured interview guide. All interviews were recorded and transcribed verbatim. Data were analyzed through phenomenologic reduction, with data coded for common themes and subthemes. Credibility was established via member checks, peer review, and intercoder reliability. Results: The 3 themes that emerged from the data were (1) transition to practice preparation, (2) orientation, and (3) mentoring. Transition to practice was rarely discussed during professional preparation, but information on the organization and administration or capstone course (eg, insurance, documentation) assisted participants in their transition. Participants felt that preceptors influenced their transition by providing or hindering the number and quality of patient encounters. Participants from larger collegiate settings reported more formal orientation methods (eg, review policies, procedures manual), whereas those in secondary school, clinic/hospital, and smaller collegiate settings reported informal orientation methods (eg, independent review of policies and procedures, tours). Some participants were assigned a formal mentor, and others engaged in peer mentoring. Conclusions: Employers could enhance the transition to practice by providing formal orientation and mentorship. Professional programs could prepare students for the transition by discussing how to find support and mentoring and by involving preceptors who provide students with opportunities to give patient care. PMID:27710092

Teaching trainers to incorporate evidence-based medicine (EBM) teaching in clinical practice: the EU-EBM project.

PubMed

Thangaratinam, Shakila; Barnfield, Gemma; Weinbrenner, Susanne; Meyerrose, Berit; Arvanitis, Theodoros N; Horvath, Andrea R; Zanrei, Gianni; Kunz, Regina; Suter, Katja; Walczak, Jacek; Kaleta, Anna; Oude Rengerink, Katrien; Gee, Harry; Mol, Ben W J; Khan, Khalid S

2009-09-10

Evidence based medicine (EBM) is considered an integral part of medical training, but integration of teaching various EBM steps in everyday clinical practice is uncommon. Currently EBM is predominantly taught through theoretical courses, workshops and e-learning. However, clinical teachers lack confidence in teaching EBM in workplace and are often unsure of the existing opportunities for teaching EBM in the clinical setting. There is a need for continuing professional development (CPD) courses that train clinical trainers to teach EBM through on-the-job training by demonstration of applied EBM real time in clinical practice. We developed such a course to encourage clinically relevant teaching of EBM in post-graduate education in various clinical environments. We devised an e-learning course targeting trainers with EBM knowledge to impart educational methods needed to teach application of EBM teaching in commonly used clinical settings. The curriculum development group comprised experienced EBM teachers, clinical epidemiologists, clinicians and educationalists from institutions in seven European countries. The e-learning sessions were designed to allow participants (teachers) to undertake the course in the workplace during short breaks within clinical activities. An independent European steering committee provided input into the process. The curriculum defined specific learning objectives for teaching EBM by exploiting educational opportunities in six different clinical settings. The e-modules incorporated video clips that demonstrate practical and effective methods of EBM teaching in everyday clinical practice. The course encouraged focussed teaching activities embedded within a trainer's personal learning plan and documentation in a CPD portfolio for reflection. This curriculum will help senior clinicians to identify and make the best use of available opportunities in everyday practice in clinical situations to teach various steps of EBM and demonstrate their applicability to clinical practice. Once fully implemented, the ultimate outcome of this pilot project will be a European qualification in teaching EBM, which will be used by doctors, hospitals, professional bodies responsible for postgraduate qualifications and continuing medical education.

A hybrid method for evaluating enterprise architecture implementation.

PubMed

Nikpay, Fatemeh; Ahmad, Rodina; Yin Kia, Chiam

2017-02-01

Enterprise Architecture (EA) implementation evaluation provides a set of methods and practices for evaluating the EA implementation artefacts within an EA implementation project. There are insufficient practices in existing EA evaluation models in terms of considering all EA functions and processes, using structured methods in developing EA implementation, employing matured practices, and using appropriate metrics to achieve proper evaluation. The aim of this research is to develop a hybrid evaluation method that supports achieving the objectives of EA implementation. To attain this aim, the first step is to identify EA implementation evaluation practices. To this end, a Systematic Literature Review (SLR) was conducted. Second, the proposed hybrid method was developed based on the foundation and information extracted from the SLR, semi-structured interviews with EA practitioners, program theory evaluation and Information Systems (ISs) evaluation. Finally, the proposed method was validated by means of a case study and expert reviews. This research provides a suitable foundation for researchers who wish to extend and continue this research topic with further analysis and exploration, and for practitioners who would like to employ an effective and lightweight evaluation method for EA projects. Copyright © 2016 Elsevier Ltd. All rights reserved.

Integrating Science and Engineering to Implement Evidence-Based Practices in Health Care Settings

PubMed Central

Wu, Shinyi; Duan, Naihua; Wisdom, Jennifer P.; Kravitz, Richard L.; Owen, Richard R.; Sullivan, Greer; Wu, Albert W.; Di Capua, Paul; Hoagwood, Kimberly Eaton

2015-01-01

Integrating two distinct and complementary paradigms, science and engineering, may produce more effective outcomes for the implementation of evidence-based practices in health care settings. Science formalizes and tests innovations, whereas engineering customizes and optimizes how the innovation is applied tailoring to accommodate local conditions. Together they may accelerate the creation of an evidence-based healthcare system that works effectively in specific health care settings. We give examples of applying engineering methods for better quality, more efficient, and safer implementation of clinical practices, medical devices, and health services systems. A specific example was applying systems engineering design that orchestrated people, process, data, decision-making, and communication through a technology application to implement evidence-based depression care among low-income patients with diabetes. We recommend that leading journals recognize the fundamental role of engineering in implementation research, to improve understanding of design elements that create a better fit between program elements and local context. PMID:25217100

Costing behavioral interventions: a practical guide to enhance translation.

PubMed

Ritzwoller, Debra P; Sukhanova, Anna; Gaglio, Bridget; Glasgow, Russell E

2009-04-01

Cost and cost effectiveness of behavioral interventions are critical parts of dissemination and implementation into non-academic settings. Due to the lack of indicative data and policy makers' increasing demands for both program effectiveness and efficiency, cost analyses can serve as valuable tools in the evaluation process. To stimulate and promote broader use of practical techniques that can be used to efficiently estimate the implementation costs of behavioral interventions, we propose a set of analytic steps that can be employed across a broad range of interventions. Intervention costs must be distinguished from research, development, and recruitment costs. The inclusion of sensitivity analyses is recommended to understand the implications of implementation of the intervention into different settings using different intervention resources. To illustrate these procedures, we use data from a smoking reduction practical clinical trial to describe the techniques and methods used to estimate and evaluate the costs associated with the intervention. Estimated intervention costs per participant were $419, with a range of $276 to $703, depending on the number of participants.

SU-E-E-05: Improving Contouring Precision and Consistency for Physicians-In-Training with Simple Lab Experiments

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

Ma, L; Larson, D A

2015-06-15

Purpose: Target contouring for high-dose treatments such as radiosurgery of brain metastases is highly critical in eliminating marginal failure and reducing complications as shown by recent clinical studies. In order to improve contouring accuracy and practice consistency for the procedure, we introduced a self-assessed physics lab practice for the physicians-in-training. Methods: A set of commercially acquired high-precision PMMA plastic spheres were randomly embedded in a Styrofoam block and then scanned with the CT/MR via the clinical procedural imaging protocol. A group of first-year physicians-in-training (n=6) from either neurosurgery or radiation oncology department were asked to contour the scanned objects (diametermore » ranged from 0.4 cm to 3.8 cm). These user-defined contours were then compared with the ideal contour sets of object shape for self assessments to determine the maximum areas of the observed discrepancies and method of improvements. Results: The largest discrepancies from initial practice were consistently found to be located near the extreme longitudinal portions of the target for all the residents. Discrepancy was especially prominent when contouring small objects < 1.0 cm in diameters. For example, the mean volumes rendered from the initial contour data set differed from the ideal data set by 7.7%±6.6% for the participants (p> 0.23 suggesting agreement cannot be established). However, when incorporating a secondary imaging scan such as reconstructed coronal or sagittal images in a repeat practice, the agreement was dramatically improved yielding p<0.02 in agreement with the reference data set for all the participants. Conclusion: A simple physics lab revealed a common pitfall in contouring small metastatic brain tumors for radiosurgical procedures and provided a systematic tool for physicians-in-training in improving their clinical contouring skills. Dr Ma is current a board member of international stereotactic radiosurgical society.« less

Self-Care for Nurse Leaders in Acute Care Environment Reduces Perceived Stress: A Mixed-Methods Pilot Study Merits Further Investigation.

PubMed

Dyess, Susan Mac Leod; Prestia, Angela S; Marquit, Doren-Elyse; Newman, David

2018-03-01

Acute care practice settings are stressful. Nurse leaders face stressful demands of numerous competing priorities. Some nurse leaders experience unmanageable stress, but success requires self-care. This article presents a repeated measures intervention design study using mixed methods to investigate a self-care simple meditation practice for nurse leaders. Themes and subthemes emerged in association with the three data collection points: at baseline (pretest), after 6 weeks, and after 12 weeks (posttest) from introduction of the self-care simple meditation practice. An analysis of variance yielded a statistically significant drop in perceived stress at 6 weeks and again at 12 weeks. Conducting future research is merited.

Comparative effectiveness research and its utility in In-clinic practice

PubMed Central

Dang, Amit; Kaur, Kirandeep

2016-01-01

One of the important components of patient-centered healthcare is comparative effectiveness research (CER), which aims at generating evidence from the real-life setting. The primary purpose of CER is to provide comparative information to the healthcare providers, patients, and policy makers about the standard of care available. This involves research on clinical questions unanswered by the explanatory trials during the regulatory approval process. Main methods of CER involve randomized controlled trials and observational methods. The limitations of these two methods have been overcome with the help of new statistical methods. After the evidence generation, it is equally important to communicate the results to all the interested organizations. CER is beginning to have its impact in the clinical practice as its results become part of the clinical practice guidelines. CER will have far-reaching scientific and financial impact. CER will make both the treating physician and the patient equally responsible for the treatment offered. PMID:26955571

Exploring health literacy competencies towards patient education programme for Chinese-speaking healthcare professionals: a Delphi study

PubMed Central

Chang, Li-Chun; Chen, Yu-Chi; Wu, Fei Ling; Liao, Li-Ling

2017-01-01

Objectives To achieve consensus on a set of competencies in health literacy practice based on a literature review and expert consultation. Setting Hospitals and community health centres in Taiwan. Method A 2-stage modified Delphi study involving a literature review was conducted, followed by qualitative interviews and 3 rounds of email-based data collection over a 3-month period in 2011. Participants 15 Chinese healthcare practitioners with more than 6 months’ experience in patient education were interviewed to collect data on health literacy practice. 24 experts (12 academic scholars in health literacy and 12 professionals with training related to health literacy practice) were invited to participate in the Delphi process. Results Qualitative data from the interviews were analysed and summarised to form 99 competency items for health literacy practice, which were categorised into 5 domains of health literacy practice including those pertaining to knowledge and skills. Consensus was reached on 92 of 99 competencies, using a modified Delphi technique. Conclusions The 92 competencies in health literacy practice embraced core components of patient education in the Chinese healthcare profession. PMID:28093428

Method and apparatus for recirculation with control of synchrotron radiation

DOEpatents

Douglas, David R.; Tennant, Christopher

2016-08-02

A method for controlling beam quality degradation from ISR and CSR and stabilizing the microbunching instability (.mu.BI) in a high brightness electron beam. The method includes providing a super-periodic second order achromat line with each super period being individually linearly achromatic and isochronous, setting individual superperiod tunes to rational fractions of an integer (such as 4.sup.th or 6.sup.th integers), setting individual bend angles to be as small as practical to reduce driving terms due to dispersion and dispersive angle, and setting bend radii as large enough to suppress ISR but not negatively affect the radial dependence of CSR. The method includes setting the structure of the individual superperiods to minimize bend plane beam envelope values in the dipoles to reduce betatron response to a CSR event at a dispersed location, increasing beam angular divergence, and creating dispersion nodes in the dipoles to similarly reduce response to CSR events, and limit R.sub.56 modulation in order to mitigate .mu.BI.

Initiating Self-Assessment Strategies in Novice Physiotherapy Students: A Method Case Study

ERIC Educational Resources Information Center

Young, Catherine

2013-01-01

Student self- and peer-assessment strategies ideally are instigated early in programmes for health professionals. This study presents an innovative method of stimulating critical evaluation of clinical skills learned in the practical class setting for first year physiotherapy students. Twice in the semester (beginning and end) students assessed…

16 CFR 309.10 - Alternative vehicle fuel rating.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Analysis of Natural Gas by Gas Chromatography.” For the purposes of this section, fuel ratings for the... methods set forth in ASTM D 1946-90, “Standard Practice for Analysis of Reformed Gas by Gas Chromatography... the principal component of compressed natural gas are to be determined in accordance with test methods...

16 CFR 309.10 - Alternative vehicle fuel rating.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Analysis of Natural Gas by Gas Chromatography.” For the purposes of this section, fuel ratings for the... methods set forth in ASTM D 1946-90, “Standard Practice for Analysis of Reformed Gas by Gas Chromatography... the principal component of compressed natural gas are to be determined in accordance with test methods...

"Observation-Projet": A Professional Tool for Caregivers. Two Experiences in Italian Day-Care Settings

ERIC Educational Resources Information Center

Molina, Paola; Marotta, Monica; Bulgarelli, Daniela

2016-01-01

Ability to reflect on practice is a key element of early childhood professionalism and is positively associated with the quality of educational services. "Observation-Projet" (Fontaine 2008, 2011b) is a method designed to support practitioners' reflection through the observational process. The method adapts the required scientific…

76 FR 38621 - Takes of Marine Mammals Incidental to Specified Activities; Marine Geophysical Survey in the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-01

... by LGL Ltd., Environmental Research Associates (LGL), on behalf of NSF and L-DEO. The NMFS Biological... must set forth the permissible methods of taking, other means of effecting the least practicable... scientific information and estimation methodology. The alternative method of conducting site-specific...

Instructional Design as Knowledge Management: A Knowledge-in-Practice Approach to Choosing Instructional Methods

ERIC Educational Resources Information Center

McIver, Derrick; Fitzsimmons, Stacey; Flanagan, David

2016-01-01

Decisions about instructional methods are becoming more complex, with options ranging from problem sets to experiential service-learning projects. However, instructors not trained in instructional design may make these important decisions based on convenience, comfort, or trends. Instead, this article draws on the knowledge management literature…

Attitudes to Childhood Overweight and Obesity: The Limits of Cultural Explanations

ERIC Educational Resources Information Center

Chakrabarti, Suparna; Abbott, Stephen

2012-01-01

Objectives: To explore attitudes to and beliefs about childhood overweight and obesity among Bangladeshi mothers and to check maternal perceptions of their children's weight status. Design: Mixed methods cross-sectional study. Setting: A general practice in East London, UK. Methods: Qualitative interviews with 14 mothers; weighing and measuring 22…

Comparison of Ethical Dilemmas across Public and Private Sectors in Rehabilitation Counseling Practice

ERIC Educational Resources Information Center

Beveridge, Scott; Garcia, Jorge; Siblo, Matt

2015-01-01

Purpose: To examine the nature of ethical dilemmas most frequently reported by rehabilitation counselors in the private and public sectors and determine if significant differences exist in how practitioners experience ethical dilemmas in these two settings. Method: A mixed-methods internet-based survey design was utilized and included descriptive,…

Persistence of unsafe practice in everyday work: an exploration of organizational and psychological factors constraining safety in the operating room.

PubMed

Espin, S; Lingard, L; Baker, G R; Regehr, G

2006-06-01

This paper explores the factors that influence the persistence of unsafe practice in an interprofessional team setting in health care, towards the development of a descriptive theoretical model for analyzing problematic practice routines. Using data collected during a mixed method interview study of 28 members of an operating room team, participants' approaches to unsafe practice were analyzed using the following three theoretical models from organizational and cognitive psychology: Reason's theory of "vulnerable system syndrome", Tucker and Edmondson's concept of first and second order problem solving, and Amalberti's model of practice migration. These three theoretical approaches provide a critical insight into key trends in the interview data, including team members' definition of error as the breaching of standards of practice, nurses' sense of scope of practice as a constraint on their reporting behaviours, and participants' reports of the forces influencing tacit agreements to work around safety regulations. However, the relational factors underlying unsafe practice routines are poorly accounted for in these theoretical approaches. Incorporating an additional theoretical construct such as "relational coordination" to account for the emotional human features of team practice would provide a more comprehensive theoretical approach for use in exploring unsafe practice routines and the forces that sustain them in healthcare team settings.

Utility of Work Samples

ERIC Educational Resources Information Center

Muchinsky, Paul M.

1975-01-01

A work sample test can provide a high degree of content validity, and offers a practical method of screening job applicants in accordance with guidelines on employee selection procedures set forth by the Equal Employment Opportunity Commission. (MW)

Practice settings and dentists' job satisfaction.

PubMed

Lo Sasso, Anthony T; Starkel, Rebecca L; Warren, Matthew N; Guay, Albert H; Vujicic, Marko

2015-08-01

The nature and organization of dental practice is changing. The aim of this study was to explore how job satisfaction among dentists is associated with dental practice setting. A survey measured satisfaction with income, benefits, hours worked, clinical autonomy, work-life balance, emotional exhaustion, and overall satisfaction among dentists working in large group, small group, and solo practice settings; 2,171 dentists responded. The authors used logistic regression to measure differences in reported levels of satisfaction across practice settings. Dentists working in small group settings reported the most satisfaction overall. Dentists working in large group settings reported more satisfaction with income and benefits than dentists in solo practice, as well as having the least stress. Findings suggest possible advantages and disadvantages of working in different types of practice settings. Dentists working in different practice settings reported differences in satisfaction. These results may help dentists decide which practice setting is best for them. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

Exploring the Effectiveness of Engagement in a Broad Range of Disciplinary Practices on Learning of Turkish High-School Chemistry Students

ERIC Educational Resources Information Center

Seda Cetin, Pinar; Eymur, Guluzar; Southerland, Sherry A.; Walker, Joi; Whittington, Kirby

2018-01-01

This study examines the influence of laboratory instruction that engages students in a wide range of the practices of science on Turkish high-school students' chemistry learning. In this mixed methods study, student learning in two different laboratory settings was compared, one that featured an instruction that engaged students in a wide range of…

How Do Preservice Teachers Understand the Use of Research to Inform Practice? Foundational Knowledge for Bridging the Gap

ERIC Educational Resources Information Center

van Ingen, Sarah; Alvarez McHatton, Patricia; Vomvoridi-Ivanovic, Eugenia

2016-01-01

Despite widespread discourse about the need for teachers to utilize education research, little is known about how teachers learn to engage in this practice. How do preservice teachers understand the use of research to inform their teaching? Set within the context of a mathematics methods course, this study provides a detailed analysis of the…

Software safety - A user's practical perspective

NASA Technical Reports Server (NTRS)

Dunn, William R.; Corliss, Lloyd D.

1990-01-01

Software safety assurance philosophy and practices at the NASA Ames are discussed. It is shown that, to be safe, software must be error-free. Software developments on two digital flight control systems and two ground facility systems are examined, including the overall system and software organization and function, the software-safety issues, and their resolution. The effectiveness of safety assurance methods is discussed, including conventional life-cycle practices, verification and validation testing, software safety analysis, and formal design methods. It is concluded (1) that a practical software safety technology does not yet exist, (2) that it is unlikely that a set of general-purpose analytical techniques can be developed for proving that software is safe, and (3) that successful software safety-assurance practices will have to take into account the detailed design processes employed and show that the software will execute correctly under all possible conditions.

Culture Care Theory: a proposed practice theory guide for nurse practitioners in primary care settings.

PubMed

McFarland, Marilyn M; Eipperle, Marilyn K

2008-04-01

Leininger's Theory of Culture Care Diversity and Universality is presented as a foundational basis for the educational preparation, primary care contextual practice, and outcomes-focused research endeavours of advanced practice nursing. Discussion emphasises the value of care and caring as the essence of advanced practice nursing through the use of three modes of care, use of the Sunrise and other enablers, and the ethnonursing method. Education, research, practice, and key concepts of the theory are connected as essential components toward the provision of culturally congruent care to meet the healthcare needs of diverse individuals, families, groups, and communities by family nurse practitioners.

Rural Doctors' Views on and Experiences with Evidence-Based Medicine: The FrEEDoM Qualitative Study.

PubMed

Hisham, Ranita; Liew, Su May; Ng, Chirk Jenn; Mohd Nor, Kamaliah; Osman, Iskandar Firzada; Ho, Gah Juan; Hamzah, Nurazira; Glasziou, Paul

2016-01-01

Evidence-based medicine is the integration of individual clinical expertise, best external evidence and patient values which was introduced more than two decades ago. Yet, primary care physicians in Malaysia face unique barriers in accessing scientific literature and applying it to their clinical practice. This study aimed to explore the views and experiences of rural doctors' about evidence-based medicine in their daily clinical practice in a rural primary care setting. Qualitative methodology was used. The interviews were conducted in June 2013 in two rural health clinics in Malaysia. The participants were recruited using purposive sampling. Four focus group discussions with 15 medical officers and three individual in-depth interviews with family medicine specialists were carried out. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked and analyzed using a thematic approach. Key themes identified were: (1) doctors viewed evidence-based medicine mainly as statistics, research and guidelines, (2) reactions to evidence-based medicine were largely negative, (3) doctors relied on specialists, peers, guidelines and non-evidence based internet sources for information, (4) information sources were accessed using novel methods such as mobile applications and (5) there are several barriers to evidence-based practice, including doctor-, evidence-based medicine-, patient- and system-related factors. These included inadequacies in knowledge, attitude, management support, time and access to evidence-based information sources. Participants recommended the use of online services to support evidence-based practice in the rural settings. The level of evidence-based practice is low in the rural setting due to poor awareness, knowledge, attitude and resources. Doctors use non-evidence based sources and access them through new methods such as messaging applications. Further research is recommended to develop and evaluate interventions to overcome the identified barriers.

Exploring the Perceptions of Newly Credentialed Athletic Trainers as They Transition to Practice.

PubMed

Walker, Stacy E; Thrasher, Ashley B; Mazerolle, Stephanie M

2016-08-01

Research is limited on the transition to practice of newly credentialed athletic trainers (ATs). Understanding this transition could provide insight to assist employers and professional programs in developing initiatives to enhance the transition. To explore newly credentialed ATs' experiences and feelings during their transition from student to autonomous practitioner. Qualitative study. Individual phone interviews. Thirty-four ATs certified between January and September 2013 participated in this study (18 women, 16 men; age = 23.8 ± 2.1 years; work settings were collegiate, secondary school, clinic, and other). Data saturation guided the number of participants. Participants were interviewed via phone using a semistructured interview guide. All interviews were recorded and transcribed verbatim. Data were analyzed through phenomenologic reduction, with data coded for common themes and subthemes. Credibility was established via member checks, peer review, and intercoder reliability. The 3 themes that emerged from the data were (1) transition to practice preparation, (2) orientation, and (3) mentoring. Transition to practice was rarely discussed during professional preparation, but information on the organization and administration or capstone course (eg, insurance, documentation) assisted participants in their transition. Participants felt that preceptors influenced their transition by providing or hindering the number and quality of patient encounters. Participants from larger collegiate settings reported more formal orientation methods (eg, review policies, procedures manual), whereas those in secondary school, clinic/hospital, and smaller collegiate settings reported informal orientation methods (eg, independent review of policies and procedures, tours). Some participants were assigned a formal mentor, and others engaged in peer mentoring. Employers could enhance the transition to practice by providing formal orientation and mentorship. Professional programs could prepare students for the transition by discussing how to find support and mentoring and by involving preceptors who provide students with opportunities to give patient care.

Evaluation of peak-picking algorithms for protein mass spectrometry.

PubMed

Bauer, Chris; Cramer, Rainer; Schuchhardt, Johannes

2011-01-01

Peak picking is an early key step in MS data analysis. We compare three commonly used approaches to peak picking and discuss their merits by means of statistical analysis. Methods investigated encompass signal-to-noise ratio, continuous wavelet transform, and a correlation-based approach using a Gaussian template. Functionality of the three methods is illustrated and discussed in a practical context using a mass spectral data set created with MALDI-TOF technology. Sensitivity and specificity are investigated using a manually defined reference set of peaks. As an additional criterion, the robustness of the three methods is assessed by a perturbation analysis and illustrated using ROC curves.

The state of cell block variation and satisfaction in the era of molecular diagnostics and personalized medicine.

PubMed

Crapanzano, John P; Heymann, Jonas J; Monaco, Sara; Nassar, Aziza; Saqi, Anjali

2014-01-01

In the recent past, algorithms and recommendations to standardize the morphological, immunohistochemical and molecular classification of lung cancers on cytology specimens have been proposed, and several organizations have recommended cell blocks (CBs) as the preferred modality for molecular testing. Based on the literature, there are several different techniques available for CB preparation-suggesting that there is no standard. The aim of this study was to conduct a survey of CB preparation techniques utilized in various practice settings and analyze current issues, if any. A single E-mail with a link to an electronic survey was distributed to members of the American Society of Cytopathology and other pathologists. Questions pertaining to the participants' practice setting and CBs-volume, method, quality and satisfaction-were included. Of 95 respondents, 90/95 (94%) completed the survey and comprise the study group. Most participants practice in a community hospital/private practice (44%) or academic center (41%). On average, 14 CBs (range 0-50; median 10) are prepared by a laboratory daily. Over 10 methods are utilized: Plasma thrombin (33%), HistoGel (27%), Cellient automated cell block system (8%) and others (31%) respectively. Forty of 90 (44%) respondents are either unsatisfied or sometimes satisfied with their CB quality, with low-cellular yield being the leading cause of dissatisfaction. There was no statistical significance between the three most common CB preparation methods and satisfaction with quality. Many are dissatisfied with their current method of CB preparation, and there is no consistent method to prepare CBs. In today's era of personalized medicine with an increasing array of molecular tests being applied to cytological specimens, there is a need for a standardized protocol for CB optimization to enhance cellularity.

Density-based cluster algorithms for the identification of core sets

NASA Astrophysics Data System (ADS)

Lemke, Oliver; Keller, Bettina G.

2016-10-01

The core-set approach is a discretization method for Markov state models of complex molecular dynamics. Core sets are disjoint metastable regions in the conformational space, which need to be known prior to the construction of the core-set model. We propose to use density-based cluster algorithms to identify the cores. We compare three different density-based cluster algorithms: the CNN, the DBSCAN, and the Jarvis-Patrick algorithm. While the core-set models based on the CNN and DBSCAN clustering are well-converged, constructing core-set models based on the Jarvis-Patrick clustering cannot be recommended. In a well-converged core-set model, the number of core sets is up to an order of magnitude smaller than the number of states in a conventional Markov state model with comparable approximation error. Moreover, using the density-based clustering one can extend the core-set method to systems which are not strongly metastable. This is important for the practical application of the core-set method because most biologically interesting systems are only marginally metastable. The key point is to perform a hierarchical density-based clustering while monitoring the structure of the metric matrix which appears in the core-set method. We test this approach on a molecular-dynamics simulation of a highly flexible 14-residue peptide. The resulting core-set models have a high spatial resolution and can distinguish between conformationally similar yet chemically different structures, such as register-shifted hairpin structures.

Machine learning applications in genetics and genomics.

PubMed

Libbrecht, Maxwell W; Noble, William Stafford

2015-06-01

The field of machine learning, which aims to develop computer algorithms that improve with experience, holds promise to enable computers to assist humans in the analysis of large, complex data sets. Here, we provide an overview of machine learning applications for the analysis of genome sequencing data sets, including the annotation of sequence elements and epigenetic, proteomic or metabolomic data. We present considerations and recurrent challenges in the application of supervised, semi-supervised and unsupervised machine learning methods, as well as of generative and discriminative modelling approaches. We provide general guidelines to assist in the selection of these machine learning methods and their practical application for the analysis of genetic and genomic data sets.

Beyond Picture Naming: Norms and Patient Data for a Verb Generation Task**

PubMed Central

Kurland, Jacquie; Reber, Alisson; Stokes, Polly

2014-01-01

Purpose The current study aimed to: 1) acquire a set of verb generation to picture norms; and 2) probe its utility as an outcomes measure in aphasia treatment. Method Fifty healthy volunteers participated in Phase I, the verb generation normative sample. They generated verbs for 218 pictures of common objects (ISI=5s). In Phase II, four persons with aphasia (PWA) generated verbs for 60 objects (ISI=10s). Their stimuli consisted of objects which were: 1) recently trained (for object naming; n=20); 2) untrained (a control set; n=20); or 3) from a set of pictures named correctly at baseline (n=20). Verb generation was acquired twice: two months into, and following, a six-month home practice program. Results No objects elicited perfect verb agreement in the normed sample. Stimuli with the highest percent agreement were mostly artifacts and dominant verbs primary functional associates. Although not targeted in treatment or home practice, PWA mostly improved performance in verb generation post-practice. Conclusions A set of clinically and experimentally useful verb generation norms was acquired for a subset of the Snodgrass and Vanderwart (1980) picture set. More cognitively demanding than confrontation naming, this task may help to fill the sizeable gap between object picture naming and propositional speech. PMID:24686752

Variation in assessment and standard setting practices across UK undergraduate medicine and the need for a benchmark.

PubMed

MacDougall, Margaret

2015-10-31

The principal aim of this study is to provide an account of variation in UK undergraduate medical assessment styles and corresponding standard setting approaches with a view to highlighting the importance of a UK national licensing exam in recognizing a common standard. Using a secure online survey system, response data were collected during the period 13 - 30 January 2014 from selected specialists in medical education assessment, who served as representatives for their respective medical schools. Assessment styles and corresponding choices of standard setting methods vary markedly across UK medical schools. While there is considerable consensus on the application of compensatory approaches, individual schools display their own nuances through use of hybrid assessment and standard setting styles, uptake of less popular standard setting techniques and divided views on norm referencing. The extent of variation in assessment and standard setting practices across UK medical schools validates the concern that there is a lack of evidence that UK medical students achieve a common standard on graduation. A national licensing exam is therefore a viable option for benchmarking the performance of all UK undergraduate medical students.

Multi-criteria evaluation methods in the production scheduling

NASA Astrophysics Data System (ADS)

Kalinowski, K.; Krenczyk, D.; Paprocka, I.; Kempa, W.; Grabowik, C.

2016-08-01

The paper presents a discussion on the practical application of different methods of multi-criteria evaluation in the process of scheduling in manufacturing systems. Among the methods two main groups are specified: methods based on the distance function (using metacriterion) and methods that create a Pareto set of possible solutions. The basic criteria used for scheduling were also described. The overall procedure of evaluation process in production scheduling was presented. It takes into account the actions in the whole scheduling process and human decision maker (HDM) participation. The specified HDM decisions are related to creating and editing a set of evaluation criteria, selection of multi-criteria evaluation method, interaction in the searching process, using informal criteria and making final changes in the schedule for implementation. According to need, process scheduling may be completely or partially automated. Full automatization is possible in case of metacriterion based objective function and if Pareto set is selected - the final decision has to be done by HDM.

Ecoinformatics (Big Data) for Agricultural Entomology: Pitfalls, Progress, and Promise.

PubMed

Rosenheim, Jay A; Gratton, Claudio

2017-01-31

Ecoinformatics, as defined in this review, is the use of preexisting data sets to address questions in ecology. We provide the first review of ecoinformatics methods in agricultural entomology. Ecoinformatics methods have been used to address the full range of questions studied by agricultural entomologists, enabled by the special opportunities associated with data sets, nearly all of which have been observational, that are larger and more diverse and that embrace larger spatial and temporal scales than most experimental studies do. We argue that ecoinformatics research methods and traditional, experimental research methods have strengths and weaknesses that are largely complementary. We address the important interpretational challenges associated with observational data sets, highlight common pitfalls, and propose some best practices for researchers using these methods. Ecoinformatics methods hold great promise as a vehicle for capitalizing on the explosion of data emanating from farmers, researchers, and the public, as novel sampling and sensing techniques are developed and digital data sharing becomes more widespread.

Supervision--growing and building a sustainable general practice supervisor system.

PubMed

Thomson, Jennifer S; Anderson, Katrina J; Mara, Paul R; Stevenson, Alexander D

2011-06-06

This article explores various models and ideas for future sustainable general practice vocational training supervision in Australia. The general practitioner supervisor in the clinical practice setting is currently central to training the future general practice workforce. Finding ways to recruit, retain and motivate both new and experienced GP teachers is discussed, as is the creation of career paths for such teachers. Some of the newer methods of practice-based teaching are considered for further development, including vertically integrated teaching, e-learning, wave consulting and teaching on the run, teaching teams and remote teaching. Approaches to supporting and resourcing teaching and the required infrastructure are also considered. Further research into sustaining the practice-based general practice supervision model will be required.

On-going collaborative priority-setting for research activity: a method of capacity building to reduce the research-practice translational gap.

PubMed

Cooke, Jo; Ariss, Steven; Smith, Christine; Read, Jennifer

2015-05-07

International policy suggests that collaborative priority setting (CPS) between researchers and end users of research should shape the research agenda, and can increase capacity to address the research-practice translational gap. There is limited research evidence to guide how this should be done to meet the needs of dynamic healthcare systems. One-off priority setting events and time-lag between decision and action prove problematic. This study illustrates the use of CPS in a UK research collaboration called Collaboration and Leadership in Applied Health Research and Care (CLAHRC). Data were collected from a north of England CLAHRC through semi-structured interviews with 28 interviewees and a workshop of key stakeholders (n = 21) including academics, NHS clinicians, and managers. Documentary analysis of internal reports and CLAHRC annual reports for the first two and half years was also undertaken. These data were thematically coded. Methods of CPS linked to the developmental phase of the CLAHRC. Early methods included pre-existing historical partnerships with on-going dialogue. Later, new platforms for on-going discussions were formed. Consensus techniques with staged project development were also used. All methods demonstrated actual or potential change in practice and services. Impact was enabled through the flexibility of research and implementation work streams; 'matched' funding arrangements to support alignment of priorities in partner organisations; the size of the collaboration offering a resource to meet project needs; and the length of the programme providing stability and long term relationships. Difficulties included tensions between being responsive to priorities and the possibility of 'drift' within project work, between academics and practice, and between service providers and commissioners in the health services. Providing protected 'matched' time proved difficult for some NHS managers, which put increasing work pressure on them. CPS is more time consuming than traditional approaches to project development. CPS can produce needs-led projects that are bedded in services using a variety of methods. Contributing factors for effective CPS include flexibility in use and type of available resources, flexible work plans, and responsive leadership. The CLAHRC model provides a translational infrastructure that enables CPS that can impact on healthcare systems.

A level set method for cupping artifact correction in cone-beam CT

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

Xie, Shipeng; Li, Haibo; Ge, Qi

2015-08-15

Purpose: To reduce cupping artifacts and improve the contrast-to-noise ratio in cone-beam computed tomography (CBCT). Methods: A level set method is proposed to reduce cupping artifacts in the reconstructed image of CBCT. The authors derive a local intensity clustering property of the CBCT image and define a local clustering criterion function of the image intensities in a neighborhood of each point. This criterion function defines an energy in terms of the level set functions, which represent a segmentation result and the cupping artifacts. The cupping artifacts are estimated as a result of minimizing this energy. Results: The cupping artifacts inmore » CBCT are reduced by an average of 90%. The results indicate that the level set-based algorithm is practical and effective for reducing the cupping artifacts and preserving the quality of the reconstructed image. Conclusions: The proposed method focuses on the reconstructed image without requiring any additional physical equipment, is easily implemented, and provides cupping correction through a single-scan acquisition. The experimental results demonstrate that the proposed method successfully reduces the cupping artifacts.« less

Surgeon General's Call to Action to Prevent Skin Cancer

MedlinePlus

... in outdoor athletic settings. • Discourage indoor tanning by students and reconsider campus practices that may encourage indoor ... most effective when used in combination with other methods. FOR MORE INFORMATION, PLEASE VISIT: www. cdc. gov/ ...

Enhancing predictive accuracy and reproducibility in clinical evaluation research: Commentary on the special section of the Journal of Evaluation in Clinical Practice.

PubMed

Bryant, Fred B

2016-12-01

This paper introduces a special section of the current issue of the Journal of Evaluation in Clinical Practice that includes a set of 6 empirical articles showcasing a versatile, new machine-learning statistical method, known as optimal data (or discriminant) analysis (ODA), specifically designed to produce statistical models that maximize predictive accuracy. As this set of papers clearly illustrates, ODA offers numerous important advantages over traditional statistical methods-advantages that enhance the validity and reproducibility of statistical conclusions in empirical research. This issue of the journal also includes a review of a recently published book that provides a comprehensive introduction to the logic, theory, and application of ODA in empirical research. It is argued that researchers have much to gain by using ODA to analyze their data. © 2016 John Wiley & Sons, Ltd.

Interprofessional Education and Practice Guide No. 6: Developing practice-based interprofessional learning using a short placement model.

PubMed

Anderson, Elizabeth Susan; Ford, Jenny; Kinnair, Daniel James

2016-07-01

Offering undergraduate and post-qualified learners opportunities to take part in, and reflect on, the nature of interprofessional working when in practice remains an important goal for interprofessional educators. There are a plethora of opportunities within hospital and community care for learners to actively participate in health and social care delivery where collaborative practice prevails. However, it remains challenging to know how to establish and sustain meaningful interprofessional practice-based learning. This is because profession-specific teaching is prioritised and many teams are under-resourced, leaving little time for additional teaching activities. In some instances, practitioners lack the knowledge concerning how to design meaningful interprofessional learning and often feel unprepared for this teaching because of limited interprofessional faculty development. Others are simply unaware of the presence of the different students within their practice area. This guide offers key lessons developed over many years for setting up practice-based interprofessional education. The learning model has been adapted and adopted in different settings and countries and offers a method for engaging clinical front-line practitioners in learning with, and from learners who can help support and in some instances advance care delivery.

Training in interprofessional collaboration

PubMed Central

Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien

2012-01-01

Abstract Problem addressed A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. Objective of the program The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Program description Based on adult learning theories, the program was divided into 3 phases—preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program’s pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. Conclusion The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training. PMID:22611607

Communication, Respect, and Leadership: Interprofessional Collaboration in Hospitals of Rural Ontario.

PubMed

Morris, Diane; Matthews, June

2014-12-01

Health care professionals are expected to work collaboratively across diverse settings. In rural hospitals, these professionals face different challenges from their urban colleagues; however, little is known about interprofessional practice in these settings. Eleven health care professionals from 2 rural interprofessional teams were interviewed about collaborative practice. The data were analyzed using a constant comparative method. Common themes included communication, respect, leadership, benefits of interprofessional teams, and the assets and challenges of working in small or rural hospitals. Differences between the cases were apparent in how the members conceptualized their teams, models of which were then compared with an "Ideal Interprofessional Team". These results suggest that many experienced health care professionals function well in interprofessional teams; yet, they did not likely receive much education about interprofessional practice in their training. Providing interprofessional education to new practitioners may help them to establish this approach early in their careers and build on it with additional experience. Finally, these findings can be applied to address concerns that have arisen from other reports by exploring innovative ways to attract health professionals to communities in rural, remote, and northern areas, as there is a constant need for dietitians and other health care professionals in these practice settings.

Changing physician behavior: what works?

PubMed

Mostofian, Fargoi; Ruban, Cynthiya; Simunovic, Nicole; Bhandari, Mohit

2015-01-01

There are various interventions for guideline implementation in clinical practice, but the effects of these interventions are generally unclear. We conducted a systematic review to identify effective methods of implementing clinical research findings and clinical guidelines to change physician practice patterns, in surgical and general practice. Systematic review of reviews. We searched electronic databases (MEDLINE, EMBASE, and PubMed) for systematic reviews published in English that evaluated the effectiveness of different implementation methods. Two reviewers independently assessed eligibility for inclusion and methodological quality, and extracted relevant data. Fourteen reviews covering a wide range of interventions were identified. The intervention methods used include: audit and feedback, computerized decision support systems, continuing medical education, financial incentives, local opinion leaders, marketing, passive dissemination of information, patient-mediated interventions, reminders, and multifaceted interventions. Active approaches, such as academic detailing, led to greater effects than traditional passive approaches. According to the findings of 3 reviews, 71% of studies included in these reviews showed positive change in physician behavior when exposed to active educational methods and multifaceted interventions. Active forms of continuing medical education and multifaceted interventions were found to be the most effective methods for implementing guidelines into general practice. Additionally, active approaches to changing physician performance were shown to improve practice to a greater extent than traditional passive methods. Further primary research is necessary to evaluate the effectiveness of these methods in a surgical setting.

The Objective Borderline method (OBM): a probability-based model for setting up an objective pass/fail cut-off score in medical programme assessments.

PubMed

Shulruf, Boaz; Turner, Rolf; Poole, Phillippa; Wilkinson, Tim

2013-05-01

The decision to pass or fail a medical student is a 'high stakes' one. The aim of this study is to introduce and demonstrate the feasibility and practicality of a new objective standard-setting method for determining the pass/fail cut-off score from borderline grades. Three methods for setting up pass/fail cut-off scores were compared: the Regression Method, the Borderline Group Method, and the new Objective Borderline Method (OBM). Using Year 5 students' OSCE results from one medical school we established the pass/fail cut-off scores by the abovementioned three methods. The comparison indicated that the pass/fail cut-off scores generated by the OBM were similar to those generated by the more established methods (0.840 ≤ r ≤ 0.998; p < .0001). Based on theoretical and empirical analysis, we suggest that the OBM has advantages over existing methods in that it combines objectivity, realism, robust empirical basis and, no less importantly, is simple to use.

The Effect of Distributed Practice in Undergraduate Statistics Homework Sets: A Randomized Trial

ERIC Educational Resources Information Center

Crissinger, Bryan R.

2015-01-01

Most homework sets in statistics courses are constructed so that students concentrate or "mass" their practice on a certain topic in one problem set. Distributed practice homework sets include review problems in each set so that practice on a topic is distributed across problem sets. There is a body of research that points to the…

Sustainability in Health care by Allocating Resources Effectively (SHARE) 2: identifying opportunities for disinvestment in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; King, Richard; Ramsey, Wayne; Kelly, Cate; Thiagarajan, Malar

2017-05-05

This is the second in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Rising healthcare costs, continuing advances in health technologies and recognition of ineffective practices and systematic waste are driving disinvestment of health technologies and clinical practices that offer little or no benefit in order to maximise outcomes from existing resources. However there is little information to guide regional health services or individual facilities in how they might approach disinvestment locally. This paper outlines the investigation of potential settings and methods for decision-making about disinvestment in the context of an Australian health service. Methods include a literature review on the concepts and terminology relating to disinvestment, a survey of national and international researchers, and interviews and workshops with local informants. A conceptual framework was drafted and refined with stakeholder feedback. There is a lack of common terminology regarding definitions and concepts related to disinvestment and no guidance for an organisation-wide systematic approach to disinvestment in a local healthcare service. A summary of issues from the literature and respondents highlight the lack of theoretical knowledge and practical experience and provide a guide to the information required to develop future models or methods for disinvestment in the local context. A conceptual framework was developed. Three mechanisms that provide opportunities to introduce disinvestment decisions into health service systems and processes were identified. Presented in order of complexity, time to achieve outcomes and resources required they include 1) Explicit consideration of potential disinvestment in routine decision-making, 2) Proactive decision-making about disinvestment driven by available evidence from published research and local data, and 3) Specific exercises in priority setting and system redesign. This framework identifies potential opportunities to initiate disinvestment activities in a systematic integrated approach that can be applied across a whole organisation using transparent, evidence-based methods. Incorporating considerations for disinvestment into existing decision-making systems and processes might be achieved quickly with minimal cost; however establishment of new systems requires research into appropriate methods and provision of appropriate skills and resources to deliver them.

Training set extension for SVM ensemble in P300-speller with familiar face paradigm.

PubMed

Li, Qi; Shi, Kaiyang; Gao, Ning; Li, Jian; Bai, Ou

2018-03-27

P300-spellers are brain-computer interface (BCI)-based character input systems. Support vector machine (SVM) ensembles are trained with large-scale training sets and used as classifiers in these systems. However, the required large-scale training data necessitate a prolonged collection time for each subject, which results in data collected toward the end of the period being contaminated by the subject's fatigue. This study aimed to develop a method for acquiring more training data based on a collected small training set. A new method was developed in which two corresponding training datasets in two sequences are superposed and averaged to extend the training set. The proposed method was tested offline on a P300-speller with the familiar face paradigm. The SVM ensemble with extended training set achieved 85% classification accuracy for the averaged results of four sequences, and 100% for 11 sequences in the P300-speller. In contrast, the conventional SVM ensemble with non-extended training set achieved only 65% accuracy for four sequences, and 92% for 11 sequences. The SVM ensemble with extended training set achieves higher classification accuracies than the conventional SVM ensemble, which verifies that the proposed method effectively improves the classification performance of BCI P300-spellers, thus enhancing their practicality.

A Conflict Management Scale for Pharmacy

PubMed Central

Gregory, Paul A.; Martin, Craig

2009-01-01

Objectives To develop and establish the validity and reliability of a conflict management scale specific to pharmacy practice and education. Methods A multistage inventory-item development process was undertaken involving 93 pharmacists and using a previously described explanatory model for conflict in pharmacy practice. A 19-item inventory was developed, field tested, and validated. Results The conflict management scale (CMS) demonstrated an acceptable degree of reliability and validity for use in educational or practice settings to promote self-reflection and self-awareness regarding individuals' conflict management styles. Conclusions The CMS provides a unique, pharmacy-specific method for individuals to determine and reflect upon their own conflict management styles. As part of an educational program to facilitate self-reflection and heighten self-awareness, the CMS may be a useful tool to promote discussions related to an important part of pharmacy practice. PMID:19960081

Profile of 1 year of fieldwork experiences for undergraduate occupational therapy students from a large regional Australian university.

PubMed

Mackenzie, Lynette; O'Toole, Gjyn

2017-10-01

Objective Fieldwork experience is a significant component of many health professional education programs and affects future practice for graduates. The present study used self-reported student data to produce a profile of undergraduate student placement experiences. Methods Cross-sectional surveys exploring placement location, setting and client types, models of supervision, interventions and financial costs were completed by students following each placement. Data were analysed using descriptive analysis. Results Placements were predominantly conducted outside capital cities (69.8%; n=184), with 25.8% (n=68) in rural settings. Students experienced predominantly public health in-patient settings and community settings, with only 15% experiencing private settings. Conclusions The placement profile of undergraduate occupational therapy students appeared to be consistent with workforce reports on occupational therapy professional practice. What is known about the topic? Fieldwork experienced by health professional students is critical to preparing new graduates for practice. Although the World Federation of Occupational Therapy provides guidance on what is required for occupational therapy fieldwork experience, little is known about what students actually experience during their fieldwork placements. What does this paper add? The present study is the first to document the range of fieldwork experienced by occupational therapy students in one program over 1 year, and provides the basis for comparison with other occupational therapy programs, as well as other disciplines nationally and internationally. What are the implications for practitioners? Occupational therapy students experienced few opportunities in private practice or speciality services, and had mostly one-on-one supervision. To provide a future workforce that is able to address the changing health system, it is vital that students are exposed to a range of fieldwork experiences and supervision styles that replicate the demands of future practice.

Intermittent kangaroo mother care: a NICU protocol.

PubMed

Davanzo, Riccardo; Brovedani, Pierpaolo; Travan, Laura; Kennedy, Jacqueline; Crocetta, Anna; Sanesi, Cecilia; Strajn, Tamara; De Cunto, Angela

2013-08-01

The practice of kangaroo mother care (KMC) is steadily increasing in high-tech settings due to its proven benefits for both infants and parents. In spite of that, clear guidelines about how to implement this method of care are lacking, and as a consequence, some restrictions are applied in many neonatal intensive care units (NICUs), preventing its practice. Based on recommendations from the Expert Group of the International Network on Kangaroo Mother Care, we developed a hospital protocol in the neonatal unit of the Institute for Maternal and Child Health in Trieste, Italy, a level 3 unit, aimed to facilitate and promote KMC implementation in high-tech settings. Our guideline is therefore proposed, based both on current scientific literature and on practical considerations and experience. Future adjustments and improvements would be considered based on increasing clinical KMC use and further knowledge.

Material selection in a sustainable manufacturing practice of a badminton racket frame using Elimination and Choice Expressing Reality (ELECTRE) Method

NASA Astrophysics Data System (ADS)

Firdhaus Che Hassan, Muhammad; Rosli, Mohd Uzair Mohd; Redzuan, Muhammad Afiq Mohd

2018-05-01

Badminton is one of the leading sports in the world. It has its own set of rules on the equipments used and general game play. One of the main equipment used is the badminton racket. Each sections of a badminton racket have its own design requirements and one of it is the racket’s material selection. Therefore, material selection is very important to improve the usage of a badminton racket. This study describes the use of the Elimination and Choice Expressing Reality (ELECTRE) method in the material selection of a badminton racket frame with reference to the sustainable manufacturing practice of the frame. By categorizing the materials of the badminton racket frame according to mechanical, physical, chemical and environmental properties, and further detailed sub criteria were set according to the usage of these frames, the ELECTRE I method was used to determine the dominant material. Out of the six materials usually used in the manufacturing of a badminton racket frame, carbon fibre was the dominant material selected from three out of the four properties which are the mechanical, chemical and most importantly the environmental properties, as to comply with the sustainable manufacturing practice of these frames.

Spatial multiobjective optimization of agricultural conservation practices using a SWAT model and an evolutionary algorithm.

PubMed

Rabotyagov, Sergey; Campbell, Todd; Valcu, Adriana; Gassman, Philip; Jha, Manoj; Schilling, Keith; Wolter, Calvin; Kling, Catherine

2012-12-09

Finding the cost-efficient (i.e., lowest-cost) ways of targeting conservation practice investments for the achievement of specific water quality goals across the landscape is of primary importance in watershed management. Traditional economics methods of finding the lowest-cost solution in the watershed context (e.g.,(5,12,20)) assume that off-site impacts can be accurately described as a proportion of on-site pollution generated. Such approaches are unlikely to be representative of the actual pollution process in a watershed, where the impacts of polluting sources are often determined by complex biophysical processes. The use of modern physically-based, spatially distributed hydrologic simulation models allows for a greater degree of realism in terms of process representation but requires a development of a simulation-optimization framework where the model becomes an integral part of optimization. Evolutionary algorithms appear to be a particularly useful optimization tool, able to deal with the combinatorial nature of a watershed simulation-optimization problem and allowing the use of the full water quality model. Evolutionary algorithms treat a particular spatial allocation of conservation practices in a watershed as a candidate solution and utilize sets (populations) of candidate solutions iteratively applying stochastic operators of selection, recombination, and mutation to find improvements with respect to the optimization objectives. The optimization objectives in this case are to minimize nonpoint-source pollution in the watershed, simultaneously minimizing the cost of conservation practices. A recent and expanding set of research is attempting to use similar methods and integrates water quality models with broadly defined evolutionary optimization methods(3,4,9,10,13-15,17-19,22,23,25). In this application, we demonstrate a program which follows Rabotyagov et al.'s approach and integrates a modern and commonly used SWAT water quality model(7) with a multiobjective evolutionary algorithm SPEA2(26), and user-specified set of conservation practices and their costs to search for the complete tradeoff frontiers between costs of conservation practices and user-specified water quality objectives. The frontiers quantify the tradeoffs faced by the watershed managers by presenting the full range of costs associated with various water quality improvement goals. The program allows for a selection of watershed configurations achieving specified water quality improvement goals and a production of maps of optimized placement of conservation practices.

Fostering Cooperative Learning with Scrum in a Semi-Capstone Systems Analysis and Design Course

ERIC Educational Resources Information Center

Magana, Alejandra J.; Seah, Ying Ying; Thomas, Paul

2018-01-01

Agile methods such as Scrum that emphasize technical, communication, and teamwork skills have been practiced by IT professionals to effectively deliver software products of good quality. The same methods combined with pedagogies of engagement can potentially be used in the setting of higher education to promote effective group learning in software…

Using Mixed Methods to Study First-Year College Impact on Liberal Arts Learning Outcomes

ERIC Educational Resources Information Center

Seifert, Tricia A.; Goodman, Kathleen; King, Patricia M.; Baxter Magolda, Marcia B.

2010-01-01

This study details the collection, analysis, and interpretation of data from a national multi-institutional longitudinal mixed methods study of college impact and student development of liberal arts outcomes. The authors found three sets of practices in the quantitative data that corroborated with the themes that emerged from the qualitative data:…

Dialectical Behavioral Therapy and EMDR for Adolescents in Residential Treatment: A Practical and Theoretical Perspective

ERIC Educational Resources Information Center

Lovelle, Carole

2005-01-01

DBT and EMDR as primary treatment methods provide effective treatment for adolescents in the setting of group residential facilities. Regardless of the intensity of the pathology or the length of stay, these compatible treatment methods provide adolescents with significant decreases in the impact of traumatic memories and increased emotional…

Indicators of Family Care for Development for Use in Multicountry Surveys

PubMed Central

Kariger, Patricia; Engle, Patrice; Britto, Pia M. Rebello; Sywulka, Sara M.; Menon, Purnima

2012-01-01

Indicators of family care for development are essential for ascertaining whether families are providing their children with an environment that leads to positive developmental outcomes. This project aimed to develop indicators from a set of items, measuring family care practices and resources important for caregiving, for use in epidemiologic surveys in developing countries. A mixed method (quantitative and qualitative) design was used for item selection and evaluation. Qualitative and quantitative analyses were conducted to examine the validity of candidate items in several country samples. Qualitative methods included the use of global expert panels to identify and evaluate the performance of each candidate item as well as in-country focus groups to test the content validity of the items. The quantitative methods included analyses of item-response distributions, using bivariate techniques. The selected items measured two family care practices (support for learning/stimulating environment and limit-setting techniques) and caregiving resources (adequacy of the alternate caregiver when the mother worked). Six play-activity items, indicative of support for learning/stimulating environment, were included in the core module of UNICEF's Multiple Cluster Indictor Survey 3. The other items were included in optional modules. This project provided, for the first time, a globally-relevant set of items for assessing family care practices and resources in epidemiological surveys. These items have multiple uses, including national monitoring and cross-country comparisons of the status of family care for development used globally. The obtained information will reinforce attention to efforts to improve the support for development of children. PMID:23304914

Responsible and controlled use: Older cannabis users and harm reduction

PubMed Central

Lau, Nicholas; Sales, Paloma; Averill, Sheigla; Murphy, Fiona; Sato, Sye-Ok; Murphy, Sheigla

2015-01-01

Background Cannabis use is becoming more accepted in mainstream society. In this paper, we use Zinberg’s classic theoretical framework of drug, set, and setting to elucidate how older adult cannabis users managed health, social and legal risks in a context of normalized cannabis use. Methods We present selected findings from our qualitative study of Baby Boomer (born 1946–1964) cannabis users in the San Francisco Bay Area. Data collection consisted of a recorded, in-depth life history interview followed by a questionnaire and health survey. Qualitative interviews were analyzed to discover the factors of cannabis harm reduction from the users’ perspectives. Results Interviewees made harm reduction choices based on preferred cannabis derivatives and routes of administration, as well as why, when, where, and with whom to use. Most interviewees minimized cannabis-related harms so they could maintain social functioning in their everyday lives. Responsible and controlled use was described as moderation of quantity and frequency of cannabis used, using in appropriate settings, and respect for non-users. Users contributed to the normalization of cannabis use through normification. Conclusion Participants followed rituals or cultural practices, characterized by sanctions that helped define “normal” or “acceptable” cannabis use. Users contributed to cannabis normalization through their harm reduction methods. These cultural practices may prove to be more effective than formal legal prohibitions in reducing cannabis-related harms. Findings also suggest that users with access to a regulated market (medical cannabis dispensaries) were better equipped to practice harm reduction. More research is needed on both cannabis culture and alternative routes of administration as harm reduction methods. PMID:25911027

The Role of Certified Registered Nurse Anesthetists in Patient Education

DTIC Science & Technology

2000-10-01

settings. AORN Journal, 64, 941-952. Burns, N., & Grove, S. (1997). The practice of nursing research conduct, critique, & utilization (3rd ed...nursing theory to perioperative nursing practice. AORN Journal, 64, 261-264 & 267-268. Patient Education 27 Haddock, J., & Burrows, C. (1997). The...Study on effects of methods of preoperative education in women. AORN Journal, 67, 203-213. Miller, B., & Capps, E. (1997). Meeting JCAHO patient

Quantifying Discipline Practices Using Absolute vs. Relative Frequencies: Clinical and Research Implications for Child Welfare

PubMed Central

Lindhiem, Oliver; Shaffer, Anne; Kolko, David J.

2014-01-01

In the parent intervention outcome literatures, discipline practices are generally quantified as absolute frequencies or, less commonly, as relative frequencies. These differences in methodology warrant direct comparison as they have critical implications for study results and conclusions among treatments targeted at reducing parental aggression and harsh discipline. In this study, we directly compared the absolute frequency method and the relative frequency method for quantifying physically aggressive, psychologically aggressive, and nonaggressive discipline practices. Longitudinal data over a 3-year period came from an existing data set of a clinical trial examining the effectiveness of a psychosocial treatment in reducing parental physical and psychological aggression and improving child behavior (N = 139; Kolko et al., 2009). Discipline practices (both aggressive and nonaggressive) were assessed using the Conflict Tactics Scale (CTS; Straus et al., 1998). The two methods yielded different patterns of results, particularly for nonaggressive discipline strategies. We suggest that each method makes its own unique contribution to a more complete understanding of the association between parental aggression and intervention effects. PMID:24106146

Primary healthcare nurses' experiences with motivational interviewing in health promotion practice.

PubMed

Brobeck, Elisabeth; Bergh, Håkan; Odencrants, Sigrid; Hildingh, Cathrine

2011-12-01

The aim of the study was to describe primary healthcare nurses' experiences with motivational interviewing as a method for health promotion practice. A person's lifestyle has a major effect on his or her health. Motivational interviewing is one way of working with lifestyle changes in health promotion practice. The basic plan of motivational interviewing is to help people understand their lifestyle problems and make positive lifestyle changes. Motivational interviewing has been proven to be more effective than conventional methods in increasing patient motivation. This study has a descriptive design and uses a qualitative method. Twenty nurses who worked in primary health care and actively used motivational interviewing in their work were interviewed. Qualitative content analysis was used to process the data. The primary healthcare nurses' experiences with motivational interviewing as a method of health promotion practice demonstrate that motivational interviewing is a demanding, enriching and useful method that promotes awareness and guidance in the care relationship. The results also show that motivational interviewing is a valuable tool for primary healthcare nurses' health promotion practice. This study shows that motivational interviewing places several different demands on nurses who use this method. Those who work with motivational interviewing must make an effort to incorporate this new method to avoid falling back into the former practice of simply giving advice. Maintaining an open mind while implementing motivational interviewing in real healthcare settings is crucial for nurses to increase this method's effectiveness. The nurses in the study had a positive experience with motivational interviewing, which can contribute to the increased use, adaption and development of motivational interviewing among primary healthcare professionals. Increased motivational interviewing knowledge and skills would also contribute to promotion of health lifestyle practices. © 2011 Blackwell Publishing Ltd.

Modern trends in infection control practices in intensive care units.

PubMed

Gandra, Sumanth; Ellison, Richard T

2014-01-01

Hospital-acquired infections (HAIs) are common in intensive care unit (ICU) patients and are associated with increased morbidity and mortality. There has been an increasing effort to prevent HAIs, and infection control practices are paramount in avoiding these complications. In the last several years, numerous developments have been seen in the infection prevention strategies in various health care settings. This article reviews the modern trends in infection control practices to prevent HAIs in ICUs with a focus on methods for monitoring hand hygiene, updates in isolation precautions, new methods for environmental cleaning, antimicrobial bathing, prevention of ventilator-associated pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and Clostridium difficile infection. © The Author(s) 2013.

Flipping the classroom to teach Millennial residents medical leadership: a proof of concept.

PubMed

Lucardie, Alicia T; Berkenbosch, Lizanne; van den Berg, Jochem; Busari, Jamiu O

2017-01-01

The ongoing changes in health care delivery have resulted in the reform of educational content and methods of training in postgraduate medical leadership education. Health care law and medical errors are domains in medical leadership where medical residents desire training. However, the potential value of the flipped classroom as a pedagogical tool for leadership training within postgraduate medical education has not been fully explored. Therefore, we designed a learning module for this purpose and made use of the flipped classroom model to deliver the training. The flipped classroom model reverses the order of learning: basic concepts are learned individually outside of class so that more time is spent applying knowledge to discussions and practical scenarios during class. Advantages include high levels of interaction, optimal utilization of student and expert time and direct application to the practice setting. Disadvantages include the need for high levels of self-motivation and time constraints within the clinical setting. Educational needs and expectations vary within various generations and call for novel teaching modalities. Hence, the choice of instructional methods should be driven not only by their intrinsic values but also by their alignment with the learners' preference. The flipped classroom model is an educational modality that resonates with Millennial students. It helps them to progress quickly beyond the mere understanding of theory to higher order cognitive skills such as evaluation and application of knowledge in practice. Hence, the successful application of this model would allow the translation of highly theoretical topics to the practice setting within postgraduate medical education.

Flipping the classroom to teach Millennial residents medical leadership: a proof of concept

PubMed Central

Lucardie, Alicia T; Berkenbosch, Lizanne; van den Berg, Jochem; Busari, Jamiu O

2017-01-01

Introduction The ongoing changes in health care delivery have resulted in the reform of educational content and methods of training in postgraduate medical leadership education. Health care law and medical errors are domains in medical leadership where medical residents desire training. However, the potential value of the flipped classroom as a pedagogical tool for leadership training within postgraduate medical education has not been fully explored. Therefore, we designed a learning module for this purpose and made use of the flipped classroom model to deliver the training. Evidence The flipped classroom model reverses the order of learning: basic concepts are learned individually outside of class so that more time is spent applying knowledge to discussions and practical scenarios during class. Advantages include high levels of interaction, optimal utilization of student and expert time and direct application to the practice setting. Disadvantages include the need for high levels of self-motivation and time constraints within the clinical setting. Discussion Educational needs and expectations vary within various generations and call for novel teaching modalities. Hence, the choice of instructional methods should be driven not only by their intrinsic values but also by their alignment with the learners’ preference. The flipped classroom model is an educational modality that resonates with Millennial students. It helps them to progress quickly beyond the mere understanding of theory to higher order cognitive skills such as evaluation and application of knowledge in practice. Hence, the successful application of this model would allow the translation of highly theoretical topics to the practice setting within postgraduate medical education. PMID:28144170

Capital Budgeting: Do Private Sector Methods of Budgeting for Capital Assets Have Applicability to the Department of Defense

DTIC Science & Technology

2005-12-01

private sector and the Department of Defense. Additionally, the purpose is to evaluate the strengths and weaknesses of each capital budgeting method and conduct a comparison. The intent is to identify those capital budgeting practices that are used in the private sector , some of which have been implemented in other public sector organizations, which may have merit for implementation in the Federal sector and possibly the Department of Defense. Finally, a set of conclusions and recommendations on how to implement best practices of capital budgeting for

Design choices made by target users for a pay-for-performance program in primary care: an action research approach.

PubMed

Kirschner, Kirsten; Braspenning, Jozé; Jacobs, J E Annelies; Grol, Richard

2012-03-27

International interest in pay-for-performance (P4P) initiatives to improve quality of health care is growing. Current programs vary in the methods of performance measurement, appraisal and reimbursement. One may assume that involvement of health care professionals in the goal setting and methods of quality measurement and subsequent payment schemes may enhance their commitment to and motivation for P4P programs and therefore the impact of these programs. We developed a P4P program in which the target users were involved in decisions about the P4P methods. For the development of the P4P program a framework was used which distinguished three main components: performance measurement, appraisal and reimbursement. Based on this framework design choices were discussed in two panels of target users using an adapted Delphi procedure. The target users were 65 general practices and two health insurance companies in the South of the Netherlands. Performance measurement was linked to the Dutch accreditation program based on three domains (clinical care, practice management and patient experience). The general practice was chosen as unit of assessment. Relative standards were set at the 25th percentile of group performance. The incentive for clinical care was set twice as high as the one for practice management and patient experience. Quality scores were to be calculated separately for all three domains, and for both the quality level and the improvement of performance. The incentive for quality level was set thrice as high as the one for the improvement of performance. For reimbursement, quality scores were divided into seven levels. A practice with a quality score in the lowest group was not supposed to receive a bonus. The additional payment grew proportionally for each extra group. The bonus aimed at was on average 5% to 10% of the practice income. Designing a P4P program for primary care with involvement of the target users gave us an insight into their motives, which can help others who need to discuss similar programs. The resulting program is in line with target users' views and assessments of relevance and applicability. This may enhance their commitment to the program as was indicated by the growing number of voluntary participants after a successfully performed field test during the procedure. The elements of our framework can be very helpful for others who are developing or evaluating a P4P program.

Introduction to special section of the Journal of Family Psychology, advances in mixed methods in family psychology: integrative and applied solutions for family science.

PubMed

Weisner, Thomas S; Fiese, Barbara H

2011-12-01

Mixed methods in family psychology refer to the systematic integration of qualitative and quantitative techniques to represent family processes and settings. Over the past decade, significant advances have been made in study design, analytic strategies, and technological support (such as software) that allow for the integration of quantitative and qualitative methods and for making appropriate inferences from mixed methods. This special section of the Journal of Family Psychology illustrates how mixed methods may be used to advance knowledge in family science through identifying important cultural differences in family structure, beliefs, and practices, and revealing patterns of family relationships to generate new measurement paradigms and inform clinical practice. Guidance is offered to advance mixed methods research in family psychology through sound principles of peer review.

A new evaluation tool to obtain practice-based evidence of worksite health promotion programs.

PubMed

Dunet, Diane O; Sparling, Phillip B; Hersey, James; Williams-Piehota, Pamela; Hill, Mary D; Hanssen, Carl; Lawrenz, Frances; Reyes, Michele

2008-10-01

The Centers for Disease Control and Prevention developed the Swift Worksite Assessment and Translation (SWAT) evaluation method to identify promising practices in worksite health promotion programs. The new method complements research studies and evaluation studies of evidence-based practices that promote healthy weight in working adults. We used nationally recognized program evaluation standards of utility, feasibility, accuracy, and propriety as the foundation for our 5-step method: 1) site identification and selection, 2) site visit, 3) post-visit evaluation of promising practices, 4) evaluation capacity building, and 5) translation and dissemination. An independent, outside evaluation team conducted process and summative evaluations of SWAT to determine its efficacy in providing accurate, useful information and its compliance with evaluation standards. The SWAT evaluation approach is feasible in small and medium-sized workplace settings. The independent evaluation team judged SWAT favorably as an evaluation method, noting among its strengths its systematic and detailed procedures and service orientation. Experts in worksite health promotion evaluation concluded that the data obtained by using this evaluation method were sufficient to allow them to make judgments about promising practices. SWAT is a useful, business-friendly approach to systematic, yet rapid, evaluation that comports with program evaluation standards. The method provides a new tool to obtain practice-based evidence of worksite health promotion programs that help prevent obesity and, more broadly, may advance public health goals for chronic disease prevention and health promotion.

Australia's first transition to professional practice in primary care program for graduate registered nurses: a pilot study.

PubMed

Aggar, Christina; Bloomfield, Jacqueline; Thomas, Tamsin H; Gordon, Christopher J

2017-01-01

Increases in ageing, chronic illness and complex co-morbidities in the Australian population are adding pressure to the primary care nursing workforce. Initiatives to attract and retain nurses are needed to establish a sustainable and skilled future primary care nursing workforce. We implemented a transition to professional practice program in general practice settings for graduate nurses and evaluated graduate nurse competency, the graduate nurse experience and program satisfaction. This study aimed to determine whether a transition to professional practice program implemented in the general practice setting led to competent practice nurses in their first year post-graduation. A longitudinal, exploratory mixed-methods design was used to assess the pilot study. Data were collected at three times points (3, 6, 12 months) with complete data sets from graduate nurses ( n =  4) and preceptors ( n =  7). We assessed perceptions of the graduates' nursing competency and confidence, satisfaction with the preceptor/graduate relationship, and experiences and satisfaction with the program. Graduate nurse competency was assessed using the National Competency Standards for Nurses in General Practice. Semi-structured interviews with participants at Time 3 sought information about barriers, enablers, and the perceived impact of the program. Graduate nurses were found to be competent within their first year of clinical practice. Program perceptions from graduate nurses and preceptors were positive and the relationship between the graduate nurse and preceptor was key to this development. With appropriate support registered nurses can transition directly into primary care and are competent in their first year post-graduation. While wider implementation and research is needed, findings from this study demonstrate the potential value of transition to professional practice programs within primary care as a nursing workforce development strategy.

A method for modelling GP practice level deprivation scores using GIS

PubMed Central

Strong, Mark; Maheswaran, Ravi; Pearson, Tim; Fryers, Paul

2007-01-01

Background A measure of general practice level socioeconomic deprivation can be used to explore the association between deprivation and other practice characteristics. An area-based categorisation is commonly chosen as the basis for such a deprivation measure. Ideally a practice population-weighted area-based deprivation score would be calculated using individual level spatially referenced data. However, these data are often unavailable. One approach is to link the practice postcode to an area-based deprivation score, but this method has limitations. This study aimed to develop a Geographical Information Systems (GIS) based model that could better predict a practice population-weighted deprivation score in the absence of patient level data than simple practice postcode linkage. Results We calculated predicted practice level Index of Multiple Deprivation (IMD) 2004 deprivation scores using two methods that did not require patient level data. Firstly we linked the practice postcode to an IMD 2004 score, and secondly we used a GIS model derived using data from Rotherham, UK. We compared our two sets of predicted scores to "gold standard" practice population-weighted scores for practices in Doncaster, Havering and Warrington. Overall, the practice postcode linkage method overestimated "gold standard" IMD scores by 2.54 points (95% CI 0.94, 4.14), whereas our modelling method showed no such bias (mean difference 0.36, 95% CI -0.30, 1.02). The postcode-linked method systematically underestimated the gold standard score in less deprived areas, and overestimated it in more deprived areas. Our modelling method showed a small underestimation in scores at higher levels of deprivation in Havering, but showed no bias in Doncaster or Warrington. The postcode-linked method showed more variability when predicting scores than did the GIS modelling method. Conclusion A GIS based model can be used to predict a practice population-weighted area-based deprivation measure in the absence of patient level data. Our modelled measure generally had better agreement with the population-weighted measure than did a postcode-linked measure. Our model may also avoid an underestimation of IMD scores in less deprived areas, and overestimation of scores in more deprived areas, seen when using postcode linked scores. The proposed method may be of use to researchers who do not have access to patient level spatially referenced data. PMID:17822545

An Integrated Fuselage-Sting Balance for a Sonic-Boom Wind-Tunnel Model

NASA Technical Reports Server (NTRS)

Mack, Robert J.

2004-01-01

Measured and predicted pressure signatures from a lifting wind-tunnel model can be compared when the lift on the model is accurately known. The model's lift can be set by bending the support sting to a desired angle of attack. This method is simple in practice, but difficult to accurately apply. A second method is to build a normal force/pitching moment balance into the aft end of the sting, and use an angle-of-attack mechanism to set model attitude. In this report, a method for designing a sting/balance into the aft fuselage/sting of a sonic-boom model is described. A computer code is given, and a sample sting design is outlined to demonstrate the method.

Factors influencing pharmacists’ adoption of prescribing: qualitative application of the diffusion of innovations theory

PubMed Central

2013-01-01

Background In 2007, Alberta became the first Canadian jurisdiction to grant pharmacists a wide range of prescribing privileges. Our objective was to understand what factors influence pharmacists’ adoption of prescribing using a model for the Diffusion of Innovations in healthcare services. Methods Pharmacists participated in semi-structured telephone interviews to discuss their prescribing practices and explore the facilitators and barriers to implementation. Pharmacists working in community, hospital, PCN, or other settings were selected using a mix of random and purposive sampling. Two investigators independently analyzed each transcript using an Interpretive Description approach to identify themes. Analyses were informed by a model explaining the Diffusion of Innovations in health service organizations. Results Thirty-eight participants were interviewed. Prescribing behaviours varied from non-adoption through to product, disease, and patient focused use of prescribing. Pharmacists’ adoption of prescribing was dependent on the innovation itself, adopter, system readiness, and communication and influence. Adopting pharmacists viewed prescribing as a legitimization of previous practice and advantageous to instrumental daily tasks. The complexity of knowledge required for prescribing increased respectively in product, disease and patient focused prescribing scenarios. Individual adopters had higher levels of self-efficacy toward prescribing skills. At a system level, pharmacists who were in practice settings that were patient focused were more likely to adopt advanced prescribing practices, over those in product-focused settings. All pharmacists stated that physician relationships impacted their prescribing behaviours and individual pharmacists’ decisions to apply for independent prescribing privileges. Conclusions Diffusion of Innovations theory was helpful in understanding the multifaceted nature of pharmacists’ adoption of prescribing. The characteristics of the prescribing model itself which legitimized prior practices, the model of practice in a pharmacy setting, and relationships with physicians were prominent influences on pharmacists’ prescribing behaviours. PMID:24034176

Educating Mental Health Clinicians About Sensory Modulation to Enhance Clinical Practice in a Youth Acute Inpatient Mental Health Unit: A Feasibility Study.

PubMed

Blackburn, Julie; McKenna, Brian; Jackson, Brian; Hitch, Danielle; Benitez, Jessica; McLennan, Cathy; Furness, Trentham

2016-07-01

There is an emergence of literature describing effective sensory modulation (SM) interventions to de-escalate violence and aggression among mental health inpatients. However, the evidence is limited to adult settings, with the effect of SM in youth acute settings unknown. Yet, before SM may be used as a de-escalation intervention in youth acute settings, multidisciplinary staff need to be educated about and supported in the clinical application of SM. In the current study, an online SM education package was developed to assist mental health staff understand SM. This was blended with action learning sets (ALS), small group experiential opportunities consisting staff and consumers to learn about SM resources, and the support of SM trained nurses. The aims of the study were to evaluate the effectiveness of this SM education intervention in (a) transferring knowledge of SM to staff, and (b) translating this knowledge into practice in a youth acute inpatient mental health unit. A mixed methods research design with an 11-item pre- and post-education questionnaire was used along with three-month follow-up focus groups. The SM education improved understanding about SM (all 11-items p ≤ 0.004, r ≥ 0.47). Three-months after SM education, four themes evident in the focus group data emerged about the practice and process of SM; (1) translating of learning into practice, (2) SM in practice, (3) perceptions of SM benefits, and (4) limitations of SM. A blended SM education process enhanced clinical practice in the unit, yet participants were mindful of limitations of SM in situations of distress or escalating agitation.

From papers to practices: district level priority setting processes and criteria for family planning, maternal, newborn and child health interventions in Tanzania.

PubMed

Chitama, Dereck; Baltussen, Rob; Ketting, Evert; Kamazima, Switbert; Nswilla, Anna; Mujinja, Phares G M

2011-10-21

Successful priority setting is increasingly known to be an important aspect in achieving better family planning, maternal, newborn and child health (FMNCH) outcomes in developing countries. However, far too little attention has been paid to capturing and analysing the priority setting processes and criteria for FMNCH at district level. This paper seeks to capture and analyse the priority setting processes and criteria for FMNCH at district level in Tanzania. Specifically, we assess the FMNCH actor's engagement and understanding, the criteria used in decision making and the way criteria are identified, the information or evidence and tools used to prioritize FMNCH interventions at district level in Tanzania. We conducted an exploratory study mixing both qualitative and quantitative methods to capture and analyse the priority setting for FMNCH at district level, and identify the criteria for priority setting. We purposively sampled the participants to be included in the study. We collected the data using the nominal group technique (NGT), in-depth interviews (IDIs) with key informants and documentary review. We analysed the collected data using both content analysis for qualitative data and correlation analysis for quantitative data. We found a number of shortfalls in the district's priority setting processes and criteria which may lead to inefficient and unfair priority setting decisions in FMNCH. In addition, participants identified the priority setting criteria and established the perceived relative importance of the identified criteria. However, we noted differences exist in judging the relative importance attached to the criteria by different stakeholders in the districts. In Tanzania, FMNCH contents in both general development policies and sector policies are well articulated. However, the current priority setting process for FMNCH at district levels are wanting in several aspects rendering the priority setting process for FMNCH inefficient and unfair (or unsuccessful). To improve district level priority setting process for the FMNCH interventions, we recommend a fundamental revision of the current FMNCH interventions priority setting process. The improvement strategy should utilize rigorous research methods combining both normative and empirical methods to further analyze and correct past problems at the same time use the good practices to improve the current priority setting process for FMNCH interventions. The suggested improvements might give room for efficient and fair (or successful) priority setting process for FMNCH interventions.

Intersections of Critical Systems Thinking and Community Based Participatory Research: A Learning Organization Example with the Autistic Community

PubMed Central

Raymaker, Dora M

2016-01-01

Critical systems thinking (CST) and community based participatory research (CBPR) are distinct approaches to inquiry which share a primary commitment to holism and human emancipation, as well as common grounding in critical theory and emancipatory and pragmatic philosophy. This paper explores their intersections and complements on a historical, philosophical, and theoretical level, and then proposes a hybrid approach achieved by applying CBPR's principles and considerations for operationalizing emancipatory practice to traditional systems thinking frameworks and practices. This hybrid approach is illustrated in practice with examples drawn from of the implementation of the learning organization model in an action research setting with the Autistic community. Our experience of being able to actively attend to, and continuously equalize, power relations within an organizational framework that otherwise has great potential for reinforcing power inequity suggests CBPR's principles and considerations for operationalizing emancipatory practice could be useful in CST settings, and CST's vocabulary, methods, and clarity around systems thinking concepts could be valuable to CBPR practioners. PMID:27833398

Intersections of Critical Systems Thinking and Community Based Participatory Research: A Learning Organization Example with the Autistic Community.

PubMed

Raymaker, Dora M

2016-10-01

Critical systems thinking (CST) and community based participatory research (CBPR) are distinct approaches to inquiry which share a primary commitment to holism and human emancipation, as well as common grounding in critical theory and emancipatory and pragmatic philosophy. This paper explores their intersections and complements on a historical, philosophical, and theoretical level, and then proposes a hybrid approach achieved by applying CBPR's principles and considerations for operationalizing emancipatory practice to traditional systems thinking frameworks and practices. This hybrid approach is illustrated in practice with examples drawn from of the implementation of the learning organization model in an action research setting with the Autistic community. Our experience of being able to actively attend to, and continuously equalize, power relations within an organizational framework that otherwise has great potential for reinforcing power inequity suggests CBPR's principles and considerations for operationalizing emancipatory practice could be useful in CST settings, and CST's vocabulary, methods, and clarity around systems thinking concepts could be valuable to CBPR practioners.

Survey of Manual Methods of Measurements of Asbestos, Beryllium, Lead, Cadmium, Selenium, and Mercury in Stationary Source Emissions. Environmental Monitoring Series.

ERIC Educational Resources Information Center

Coulson, Dale M.; And Others

The purpose of this study is to evaluate existing manual methods for analyzing asbestos, beryllium, lead, cadmium, selenium, and mercury, and from this evaluation to provide the best and most practical set of analytical methods for measuring emissions of these elements from stationary sources. The work in this study was divided into two phases.…

A Critical Enquiry into the Implementation of the Montessori Teaching Method as a First Step towards Inclusive Practice in Early Childhood Settings Specifically in Developing Countries

ERIC Educational Resources Information Center

Vettiveloo, Roshini

2008-01-01

The analysis was carried out as part of a master's thesis and it aimed to analyse the extent to which the Montessori educational philosophy and teaching method incorporated inclusive educational qualities. The Montessori Method was first developed for children who were disadvantaged and considered "idiots", in the slums of Italy's San…

Methods and means of diagnostics of oncological diseases on the basis of pattern recognition: intelligent morphological systems - problems and solutions

NASA Astrophysics Data System (ADS)

Nikitaev, V. G.

2017-01-01

The development of methods of pattern recognition in modern intelligent systems of clinical cancer diagnosis are discussed. The histological (morphological) diagnosis - primary diagnosis for medical setting with cancer are investigated. There are proposed: interactive methods of recognition and structure of intellectual morphological complexes based on expert training-diagnostic and telemedicine systems. The proposed approach successfully implemented in clinical practice.

Extending the Peak Bandwidth of Parameters for Softmax Selection in Reinforcement Learning.

PubMed

Iwata, Kazunori

2016-05-11

Softmax selection is one of the most popular methods for action selection in reinforcement learning. Although various recently proposed methods may be more effective with full parameter tuning, implementing a complicated method that requires the tuning of many parameters can be difficult. Thus, softmax selection is still worth revisiting, considering the cost savings of its implementation and tuning. In fact, this method works adequately in practice with only one parameter appropriately set for the environment. The aim of this paper is to improve the variable setting of this method to extend the bandwidth of good parameters, thereby reducing the cost of implementation and parameter tuning. To achieve this, we take advantage of the asymptotic equipartition property in a Markov decision process to extend the peak bandwidth of softmax selection. Using a variety of episodic tasks, we show that our setting is effective in extending the bandwidth and that it yields a better policy in terms of stability. The bandwidth is quantitatively assessed in a series of statistical tests.

Internal audit in a microbiology laboratory.

PubMed Central

Mifsud, A J; Shafi, M S

1995-01-01

AIM--To set up a programme of internal laboratory audit in a medical microbiology laboratory. METHODS--A model of laboratory based process audit is described. Laboratory activities were examined in turn by specimen type. Standards were set using laboratory standard operating procedures; practice was observed using a purpose designed questionnaire and the data were analysed by computer; performance was assessed at laboratory audit meetings; and the audit circle was closed by re-auditing topics after an interval. RESULTS--Improvements in performance scores (objective measures) and in staff morale (subjective impression) were observed. CONCLUSIONS--This model of process audit could be applied, with amendments to take local practice into account, in any microbiology laboratory. PMID:7665701

Comparison of national health research priority-setting methods and characteristics in Latin America and the Caribbean, 2002-2012.

PubMed

Reveiz, Ludovic; Elias, Vanessa; Terry, Robert F; Alger, Jackeline; Becerra-Posada, Francisco

2013-07-01

To compare health research priority-setting methods and characteristics among countries in Latin America and the Caribbean during 2002 - 2012. This was a systematic review that identified national health research policies and priority agendas through a search of ministry and government databases related to health care institutions. PubMed, LILACS, the Health Research Web, and others were searched for the period from January 2002 - February 2012. The study excluded research organized by governmental institutions and specific national strategies on particular disease areas. Priority-setting methods were compared to the "nine common themes for good practice in health research priorities." National health research priorities were compared to those of the World Health Organization's Millennium Development Goals (MDG). Of the 18 Latin American countries assessed, 13 had documents that established national health research priorities; plus the Caribbean Health Research Council had a research agenda for its 19 constituents. These 14 total reports varied widely in terms of objectives, content, dissemination, and implementation; most provided a list of strategic areas, suggestions, and/or sub-priorities for each country; however, few proposed specific research topics and questions. Future reports could be improved by including more details on the comprehensive approach employed to identify priorities, on the information gathering process, and on practices to be undertaken after priorities are set. There is a need for improving the quality of the methodologies utilized and coordinating Regional efforts as countries strive to meet the MDG.

One repetition maximum bench press performance: a new approach for its evaluation in inexperienced males and females: a pilot study.

PubMed

Bianco, Antonino; Filingeri, Davide; Paoli, Antonio; Palma, Antonio

2015-04-01

The aim of this study was to evaluate a new method to perform the one repetition maximum (1RM) bench press test, by combining previously validated predictive and practical procedures. Eight young male and 7 females participants, with no previous experience of resistance training, performed a first set of repetitions to fatigue (RTF) with a workload corresponding to ⅓ of their body mass (BM) for a maximum of 25 repetitions. Following a 5-min recovery period, a second set of RTF was performed with a workload corresponding to ½ of participants' BM. The number of repetitions performed in this set was then used to predict the workload to be used for the 1RM bench press test using Mayhew's equation. Oxygen consumption, heart rate and blood lactate were monitored before, during and after each 1RM attempt. A significant effect of gender was found on the maximum number of repetitions achieved during the RTF set performed with ½ of participants' BM (males: 25.0 ± 6.3; females: 11.0x± 10.6; t = 6.2; p < 0.001). The 1RM attempt performed with the workload predicted by Mayhew's equation resulted in females performing 1.2 ± 0.7 repetitions, while males performed 4.8 ± 1.9 repetitions. All participants reached their 1RM performance within 3 attempts, thus resulting in a maximum of 5 sets required to successfully perform the 1RM bench press test. We conclude that, by combining previously validated predictive equations with practical procedures (i.e. using a fraction of participants' BM to determine the workload for an RTF set), the new method we tested appeared safe, accurate (particularly in females) and time-effective in the practical evaluation of 1RM performance in inexperienced individuals. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effectiveness of practices to reduce blood culture contamination: A Laboratory Medicine Best Practices systematic review and meta-analysis☆

PubMed Central

Snyder, Susan R.; Favoretto, Alessandra M.; Baetz, Rich Ann; Derzon, James H.; Madison, Bereneice M.; Mass, Diana; Shaw, Colleen S.; Layfield, Christopher D.; Christenson, Robert H.; Liebow, Edward B.

2015-01-01

Objectives This article is a systematic review of the effectiveness of three practices for reducing blood culture contamination rates: venipuncture, phlebotomy teams, and prepackaged preparation/collection (prep) kits. Design and methods The CDC-funded Laboratory Medicine Best Practices Initiative systematic review methods for quality improvement practices were used. Results Studies included as evidence were: 9 venipuncture (vs. versus intravenous catheter), 5 phlebotomy team; and 7 prep kit. All studies for venipuncture and phlebotomy teams favored these practices, with meta-analysis mean odds ratios for venipuncture of 2.69 and phlebotomy teams of 2.58. For prep kits 6 studies’ effect sizes were not statistically significantly different from no effect (meta-analysis mean odds ratio 1.12). Conclusions Venipuncture and the use of phlebotomy teams are effective practices for reducing blood culture contamination rates in diverse hospital settings and are recommended as evidence-based “best practices” with high overall strength of evidence and substantial effect size ratings. No recommendation is made for or against prep kits based on uncertain improvement. PMID:22709932

Practice-based evidence study design for comparative effectiveness research.

PubMed

Horn, Susan D; Gassaway, Julie

2007-10-01

To describe a new, rigorous, comprehensive practice-based evidence for clinical practice improvement (PBE-CPI) study methodology, and compare its features, advantages, and disadvantages to those of randomized controlled trials and sophisticated statistical methods for comparative effectiveness research. PBE-CPI incorporates natural variation within data from routine clinical practice to determine what works, for whom, when, and at what cost. It uses the knowledge of front-line caregivers, who develop study questions and define variables as part of a transdisciplinary team. Its comprehensive measurement framework provides a basis for analyses of significant bivariate and multivariate associations between treatments and outcomes, controlling for patient differences, such as severity of illness. PBE-CPI studies can uncover better practices more quickly than randomized controlled trials or sophisticated statistical methods, while achieving many of the same advantages. We present examples of actionable findings from PBE-CPI studies in postacute care settings related to comparative effectiveness of medications, nutritional support approaches, incontinence products, physical therapy activities, and other services. Outcomes improved when practices associated with better outcomes in PBE-CPI analyses were adopted in practice.

Accounting for the Multiple Natures of Missing Values in Label-Free Quantitative Proteomics Data Sets to Compare Imputation Strategies.

PubMed

Lazar, Cosmin; Gatto, Laurent; Ferro, Myriam; Bruley, Christophe; Burger, Thomas

2016-04-01

Missing values are a genuine issue in label-free quantitative proteomics. Recent works have surveyed the different statistical methods to conduct imputation and have compared them on real or simulated data sets and recommended a list of missing value imputation methods for proteomics application. Although insightful, these comparisons do not account for two important facts: (i) depending on the proteomics data set, the missingness mechanism may be of different natures and (ii) each imputation method is devoted to a specific type of missingness mechanism. As a result, we believe that the question at stake is not to find the most accurate imputation method in general but instead the most appropriate one. We describe a series of comparisons that support our views: For instance, we show that a supposedly "under-performing" method (i.e., giving baseline average results), if applied at the "appropriate" time in the data-processing pipeline (before or after peptide aggregation) on a data set with the "appropriate" nature of missing values, can outperform a blindly applied, supposedly "better-performing" method (i.e., the reference method from the state-of-the-art). This leads us to formulate few practical guidelines regarding the choice and the application of an imputation method in a proteomics context.

Study of Burn Scar Extraction Automatically Based on Level Set Method using Remote Sensing Data

PubMed Central

Liu, Yang; Dai, Qin; Liu, JianBo; Liu, ShiBin; Yang, Jin

2014-01-01

Burn scar extraction using remote sensing data is an efficient way to precisely evaluate burn area and measure vegetation recovery. Traditional burn scar extraction methodologies have no well effect on burn scar image with blurred and irregular edges. To address these issues, this paper proposes an automatic method to extract burn scar based on Level Set Method (LSM). This method utilizes the advantages of the different features in remote sensing images, as well as considers the practical needs of extracting the burn scar rapidly and automatically. This approach integrates Change Vector Analysis (CVA), Normalized Difference Vegetation Index (NDVI) and the Normalized Burn Ratio (NBR) to obtain difference image and modifies conventional Level Set Method Chan-Vese (C-V) model with a new initial curve which results from a binary image applying K-means method on fitting errors of two near-infrared band images. Landsat 5 TM and Landsat 8 OLI data sets are used to validate the proposed method. Comparison with conventional C-V model, OSTU algorithm, Fuzzy C-mean (FCM) algorithm are made to show that the proposed approach can extract the outline curve of fire burn scar effectively and exactly. The method has higher extraction accuracy and less algorithm complexity than that of the conventional C-V model. PMID:24503563

A functional-dependencies-based Bayesian networks learning method and its application in a mobile commerce system.

PubMed

Liao, Stephen Shaoyi; Wang, Huai Qing; Li, Qiu Dan; Liu, Wei Yi

2006-06-01

This paper presents a new method for learning Bayesian networks from functional dependencies (FD) and third normal form (3NF) tables in relational databases. The method sets up a linkage between the theory of relational databases and probabilistic reasoning models, which is interesting and useful especially when data are incomplete and inaccurate. The effectiveness and practicability of the proposed method is demonstrated by its implementation in a mobile commerce system.

Practical guide to understanding Comparative Effectiveness Research (CER).

PubMed

Neely, J Gail; Sharon, Jeffrey D; Graboyes, Evan M; Paniello, Randal C; Nussenbaum, Brian; Grindler, David J; Dassopoulos, Themistocles

2013-12-01

"Comparative effectiveness research" (CER) is not a new concept; however, recently it has been popularized as a method to develop scientifically sound actionable data by which patients, physicians, payers, and policymakers may make informed health care decisions. Fundamental to CER is that the comparative data are derived from large diverse populations of patients assembled from point-of-care general primary care practices and that measured outcomes include patient value judgments. The challenge is to obtain scientifically valid data to be acted upon by decision-making stakeholders with potentially quite diversely different agenda. The process requires very thoughtful research designs modulated by complex statistical and analytic methods. This article is composed of a guiding narrative with an extensive set of tables outlining many of the details required in performing and understanding CER. It ends with short discussions of three example papers, limitations of the method, and how a practicing physician may view such reports.

Looking for trees in the forest: summary tree from posterior samples

PubMed Central

2013-01-01

Background Bayesian phylogenetic analysis generates a set of trees which are often condensed into a single tree representing the whole set. Many methods exist for selecting a representative topology for a set of unrooted trees, few exist for assigning branch lengths to a fixed topology, and even fewer for simultaneously setting the topology and branch lengths. However, there is very little research into locating a good representative for a set of rooted time trees like the ones obtained from a BEAST analysis. Results We empirically compare new and known methods for generating a summary tree. Some new methods are motivated by mathematical constructions such as tree metrics, while the rest employ tree concepts which work well in practice. These use more of the posterior than existing methods, which discard information not directly mapped to the chosen topology. Using results from a large number of simulations we assess the quality of a summary tree, measuring (a) how well it explains the sequence data under the model and (b) how close it is to the “truth”, i.e to the tree used to generate the sequences. Conclusions Our simulations indicate that no single method is “best”. Methods producing good divergence time estimates have poor branch lengths and lower model fit, and vice versa. Using the results presented here, a user can choose the appropriate method based on the purpose of the summary tree. PMID:24093883

Looking for trees in the forest: summary tree from posterior samples.

PubMed

Heled, Joseph; Bouckaert, Remco R

2013-10-04

Bayesian phylogenetic analysis generates a set of trees which are often condensed into a single tree representing the whole set. Many methods exist for selecting a representative topology for a set of unrooted trees, few exist for assigning branch lengths to a fixed topology, and even fewer for simultaneously setting the topology and branch lengths. However, there is very little research into locating a good representative for a set of rooted time trees like the ones obtained from a BEAST analysis. We empirically compare new and known methods for generating a summary tree. Some new methods are motivated by mathematical constructions such as tree metrics, while the rest employ tree concepts which work well in practice. These use more of the posterior than existing methods, which discard information not directly mapped to the chosen topology. Using results from a large number of simulations we assess the quality of a summary tree, measuring (a) how well it explains the sequence data under the model and (b) how close it is to the "truth", i.e to the tree used to generate the sequences. Our simulations indicate that no single method is "best". Methods producing good divergence time estimates have poor branch lengths and lower model fit, and vice versa. Using the results presented here, a user can choose the appropriate method based on the purpose of the summary tree.

Vaginal Birth After Caesarean Section in Low Resource Settings: The Clinical and Ethical Dilemma.

PubMed

Wanyonyi, Sikolia; Muriithi, Francis G

2015-10-01

Vaginal birth after Caesarean section (VBAC) has long been practised in low resource settings using unconventional methods. This not only poses danger to the woman and her baby, but could also have serious legal and ethical implications. The adoption of this practice has been informed by observational studies with many deficiencies; this is so despite other studies from settings in which the standard of care is much better that show that elective repeat Caesarean section (ERCS) may actually be safer than VBAC. This raises questions about whether we should insist on a dangerous practice when there are safer alternatives. We highlight some of the challenges faced in making this decision, and discuss why the fear of ERCS may not be justified after all in low resource settings. Since a reduction in rates of Caesarean section may not be applicable in these regions, because their rates are already low, the emphasis should instead be on adequate birth spacing and safer primary operative delivery.

Implementation of customized health information technology in diabetes self management programs.

PubMed

Alexander, Susan; Frith, Karen H; O'Keefe, Louise; Hennigan, Michael A

2011-01-01

The project was a nurse-led implementation of a software application, designed to combine clinical and demographic records for a diabetes education program, which would result in secure, long-term record storage. Clinical information systems may be prohibitively expensive for small practices and require extensive training for implementation. A review of the literature suggests that the use of simple, practice-based registries offer an economical method of monitoring the outcomes of diabetic patients. The database was designed using a common software application, Microsoft Access. The theory used to guide implementation and staff training was Rogers' Diffusion of Innovations theory (1995). Outcomes after a 3-month period included incorporation of 100% of new clinical and demographic patient records into the database and positive changes in staff attitudes regarding software applications used in diabetes self-management training. These objectives were met while keeping project costs under budgeted amounts. As a function of the clinical nurse specialist (CNS) researcher role, there is a need for CNSs to identify innovative and economical methods of data collection. The success of this nurse-led project reinforces suggestions in the literature for less costly methods of data maintenance in small practice settings. Ongoing utilization and enhancement have resulted in the creation of a robust database that could aid in the research of multiple clinical issues. Clinical nurse specialists can use existing evidence to guide and improve both their own practice and outcomes for patients and organizations. Further research regarding specific factors that predict efficient transition of informatics applications, how these factors vary according to practice settings, and the role of the CNS in implementation of such applications is needed.

Conducting phenomenological research: Rationalizing the methods and rigour of the phenomenology of practice.

PubMed

Errasti-Ibarrondo, Begoña; Jordán, José Antonio; Díez-Del-Corral, Mercedes P; Arantzamendi, María

2018-07-01

To offer a complete outlook in a readable easy way of van Manen's hermeneutic-phenomenological method to nurses interested in undertaking phenomenological research. Phenomenology, as research methodology, involves a certain degree of complexity. It is difficult to identify a single article or author which sets out the didactic guidelines that specifically guide research of this kind. In this context, the theoretical-practical view of Max van Manen's Phenomenology of Practice may be seen as a rigorous guide and directive on which researchers may find support to undertake phenomenological research. Discussion paper. This discussion paper is based on our own experiences and supported by literature and theory. Our central sources of data have been the books and writings of Max van Manen and his website "Phenomenologyonline". The principal methods of the hermeneutic-phenomenological method are addressed and explained providing an enriching overview of phenomenology of practice. A proposal is made for the way the suggestions made by van Manen might be organized for use with the methods involved in Phenomenology of Practice: Social sciences, philosophical and philological methods. Thereby, nurse researchers interested in conducting phenomenological research may find a global outlook and support to understand and conduct this type of inquiry which draws on the art. The approach in this article may help nurse scholars and researchers reach an overall, encompassing perspective of the main methods and activities involved in doing phenomenological research. Nurses interested in doing phenomenology of practice are expected to commit with reflection and writing. © 2018 John Wiley & Sons Ltd.

Cross-cultural dataset for the evolution of religion and morality project.

PubMed

Purzycki, Benjamin Grant; Apicella, Coren; Atkinson, Quentin D; Cohen, Emma; McNamara, Rita Anne; Willard, Aiyana K; Xygalatas, Dimitris; Norenzayan, Ara; Henrich, Joseph

2016-11-08

A considerable body of research cross-culturally examines the evolution of religious traditions, beliefs and behaviors. The bulk of this research, however, draws from coded qualitative ethnographies rather than from standardized methods specifically designed to measure religious beliefs and behaviors. Psychological data sets that examine religious thought and behavior in controlled conditions tend to be disproportionately sampled from student populations. Some cross-national databases employ standardized methods at the individual level, but are primarily focused on fully market integrated, state-level societies. The Evolution of Religion and Morality Project sought to generate a data set that systematically probed individual level measures sampling across a wider range of human populations. The set includes data from behavioral economic experiments and detailed surveys of demographics, religious beliefs and practices, material security, and intergroup perceptions. This paper describes the methods and variables, briefly introduces the sites and sampling techniques, notes inconsistencies across sites, and provides some basic reporting for the data set.

Cross-cultural dataset for the evolution of religion and morality project

PubMed Central

Purzycki, Benjamin Grant; Apicella, Coren; Atkinson, Quentin D.; Cohen, Emma; McNamara, Rita Anne; Willard, Aiyana K.; Xygalatas, Dimitris; Norenzayan, Ara; Henrich, Joseph

2016-01-01

A considerable body of research cross-culturally examines the evolution of religious traditions, beliefs and behaviors. The bulk of this research, however, draws from coded qualitative ethnographies rather than from standardized methods specifically designed to measure religious beliefs and behaviors. Psychological data sets that examine religious thought and behavior in controlled conditions tend to be disproportionately sampled from student populations. Some cross-national databases employ standardized methods at the individual level, but are primarily focused on fully market integrated, state-level societies. The Evolution of Religion and Morality Project sought to generate a data set that systematically probed individual level measures sampling across a wider range of human populations. The set includes data from behavioral economic experiments and detailed surveys of demographics, religious beliefs and practices, material security, and intergroup perceptions. This paper describes the methods and variables, briefly introduces the sites and sampling techniques, notes inconsistencies across sites, and provides some basic reporting for the data set. PMID:27824332

Cross-domain expression recognition based on sparse coding and transfer learning

NASA Astrophysics Data System (ADS)

Yang, Yong; Zhang, Weiyi; Huang, Yong

2017-05-01

Traditional facial expression recognition methods usually assume that the training set and the test set are independent and identically distributed. However, in actual expression recognition applications, the conditions of independent and identical distribution are hardly satisfied for the training set and test set because of the difference of light, shade, race and so on. In order to solve this problem and improve the performance of expression recognition in the actual applications, a novel method based on transfer learning and sparse coding is applied to facial expression recognition. First of all, a common primitive model, that is, the dictionary is learnt. Then, based on the idea of transfer learning, the learned primitive pattern is transferred to facial expression and the corresponding feature representation is obtained by sparse coding. The experimental results in CK +, JAFFE and NVIE database shows that the transfer learning based on sparse coding method can effectively improve the expression recognition rate in the cross-domain expression recognition task and is suitable for the practical facial expression recognition applications.

An integrated methods study of the experiences of youth with severe disabilities in leisure activity settings: the importance of belonging, fun, and control and choice.

PubMed

King, Gillian; Gibson, Barbara E; Mistry, Bhavnita; Pinto, Madhu; Goh, Freda; Teachman, Gail; Thompson, Laura

2014-01-01

The aim was to examine the leisure activity setting experiences of two groups of youth with severe disabilities - those with complex continuing care (CCC) needs and those who have little functional speech and communicate using augmentative and alternative communication (AAC). Twelve youth took part in a mixed methods study, in which their experiences were ascertained using qualitative methods (observations, photo elicitation and interviews) and the measure of Self-Reported Experiences of Activity Settings (SEAS). Data integration occurred using a "following a thread" technique and case-by-case analysis. The analysis revealed several highly valued aspects of leisure activity setting experiences for youth, including engagement with others, enjoying the moment, and control and choice in selection and participation in activity settings. The findings provide preliminary insights into the nature of optimal activity settings for youth with severe disabilities, and the mediators of these experiences. Compared to other youth, the data illustrate both the commonalities of experiences and differences in the ways in which these experiences are attained. Implications for research concern the utility of mixed methods approaches in understanding the complex nature of participation experiences. Implications for clinical practice concern the importance of not assuming the nature of youths' experiences.

Reading in Class & out of Class: An Experience Sampling Method Study

ERIC Educational Resources Information Center

Shumow, Lee; Schmidt, Jennifer A.; Kackar, Hayal

2008-01-01

This study described and compared the reading of sixth and eighth grade students both in and out of school using a unique data set collected with the Experience Sampling Method (ESM). On average, students read forty minutes a day out of class and seventeen minutes a day in class indicating that reading is a common leisure practice for…

Research methods to change clinical practice for patients with rare cancers.

PubMed

Billingham, Lucinda; Malottki, Kinga; Steven, Neil

2016-02-01

Rare cancers are a growing group as a result of reclassification of common cancers by molecular markers. There is therefore an increasing need to identify methods to assess interventions that are sufficiently robust to potentially affect clinical practice in this setting. Methods advocated for clinical trials in rare diseases are not necessarily applicable in rare cancers. This Series paper describes research methods that are relevant for rare cancers in relation to the range of incidence levels. Strategies that maximise recruitment, minimise sample size, or maximise the usefulness of the evidence could enable the application of conventional clinical trial design to rare cancer populations. Alternative designs that address specific challenges for rare cancers with the aim of potentially changing clinical practice include Bayesian designs, uncontrolled n-of-1 trials, and umbrella and basket trials. Pragmatic solutions must be sought to enable some level of evidence-based health care for patients with rare cancers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Goal setting and action planning in the rehabilitation setting: development of a theoretically informed practice framework.

PubMed

Scobbie, Lesley; Dixon, Diane; Wyke, Sally

2011-05-01

Setting and achieving goals is fundamental to rehabilitation practice but has been criticized for being a-theoretical and the key components of replicable goal-setting interventions are not well established. To describe the development of a theory-based goal setting practice framework for use in rehabilitation settings and to detail its component parts. Causal modelling was used to map theories of behaviour change onto the process of setting and achieving rehabilitation goals, and to suggest the mechanisms through which patient outcomes are likely to be affected. A multidisciplinary task group developed the causal model into a practice framework for use in rehabilitation settings through iterative discussion and implementation with six patients. Four components of a goal-setting and action-planning practice framework were identified: (i) goal negotiation, (ii) goal identification, (iii) planning, and (iv) appraisal and feedback. The variables hypothesized to effect change in patient outcomes were self-efficacy and action plan attainment. A theory-based goal setting practice framework for use in rehabilitation settings is described. The framework requires further development and systematic evaluation in a range of rehabilitation settings.

Clinical Pharmacy Consultations Provided by American and Kenyan Pharmacy Students During an Acute Care Advanced Pharmacy Practice Experience

PubMed Central

Pastakia, Sonak D.; Manji, Imran; Kamau, Evelyn; Schellhase, Ellen M.

2011-01-01

Objective To compare the clinical consultations provided by American and Kenyan pharmacy students in an acute care setting in a developing country. Methods The documented pharmacy consultation recommendations made by American and Kenyan pharmacy students during patient care rounds on an advanced pharmacy practice experience at a referral hospital in Kenya were reviewed and classified according to type of intervention and therapeutic area. Results The Kenyan students documented more interventions than American students (16.7 vs. 12.0 interventions/day) and provided significantly more consultations regarding human immunodeficiency virus (HIV) and antibiotics. The top area of consultations provided by American students was cardiovascular diseases. Conclusions American and Kenyan pharmacy students successfully providing clinical pharmacy consultations in a resource-constrained, acute-care practice setting suggests an important role for pharmacy students in the reconciliation of prescriber orders with medication administration records and in providing drug information. PMID:21655396

Nursing Clinical Instructor Experiences of Empowerment in Rwanda: Applying Kanter's and Spreitzer's Theories.

PubMed

Thuss, Mary; Babenko-Mould, Yolanda; Andrusyszyn, Mary-Anne; Laschinger, Heather K S

2016-10-15

The purpose of this study was to explore Rwandan nursing clinical instructors' (CIs) experiences of structural and psychological empowerment. CIs play a vital role in students' development by facilitating learning in health care practice environments. Quality nursing education hinges on the CI's ability to enact a professional role. A descriptive qualitative method was used to obtain an understanding of CIs empowerment experiences in practice settings. Kanter's Theory of Structural Power in Organizations and Spreitzer's Psychological Empowerment Theory were used as theoretical frameworks to interpret experiences. Interview data from 21 CIs were used to complete a secondary analysis. Most participants perceived the structural components of informal power, resources, and support while formal power and opportunity were limited, diminishing their sense of structural empowerment. Psychological empowerment for CIs stemmed from a sense of competence, meaning, impact and self-determination they had for their teaching roles and responsibilities in the practice setting.

From "best practice" to "next practice": the effectiveness of school-based health promotion in improving healthy eating and physical activity and preventing childhood obesity

PubMed Central

2012-01-01

Background In 2005, we reported on the success of Comprehensive School Health (CSH) in improving diets, activity levels, and body weights. The successful program was recognized as a "best practice" and has inspired the development of the Alberta Project Promoting active Living and healthy Eating (APPLE) Schools. The project includes 10 schools, most of which are located in socioeconomically disadvantaged areas. The present study examines the effectiveness of a CSH program adopted from a "best practice" example in another setting by evaluating temporal changes in diets, activity levels and body weight. Methods In 2008 and 2010, we surveyed grade 5 students from approximately 150 randomly selected schools from the Canadian province of Alberta and students from 10 APPLE Schools. Students completed the Harvard Youth/Adolescent Food Frequency Questionnaire, questions on physical activity, and had their height and weight measured. Multilevel regression methods were used to analyze changes in diets, activity levels, and body weight between 2008 and 2010. Results In 2010 relative to 2008, students attending APPLE Schools were eating more fruits and vegetables, consuming fewer calories, were more physically active and were less likely obese. These changes contrasted changes observed among students elsewhere in the province. Conclusions These findings provide evidence on the effectiveness of CSH in improving health behaviors. They show that an example of "best practice" may lead to success in another setting. Herewith the study provides the evidence that investments for broader program implementation based on "best practice" are justified. PMID:22413778

Searching for Elements of Evidence-based Practices in Children’s Usual Care and Examining their Impact

PubMed Central

Garland, Ann F.; Accurso, Erin C.; Haine-Schlagel, Rachel; Brookman-Frazee, Lauren; Roesch, Scott; Zhang, Jin Jin

2014-01-01

Objective Most of the knowledge generated to bridge the research - practice gap has been derived from experimental studies implementing specific treatment models. Alternatively, this study uses observational methods to generate knowledge about community-based treatment processes and outcomes. Aims are to (1) describe outcome trajectories for children with disruptive behavior problems (DBPs), and (2) test how observed delivery of a benchmark set of practice elements common in evidence-based (EB) treatments may be associated with outcome change, while accounting for potential confounding variables. Method Participants included 190 children ages 4–13 with DBPs and their caregivers, plus 85 psychotherapists, recruited from six clinics. All treatment sessions were video-taped and a random sample of four sessions in the first four months of treatment was reliably coded for intensity on 27 practice elements (benchmark set and others). Three outcomes (child symptom severity, parent discipline, and family functioning) were assessed by parent report at intake, four, and eight months. Data were collected on several potential covariates including child, parent, therapist, and service use characteristics. Multi-level modeling was used to assess relationships between observed practice and outcome slopes, while accounting for covariates. Results Children and families demonstrated improvements in all three outcomes, but few significant associations between treatment processes and outcome change were identified. Families receiving greater intensity on the benchmark practice elements did demonstrate greater improvement in the parental discipline outcome. Conclusion Observed changes in outcomes for families in community care were generally not strongly associated with the type or amount of treatment received. PMID:24555882

Dissemination and implementation research in dementia care: a systematic scoping review and evidence map.

PubMed

Lourida, Ilianna; Abbott, Rebecca A; Rogers, Morwenna; Lang, Iain A; Stein, Ken; Kent, Bridie; Thompson Coon, Jo

2017-07-14

The need to better understand implementing evidence-informed dementia care has been recognised in multiple priority-setting partnerships. The aim of this scoping review was to give an overview of the state of the evidence on implementation and dissemination of dementia care, and create a systematic evidence map. We sought studies that addressed dissemination and implementation strategies or described barriers and facilitators to implementation across dementia stages and care settings. Twelve databases were searched from inception to October 2015 followed by forward citation and grey literature searches. Quantitative studies with a comparative research design and qualitative studies with recognised methods of data collection were included. Titles, abstracts and full texts were screened independently by two reviewers with discrepancies resolved by a third where necessary. Data extraction was performed by one reviewer and checked by a second. Strategies were mapped according to the ERIC compilation. Eighty-eight studies were included (30 quantitative, 34 qualitative and 24 mixed-methods studies). Approximately 60% of studies reported implementation strategies to improve practice: training and education of professionals (94%), promotion of stakeholder interrelationships (69%) and evaluative strategies (46%) were common; financial strategies were rare (15%). Nearly 70% of studies reported barriers or facilitators of care practices primarily within residential care settings. Organisational factors, including time constraints and increased workload, were recurrent barriers, whereas leadership and managerial support were often reported to promote implementation. Less is known about implementation activities in primary care and hospital settings, or the views and experiences of people with dementia and their family caregivers. This scoping review and mapping of the evidence reveals a paucity of robust evidence to inform the successful dissemination and implementation of evidence-based dementia care. Further exploration of the most appropriate methods to evaluate and report initiatives to bring about change and of the effectiveness of implementation strategies is necessary if we are to make changes in practice that improve dementia care.

Engaging pediatric intensive care unit (PICU) clinical staff to lead practice improvement: the PICU participatory action research project (PICU-PAR).

PubMed

Collet, Jean-Paul; Skippen, Peter W; Mosavianpour, Mir Kaber; Pitfield, Alexander; Chakraborty, Bubli; Hunte, Garth; Lindstrom, Ronald; Kissoon, Niranjan; McKellin, William H

2014-01-08

Despite considerable efforts, engaging staff to lead quality improvement activities in practice settings is a persistent challenge. At British Columbia Children's Hospital (BCCH), the pediatric intensive care unit (PICU) undertook a new phase of quality improvement actions based on the Community of Practice (CoP) model with Participatory Action Research (PAR). This approach aims to mobilize the PICU 'community' as a whole with a focus on practice; namely, to create a 'community of practice' to support reflection, learning, and innovation in everyday work. An iterative two-stage PAR process using mixed methods has been developed among the PICU CoP to describe the environment (stage 1) and implement specific interventions (stage 2). Stage 1 is ethnographic description of the unit's care practice. Surveys, interviews, focus groups, and direct observations describe the clinical staff's experiences and perspectives around bedside care and quality endeavors in the PICU. Contrasts and comparisons across participants, time and activities help understanding the PICU culture and experience. Stage 2 is a succession of PAR spirals, using results from phase 1 to set up specific interventions aimed at building the staff's capability to conduct QI projects while acquiring appropriate technical skills and leadership capacity (primary outcome). Team communication, information, and interaction will be enhanced through a knowledge exchange (KE) and a wireless network of iPADs. Lack of leadership at the staff level in order to improve daily practice is a recognized challenge that faces many hospitals. We believe that the PAR approach within a highly motivated CoP is a sound method to create the social dynamic and cultural context within which clinical teams can grow, reflect, innovate and feel proud to better serve patients.

Implementing the information prescription protocol in a family medicine practice: a case study*†‡

PubMed Central

Carey, Peggy; Haines, Laura; Lampson, Alan P; Pond, Fred

2010-01-01

Question: Can an information prescription protocol be successfully integrated into a family medicine practice seeking to enhance patient education and self-management? Setting: Milton Family Practice, an outpatient clinic and resident teaching site of the University of Vermont and Fletcher Allen Health Care, is located in a semirural area fifteen miles from main campus. Objectives: The objectives were to increase physicians' knowledge and use of information prescriptions, sustain integration of information prescription use, and increase physicians' ability to provide patient education information. Methods: Methods used were promotion of the National Library of Medicine's Information Rx, physician instruction, installation of patient and provider workstations, and a collaborative approach to practice integration. Main Results: A post-intervention survey showed increased physician knowledge and use of the Information Rx protocol. Support procedures were integrated at the practice. Conclusions: Sustainable integration of Information Rx in a primary care clinic requires not only promotion and education, but also attention to clinic organization and procedures. PMID:20648257

A new method to extract modal parameters using output-only responses

NASA Astrophysics Data System (ADS)

Kim, Byeong Hwa; Stubbs, Norris; Park, Taehyo

2005-04-01

This work proposes a new output-only modal analysis method to extract mode shapes and natural frequencies of a structure. The proposed method is based on an approach with a single-degree-of-freedom in the time domain. For a set of given mode-isolated signals, the un-damped mode shapes are extracted utilizing the singular value decomposition of the output energy correlation matrix with respect to sensor locations. The natural frequencies are extracted from a noise-free signal that is projected on the estimated modal basis. The proposed method is particularly efficient when a high resolution of mode shape is essential. The accuracy of the method is numerically verified using a set of time histories that are simulated using a finite-element method. The feasibility and practicality of the method are verified using experimental data collected at the newly constructed King Storm Water Bridge in California, United States.

Pharmacy students' preference for using mobile devices in a clinical setting for practice-related tasks.

PubMed

Richard, Craig A H; Hastings, Justine F; Bryant, Jennifer E

2015-03-25

To examine pharmacy students' ownership of, use of, and preference for using a mobile device in a practice setting. Eighty-one pharmacy students were recruited and completed a pretest that collected information about their demographics and mobile devices and also had them rank the iPhone, iPad mini, and iPad for preferred use in a pharmacy practice setting. Students used the 3 devices to perform pharmacy practice-related tasks and then completed a posttest to again rank the devices for preferred use in a pharmacy practice setting. The iPhone was the most commonly owned mobile device (59.3% of students), and the iPad mini was the least commonly owned (18.5%). About 70% of the students used their mobile devices at least once a week in a pharmacy practice setting. The iPhone was the most commonly used device in a practice setting (46.9% of students), and the iPod Touch was the least commonly used device (1.2%). The iPad mini was the most preferred device for use in a pharmacy practice setting prior to performing pharmacy practice-related tasks (49.4% of students), and was preferred by significantly more students after performing the tasks (70.4%). Pharmacy students commonly use their mobile devices in pharmacy practice settings and most selected the iPad mini as the preferred device for use in a practice setting even though it was the device owned by the fewest students.

Standardized development of computer software. Part 1: Methods

NASA Technical Reports Server (NTRS)

Tausworthe, R. C.

1976-01-01

This work is a two-volume set on standards for modern software engineering methodology. This volume presents a tutorial and practical guide to the efficient development of reliable computer software, a unified and coordinated discipline for design, coding, testing, documentation, and project organization and management. The aim of the monograph is to provide formal disciplines for increasing the probability of securing software that is characterized by high degrees of initial correctness, readability, and maintainability, and to promote practices which aid in the consistent and orderly development of a total software system within schedule and budgetary constraints. These disciplines are set forth as a set of rules to be applied during software development to drastically reduce the time traditionally spent in debugging, to increase documentation quality, to foster understandability among those who must come in contact with it, and to facilitate operations and alterations of the program as requirements on the program environment change.

Peer mentoring supports the learning needs of nurses providing palliative care in a rural acute care setting.

PubMed

Rabbetts, Lyn

2017-06-02

A specific set of assessment scales can underpin the management of distressing symptoms of patients requiring palliative care. A research assistant supported nurses working in a rural hospital setting during the introduction of these scales. A secondary analysis was conducted to further explore the qualitative data of a previously reported mixed-method study. In particular, the experiences of nurses working alongside a research assistant in the facilitation of using a new assessment form. Purposeful sampling was employed: participating nurses were invited to attend one of three focus group meetings. Data analysis revealed three main themes: a contact person, coach/mentor and extra help initiatives. Three to four subthemes corresponded with each main theme. Findings suggest nurses benefit from having someone to assist in learning about new documentation. Nurses respond positively to mentorship and practical guidance when integrating a new assessment form into routine evidence-based practice.

Making the Most of Five Minutes: The Clinical Teaching Moment.

PubMed

Smith, Jo R; Lane, India F

2015-01-01

Clinical educators face the challenge of simultaneously caring for patients and teaching learners, often with an unpredictable caseload and learners of varied abilities. They also often have little control over the organization of their time. Effective clinical teaching must encourage student participation, problem solving, integration of basic and clinical knowledge, and deliberate practice. Close supervision and timely feedback are also essential. Just as one develops an effective lecture through training and practice, clinical teaching effectiveness may also be improved by using specific skills to teach in small increments. The purpose of this paper is to identify potential teachable moments and to describe efficient instructional methods to use in the clinical setting under time constraints. These techniques include asking better questions, performing focused observations, thinking aloud, and modeling reflection. Different frameworks for teaching encounters during case presentations can be selected according to learner ability and available time. These methods include modeling and deconstructing the concrete experience; guiding the thinking and reflecting process; and providing the setting and opportunity for active practice. Use of these educational strategies encourages the learner to acquire knowledge, clinical reasoning, and technical skills, and also values, attitudes, and professional judgment.

Improving opioid safety practices in primary care: protocol for the development and evaluation of a multifaceted, theory-informed pilot intervention for healthcare providers

PubMed Central

Leece, Pamela; Buchman, Daniel Z; Hamilton, Michael; Timmings, Caitlyn; Shantharam, Yalnee; Moore, Julia; Furlan, Andrea D

2017-01-01

Introduction In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. Methods and analysis Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians. The intervention uses practical educational and self-assessment tools to provide prescribers with feedback on their current knowledge and practices, and resources to improve their practice. The evaluation approach uses a pretest and post-test design and includes both quantitative and qualitative methods at baseline and 6 months. We will recruit a purposive sample of approximately 10 family physicians in Ontario from diverse practice settings, who currently treat patients with long-term opioid therapy for chronic pain. Quantitative data will be analysed using basic descriptive statistics, and qualitative data will be analysed using the Framework Method. Ethics and dissemination The University Health Network Research Ethics Board approved this study. Dissemination plan includes publications, conference presentations and brief stakeholder reports. This evidence-informed, theory-driven intervention has implications for national application of opioid quality improvement tools in primary care settings. We are engaging experts and end users in advisory and stakeholder roles throughout our project to increase its national relevance, application and sustainability. The performance measures could be used as the basis for health system quality improvement indicators to monitor opioid prescribing. Additionally, the methods and approach used in this study could be adapted for other opioid guidelines, or applied to other areas of preventive healthcare and clinical guideline implementation processes. PMID:28446522

Email consultations in general practice.

PubMed

Neville, Ron G; Marsden, Wendy; McCowan, Colin; Pagliari, Claudia; Mullen, Helen; Fannin, Allison

2004-01-01

Email is an established method of communication in business, leisure and education but not yet health care. To evaluate an email service enabling communication between patients and their general practice regarding repeat prescriptions, appointment booking and clinical enquiries. Qualitative analysis of interactions and an electronic user survey. An urban practice in Dundee, Scotland. 150 patients aged 24 to 85. We set up a practice facility to allow our patients to use email to book appointments, order repeat prescriptions and consult their general practitioner (GP). Patient satisfaction with the service was very high. Patients specifically commended the practice for setting up a facility to allow communication outside standard working hours and for the ease of ordering repeat prescriptions. Patients were pleased to have a means of seeking their doctor's comment or opinion without bothering him or her by making and attending a formal face-to-face consultation. Email dialogue was polite, factual, but less formal than standard letters. Staff did not experience any perceptible rise in workload. Use of an email consultation facility worked well within an urban practice, was deemed helpful by patients, and resulted in no apparent increase in GP workload. Our results suggest that there may be an unmet need amongst patients for clinical email services, and that such services may have positive outcomes for patients and practices.

Barriers and facilitators to HPV vaccination in primary care practices: a mixed methods study using the Consolidated Framework for Implementation Research.

PubMed

Garbutt, Jane M; Dodd, Sherry; Walling, Emily; Lee, Amanda A; Kulka, Katharine; Lobb, Rebecca

2018-05-07

In the United States, the effective, safe huma papilloma virus (HPV) vaccine is underused and opportunities to prevent cancer continue to be missed. National guidelines recommend completing the 2-3 dose HPV vaccine series by age 13, well before exposure to the sexually transmitted virus. Accurate characterization of the facilitators and barriers to full implementation of HPV vaccine recommendations in the primary care setting could inform effective implementation strategies. We used the Consolidated Framework for Implementation Research (CFIR) to systematically investigate and characterize factors that influence HPV vaccine use in 10 primary care practices (16 providers) using a concurrent mixed methods design. The CFIR was used to guide collection and analysis of qualitative data collected through in-person semi-structured interviews with the primary care providers. We analyzed HPV vaccine use with data abstracted from medical charts. Constructs that most strongly influenced vaccine use were identified by integrating the qualitative and quantitative data. Of the 72 CFIR constructs assessed, seven strongly distinguished and seven weakly distinguished between providers with higher versus lower HPV vaccine coverage. The majority of strongly distinguishing constructs were facilitators and were related to characteristics of the providers (knowledge and beliefs; self-efficacy; readiness for change), their perception of the intervention (relative advantage of vaccinating younger vs. older adolescents), and their process to deliver the vaccine (executing). Additional weakly distinguishing constructs that were facilitators were from outer setting (peer pressure; financial incentives), inner setting (networks and communications and readiness for implementation) and process (planning; engaging, and reflecting and evaluating). Two strongly distinguishing constructs were barriers to use, one from the intervention (adaptability of the age of initiation) and the other from outer setting (patient needs and resources). Using CFIR to systematically examine the use of this vaccine in independent primary care practices enabled us to identify facilitators and barriers at the provider, interpersonal and practice level that need to be addressed in future efforts to increase vaccine use in such settings. Our findings suggest that implementation strategies that target the provider and help them to address multi-level barriers to HPV vaccine use merit further investigation.

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

PubMed

Kemeny, M Elizabeth; Mabry, J Beth

2017-01-01

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

Development, implementation and evaluation of a clinical research engagement and leadership capacity building program in a large Australian health care service.

PubMed

Misso, Marie L; Ilic, Dragan; Haines, Terry P; Hutchinson, Alison M; East, Christine E; Teede, Helena J

2016-01-14

Health professionals need to be integrated more effectively in clinical research to ensure that research addresses clinical needs and provides practical solutions at the coal face of care. In light of limited evidence on how best to achieve this, evaluation of strategies to introduce, adapt and sustain evidence-based practices across different populations and settings is required. This project aims to address this gap through the co-design, development, implementation, evaluation, refinement and ultimately scale-up of a clinical research engagement and leadership capacity building program in a clinical setting with little to no co-ordinated approach to clinical research engagement and education. The protocol is based on principles of research capacity building and on a six-step framework, which have previously led to successful implementation and long-term sustainability. A mixed methods study design will be used. Methods will include: (1) a review of the literature about strategies that engage health professionals in research through capacity building and/or education in research methods; (2) a review of existing local research education and support elements; (3) a needs assessment in the local clinical setting, including an online cross-sectional survey and semi-structured interviews; (4) co-design and development of an educational and support program; (5) implementation of the program in the clinical environment; and (6) pre- and post-implementation evaluation and ultimately program scale-up. The evaluation focuses on research activity and knowledge, attitudes and preferences about clinical research, evidence-based practice and leadership and post implementation, about their satisfaction with the program. The investigators will evaluate the feasibility and effect of the program according to capacity building measures and will revise where appropriate prior to scale-up. It is anticipated that this clinical research engagement and leadership capacity building program will enable and enhance clinically relevant research to be led and conducted by health professionals in the health setting. This approach will also encourage identification of areas of clinical uncertainty and need that can be addressed through clinical research within the health setting.

Advanced two-layer level set with a soft distance constraint for dual surfaces segmentation in medical images

NASA Astrophysics Data System (ADS)

Ji, Yuanbo; van der Geest, Rob J.; Nazarian, Saman; Lelieveldt, Boudewijn P. F.; Tao, Qian

2018-03-01

Anatomical objects in medical images very often have dual contours or surfaces that are highly correlated. Manually segmenting both of them by following local image details is tedious and subjective. In this study, we proposed a two-layer region-based level set method with a soft distance constraint, which not only regularizes the level set evolution at two levels, but also imposes prior information on wall thickness in an effective manner. By updating the level set function and distance constraint functions alternatingly, the method simultaneously optimizes both contours while regularizing their distance. The method was applied to segment the inner and outer wall of both left atrium (LA) and left ventricle (LV) from MR images, using a rough initialization from inside the blood pool. Compared to manual annotation from experience observers, the proposed method achieved an average perpendicular distance (APD) of less than 1mm for the LA segmentation, and less than 1.5mm for the LV segmentation, at both inner and outer contours. The method can be used as a practical tool for fast and accurate dual wall annotations given proper initialization.

On the accuracy of density functional theory and wave function methods for calculating vertical ionization energies

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

McKechnie, Scott; Booth, George H.; Cohen, Aron J.

The best practice in computational methods for determining vertical ionization energies (VIEs) is assessed, via reference to experimentally determined VIEs that are corroborated by highly accurate coupled-cluster calculations. These reference values are used to benchmark the performance of density-functional theory (DFT) and wave function methods: Hartree-Fock theory (HF), second-order Møller-Plesset perturbation theory (MP2) and Electron Propagator Theory (EPT). The core test set consists of 147 small molecules. An extended set of six larger molecules, from benzene to hexacene, is also considered to investigate the dependence of the results on molecule size. The closest agreement with experiment is found for ionizationmore » energies obtained from total energy diff calculations. In particular, DFT calculations using exchange-correlation functionals with either a large amount of exact exchange or long-range correction perform best. The results from these functionals are also the least sensitive to an increase in molecule size. In general, ionization energies calculated directly from the orbital energies of the neutral species are less accurate and more sensitive to an increase in molecule size. For the single-calculation approach, the EPT calculations are in closest agreement for both sets of molecules. For the orbital energies from DFT functionals, only those with long-range correction give quantitative agreement with dramatic failing for all other functionals considered. The results offer a practical hierarchy of approximations for the calculation of vertical ionization energies. In addition, the experimental and computational reference values can be used as a standardized set of benchmarks, against which other approximate methods can be compared.« less

Managing patient demand: a qualitative study of appointment making in general practice.

PubMed Central

Gallagher, M; Pearson, P; Drinkwater, C; Guy, J

2001-01-01

BACKGROUND: Managing patients' requests for appointments is an important general practice activity. No previous research has systematically observed how patients and receptionists negotiate appointments. AIM: To observe appointment making and investigate patients' and professionals' experiences of appointment negotiations. DESIGN OF STUDY: A qualitative study using participant observation. SETTING: Three general practices on Tyneside; a single-handed practice, a practice comprising three doctors, and a seven-doctor practice. METHOD: Participant observation sessions, consisting of 35 activity recordings and 34 periods of observation and 38 patient and 15 professional interviews, were set up. Seven groups of patients were selected for interview. These included patients attending an 'open access' surgery, patients who complained about making an appointment, and patients who complimented the receptionists. RESULTS: Appointment making is a complex social process. Outcomes are dependent on the process of negotiation and factors, such as patients' expectations and appointment availability. Receptionists felt that patients in employment, patients allocated to the practice by the Health Authority, and patients who did not comply with practice appointment rules were most demanding. Appointment requests are legitimised by receptionists enforcing practice rules and requesting clinical information. Patients volunteer information to provide evidence that their complaint is appropriate and employ strategies, such as persistence, assertiveness, and threats, to try and persuade receptionists to grant appointments. CONCLUSION: Appointment making is a complex social process where outcomes are negotiated. Receptionists have an important role in managing patient demand. Practices should be explicit about how appointments are allocated, including publishing practice criteria. PMID:11458480

Thank you for asking: Exploring patient perceptions of barcode medication administration identification practices in inpatient mental health settings.

PubMed

Strudwick, Gillian; Clark, Carrie; McBride, Brittany; Sakal, Moshe; Kalia, Kamini

2017-09-01

Barcode medication administration systems have been implemented in a number of healthcare settings in an effort to decrease medication errors. To use the technology, nurses are required to login to an electronic health record, scan a medication and a form of patient identification to ensure that these correspond correctly with the ordered medications prior to medication administration. In acute care settings, patient wristbands have been traditionally used as a form of identification; however, past research has suggested that this method of identification may not be preferred in inpatient mental health settings. If barcode medication administration technology is to be effectively used in this context, healthcare organizations need to understand patient preferences with regards to identification methods. The purpose of this study was to elicit patient perceptions of barcode medication administration identification practices in inpatient mental health settings. Insights gathered can be used to determine patient-centered preferences of identifying patients using barcode medication administration technology. Using a qualitative descriptive approach, fifty-two (n=52) inpatient interviews were completed by a Peer Support Worker using a semi-structured interview guide over a period of two months. Interviews were conducted in a number of inpatient mental health areas including forensic, youth, geriatric, acute, and rehabilitation services. An interprofessional team, inclusive of a Peer Support Worker, completed a thematic analysis of the interview data. Six themes emerged as a result of the inductive data analysis. These included: management of information, privacy and security, stigma, relationships, safety and comfort, and negative associations with the technology. Patients also indicated that they would like a choice in the type of identification method used during barcode medication administration. As well, suggestions were made for how barcode medication administration practices could be modified to become more patient-centered. The results of this study have a number of implications for healthcare organizations. As patients indicated that they would like a choice in the type of identification method used during barcode medication administration, healthcare organizations will need to determine how they can facilitate this process. Furthermore, many of the concerns that patients had with barcode medication administration technology could be addressed through patient education. Copyright © 2017 Elsevier B.V. All rights reserved.

Silent method for mathematics instruction: An overview of teaching subsets

NASA Astrophysics Data System (ADS)

Sugiman, Apino, Ezi

2017-05-01

Generally, teachers use oral communication for teaching mathematics. Taking an opposite perspective, this paper describes how instructional practices for mathematics can be carried out namely a silent method. Silent method uses body language, written, and oral communication for classroom interaction. This research uses a design research approach consisting of four phases: preliminary, prototyping and developing the instruction, and assessment. There are four stages of silent method. The first stage is conditioning stage in which the teacher introduces the method and makes agreement about the `rule of the game'. It is followed by the second one, elaborating stage, where students guess and explore alternative answers. The third stage is developing mathematical thinking by structuring and symbolizing. Finally, the method is ended by reinforcing stage which aims at strengthening and reflecting student's understanding. In this paper, every stage is described on the basis of practical experiences in a real mathematics classroom setting.

A Comparison of the Long-Term Learning Effects of Comprehensive and Topic-Specific Practice Set Assignments

ERIC Educational Resources Information Center

Fatemi, Darius; Marley, Robert; Marquis, Linda M.

2015-01-01

The authors examined the long-term learning effects of two different practice set assignment approaches on business students' long-term learning: a comprehensive, multiple-period practice set and a topic-specific practice set. Student learning was measured longitudinally across semesters. The authors found evidence that students using a…

Optimized detection of steering via linear criteria for arbitrary-dimensional states

NASA Astrophysics Data System (ADS)

Zheng, Yu-Lin; Zhen, Yi-Zheng; Cao, Wen-Fei; Li, Li; Chen, Zeng-Bing; Liu, Nai-Le; Chen, Kai

2017-03-01

Einstein-Podolsky-Rosen (EPR) steering, as a new form of nonlocality, stands between entanglement and Bell nonlocality, implying promising applications for quantum information tasks. The problem of detecting EPR steering plays an important role in characterization of quantum nonlocality. Despite some significant progress, one still faces a practical issue: how to detect EPR steering in an experimentally friendly fashion. Resorting to an EPR steering inequality, one is required to apply a strategy as efficiently as possible for any selected measurement settings on the two subsystems, one of which may not be trusted. Inspired by the recent powerful linear criteria proposed by Saunders et al. [D. J. Saunders, S. J. Jones, H. M. Wiseman, and G. J. Pryde, Nat. Phys. 6, 845 (2010)., 10.1038/nphys1766], we present an optimized method of certifying steering for an arbitrary-dimensional state in a cost-effective manner. We provide a practical way to signify steering via only a few settings to optimally violate the steering inequality. Our method leads to steering detections in a highly efficient way, and can be performed with any number of settings, for an arbitrary bipartite mixed state, which can reduce experimental overheads significantly.

Assessing the suitability of fractional polynomial methods in health services research: a perspective on the categorization epidemic.

PubMed

Williams, Jennifer Stewart

2011-07-01

To show how fractional polynomial methods can usefully replace the practice of arbitrarily categorizing data in epidemiology and health services research. A health service setting is used to illustrate a structured and transparent way of representing non-linear data without arbitrary grouping. When age is a regressor its effects on an outcome will be interpreted differently depending upon the placing of cutpoints or the use of a polynomial transformation. Although it is common practice, categorization comes at a cost. Information is lost, and accuracy and statistical power reduced, leading to spurious statistical interpretation of the data. The fractional polynomial method is widely supported by statistical software programs, and deserves greater attention and use.

Safe Injection Practices in Primary Health Care Settings of Naxalbari Block, Darjeeling District, West Bengal.

PubMed

Chaudhuri, Sudip Banik; Ray, Kuntala

2016-01-01

Unsafe injection can transmit many diseases to patients, injection providers and healthy people of community. To find out critical steps whether executed according to recommended best practice methods, availability of equipments in health facilities for safe injection practices and some important steps of waste disposal methods. This facility-based cross-sectional observational study was conducted among 30 Auxiliary nurse midwives (ANM) & 27 nursing staffs (NS) to assess certain aspects of their practice while administrating injection and disposal of the disposables. Health facilities were also observed to asses necessary equipments of safe injection and waste disposal methods. Among the health workers 93.3% ANM and 100% NS took sterile syringe from sterile unopened packet, all of the study subjects washed hand before giving injection, 13.3% of ANMs and 8% of NS are fully vaccinated against Hep B, 53.3% of ANM and all NS are practices non recapping. Only 13.33% sub centres along with PHC & BPHC had at least one puncture resistant leak proof container, 86.7% sub centres, PHC are free from loose needles. Transport for off side treatment is the method of waste disposal in case of 73.3% cases sub centres, PHC & BPHC. There is need to educate, train and motivate service providers in proper methods of giving injection along with improve the adequacy of supply of required equipments.

Chapter 1: Introduction. The Uniform Methods Project: Methods for Determining Energy-Efficiency Savings for Specific Measures

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

Li, Michael; Haeri, Hossein; Reynolds, Arlis

This chapter provides a set of model protocols for determining energy and demand savings that result from specific energy efficiency measures implemented through state and utility efficiency programs. The methods described here are approaches that are or are among the most commonly used and accepted in the energy efficiency industry for certain measures or programs. As such, they draw from the existing body of research and best practices for energy efficiency program evaluation, measurement, and verification (EM&V). These protocols were developed as part of the Uniform Methods Project (UMP), funded by the U.S. Department of Energy (DOE). The principal objectivemore » for the project was to establish easy-to-follow protocols based on commonly accepted methods for a core set of widely deployed energy efficiency measures.« less

Understanding density functional theory (DFT) and completing it in practice

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

Bagayoko, Diola

2014-12-15

We review some salient points in the derivation of density functional theory (DFT) and of the local density approximation (LDA) of it. We then articulate an understanding of DFT and LDA that seems to be ignored in the literature. We note the well-established failures of many DFT and LDA calculations to reproduce the measured energy gaps of finite systems and band gaps of semiconductors and insulators. We then illustrate significant differences between the results from self consistent calculations using single trial basis sets and those from computations following the Bagayoko, Zhao, and Williams (BZW) method, as enhanced by Ekuma andmore » Franklin (BZW-EF). Unlike the former, the latter calculations verifiably attain the absolute minima of the occupied energies, as required by DFT. These minima are one of the reasons for the agreement between their results and corresponding, experimental ones for the band gap and a host of other properties. Further, we note predictions of DFT BZW-EF calculations that have been confirmed by experiment. Our subsequent description of the BZW-EF method ends with the application of the Rayleigh theorem in the selection, among the several calculations the method requires, of the one whose results have a full, physics content ascribed to DFT. This application of the Rayleigh theorem adds to or completes DFT, in practice, to preserve the physical content of unoccupied, low energy levels. Discussions, including implications of the method, and a short conclusion follow the description of the method. The successive augmentation of the basis set in the BZW-EF method, needed for the application of the Rayleigh theorem, is also necessary in the search for the absolute minima of the occupied energies, in practice.« less

Accurate and Efficient Approximation to the Optimized Effective Potential for Exchange

NASA Astrophysics Data System (ADS)

Ryabinkin, Ilya G.; Kananenka, Alexei A.; Staroverov, Viktor N.

2013-07-01

We devise an efficient practical method for computing the Kohn-Sham exchange-correlation potential corresponding to a Hartree-Fock electron density. This potential is almost indistinguishable from the exact-exchange optimized effective potential (OEP) and, when used as an approximation to the OEP, is vastly better than all existing models. Using our method one can obtain unambiguous, nearly exact OEPs for any reasonable finite one-electron basis set at the same low cost as the Krieger-Li-Iafrate and Becke-Johnson potentials. For all practical purposes, this solves the long-standing problem of black-box construction of OEPs in exact-exchange calculations.

Core outcome sets for research and clinical practice.

PubMed

Chiarotto, Alessandro; Ostelo, Raymond W; Turk, Dennis C; Buchbinder, Rachelle; Boers, Maarten

This masterclass introduces the topic of core outcome sets, describing rationale and methods for developing them, and providing some examples that are relevant for clinical research and practice. A core outcome set is a minimum consensus-based set of outcomes that should be measured and reported in all clinical trials for a specific health condition and/or intervention. Issues surrounding outcome assessment, such as selective reporting and inconsistency across studies, can be addressed by the development of a core set. As suggested by key initiatives in this field (i.e. OMERACT and COMET), the development requires achieving consensus on: (1) core outcome domains and (2) core outcome measurement instruments. Different methods can be used to reach consensus, including: literature systematic reviews to inform the process, qualitative research with clinicians and patients, group discussions (e.g. nominal group technique), and structured surveys (e.g. Delphi technique). Various stakeholders should be involved in the process, with particular attention to patients. Several COSs have been developed for musculoskeletal conditions including a longstanding one for low back pain, IMMPACT recommendations on outcomes for chronic pain, and OMERACT COSs for hip, knee and hand osteoarthritis. There is a lack of COSs for neurological, geriatric, cardio-respiratory and pediatric conditions, therefore, future research could determine the value of developing COSs for these conditions. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Changing Habits of Practice

PubMed Central

Bowen, Judith L; Salerno, Stephen M; Chamberlain, John K; Eckstrom, Elizabeth; Chen, Helen L; Brandenburg, Suzanne

2005-01-01

Purpose The majority of health care, both for acute and chronic conditions, is delivered in the ambulatory setting. Despite repeated proposals for change, the majority of internal medicine residency training still occurs in the inpatient setting. Substantial changes in ambulatory education are needed to correct the current imbalance. To assist educators and policy makers in this process, this paper reviews the literature on ambulatory education and makes recommendations for change. Methods The authors searched the Medline, Psychlit, and ERIC databases from 2000 to 2004 for studies that focused specifically on curriculum, teaching, and evaluation of internal medicine residents in the ambulatory setting to update previous reviews. Studies had to contain primary data and were reviewed for methodological rigor and relevance. Results Fifty-five studies met criteria for review. Thirty-five of the studies focused on specific curricular areas and 11 on ambulatory teaching methods. Five involved evaluating performance and 4 focused on structural issues. No study evaluated the overall effectiveness of ambulatory training or investigated the effects of current resident continuity clinic microsystems on education. Conclusion This updated review continues to identify key deficiencies in ambulatory training curriculum and faculty skills. The authors make several recommendations: (1) Make training in the ambulatory setting a priority. (2) Address systems problems in practice environments. (3) Create learning experiences appropriate to the resident's level of development. (4) Teach and evaluate in the examination room. (5) Expand subspecialty-based training to the ambulatory setting. (6) Make faculty development a priority. (7) Create and fund multiinstitutional educational research consortia. PMID:16423112

Organizing a Community Advanced Pharmacy Practice Experience

PubMed Central

Koenigsfeld, Carrie Foust; Tice, Angela L

2006-01-01

Setting up a community advanced pharmacy practice experience can be an overwhelming task for many pharmacy preceptors. This article provides guidance to pharmacist preceptors in developing a complete and effective community advanced pharmacy practice experience (APPE). When preparing for the APPE, initial discussions with the college or school of pharmacy are key. Benefits, training, and requirements should be addressed. Site preparation, including staff education, will assist in the development process. The preceptor should plan orientation day activities and determine appropriate evaluation and feedback methods. With thorough preparation, the APPE will be rewarding for both the student and the pharmacy site. PMID:17136163

Organizing a community advanced pharmacy practice experience.

PubMed

Koenigsfeld, Carrie Foust; Tice, Angela L

2006-02-15

Setting up a community advanced pharmacy practice experience can be an overwhelming task for many pharmacy preceptors. This article provides guidance to pharmacist preceptors in developing a complete and effective community advanced pharmacy practice experience (APPE). When preparing for the APPE, initial discussions with the college or school of pharmacy are key. Benefits, training, and requirements should be addressed. Site preparation, including staff education, will assist in the development process. The preceptor should plan orientation day activities and determine appropriate evaluation and feedback methods. With thorough preparation, the APPE will be rewarding for both the student and the pharmacy site.

Standard setting for OSCEs: trial of borderline approach.

PubMed

Kilminster, Sue; Roberts, Trudie

2004-01-01

OSCE examinations were held in May and June 2002 for all third and fourth year and some fifth year medical students at the University of Leeds. There has been an arbitrary pass mark of 65% for these examinations. However, we recognise that it is important to adopt a systematic approach towards standard setting in all examinations so held a trial of the borderline approach to standard setting for third and fifth year examinations. This paper reports our findings. The results for the year 3 OSCE demonstrated that the borderline approach to standard setting is feasible and offers a method to ensure that the pass standard is both justifiable and credible. It is efficient, requiring much less time than other methods and has the advantage of using the judgements of expert clinicians about actual practice. In addition it offers a way of empowering clinicians because it uses their expertise.

Multiple Versus Single Set Validation of Multivariate Models to Avoid Mistakes.

PubMed

Harrington, Peter de Boves

2018-01-02

Validation of multivariate models is of current importance for a wide range of chemical applications. Although important, it is neglected. The common practice is to use a single external validation set for evaluation. This approach is deficient and may mislead investigators with results that are specific to the single validation set of data. In addition, no statistics are available regarding the precision of a derived figure of merit (FOM). A statistical approach using bootstrapped Latin partitions is advocated. This validation method makes an efficient use of the data because each object is used once for validation. It was reviewed a decade earlier but primarily for the optimization of chemometric models this review presents the reasons it should be used for generalized statistical validation. Average FOMs with confidence intervals are reported and powerful, matched-sample statistics may be applied for comparing models and methods. Examples demonstrate the problems with single validation sets.

Opinions of sports clinical practice chiropractors, with sports specialty training and those without, about chiropractic research priorities in sports health care: a centering resonance analysis

PubMed Central

Lee, Alexander D; Szabo, Kaitlyn; McDowell, Kirstie; Granger, Sydney

2016-01-01

Introduction: A Canadian sports chiropractic research agenda has yet to be defined. The Delphi method can be utilized to achieve this purpose; however, the sample of experts who participate can influence the results. To better inform sample selection for future research agenda development, we set out to determine if differences in opinions about research priorities exist between chiropractors who have their sports specialty designation and those who do not. Methods: Fifteen sports clinical practice chiropractors who have their sports fellowship designation and fifteen without, were interviewed with a set of standardized questions about sports chiropractic research priorities. A centering resonance analysis and cluster analysis were conducted on the interview responses. Results: The two practitioner groups differed in their opinions about the type of research that they would like to see conducted, the research that would impact their clinical practice the most, and where they believed research was lacking. However, both groups were similar in their opinions about research collaborations. Conclusion: Sports clinical practice chiropractors, with their sports specialty designation and those without, differed in their opinions about sports chiropractic research priorities; however, they had similar opinions about research collaborations. These results suggest that it may be important to sample from both practitioner groups in future studies aimed at developing research agendas for chiropractic research in sport. PMID:28065995

Exploring the perception of nursing students about consequences of reflection in clinical settings

PubMed Central

Karimi, Shahnaz; Haghani, Fariba; Yamani, Nikoo; Kalyani, Majid Najafi

2017-01-01

Background Reflection on practical experiences is a key element that enables students to recognize their own strengths and weaknesses and develop nursing skills. Whilst reflection may enhance students’ learning in practice, there is little evidence about nursing students’ perception of the consequences of reflection in clinical settings. Objective This study aimed to explore Iranian nursing students’ perception regarding the consequences of reflection during clinical practices. Methods This qualitative study was conducted by a conventional content analysis approach in two nursing schools at Shiraz and Fasa Universities of Medical Sciences in Iran. Data were collected through in-depth semi-structured interviews during 2015–2016, from 20 students selected by purposive sampling. All the interviews were tape-recorded, transcribed verbatim, and analyzed by content analysis method. Rigor of this study was approved by member check and external audit. Results Two categories emerged from the data analysis, including movement toward professionalism and self-actualization of emotions. The former consisted of three subcategories of function modification, sharing experiences and generalizing experiences. The latter consisted of two subcategories of inner satisfaction and peace of mind. Conclusion The results indicated that nursing students’ reflection in clinical settings is effective in personal and professional levels. Reflection in a personal level led to positive emotions that increased the quality of care in patients. Accordingly, nursing educators need to create a nurturing climate as well as supporting reflective behaviors of nursing students. PMID:29038696

Goal Setting as Teacher Development Practice

ERIC Educational Resources Information Center

Camp, Heather

2017-01-01

This article explores goal setting as a teacher development practice in higher education. It reports on a study of college teacher goal setting informed by goal setting theory. Analysis of study participants' goal setting practices and their experiences with goal pursuit offers a framework for thinking about the kinds of goals teachers might set…

Implementation of the evidence review on best practice for confirming the correct placement of nasogastric tube in patients in an acute care hospital.

PubMed

Tho, Poh Chi; Mordiffi, Siti; Ang, Emily; Chen, Helen

2011-03-01

Nasogastric (NG) tube is a device passed through the gastrointestinal tract of patients for the purpose of feeding, gastric decompression and medication administration. However, a small risk involved in the process is that the tube may be misplaced into the trachea during insertion or may get displaced at a later stage, leading to disastrous results. Recent adverse incidences arising out of the misplacement of NG tube raised concerns among the nursing and medical community and the Patient Safety Officer of the hospital. The Evidence Based Nursing Unit, in collaboration with some of the key nursing leaders in nursing administration, was tasked to explore and institute the current best practice in confirming the correct placement of NG tube. The aim of this project was to institute the best practice to confirm the correct placement of NG tube in patients in an acute care hospital setting. The project comprised of a few stages. The first stage involved reviewing the existing recommendations and guidelines on the methods for checking correct NG tube placement. The second stage involved incorporation of the change of practice into the clinical setting. The final stage was to monitor and evaluate the impact of the new practice on the patients, nurses and other healthcare professionals. Evidence search from guidelines and journals supported the test that used pH indicator instead of the litmus test. There is no evidence that supports the method of auscultation and bubbling to confirm correct NG tube placement in the absence of aspirate. Radiology remains the 'gold standard' for checking correct NG tube placement. The revised method of NG tube placement and workflow was incorporated in the revised Standard Operating Procedures. A total of 17 roadshows were conducted to create awareness regarding the new method amongst the nurses, and the implementation of the revised method and workflow was commenced on 3 November 2008. The initial audit conducted 1 month after the practice change was implemented reported 26 (50%) observations of NG tube feeding in 26 audit wards. The key areas of practice change in feeding when tube placement was confirmed (84.6%) and proper testing of aspirate (76.9%) showed good compliance. The implementation of the change in the practice of confirming the correct placement of the NG tube in patients requires good coordination and a multidisciplinary team approach. © 2011 The Authors. International Journal of Evidence-Based Healthcare © 2011 The Joanna Briggs Institute.

The Ideology and Practices of "Seikatsu-Tsuzurikata": Education by Teaching of Expressive Writing

ERIC Educational Resources Information Center

Hiraoka, Satsuki

2011-01-01

Seikatsu-Tsuzurikata is an educational method related to teaching of written expression for children that was pioneered in elementary school education settings throughout the 1920s and 1930s, and which was widely adopted in Japan in the 1930s. It is a unique method developed in Japan that uses both school and non-school resources, not only in…

A Mixed-Method Evaluation of the Feasibility and Acceptability of a Telehealth-Based Parent-Mediated Intervention for Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Pickard, Katherine E.; Wainer, Allison L.; Bailey, Kathryn M.; Ingersoll, Brooke R.

2016-01-01

Research within the autism spectrum disorder field has called for the use of service delivery models that are able to more efficiently disseminate evidence-based practices into community settings. This study employed telehealth methods in order to deliver an Internet-based, parent training intervention for autism spectrum disorder, ImPACT Online.…

Prophylactic Z-plasty - correcting helical rim deformity from wedge excision.

PubMed

Kim, Peter

2010-09-01

Wedge excision is a popular and well documented surgical method for treating a wide range of skin lesions and cancers of the ear in the general practice setting. In the majority of cases, this is a simple and cosmetically pleasing treatment. However, it may create helical rim deformity. This article describes a simple method of preventing such deformity using prophylactic Z-plasty.

Definition of the Mathematical Model Coefficients on the Weld Size of Butt Joint Without Edge Preparation

NASA Astrophysics Data System (ADS)

Sidorov, Vladimir P.; Melzitdinova, Anna V.

2017-10-01

This paper represents the definition methods for thermal constants according to the data of the weld width under the normal-circular heat source. The method is based on isoline contouring of “effective power - temperature conductivity coefficient”. The definition of coefficients provides setting requirements to the precision of welding parameters support with the enough accuracy for an engineering practice.

Instructional Development for Clinical Settings.

ERIC Educational Resources Information Center

Cranton, P. A.

Clinical teaching involves instruction in a natural health-related environment which allows students to observe and participate in the actual practice of the profession. The use of objectives, the sequence of instruction, the instructional methods and materials, and the evaluation of student performance constitute the components studied in…

Entrance and Exit Requirements of Professional Social Work Education

ERIC Educational Resources Information Center

Duehn, Wayne D.; Mayadas, Nazneen Sada

1977-01-01

A competency-based direct practice curriculum for graduate social work education is described based on: (1) interpersonal behavioral control; (2) judgment and decision making; (3) contracting and goal setting; (4) selection and application of change method; and (5) assessment of outcomes. (Author/LBH)

Drilled shaft bridge foundation design parameters and procedures for bearing in SGC soils.

DOT National Transportation Integrated Search

2006-04-01

This report provides a simplified method to be used for evaluating the skin friction and tip resistance of : axially loaded drilled shafts. A summary of literature and current practice was completed and then a : comprehensive set of field and laborat...

Learning to recognize rat social behavior: Novel dataset and cross-dataset application.

PubMed

Lorbach, Malte; Kyriakou, Elisavet I; Poppe, Ronald; van Dam, Elsbeth A; Noldus, Lucas P J J; Veltkamp, Remco C

2018-04-15

Social behavior is an important aspect of rodent models. Automated measuring tools that make use of video analysis and machine learning are an increasingly attractive alternative to manual annotation. Because machine learning-based methods need to be trained, it is important that they are validated using data from different experiment settings. To develop and validate automated measuring tools, there is a need for annotated rodent interaction datasets. Currently, the availability of such datasets is limited to two mouse datasets. We introduce the first, publicly available rat social interaction dataset, RatSI. We demonstrate the practical value of the novel dataset by using it as the training set for a rat interaction recognition method. We show that behavior variations induced by the experiment setting can lead to reduced performance, which illustrates the importance of cross-dataset validation. Consequently, we add a simple adaptation step to our method and improve the recognition performance. Most existing methods are trained and evaluated in one experimental setting, which limits the predictive power of the evaluation to that particular setting. We demonstrate that cross-dataset experiments provide more insight in the performance of classifiers. With our novel, public dataset we encourage the development and validation of automated recognition methods. We are convinced that cross-dataset validation enhances our understanding of rodent interactions and facilitates the development of more sophisticated recognition methods. Combining them with adaptation techniques may enable us to apply automated recognition methods to a variety of animals and experiment settings. Copyright © 2017 Elsevier B.V. All rights reserved.

Disinfection methods in general practice and health authority clinics: a telephone survey

PubMed Central

Farrow, S.C.; Kaul, S.; Littlepage, B.C.

1988-01-01

Concern about the epidemic of the acquired immune deficiency syndrome led to discussions in one health district about the dangers of cross-infection from instruments in general practice and health authority clinics. In order to establish what current disinfection practices were in use a telephone survey was adopted as a quick and easy method of data collection. Information was collected on who was responsible for disinfection as well as details of how each instrument was disinfected. Results from 69 general practices and 21 health authority clinice in one health district are reported. Some form of sterilizer was used in 63 general practices. These included water boilers (49%), dry heat sterilizers (41%), autoclaves (5%) and pressure cookers (5%). Sixty one practices were using metal vaginal specula and of these 29 were disinfecting by boiling, three were using pressure cookers, 18 dry heat, seven chemical methods, three autoclaves and one the central sterile department of the local hospital. Of those who were boiling after simple washing, three practices boiled for five to 10 minutes and reused instruments during the same clinic. Of the 29 using simple boiling 20 (69%) were boiling for less than 20 minutes. The study highlights the fact that no formal advice has been given on disinfection practice by the DHSS, the health authorities or the family practitioner committees. The need to set up local guidelines and develop practical steps for their introduction are discussed. PMID:3271009

The safety climate in primary care (SAP-C) study: study protocol for a randomised controlled feasibility study.

PubMed

Lydon, Sinéad; Cupples, Margaret E; Hart, Nigel; Murphy, Andrew W; Faherty, Aileen; O'Connor, Paul

2016-01-01

Research on patient safety has focused largely on secondary care settings, and there is a dearth of knowledge relating to safety culture or climate, and safety climate improvement strategies, in the context of primary care. This is problematic given the high rates of usage of primary care services and the myriad of opportunities for clinical errors daily. The current research programme aimed to assess the effectiveness of an intervention derived from the Scottish Patient Safety Programme in Primary Care. The intervention consists of safety climate measurement and feedback and patient chart audit using the trigger review method. The purpose of this paper is to describe the background to this research and to present the methodology of this feasibility study in preparation for a future definitive RCT. The SAP-C study is a feasibility study employing a randomised controlled pretest-posttest design that will be conducted in 10 general practices in the Republic of Ireland and Northern Ireland. Five practices will receive the safety climate intervention over a 9-month period. The five practices in the control group will continue care as usual but will complete the GP-SafeQuest safety climate questionnaire at baseline (month 1) and at the terminus of the intervention (month 9). The outcomes of the study include process evaluation metrics (i.e. rates of participant recruitment and retention, rates of completion of safety climate measures, qualitative data regarding participants' perceptions of the intervention's potential efficacy, acceptability, and sustainability), patient safety culture in intervention and control group practices at posttest, and instances of undetected patient harm identified through patient chart audit using the trigger review method. The planned study investigates an intervention to improve safety climate in Irish primary care settings. The resulting data may inform our knowledge of the frequency of undetected patient safety incidents in primary care, may contribute to improved patient safety practices in primary care settings, and may inform future research on patient safety improvement initiatives.

Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature

PubMed Central

Waithaka, Dennis; Tsofa, Benjamin; Barasa, Edwine

2018-01-01

Background: Decentralization of health systems has made sub-national/regional healthcare systems the backbone of healthcare delivery. These regions are tasked with the difficult responsibility of determining healthcare priorities and resource allocation amidst scarce resources. We aimed to review empirical literature that evaluated priority setting practice at the meso (sub-national) level of health systems. Methods: We systematically searched PubMed, ScienceDirect and Google scholar databases and supplemented these with manual searching for relevant studies, based on the reference list of selected papers. We only included empirical studies that described and evaluated, or those that only evaluated priority setting practice at the meso-level. A total of 16 papers were identified from LMICs and HICs. We analyzed data from the selected papers by thematic review. Results: Few studies used systematic priority setting processes, and all but one were from HICs. Both formal and informal criteria are used in priority-setting, however, informal criteria appear to be more perverse in LMICs compared to HICs. The priority setting process at the meso-level is a top-down approach with minimal involvement of the community. Accountability for reasonableness was the most common evaluative framework as it was used in 12 of the 16 studies. Efficiency, reallocation of resources and options for service delivery redesign were the most common outcome measures used to evaluate priority setting. Limitations: Our study was limited by the fact that there are very few empirical studies that have evaluated priority setting at the meso-level and there is likelihood that we did not capture all the studies. Conclusions: Improving priority setting practices at the meso level is crucial to strengthening health systems. This can be achieved through incorporating and adapting systematic priority setting processes and frameworks to the context where used, and making considerations of both process and outcome measures during priority setting and resource allocation. PMID:29511741

Reorienting health services in the Northern Territory of Australia: a conceptual model for building health promotion capacity in the workforce.

PubMed

Judd, Jenni; Keleher, Helen

2013-06-01

Reorienting work practices to include health promotion and prevention is complex and requires specific strategies and interventions. This paper presents original research that used 'real-world' practice to demonstrate that knowledge gathered from practice is relevant for the development of practice-based evidence. The paper shows how practitioners can inform and influence improvements in health promotion practice. Practitioner-informed evidence necessarily incorporates qualitative research to capture the richness of their reflective experiences. Using a participatory action research (PAR) approach, the research question asked 'what are the core dimensions of building health promotion capacity in a primary health care workforce in a real-world setting?' PAR is a method in which the researcher operates in full collaboration with members of the organisation being studied for the purposes of achieving some kind of change, in this case to increase the amount of health promotion and prevention practice within this community health setting. The PAR process involved six reflection and action cycles over two years. Data collection processes included: survey; in-depth interviews; a training intervention; observations of practice; workplace diaries; and two nominal groups. The listen/reflect/act process enabled lessons from practice to inform future capacity-building processes. This research strengthened and supported the development of health promotion to inform 'better health' practices through respectful change processes based on research, practitioner-informed evidence, and capacity-building strategies. A conceptual model for building health promotion capacity in the primary health care workforce was informed by the PAR processes and recognised the importance of the determinants approach. Practitioner-informed evidence is the missing link in the evidence debate and provides the links between evidence and its translation to practice. New models of health promotion service delivery can be developed in community settings recognising the importance of involving practitioners themselves in these processes.

Basic practical skills teaching and learning in undergraduate medical education – a review on methodological evidence

PubMed Central

Vogel, Daniela; Harendza, Sigrid

2016-01-01

Objective: Practical skills are an essential part of physicians’ daily routine. Nevertheless, medical graduates’ performance of basic skills is often below the expected level. This review aims to identify and summarize teaching approaches of basic practical skills in undergraduate medical education which provide evidence with respect to effective students’ learning of these skills. Methods: Basic practical skills were defined as basic physical examination skills, routine skills which get better with practice, and skills which are also performed by nurses. We searched PubMed with different terms describing these basic practical skills. In total, 3467 identified publications were screened and 205 articles were eventually reviewed for eligibility. Results: 43 studies that included at least one basic practical skill, a comparison of two groups of undergraduate medical students and effects on students’ performance were analyzed. Seven basic practical skills and 15 different teaching methods could be identified. The most consistent results with respect to effective teaching and acquisition of basic practical skills were found for structured skills training, feedback, and self-directed learning. Simulation was effective with specific teaching methods and in several studies no differences in teaching effects were detected between expert or peer instructors. Multimedia instruction, when used in the right setting, also showed beneficial effects for basic practical skills learning. Conclusion: A combination of voluntary or obligatory self-study with multimedia applications like video clips in combination with a structured program including the possibility for individual exercise with personal feedback by peers or teachers might provide a good learning opportunity for basic practical skills. PMID:27579364

Two methods for parameter estimation using multiple-trait models and beef cattle field data.

PubMed

Bertrand, J K; Kriese, L A

1990-08-01

Two methods are presented for estimating variances and covariances from beef cattle field data using multiple-trait sire models. Both methods require that the first trait have no missing records and that the contemporary groups for the second trait be subsets of the contemporary groups for the first trait; however, the second trait may have missing records. One method uses pseudo expectations involving quadratics composed of the solutions and the right-hand sides of the mixed model equations. The other method is an extension of Henderson's Simple Method to the multiple trait case. Neither of these methods requires any inversions of large matrices in the computation of the parameters; therefore, both methods can handle very large sets of data. Four simulated data sets were generated to evaluate the methods. In general, both methods estimated genetic correlations and heritabilities that were close to the Restricted Maximum Likelihood estimates and the true data set values, even when selection within contemporary groups was practiced. The estimates of residual correlations by both methods, however, were biased by selection. These two methods can be useful in estimating variances and covariances from multiple-trait models in large populations that have undergone a minimal amount of selection within contemporary groups.

Practices Regarding Rape-related Pregnancy in U.S. Abortion Care Settings.

PubMed

Perry, Rachel; Murphy, Molly; Rankin, Kristin M; Cowett, Allison; Harwood, Bryna

2016-01-01

We aimed to explore current practices regarding screening for rape and response to disclosure of rape-related pregnancy in the abortion care setting. We performed a cross-sectional, nonprobability survey of U.S. abortion providers. Individuals were recruited in person and via emailed invitations to professional organization member lists. Questions in this web-based survey pertained to providers' practice setting, how they identify rape-related pregnancy, the availability of support services, and their experiences with law enforcement. Providers were asked their perceptions of barriers to care for women who report rape-related pregnancy. Surveys were completed by 279 providers (21% response rate). Most respondents were female (93.1%), and the majority were physicians in a clinical role (69.4%). One-half (49.8%) reported their practice screens for pregnancy resulting from rape, although fewer (34.8%) reported that screening is the method through which most patients with this history are identified. Most (80.6%) refer women with rape-related pregnancy to support services such as rape crisis centers. Relatively few (19.7%) have a specific protocol for care of women who report rape-related pregnancy. Clinics that screen were 79% more likely to have a protocol for care than centers that do not screen. Although the majority (67.4%) reported barriers to identification of women with rape-related pregnancy, fewer (33.3%) reported barriers to connecting them to support services. Practices for identifying and providing care to women with rape-related pregnancy in the abortion care setting are variable. Further research should address barriers to care provision, as well as identifying protocols for care. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Practical methodological guide for hydrometric inter-laboratory organisation

NASA Astrophysics Data System (ADS)

Besson, David; Bertrand, Xavier

2015-04-01

Discharge measurements performed by the French governmental hydrometer team feed a national database. This data is available for general river flows knowkedge, flood forecasting, low water survey, statistical calculations flow, control flow regulatory and many other uses. Regularly checking the measurements quality and better quantifying its accuracy is therefore an absolute need. The practice of inter-laboratory comparison in hydrometry particularly developed during the last decade. Indeed, discharge measurement can not easily be linked to a standard. Therefore, on-site measurement accuracy control is very difficult. Inter-laboratory comparison is thus a practical solution to this issue. However, it needs some regulations in order to ease its practice and legitimize its results. To do so, the French government hydrometrics teams produced a practical methodological guide for hydrometric inter-laboratory organisation in destination of hydrometers community in view of ensure the harmonization of inter-laboratory comparison practices for different materials (ADCP, current meter on wadind rod or gauging van, tracer dilution, surface speed) and flow range (flood, low water). Ensure the results formalization and banking. The realisation of this practice guide is grounded on the experience of the governmental teams & their partners (or fellows), following existing approaches (Doppler group especially). The guide is designated to validate compliance measures and identify outliers : Hardware, methodological, environmental, or human. Inter-laboratory comparison provides the means to verify the compliance of the instruments (devices + methods + operators) and provides methods to determine an experimental uncertainty of the tested measurement method which is valid only for the site and the measurement conditions but does not address the calibration or periodic monitoring of the few materials. After some conceptual definitions, the guide describes the different stages of an inter-comparison campaign: the campaing creation: targets, participants ( instruments type and number) and site preparation of test protocols and schedule; the campaign set-up (organization): invitation and pre-information of the participants, logistics, field preparation; the campaign conduct: participants reception and information, sequences of tests, results analysis and communication, balance sheet; post-campaign work: further analysis, dissemination and periodic verification of the instruments. This guide is associated with measurement instruments forms, reminding their limits and conditions for use, land forms, used to record all the necessary information during the inter-comparison campaign (site description and measurement conditions, equipment and its settings, and the set of measurements or intermediate calculations to the final results) as well as a calculation tool and banking measures and results.

Cancer Screening Practices Among Physicians in the National Breast and Cervical Cancer Early Detection Program

PubMed Central

Saraiya, Mona S.; Soman, Ashwini; Roland, Katherine B.; Yabroff, K. Robin; Miller, Jackie

2011-01-01

Abstract Background The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides low-income, uninsured women with screening and diagnostic services for breast and cervical cancer. Our study was conducted to describe the demographic and practice characteristics of participating and nonparticipating physicians, as well as their beliefs, adoption of new screening technologies, and recommendations for breast and cervical cancer screening. Methods From a 2006–2007 nationally representative survey, we identified 1,111 practicing primary care physicians who provide breast and cervical cancer screenings and assessed their recommendations using clinical vignettes related to screening initiation, frequency, and cessation. Responses of physicians participating in the NBCCEDP were compared with those from nonparticipating physicians. Results Of the physicians surveyed, 15% reported participation in the NBCCEDP, 65% were not participants, and 20% were not sure or did not respond to this question. Program physicians were significantly more likely to practice in multispecialty settings, in a rural location, and in a hospital or clinic setting and had more patients who were female and insured by Medicaid or uninsured compared with nonprogram physicians. Beliefs about the effectiveness of screening tools or procedures in reducing breast or cervical cancer mortality were similar by program participation. Adoption of new technologies, including digital mammography and human papillomavirus (HPV) testing, and making guideline-consistent recommendations for screening initiation, frequency, and cessation did not differ significantly by program participation. Conclusions Although there may be differences in physician characteristics and practice settings, the beliefs and screening practices for both breast and cervical cancer are similar between program and nonprogram providers. PMID:21774673

Occupational therapy practice in acute physical hospital settings: Evidence from a scoping review.

PubMed

Britton, Lauren; Rosenwax, Lorna; McNamara, Beverley

2015-12-01

Increased accountability and growing fiscal limitations in global health care continue to challenge how occupational therapy practices are undertaken. Little is known about how these changes affect current practice in acute hospital settings. This article reviews the relevant literature to further understanding of occupational therapy practice in acute physical hospital settings. A scoping review of five electronic databases was completed using the keywords Occupational therapy, acute hospital settings/acute physical hospital settings, acute care setting/acute care hospital setting, general medicine/general medical wards, occupational therapy service provision/teaching hospitals/tertiary care hospitals. Criteria were applied to determine suitability for inclusion and the articles were analysed to uncover key themes. In total 34 publications were included in the review. Analysis of the publications revealed four themes: (1) Comparisons between the practice of novice and experienced occupational therapists in acute care (2) Occupational therapists and the discharge planning process (3) Role of occupation in the acute care setting and (4) Personal skills needed and organisation factors affecting acute care practice. The current literature has highlighted the challenges occupational therapists face in practicing within an acute setting. Findings from this review enhance understanding of how occupational therapy department managers and educators can best support staff that practise in acute hospital settings. © 2015 Occupational Therapy Australia.

Achieving Good Outcomes for Asthma Living (GOAL): mixed methods feasibility and pilot cluster randomised controlled trial of a practical intervention for eliciting, setting and achieving goals for adults with asthma.

PubMed

Hoskins, Gaylor; Williams, Brian; Abhyankar, Purva; Donnan, Peter; Duncan, Edward; Pinnock, Hilary; van der Pol, Marjon; Rauchhaus, Petra; Taylor, Anne; Sheikh, Aziz

2016-12-08

Despite being a core component of self-management, goal setting is rarely used in routine care. We piloted a primary care, nurse-led intervention called Achieving Good Outcomes for Asthma Living (GOAL) for adults with asthma. Patients were invited to identify and prioritise their goals in preparation for discussing and negotiating an action/coping plan with the nurse at a routine asthma review. The 18-month mixed methods feasibility cluster pilot trial stratified and then randomised practices to deliver usual care (UC) or a goal-setting intervention (GOAL). Practice asthma nurses and adult patients with active asthma were invited to participate. The primary outcome was asthma-specific quality of life. Semi-structured interviews with a purposive patient sample (n = 14) and 10 participating nurses explored GOAL perception. The constructs of normalisation process theory (NPT) were used to analyse and interpret data. Ten practices participated (five in each arm), exceeding our target of eight. However, only 48 patients (target 80) were recruited (18 in GOAL practices). At 6 months post-intervention, the difference in mean asthma-related quality of life (mAQLQ) between intervention and control was 0.1 (GOAL 6.20: SD 0.76 (CI 5.76-6.65) versus UC 6.1: SD 0.81 (CI 5.63-6.57)), less than the minimal clinically important difference (MCID) of 0.5. However, change from baseline was stronger in the intervention group: at 6 months the change in the emotions sub-score was 0.8 for intervention versus 0.2 for control. Costs were higher in the intervention group by £22.17. Routine review with goal setting was considered more holistic, enhancing rapport and enabling patients to become active rather than passive participants in healthcare. However, time was a major barrier for nurses, who admitted to screening out patient goals they believed were unrelated to asthma. The difference in AQLQ score from baseline is larger in the intervention arm than the control, indicating the intervention may have impact if appropriately strengthened. The GOAL intervention changed the review dynamic and was well received by patients, but necessitated additional time, which was problematic in the confines of the traditional nurse appointment. Modification to recruitment methods and further development of the intervention are needed before proceeding to a definitive cluster randomised controlled trial. ISRCTN18912042 . Registered on 26 June 2012.

Nursing and midwifery use, perceptions and barriers to evidence-based practice: a cross-sectional survey.

PubMed

Fry, Margaret; Attawet, Jutharat

2018-03-01

The study aimed to explore how nurses and midwives obtain, use and embed evidence in everyday practice. The study design was cross-sectional survey method. The setting was one local health district in metropolitan Sydney, Australia. All nurses and midwives working within the local health district, with access to an email account, were invited to participate in the study. An online survey questionnaire was distributed to explore how evidence is obtained, used and embedded within the clinical setting. The data were analysed using descriptive statistics (frequency and percentages). Pearson's Chi-square tests were used for comparison between groups. There were 204 survey respondents. The findings identified that the majority (n = 157; 76.96%) of respondents obtained evidence primarily from clinical practice guidelines. The majority (n = 149; 73.04%) of respondents reportedly searched databases and used evidence related to general clinical practice. There was a statistical difference (χ = 17.069; df = 8; P = 0.029) when comparing leadership positions and other registered practitioner groups in the frequency of searching for evidence. Most respondents (n = 138; 67.65%) were confident in their ability to change practice on the basis of available evidence. Thematic analysis identified four barriers to sustaining evidence-based practice, which included: the need for time; the need for organizational and management support; the need for educational opportunities and challenges to accessing evidence. The study provided an understanding of how nurses and midwives obtain, use and embed evidence into everyday practice. More importantly, the role of leadership is significant to support a process of knowledge generation, research translation and the implementation of evidence into clinical settings.

Facilitators and barriers to the use of standing orders for vaccination in obstetrics and gynecology settings.

PubMed

Barnard, Juliana G; Dempsey, Amanda F; Brewer, Sarah E; Pyrzanowski, Jennifer; Mazzoni, Sara E; O'Leary, Sean T

2017-01-01

Many young and middle-aged women receive their primary health care from their obstetrician-gynecologists. A recent change to vaccination recommendations during pregnancy has forced the integration of new clinical processes at obstetrician-gynecology practices. Evidence-based best practices for vaccination delivery include the establishment of vaccination standing orders. As part of an intervention to increase adoption of evidence-based vaccination strategies for women in safety-net and private obstetrician-gynecology settings, we conducted a qualitative study to identify the facilitators and barriers experienced by obstetrician-gynecology sites when establishing vaccination standing orders. At 6 safety-net and private obstetrician-gynecology practices, 51 semistructured interviews were completed by trained qualitative researchers over 2 years with clinical staff and vaccination program personnel. Standardized qualitative research methods were used during data collection and team-based data analysis to identify major themes and subthemes within the interview data. All study practices achieved partial to full implementation of vaccine standing orders for human papillomavirus, tetanus diphtheria pertussis, and influenza vaccines. Facilitating factors for vaccine standing order adoption included process standardization, acceptance of a continual modification process, and staff training. Barriers to vaccine standing order adoption included practice- and staff-level competing demands, pregnant women's preference for medical providers to discuss vaccine information with them, and staff hesitation in determining HPV vaccine eligibility. With guidance and commitment to integration of new processes, obstetrician-gynecology practices are able to establish vaccine standing orders for pregnant and nonpregnant women. Attention to certain process barriers can aid the adoption of processes to support the delivery of vaccinations in obstetrician-gynecology practice setting, and provide access to preventive health care for many women. Copyright © 2016 Elsevier Inc. All rights reserved.

Positive Parenting Practices Associated with Subsequent Childhood Weight Change

ERIC Educational Resources Information Center

Avula, Rasmi; Gonzalez, Wendy; Shapiro, Cheri J.; Fram, Maryah S.; Beets, Michael W.; Jones, Sonya J.; Blake, Christine E.; Frongillo, Edward A.

2011-01-01

We aimed to identify positive parenting practices that set children on differential weight-trajectories. Parenting practices studied were cognitively stimulating activities, limit-setting, disciplinary practices, and parent warmth. Data from two U.S. national longitudinal data sets and linear and logistic regression were used to examine…

Revenue-based cost assignment: a potent but hidden threat to the survival of the multispecialty medical practice.

PubMed

Cooper, Robin; Kramer, Theresa R

2010-03-01

To demonstrate detrimental effects of revenue-based cost assignment (RBCA) in clinical practice and to compare that system with activity-based costing (ABC). Four cost-allocation methods including RBCA were applied to a comprehensive ophthalmology practice using typical accounting methods. Data were obtained by a survey of practitioners or practices and/or extracted from decision support and practice management systems. Inaccuracies and distortions in reported costs were enumerated. Accounting scenario analysis was used to predict resultant provider and managerial decisions. A sampling survey was used to analyze other specialties. ABC was applied to the practice. RBCA causes procedures with higher profitability to appear less profitable and those with lower profitability to appear more profitable. The distortion in reported costs, in medical settings, is often sufficient to incentivize providers with higher profitability to exit a practice and those with lower profitability to remain in it. The departure of providers causes the residual practice profits to decline. These detrimental effects occur in many subspecialties, which suggests a national effect on health care. ABC allocation can reduce cost distortions and eliminate detrimental effects. RBCA leads to fragmentation of health care and a reduction in the profitability of multispecialty practices. Its use may slow the updating of reimbursement and help eliminate low-profitability specialties.

Transmission of blood-borne pathogens in US dental health care settings

PubMed Central

Cleveland, Jennifer L.; Gray, Shellie Kolavic; Harte, Jennifer A.; Robison, Valerie A.; Moorman, Anne C.; Gooch, Barbara F.

2016-01-01

Background During the past decade, investigators have reported transmissions of blood-borne pathogens (BBPs) in dental settings. In this article, the authors describe these transmissions and examine the lapses in infection prevention on the basis of available information. Methods The authors reviewed the literature from 2003 through 2015 to identify reports of the transmission of BBPs in dental settings and related lapses in infection prevention efforts, as well as to identify reports of known or suspected health care–associated BBP infections submitted by state health departments to the Centers for Disease Control and Prevention. Results The authors identified 3 published reports whose investigators described the transmission of hepatitis B virus and hepatitis C virus. In 2 of these reports, the investigators described single-transmission events (from 1 patient to another) in outpatient oral surgery practices. The authors of the third report described the possible transmission of hepatitis B virus to 3 patients and 2 dental health care personnel in a large temporary dental clinic. The authors identified lapses in infection prevention practices that occurred during 2 of the investigations; however, the investigators were not always able to link a specific lapse to a transmission event. Examples of lapses included the failure to heat-sterilize handpieces between patients, a lack of training for volunteers on BBPs, and the use of a combination of unsafe injection practices. Conclusions The authors found that reports describing the transmission of BBPs in dental settings since 2003 were rare. Failure to adhere to Centers for Disease Control and Prevention recommendations for infection control in dental settings likely led to disease transmission in these cases. Practical Implications The existence of these reports emphasizes the need to improve dental health care personnel's understanding of the basic principles and implementation of standard precautions through the use of checklists, policies, and practices. PMID:27233680

The 5C Concept and 5S Principles in Inflammatory Bowel Disease Management

PubMed Central

Hibi, Toshifumi; Panaccione, Remo; Katafuchi, Miiko; Yokoyama, Kaoru; Watanabe, Kenji; Matsui, Toshiyuki; Matsumoto, Takayuki; Travis, Simon; Suzuki, Yasuo

2017-01-01

Abstract Background and Aims The international Inflammatory Bowel Disease [IBD] Expert Alliance initiative [2012–2015] served as a platform to define and support areas of best practice in IBD management to help improve outcomes for all patients with IBD. Methods During the programme, IBD specialists from around the world established by consensus two best practice charters: the 5S Principles and the 5C Concept. Results The 5S Principles were conceived to provide health care providers with key guidance for improving clinical practice based on best management approaches. They comprise the following categories: Stage the disease; Stratify patients; Set treatment goals; Select appropriate treatment; and Supervise therapy. Optimised management of patients with IBD based on the 5S Principles can be achieved most effectively within an optimised clinical care environment. Guidance on optimising the clinical care setting in IBD management is provided through the 5C Concept, which encompasses: Comprehensive IBD care; Collaboration; Communication; Clinical nurse specialists; and Care pathways. Together, the 5C Concept and 5S Principles provide structured recommendations on organising the clinical care setting and developing best-practice approaches in IBD management. Conclusions Consideration and application of these two dimensions could help health care providers optimise their IBD centres and collaborate more effectively with their multidisciplinary team colleagues and patients, to provide improved IBD care in daily clinical practice. Ultimately, this could lead to improved outcomes for patients with IBD. PMID:28981622

An acuity cards cookbook.

PubMed

Vital-Durand, F

1996-01-01

Acuity cards are being more commonly used in clinical and screening practice. The author describes his experience from over 6000 infants tested with the method, using two commercially available sets of cards to provide users with comprehensive guidelines to allow them to get the most out of this useful test.

Promoting Entrepreneurship Studies in the Community College Setting.

ERIC Educational Resources Information Center

Watts, Karen Southall

This document examines the current promotional methods used by North Carolina community colleges to advance entrepreneurship education and identifies practical strategies for improving promotional efforts and outcomes. The observations, interviews, and anecdotal information presented in the paper are based on the author's three years of community…

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…

Implementation and evaluation of a peer review process for advanced practice nurses in a university hospital setting.

PubMed

Bergum, Shelly K; Canaan, Talitha; Delemos, Christi; Gall, Elizabeth Funke; McCracken, Bonnie; Rowen, Dave; Salvemini, Steve; Wiens, Kimberly

2017-07-01

Over the past decade, implementation of the peer review process for the development of the advanced practice nurse (APN) has been emphasized. However, little exists in the literature regarding APN peer review. The peer review process is intended to help demonstrate competency of care, enhance quality improvement measures, and foster the professional growth of the APN. APNs serving on a professional governance council within a university teaching hospital developed a model of peer review for APNs. Nine months after the tool was implemented, an anonymous follow-up survey was conducted. A follow-up request was sent 4 weeks later to increase the number of respondents. Likert scales were used to elicit subjective data regarding the process. Of 81 APNs who participated in the survey, more than half (52%) felt that the process would directly improve their professional practice. Survey results show that the peer review process affected APN professional practice positively. Additional research might include pathways for remediation and education of staff, evaluation of alternate methods to improve application to clinical practice, and collection of outcome data. The models presented provide a foundation for future refinement to accommodate different APN practice settings. ©2017 American Association of Nurse Practitioners.

Engaging Pediatric Intensive Care Unit (PICU) clinical staff to lead practice improvement: the PICU Participatory Action Research Project (PICU-PAR)

PubMed Central

2014-01-01

Background Despite considerable efforts, engaging staff to lead quality improvement activities in practice settings is a persistent challenge. At British Columbia Children’s Hospital (BCCH), the pediatric intensive care unit (PICU) undertook a new phase of quality improvement actions based on the Community of Practice (CoP) model with Participatory Action Research (PAR). This approach aims to mobilize the PICU ‘community’ as a whole with a focus on practice; namely, to create a ‘community of practice’ to support reflection, learning, and innovation in everyday work. Methodology An iterative two-stage PAR process using mixed methods has been developed among the PICU CoP to describe the environment (stage 1) and implement specific interventions (stage 2). Stage 1 is ethnographic description of the unit’s care practice. Surveys, interviews, focus groups, and direct observations describe the clinical staff’s experiences and perspectives around bedside care and quality endeavors in the PICU. Contrasts and comparisons across participants, time and activities help understanding the PICU culture and experience. Stage 2 is a succession of PAR spirals, using results from phase 1 to set up specific interventions aimed at building the staff’s capability to conduct QI projects while acquiring appropriate technical skills and leadership capacity (primary outcome). Team communication, information, and interaction will be enhanced through a knowledge exchange (KE) and a wireless network of iPADs. Relevance Lack of leadership at the staff level in order to improve daily practice is a recognized challenge that faces many hospitals. We believe that the PAR approach within a highly motivated CoP is a sound method to create the social dynamic and cultural context within which clinical teams can grow, reflect, innovate and feel proud to better serve patients. PMID:24401288

Combining large number of weak biomarkers based on AUC.

PubMed

Yan, Li; Tian, Lili; Liu, Song

2015-12-20

Combining multiple biomarkers to improve diagnosis and/or prognosis accuracy is a common practice in clinical medicine. Both parametric and non-parametric methods have been developed for finding the optimal linear combination of biomarkers to maximize the area under the receiver operating characteristic curve (AUC), primarily focusing on the setting with a small number of well-defined biomarkers. This problem becomes more challenging when the number of observations is not order of magnitude greater than the number of variables, especially when the involved biomarkers are relatively weak. Such settings are not uncommon in certain applied fields. The first aim of this paper is to empirically evaluate the performance of existing linear combination methods under such settings. The second aim is to propose a new combination method, namely, the pairwise approach, to maximize AUC. Our simulation studies demonstrated that the performance of several existing methods can become unsatisfactory as the number of markers becomes large, while the newly proposed pairwise method performs reasonably well. Furthermore, we apply all the combination methods to real datasets used for the development and validation of MammaPrint. The implication of our study for the design of optimal linear combination methods is discussed. Copyright © 2015 John Wiley & Sons, Ltd.

Combining large number of weak biomarkers based on AUC

PubMed Central

Yan, Li; Tian, Lili; Liu, Song

2018-01-01

Combining multiple biomarkers to improve diagnosis and/or prognosis accuracy is a common practice in clinical medicine. Both parametric and non-parametric methods have been developed for finding the optimal linear combination of biomarkers to maximize the area under the receiver operating characteristic curve (AUC), primarily focusing on the setting with a small number of well-defined biomarkers. This problem becomes more challenging when the number of observations is not order of magnitude greater than the number of variables, especially when the involved biomarkers are relatively weak. Such settings are not uncommon in certain applied fields. The first aim of this paper is to empirically evaluate the performance of existing linear combination methods under such settings. The second aim is to propose a new combination method, namely, the pairwise approach, to maximize AUC. Our simulation studies demonstrated that the performance of several existing methods can become unsatisfactory as the number of markers becomes large, while the newly proposed pairwise method performs reasonably well. Furthermore, we apply all the combination methods to real datasets used for the development and validation of MammaPrint. The implication of our study for the design of optimal linear combination methods is discussed. PMID:26227901

Noninvasive evaluation of mental stress using by a refined rough set technique based on biomedical signals.

PubMed

Liu, Tung-Kuan; Chen, Yeh-Peng; Hou, Zone-Yuan; Wang, Chao-Chih; Chou, Jyh-Horng

2014-06-01

Evaluating and treating of stress can substantially benefits to people with health problems. Currently, mental stress evaluated using medical questionnaires. However, the accuracy of this evaluation method is questionable because of variations caused by factors such as cultural differences and individual subjectivity. Measuring of biomedical signals is an effective method for estimating mental stress that enables this problem to be overcome. However, the relationship between the levels of mental stress and biomedical signals remain poorly understood. A refined rough set algorithm is proposed to determine the relationship between mental stress and biomedical signals, this algorithm combines rough set theory with a hybrid Taguchi-genetic algorithm, called RS-HTGA. Two parameters were used for evaluating the performance of the proposed RS-HTGA method. A dataset obtained from a practice clinic comprising 362 cases (196 male, 166 female) was adopted to evaluate the performance of the proposed approach. The empirical results indicate that the proposed method can achieve acceptable accuracy in medical practice. Furthermore, the proposed method was successfully used to identify the relationship between mental stress levels and bio-medical signals. In addition, the comparison between the RS-HTGA and a support vector machine (SVM) method indicated that both methods yield good results. The total averages for sensitivity, specificity, and precision were greater than 96%, the results indicated that both algorithms produced highly accurate results, but a substantial difference in discrimination existed among people with Phase 0 stress. The SVM algorithm shows 89% and the RS-HTGA shows 96%. Therefore, the RS-HTGA is superior to the SVM algorithm. The kappa test results for both algorithms were greater than 0.936, indicating high accuracy and consistency. The area under receiver operating characteristic curve for both the RS-HTGA and a SVM method were greater than 0.77, indicating a good discrimination capability. In this study, crucial attributes in stress evaluation were successfully recognized using biomedical signals, thereby enabling the conservation of medical resources and elucidating the mapping relationship between levels of mental stress and candidate attributes. In addition, we developed a prototype system for mental stress evaluation that can be used to provide benefits in medical practice. Copyright © 2014. Published by Elsevier B.V.

Probability or Reasoning: Current Thinking and Realistic Strategies for Improved Medical Decisions

PubMed Central

2017-01-01

A prescriptive model approach in decision making could help achieve better diagnostic accuracy in clinical practice through methods that are less reliant on probabilistic assessments. Various prescriptive measures aimed at regulating factors that influence heuristics and clinical reasoning could support clinical decision-making process. Clinicians could avoid time-consuming decision-making methods that require probabilistic calculations. Intuitively, they could rely on heuristics to obtain an accurate diagnosis in a given clinical setting. An extensive literature review of cognitive psychology and medical decision-making theory was performed to illustrate how heuristics could be effectively utilized in daily practice. Since physicians often rely on heuristics in realistic situations, probabilistic estimation might not be a useful tool in everyday clinical practice. Improvements in the descriptive model of decision making (heuristics) may allow for greater diagnostic accuracy. PMID:29209469

Probability or Reasoning: Current Thinking and Realistic Strategies for Improved Medical Decisions.

PubMed

Nantha, Yogarabindranath Swarna

2017-11-01

A prescriptive model approach in decision making could help achieve better diagnostic accuracy in clinical practice through methods that are less reliant on probabilistic assessments. Various prescriptive measures aimed at regulating factors that influence heuristics and clinical reasoning could support clinical decision-making process. Clinicians could avoid time-consuming decision-making methods that require probabilistic calculations. Intuitively, they could rely on heuristics to obtain an accurate diagnosis in a given clinical setting. An extensive literature review of cognitive psychology and medical decision-making theory was performed to illustrate how heuristics could be effectively utilized in daily practice. Since physicians often rely on heuristics in realistic situations, probabilistic estimation might not be a useful tool in everyday clinical practice. Improvements in the descriptive model of decision making (heuristics) may allow for greater diagnostic accuracy.

Achievement, attributions, self-efficacy, and goal setting by accounting undergraduates.

PubMed

Cheng, Pi-Yueh; Chiou, Wen-Bin

2010-02-01

Correlations were examined between two measures of accounting self-efficacy achievement goal setting, attributions, and scores on the Accounting Practice Achievement Test, obtained 1 yr. apart for 124 freshmen in junior college. Analysis indicated favorable attribution contributed to a higher mean score on accounting self-efficacy. Students with higher perceived self-efficacy performed better on the proficiency tests. Those with higher self-efficacy also set higher goals for subsequent achievement tests. Moreover, students who set higher achievement goals performed better. Goal setting mediated the relation of initial self-efficacy with subsequent test performance. However, the amount of variance accounted for by self-efficacy was small. An effective method for enhancing performance on an accounting achievement test might be to increase beneficial attributions, self-efficacy in accounting, and to encourage setting reasonable achievement goals.

Ultrasonic Method for Deployment Mechanism Bolt Element Preload Verification

NASA Technical Reports Server (NTRS)

Johnson, Eric C.; Kim, Yong M.; Morris, Fred A.; Mitchell, Joel; Pan, Robert B.

2014-01-01

Deployment mechanisms play a pivotal role in mission success. These mechanisms often incorporate bolt elements for which a preload within a specified range is essential for proper operation. A common practice is to torque these bolt elements to a specified value during installation. The resulting preload, however, can vary significantly with applied torque for a number of reasons. The goal of this effort was to investigate ultrasonic methods as an alternative for bolt preload verification in such deployment mechanisms. A family of non-explosive release mechanisms widely used by satellite manufacturers was chosen for the work. A willing contractor permitted measurements on a sampling of bolt elements for these release mechanisms that were installed by a technician following a standard practice. A variation of approximately 50% (+/- 25%) in the resultant preloads was observed. An alternative ultrasonic method to set the preloads was then developed and calibration data was accumulated. The method was demonstrated on bolt elements installed in a fixture instrumented with a calibrated load cell and designed to mimic production practice. The ultrasonic method yielded results within +/- 3% of the load cell reading. The contractor has since adopted the alternative method for its future production. Introduction

The learner’s perspective in GP teaching practices with multi-level learners: a qualitative study

PubMed Central

2014-01-01

Background Medical students, junior hospital doctors on rotation and general practice (GP) registrars are undertaking their training in clinical general practices in increasing numbers in Australia. Some practices have four levels of learner. This study aimed to explore how multi-level teaching (also called vertical integration of GP education and training) is occurring in clinical general practice and the impact of such teaching on the learner. Methods A qualitative research methodology was used with face-to-face, semi-structured interviews of medical students, junior hospital doctors, GP registrars and GP teachers in eight training practices in the region that taught all levels of learners. Interviews were audio-recorded and transcribed. Qualitative analysis was conducted using thematic analysis techniques aided by the use of the software package N-Vivo 9. Primary themes were identified and categorised by the co-investigators. Results 52 interviews were completed and analysed. Themes were identified relating to both the practice learning environment and teaching methods used. A practice environment where there is a strong teaching culture, enjoyment of learning, and flexible learning methods, as well as learning spaces and organised teaching arrangements, all contribute to positive learning from a learners’ perspective. Learners identified a number of innovative teaching methods and viewed them as positive. These included multi-level learner group tutorials in the practice, being taught by a team of teachers, including GP registrars and other health professionals, and access to a supernumerary GP supervisor (also termed “GP consultant teacher”). Other teaching methods that were viewed positively were parallel consulting, informal learning and rural hospital context integrated learning. Conclusions Vertical integration of GP education and training generally impacted positively on all levels of learner. This research has provided further evidence about the learning culture, structures and teaching processes that have a positive impact on learners in the clinical general practice setting where there are multiple levels of learners. It has also identified some innovative teaching methods that will need further examination. The findings reinforce the importance of the environment for learning and learner centred approaches and will be important for training organisations developing vertically integrated practices and in their training of GP teachers. PMID:24645670

Reflotron cholesterol measurement in general practice: accuracy and detection of errors.

PubMed

Ball, M J; Robertson, I K; Woods, M

1994-11-01

Comparison of cholesterol determinations by nurses using a Reflotron analyser in a general practice setting showed a good correlation with plasma cholesterol determinations by wet chemistry in a clinical biochemistry laboratory. A limited number of comparisons did, however, give a much lower result on the Reflotron. In an experimental situation, small sample volumes (which could result from poor technique) were shown to produce falsely low readings. A simple method which may immediately detect falsely low Reflotron readings is discussed.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 11: reporting outcomes of an evidence-driven approach to disinvestment in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; Ramsey, Wayne; King, Richard; Green, Sally

2018-05-30

This is the final paper in a thematic series reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was established to explore a systematic, integrated, evidence-based organisation-wide approach to disinvestment in a large Australian health service network. This paper summarises the findings, discusses the contribution of the SHARE Program to the body of knowledge and understanding of disinvestment in the local healthcare setting, and considers implications for policy, practice and research. The SHARE program was conducted in three phases. Phase One was undertaken to understand concepts and practices related to disinvestment and the implications for a local health service and, based on this information, to identify potential settings and methods for decision-making about disinvestment. The aim of Phase Two was to implement and evaluate the proposed methods to determine which were sustainable, effective and appropriate in a local health service. A review of the current literature incorporating the SHARE findings was conducted in Phase Three to contribute to the understanding of systematic approaches to disinvestment in the local healthcare context. SHARE differed from many other published examples of disinvestment in several ways: by seeking to identify and implement disinvestment opportunities within organisational infrastructure rather than as standalone projects; considering disinvestment in the context of all resource allocation decisions rather than in isolation; including allocation of non-monetary resources as well as financial decisions; and focusing on effective use of limited resources to optimise healthcare outcomes. The SHARE findings provide a rich source of new information about local health service decision-making, in a level of detail not previously reported, to inform others in similar situations. Multiple innovations related to disinvestment were found to be acceptable and feasible in the local setting. Factors influencing decision-making, implementation processes and final outcomes were identified; and methods for further exploration, or avoidance, in attempting disinvestment in this context are proposed based on these findings. The settings, frameworks, models, methods and tools arising from the SHARE findings have potential to enhance health care and patient outcomes.

Developing adaptive interventions for adolescent substance use treatment settings: protocol of an observational, mixed-methods project.

PubMed

Grant, Sean; Agniel, Denis; Almirall, Daniel; Burkhart, Q; Hunter, Sarah B; McCaffrey, Daniel F; Pedersen, Eric R; Ramchand, Rajeev; Griffin, Beth Ann

2017-12-19

Over 1.6 million adolescents in the United States meet criteria for substance use disorders (SUDs). While there are promising treatments for SUDs, adolescents respond to these treatments differentially in part based on the setting in which treatments are delivered. One way to address such individualized response to treatment is through the development of adaptive interventions (AIs): sequences of decision rules for altering treatment based on an individual's needs. This protocol describes a project with the overarching goal of beginning the development of AIs that provide recommendations for altering the setting of an adolescent's substance use treatment. This project has three discrete aims: (1) explore the views of various stakeholders (parents, providers, policymakers, and researchers) on deciding the setting of substance use treatment for an adolescent based on individualized need, (2) generate hypotheses concerning candidate AIs, and (3) compare the relative effectiveness among candidate AIs and non-adaptive interventions commonly used in everyday practice. This project uses a mixed-methods approach. First, we will conduct an iterative stakeholder engagement process, using RAND's ExpertLens online system, to assess the importance of considering specific individual needs and clinical outcomes when deciding the setting for an adolescent's substance use treatment. Second, we will use results from the stakeholder engagement process to analyze an observational longitudinal data set of 15,656 adolescents in substance use treatment, supported by the Substance Abuse and Mental Health Services Administration, using the Global Appraisal of Individual Needs questionnaire. We will utilize methods based on Q-learning regression to generate hypotheses about candidate AIs. Third, we will use robust statistical methods that aim to appropriately handle casemix adjustment on a large number of covariates (marginal structural modeling and inverse probability of treatment weights) to compare the relative effectiveness among candidate AIs and non-adaptive decision rules that are commonly used in everyday practice. This project begins filling a major gap in clinical and research efforts for adolescents in substance use treatment. Findings could be used to inform the further development and revision of influential multi-dimensional assessment and treatment planning tools, or lay the foundation for subsequent experiments to further develop or test AIs for treatment planning.

Building capacity for cognitive behavioral therapy delivery for depression in disaster-impacted contexts.

PubMed

Ngo, Victoria K; Centanni, Angela; Wong, Eunice; Wennerstrom, Ashley; Miranda, Jeanne

2011-01-01

Numerous challenges exist in implementing evidence-based practices, such as cognitive behavioral therapy, in resource poor, ethnic minority, and/or disaster-affected communities with disparities in mental health. Community-academic participatory partnerships are a promising approach to addressing disparities by implementing community-appropriate, evidence-based depression care. A community-academic collaborative was formed in New Orleans after Hurricane Katrina to expand resources for effective depression care, including cognitive behavioral therapy. In this article, we: 1) describe our model of building capacity to deliver cognitive behavioral therapy for depression in post-disaster community-based settings; 2) discuss the impact of this training program on therapist reported practice; and 3) share lessons learned regarding disseminating and sustaining evidence-based interventions in the context of a disaster impacted community. Using a mixed methods approach, we found that this model was feasible, acceptable, and disseminated knowledge about cognitive behavioral therapy in community settings. Over the course of two years, community providers demonstrated the feasibility of implementing evidence-based practice and potential for local community leadership. The lessons learned from this model of implementation may help address barriers to disseminating evidence-based interventions in other low-resource, disaster-impacted community settings.

Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia

PubMed Central

Bazzano, Alessandra N.; Taub, Leah; Oberhelman, Richard A.; Var, Chivorn

2016-01-01

Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming. PMID:28009812

Exponential operations and aggregation operators of interval neutrosophic sets and their decision making methods.

PubMed

Ye, Jun

2016-01-01

An interval neutrosophic set (INS) is a subclass of a neutrosophic set and a generalization of an interval-valued intuitionistic fuzzy set, and then the characteristics of INS are independently described by the interval numbers of its truth-membership, indeterminacy-membership, and falsity-membership degrees. However, the exponential parameters (weights) of all the existing exponential operational laws of INSs and the corresponding exponential aggregation operators are crisp values in interval neutrosophic decision making problems. As a supplement, this paper firstly introduces new exponential operational laws of INSs, where the bases are crisp values or interval numbers and the exponents are interval neutrosophic numbers (INNs), which are basic elements in INSs. Then, we propose an interval neutrosophic weighted exponential aggregation (INWEA) operator and a dual interval neutrosophic weighted exponential aggregation (DINWEA) operator based on these exponential operational laws and introduce comparative methods based on cosine measure functions for INNs and dual INNs. Further, we develop decision-making methods based on the INWEA and DINWEA operators. Finally, a practical example on the selecting problem of global suppliers is provided to illustrate the applicability and rationality of the proposed methods.

Good practice statements on safe laboratory testing: A mixed methods study by the LINNEAUS collaboration on patient safety in primary care.

PubMed

Bowie, Paul; Forrest, Eleanor; Price, Julie; Verstappen, Wim; Cunningham, David; Halley, Lyn; Grant, Suzanne; Kelly, Moya; Mckay, John

2015-09-01

The systems-based management of laboratory test ordering and results handling is a known source of error in primary care settings worldwide. The consequences are wide-ranging for patients (e.g. avoidable harm or poor care experience), general practitioners (e.g. delayed clinical decision making and potential medico-legal implications) and the primary care organization (e.g. increased allocation of resources to problem-solve and dealing with complaints). Guidance is required to assist care teams to minimize associated risks and improve patient safety. To identify, develop and build expert consensus on 'good practice' guidance statements to inform the implementation of safe systems for ordering laboratory tests and managing results in European primary care settings. Mixed methods studies were undertaken in the UK and Ireland, and the findings were triangulated to develop 'good practice' statements. Expert consensus was then sought on the findings at the wider European level via a Delphi group meeting during 2013. We based consensus on 10 safety domains and developed 77 related 'good practice' statements (≥ 80% agreement levels) judged to be essential to creating safety and minimizing risks in laboratory test ordering and subsequent results handling systems in international primary care. Guidance was developed for improving patient safety in this important area of primary care practice. We need to consider how this guidance can be made accessible to frontline care teams, utilized by clinical educators and improvement advisers, implemented by decision makers and evaluated to determine acceptability, feasibility and impacts on patient safety.

Prioritizing individual genetic variants after kernel machine testing using variable selection.

PubMed

He, Qianchuan; Cai, Tianxi; Liu, Yang; Zhao, Ni; Harmon, Quaker E; Almli, Lynn M; Binder, Elisabeth B; Engel, Stephanie M; Ressler, Kerry J; Conneely, Karen N; Lin, Xihong; Wu, Michael C

2016-12-01

Kernel machine learning methods, such as the SNP-set kernel association test (SKAT), have been widely used to test associations between traits and genetic polymorphisms. In contrast to traditional single-SNP analysis methods, these methods are designed to examine the joint effect of a set of related SNPs (such as a group of SNPs within a gene or a pathway) and are able to identify sets of SNPs that are associated with the trait of interest. However, as with many multi-SNP testing approaches, kernel machine testing can draw conclusion only at the SNP-set level, and does not directly inform on which one(s) of the identified SNP set is actually driving the associations. A recently proposed procedure, KerNel Iterative Feature Extraction (KNIFE), provides a general framework for incorporating variable selection into kernel machine methods. In this article, we focus on quantitative traits and relatively common SNPs, and adapt the KNIFE procedure to genetic association studies and propose an approach to identify driver SNPs after the application of SKAT to gene set analysis. Our approach accommodates several kernels that are widely used in SNP analysis, such as the linear kernel and the Identity by State (IBS) kernel. The proposed approach provides practically useful utilities to prioritize SNPs, and fills the gap between SNP set analysis and biological functional studies. Both simulation studies and real data application are used to demonstrate the proposed approach. © 2016 WILEY PERIODICALS, INC.

Primary health care registered nurses' types in implementation of health promotion practices.

PubMed

Maijala, Virpi; Tossavainen, Kerttu; Turunen, Hannele

2016-09-01

Aim This study aimed to identify and reach consensus among primary health care participants [registered nurses (RNs) who receive clients, directors of nursing, senior physicians, health promotion officers, and local councillors] on the types of service provider that RNs who receive clients represent in the implementation of health promotion practices in primary health care in Eastern Finland. There is an increasing focus on public health thinking in many countries as the population ages. To meet the growing needs of the health promotion practices of populations, advance practice has been recognized as effective in the primary health care setting. The advance practice nurses share many common features, such as being RNs with additional education, possessing competencies to work independently, treating clients in both acute and primary care settings, and applying a variety of health promotion practices into nursing. The two-stage modified Delphi method was applied. In round one, semi-structured interviews were conducted among primary health care participants (n=42) in 11 health centres in Eastern Finland. In round two, a questionnaire survey was conducted in the same health centres. The questionnaire was answered by 64% of those surveyed (n=56). For data analysis, content analysis and descriptive statistics were used. Findings This study resulted in four types of service provider that RNs who receive clients represented in the implementation of health promotion practices in the primary health care setting in Eastern Finland. First, the client-oriented health promoter demonstrated four dimensions, which reached consensus levels ranging between 82.1 and 89.3%. Second, the developer of health promotion practices comprised four dimensions, which reached consensus levels between 71.4 and 85.7%. Third, the member of multi-professional teams of health promotion practices representing three dimensions, with consensus levels between 69.6 and 82.1%. Fourth, the type who showed interest towards health policy reached a consensus level of 55.4% in this study.

The Joint Experiment for Crop Assessment and Monitoring (JECAM) Initiative: Developing methods and best practices for global agricultural monitoring

NASA Astrophysics Data System (ADS)

Champagne, C.; Jarvis, I.; Defourny, P.; Davidson, A.

2014-12-01

Agricultural systems differ significantly throughout the world, making a 'one size fits all' approach to remote sensing and monitoring of agricultural landscapes problematic. The Joint Experiment for Crop Assessment and Monitoring (JECAM) was established in 2009 to bring together the global scientific community to work towards a set of best practices and recommendations for using earth observation data to map, monitor and report on agricultural productivity globally across an array of diverse agricultural systems. These methods form the research and development component of the Group on Earth Observation Global Agricultural Monitoring (GEOGLAM) initiative to harmonize global monitoring efforts and increase market transparency. The JECAM initiative brings together researchers from a large number of globally distributed, well monitored agricultural test sites that cover a range of crop types, cropping systems and climate regimes. Each test site works independently as well as together across multiple sites to test methods, sensors and field data collection techniques to derive key agricultural parameters, including crop type, crop condition, crop yield and soil moisture. The outcome of this project will be a set of best practices that cover the range of remote sensing monitoring and reporting needs, including satellite data acquisition, pre-processing techniques, information retrieval and ground data validation. These outcomes provide the research and development foundation for GEOGLAM and will help to inform the development of the GEOGLAM "system of systems" for global agricultural monitoring. The outcomes of the 2014 JECAM science meeting will be discussed as well as examples of methods being developed by JECAM scientists.

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.

From Blank Canvas to Masterwork: Creating a Professional Practice Model at a Magnet Hospital

PubMed Central

Tydings, Donna M.; Nickoley, Sue; Nichols, Lynn W.; Krenzer, Maureen E.

2016-01-01

Objective. The purpose of this study was to engage registered nurses (RNs) in the creation of a Professional Practice Model (PPM). Background. PPMs are essential as the philosophical underpinnings for nursing practice. The study institution created a new PPM utilizing the voice of their RNs. Methods. Qualitative inquiry with focus groups was conducted to explore RNs values and beliefs about their professional practice. Constant-comparative analysis was used to code data and identify domains. Results. The 92 RN participants represented diverse roles and practice settings. The four domains identified were caring, knowing, navigating, and leading. Conclusions. Nurse leaders face the challenge of assisting nurses in articulating their practice using a common voice. In this study, nurses described their identity, their roles, and how they envisioned nursing should be practiced. The results align with the ANCC Magnet® Model, ANA standards, and important foundational and organization specific documents. PMID:28097022

Effects of Three Sets of Instructional Strategies and Three Demographic Variables on the Food and Nutrition Test Performance of Some Jamaican Tenth-Graders

ERIC Educational Resources Information Center

Kelly, Dennis; Soyibo, Kola

2005-01-01

This study was designed to find out if students taught food and nutrition concepts using the lecture method and practical work would perform significantly better than their counterparts taught with the lecture and teacher demonstrations and the lecture method only. The sample comprised 114 Jamaican 10th-graders (56 boys, 58 girls) selected from…

Standardized methods for photography in procedural dermatology using simple equipment.

PubMed

Hexsel, Doris; Hexsel, Camile L; Dal'Forno, Taciana; Schilling de Souza, Juliana; Silva, Aline F; Siega, Carolina

2017-04-01

Photography is an important tool in dermatology. Reproducing the settings of before photos after interventions allows more accurate evaluation of treatment outcomes. In this article, we describe standardized methods and tips to obtain photographs, both for clinical practice and research procedural dermatology, using common equipment. Standards for the studio, cameras, photographer, patients, and framing are presented in this article. © 2017 The International Society of Dermatology.

OARSI Clinical Trials Recommendations: Design and conduct of clinical trials of lifestyle diet and exercise interventions for osteoarthritis.

PubMed

Messier, S P; Callahan, L F; Golightly, Y M; Keefe, F J

2015-05-01

The objective was to develop a set of "best practices" for use as a primer for those interested in entering the clinical trials field for lifestyle diet and/or exercise interventions in osteoarthritis (OA), and as a set of recommendations for experienced clinical trials investigators. A subcommittee of the non-pharmacologic therapies committee of the OARSI Clinical Trials Working Group was selected by the Steering Committee to develop a set of recommended principles for non-pharmacologic diet/exercise OA randomized clinical trials. Topics were identified for inclusion by co-authors and reviewed by the subcommittee. Resources included authors' expert opinions, traditional search methods including MEDLINE (via PubMed), and previously published guidelines. Suggested steps and considerations for study methods (e.g., recruitment and enrollment of participants, study design, intervention and assessment methods) were recommended. The recommendations set forth in this paper provide a guide from which a research group can design a lifestyle diet/exercise randomized clinical trial in patients with OA. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

An improved initialization center k-means clustering algorithm based on distance and density

NASA Astrophysics Data System (ADS)

Duan, Yanling; Liu, Qun; Xia, Shuyin

2018-04-01

Aiming at the problem of the random initial clustering center of k means algorithm that the clustering results are influenced by outlier data sample and are unstable in multiple clustering, a method of central point initialization method based on larger distance and higher density is proposed. The reciprocal of the weighted average of distance is used to represent the sample density, and the data sample with the larger distance and the higher density are selected as the initial clustering centers to optimize the clustering results. Then, a clustering evaluation method based on distance and density is designed to verify the feasibility of the algorithm and the practicality, the experimental results on UCI data sets show that the algorithm has a certain stability and practicality.

The Influence of Repeated Teaching and Reflection on Preservice Teachers' Views of Inquiry and Nature of Science

NASA Astrophysics Data System (ADS)

Lotter, Christine; Singer, Jonathan; Godley, Jenice

2009-12-01

This study describes the influence of a secondary science methods program on secondary science preservice teachers’ views and enactment of nature of science and inquiry-based instructional practices. Built into the structure of this program were three cycles of practice teaching and reflection in which the preservice teachers focused on key pedagogical ideas in classroom settings with middle and high school students. The nine secondary preservice teachers improved both their understanding and enactment of inquiry and nature of science throughout the program period. This study provides evidence of the importance of incorporating multiple low-stakes practicum experiences that are closely tied to methods course goals that are highly scaffolded through both methods instructor and cooperating teacher support and tied to analytic self-reflection.

Development of a core set of quality indicators for paediatric primary care practices in Europe, COSI-PPC-EU.

PubMed

Ewald, Dominik A; Huss, Gottfried; Auras, Silke; Caceres, Juan Ruiz-Canela; Hadjipanayis, Adamos; Geraedts, Max

2018-06-01

Paediatric ambulatory healthcare systems in Europe are, because of historical reasons, diverse and show strikingly different outcomes. All across Europe, the benchmarking of structures, processes and outcomes could reveal opportunities for improving Paediatric Primary Care (PPC). The aim of this study was to develop a set of Quality Indicators (QIs) to assess and monitor PPC in Europe. In a three-step process, we used the available external evidence and European expert consensus in a modified RAND/UCLA Appropriateness Method (RAM) to develop an indicator set. (1) A broad literature and online research of published QI and guidelines yielded an inventory of 1516 QI. (2) A collaborative panel of paediatric senior experts from the European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) from 15 European countries participated in a first consensus process to reduce the initial indicator inventory by eliminating not PPC-focused indicators and duplicates. (3) In a second consensus process, the panel rated the QI regarding validity and feasibility. The final QI set "COSI-PPC-EU" consists of 42 indicators in five categories of PPC: (A) health promotion/prevention/screening (13 QI), (B) acute care (9 QI), (C) chronic care (8 QI), (D) practice management (3 QI) and (E) patient safety (9 QI). COSI-PPC-EU represents a consented set of a limited number of valid quality indicators for the application in paediatric primary care in different healthcare systems throughout Europe. What is Known: • Paediatric ambulatory healthcare systems in Europe are diverse and show strikingly different outcomes. • There are known gaps in quality performance measures of paediatric primary care in Europe. Pre-existing sets of quality indicators are predominantly limited to national populations, specific diseases and hospital care. What is New: • A set of 42 quality indicators for primary paediatric care in Europe was developed in a multi-country collaborative effort. The method combined a systematic literature review and a consensus process among European paediatric experts. • The quality indicator set can facilitate quality improvement of PPC. After studying the feasibility, providers can use COSI-PPC-EU to monitor, compare and improve performance of practices, regions and countries.

Rural nursing education: a photovoice perspective.

PubMed

Leipert, Beverly; Anderson, Emma

2012-01-01

For many rural Canadians nursing care is the primary and often the sole access point to health care. As such, rural nurses are an invaluable resource to the health and wellbeing of rural populations. However, due to a nursing workforce that is aging and retiring, limited resources and support, healthcare reform issues, and other factors, these rural professionals are in short supply. Because of limited opportunities to learn about rural practice settings, nursing students may be reluctant to select rural practice locations. Relevant and effective educational initiatives are needed to attract nursing students to underserved rural and remote communities so that rural people receive the health care they require. The purpose of this study was to explore the use of the innovative research approach called photovoice as an educational strategy to foster learning about and interest in rural locations and rural nursing as future practice settings. Fostering of interest in rural may help to address nursing workforce shortages in rural settings. Thirty-eight third and fourth year nursing and health sciences students enrolled in an elective 'Rural Nursing' course used the qualitative research method photovoice to take photographs that represented challenges and facilitators of rural nursing practice. They then engaged in written reflection about their photos. Photos were to be taken in rural settings of their choice, thus fostering both urban and rural student exposure to diverse rural communities. One hundred forty-four photos and reflections were submitted, representing students' appreciation of diverse facilitators and challenges to rural nursing practice. Facilitators included technology, a generalist role, strong sense of community, and slower pace of life. Challenges included inadequate rural education in undergraduate nursing programs, professional isolation, safety issues, few opportunities for professional development, lack of anonymity, and insider/outsider status. Exemplar photos and reflections are provided. The photovoice research approach used in this rural education endeavour proved to be very useful in fostering students' exposure to, interest in, and understanding of rural settings and their influence on rural nursing practice. Photovoice is also recommended for use in rural courses other than nursing. Suggested strategies include group photovoice experience and the expansion of reflection to enhance rural health research.

Shared decision-making – transferring research into practice: the Analytic Hierarchy Process (AHP)

PubMed Central

Dolan, James G.

2008-01-01

Objective To illustrate how the Analytic Hierarchy Process (AHP) can be used to promote shared decision-making and enhance clinician-patient communication. Methods Tutorial review. Results The AHP promotes shared decision making by creating a framework that is used to define the decision, summarize the information available, prioritize information needs, elicit preferences and values, and foster meaningful communication among decision stakeholders. Conclusions The AHP and related multi-criteria methods have the potential for improving the quality of clinical decisions and overcoming current barriers to implementing shared decision making in busy clinical settings. Further research is needed to determine the best way to implement these tools and to determine their effectiveness. Practice Implications Many clinical decisions involve preference-based trade-offs between competing risks and benefits. The AHP is a well-developed method that provides a practical approach for improving patient-provider communication, clinical decision-making, and the quality of patient care in these situations. PMID:18760559

Factors impacting on nurses' transference of theoretical knowledge of holistic care into clinical practice.

PubMed

Henderson, Saras

2002-12-01

Since nurse education moved to universities, a reoccurring concern of health consumers, health administrators, and some practising nurses is that nurses are not able to transfer the theoretical knowledge of holistic care into practice. Much has been written about this concern usually under the heading of the theory-practice gap. A common reason that has been highlighted as the cause of this gap is that the theoretical knowledge that nurses learn in academia is predicated on concepts such as humanism and holistic caring. In contrast, the bureaucratic organisation where nurses provide care tends to be based on management concepts where cost containment and outcome measures are more acceptable. Hence nurses' learned values of holistic caring are pitted against the reality of the practice setting. So what is this practice reality? This paper attempts to provide an insider view of why the theoretical knowledge of holistic care may be difficult to enact in the clinical setting. In-depth taped interviews with nurses and participant observation were conducted in acute care hospitals in Western Australia. The interviews were transcribed verbatim and analysed using the constant comparative method. The findings indicated that utilitarian nursing and role models had impacted on the transference of theoretical knowledge of holistic care into practice. The paper outlines some measures that nurses themselves can undertake to ensure the narrowing of the theory-practice gap in this area.

PROSPECT: a practical method for formulating evidence-based expert recommendations for the management of postoperative pain.

PubMed

Neugebauer, E A M; Wilkinson, R C; Kehlet, H; Schug, S A

2007-07-01

Many patients still suffer severe acute pain in the postoperative period. Although guidelines for treating acute pain are widely published and promoted, most do not consider procedure-specific differences in pain experienced or in techniques that may be most effective and appropriate for different surgical settings. The procedure-specific postoperative pain management (PROSPECT) Working Group provides procedure-specific recommendations for postoperative pain management together with supporting evidence from systematic literature reviews and related procedures at http://www.postoppain.org The methodology for PROSPECT reviews was developed and refined by discussion of the Working Group, and it adapts existing methods for formulation of consensus recommendations to the specific requirements of PROSPECT. To formulate PROSPECT recommendations, we use a methodology that takes into account study quality and source and level of evidence, and we use recognized methods for achieving group consensus, thus reducing potential bias. The new methodology is first applied in full for the 2006 update of the PROSPECT review of postoperative pain management for laparoscopic cholecystectomy. Transparency in PROSPECT processes allows the users to be fully aware of any limitations of the evidence and recommendations, thereby allowing for appropriate decisions in their own practice setting.

Block matching sparsity regularization-based image reconstruction for incomplete projection data in computed tomography

NASA Astrophysics Data System (ADS)

Cai, Ailong; Li, Lei; Zheng, Zhizhong; Zhang, Hanming; Wang, Linyuan; Hu, Guoen; Yan, Bin

2018-02-01

In medical imaging many conventional regularization methods, such as total variation or total generalized variation, impose strong prior assumptions which can only account for very limited classes of images. A more reasonable sparse representation frame for images is still badly needed. Visually understandable images contain meaningful patterns, and combinations or collections of these patterns can be utilized to form some sparse and redundant representations which promise to facilitate image reconstructions. In this work, we propose and study block matching sparsity regularization (BMSR) and devise an optimization program using BMSR for computed tomography (CT) image reconstruction for an incomplete projection set. The program is built as a constrained optimization, minimizing the L1-norm of the coefficients of the image in the transformed domain subject to data observation and positivity of the image itself. To solve the program efficiently, a practical method based on the proximal point algorithm is developed and analyzed. In order to accelerate the convergence rate, a practical strategy for tuning the BMSR parameter is proposed and applied. The experimental results for various settings, including real CT scanning, have verified the proposed reconstruction method showing promising capabilities over conventional regularization.

Developing prehospital clinical practice guidelines for resource limited settings: why re-invent the wheel?

PubMed

McCaul, Michael; de Waal, Ben; Hodkinson, Peter; Pigoga, Jennifer L; Young, Taryn; Wallis, Lee A

2018-02-05

Methods on developing new (de novo) clinical practice guidelines (CPGs) have received substantial attention. However, the volume of literature is not matched by research into alternative methods of CPG development using existing CPG documents-a specific issue for guideline development groups in low- and middle-income countries. We report on how we developed a context specific prehospital CPG using an alternative guideline development method. Difficulties experienced and lessons learnt in applying existing global guidelines' recommendations to a national context are highlighted. The project produced the first emergency care CPG for prehospital providers in Africa. It included > 270 CPGs and produced over 1000 recommendations for prehospital emergency care. We encountered various difficulties, including (1) applicability issues: few pre-hospital CPGs applicable to Africa, (2) evidence synthesis: heterogeneous levels of evidence classifications and (3) guideline quality. Learning points included (1) focusing on key CPGs and evidence mapping, (2) searching other resources for CPGs, (3) broad representation on CPG advisory boards and (4) transparency and knowledge translation. Re-inventing the wheel to produce CPGs is not always feasible. We hope this paper will encourage further projects to use existing CPGs in developing guidance to improve patient care in resource-limited settings.

Incorporating Argumentation through Forensic Science

ERIC Educational Resources Information Center

Wheeler, Lindsay B.; Maeng, Jennifer L.; Smetana, Lara K.

2014-01-01

This article outlines how to incorporate argumentation into a forensic science unit using a mock trial. Practical details of the mock trial include: (1) a method of scaffolding students' development of their argument for the trial, (2) a clearly outlined set of expectations for students during the planning and implementation of the mock…

Incorporating Problem-Based Learning in Physical Education Teacher Education

ERIC Educational Resources Information Center

Hushman, Glenn; Napper-Owen, Gloria

2011-01-01

Problem-based learning (PBL) is an educational method that identifies a problem as a context for student learning. Critical-thinking skills, deductive reasoning, knowledge, and behaviors are developed as students learn how theory can be applied to practical settings. Problem-based learning encourages self-direction, lifelong learning, and sharing…

An Inexpensive Family Index of Risk for Mood Issues Improves Identification of Pediatric Bipolar Disorder

ERIC Educational Resources Information Center

Algorta, Guillermo Perez; Youngstrom, Eric A.; Phelps, James; Jenkins, Melissa M.; Youngstrom, Jennifer Kogos; Findling, Robert L.

2013-01-01

Family history of mental illness provides important information when evaluating pediatric bipolar disorder (PBD). However, such information is often challenging to gather within clinical settings. This study investigates the feasibility and utility of gathering family history information using an inexpensive method practical for outpatient…

Measuring Well What is Ill Defined?

ERIC Educational Resources Information Center

Torres Irribarra, David

2017-01-01

Maul's paper, "Rethinking Traditional Methods of Survey Validation," is a clever and pointed indictment of a set of specific but widespread practices in psychological measurement and the social sciences at large. Through it, Maul highlights central issues in the way to approach theory building and theory testing, bringing to mind the…

Training Medical Students about Hazardous Drinking Using Simple Assessment Techniques

ERIC Educational Resources Information Center

Hidalgo, Jesús López-Torres; Pretel, Fernando Andrés; Bravo, Beatriz Navarro; Rabadan, Francisco Escobar; Serrano Selva, Juan Pedro; Latorre Postigo, Jose Miguel; Martínez, Ignacio Párraga

2014-01-01

Objective: To examine the ability of medical students to identify hazardous drinkers using screening tools recommended in clinical practice. Design: Observational cross-sectional study. Setting: Faculty of Medicine of Castilla-La Mancha, Spain. Method: The medical students learnt to use Alcohol Use Disorders Identification Test (AUDIT) and…

Adult Career Development: Concepts, Issues, and Practices. Second Edition.

ERIC Educational Resources Information Center

Lea, H. Daniel, Ed.; Leibowitz, Zandy B., Ed.

This book contains 23 chapters organized into seven sections that center around the following themes: (1) theories and concepts; (2) strategies and methods; (3) target populations; (4) settings; (5) training programs; (6) evaluation and accountability; and (7) future trends. The following papers are included: "Adult Development Theories: Ways to…

Methodological Foundations for the Empirical Evaluation of Non-Experimental Methods in Field Settings

ERIC Educational Resources Information Center

Wong, Vivian C.; Steiner, Peter M.

2015-01-01

Across the disciplines of economics, political science, public policy, and now, education, the randomized controlled trial (RCT) is the preferred methodology for establishing causal inference about program impacts. But randomized experiments are not always feasible because of ethical, political, and/or practical considerations, so non-experimental…

Pollutant Emissions and Energy Efficiency under Controlled Conditions for Household Biomass Cookstoves and Implications for Metrics Useful in Setting International Test Standards

EPA Science Inventory

Realistic metrics and methods for testing household biomass cookstoves are required to develop standards needed by international policy makers, donors, and investors. Application of consistent test practices allows emissions and energy efficiency performance to be benchmarked and...

Coaching: An Apprenticeship Approach for the 21st Century

ERIC Educational Resources Information Center

Salavert, Roser

2015-01-01

Coaching, an apprentice-based approach to support professional and personal development towards achieving set goals, is a well-established practice in the fields of sports training and management and one of the fastest growing professional development methods in the education field. How the coaching partnership fosters leadership and improves…

Authentication of organically and conventionally grown basils by gas chromatograpy/mass spectrometry chemical profiles

USDA-ARS?s Scientific Manuscript database

Basil plants cultivated by organic and conventional farming practices were differentiated using gas chromatography/mass spectrometry (GC/MS) and chemometric methods. The two-way GC/MS data sets were baseline-corrected and retention time-aligned prior to data processing. Two self-devised fuzzy clas...

Improving Nursing Home Staff Knowledge and Attitudes about Pain

ERIC Educational Resources Information Center

Jones, Katherine R.; Fink, Regina; Pepper, Ginny; Hutt, Eveyln; Vojir, Carol P.; Scott, Jill; Clark, Lauren; Mellis, Karen

2004-01-01

Purpose: Effective pain management remains a serious problem in the nursing home setting. Barriers to achieving optimal pain practices include staff knowledge deficits, biases, and attitudes that influence assessment and management of the residents' pain. Design and Methods: Twelve nursing homes participated in this intervention study: six…

Differential Outcomes in Agency-Based Mental Health Care between Minority and Majority Youth

ERIC Educational Resources Information Center

Patterson, David A.; Dulmus, Catherine N.; Maguin, Eugene; Perkins, Jacob

2016-01-01

Background: Childhood mental health problems represent a significant public health concern globally. There is a converging discussion among researchers and practitioners alike that the research results of effectiveness studies are not fully generalizable and applicable to ethnoracial minority groups in real-world practice settings. Methods:…

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

PubMed Central

2014-01-01

Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945

Teaching Reflective Practice in Practice Settings: Students' Perceptions of Their Clinical Educators

ERIC Educational Resources Information Center

Trede, Franziska; Smith, Megan

2012-01-01

Reflective practice in practice settings can enhance practice knowledge, self-assessment and lifelong learning, develop future practice capability and professional identity, and critically appraise practice traditions rather than reproduce them. The inherent power imbalance between student and educator runs the risk for the reflective practice…

Implementing Model-Check for Employee and Management Satisfaction

NASA Technical Reports Server (NTRS)

Jones, Corey; LaPha, Steven

2013-01-01

This presentation will discuss methods to which ModelCheck can be implemented to not only improve model quality, but also satisfy both employees and management through different sets of quality checks. This approach allows a standard set of modeling practices to be upheld throughout a company, with minimal interaction required by the end user. The presenter will demonstrate how to create multiple ModelCheck standards, preventing users from evading the system, and how it can improve the quality of drawings and models.

Simulation Studies as Designed Experiments: The Comparison of Penalized Regression Models in the “Large p, Small n” Setting

PubMed Central

Chaibub Neto, Elias; Bare, J. Christopher; Margolin, Adam A.

2014-01-01

New algorithms are continuously proposed in computational biology. Performance evaluation of novel methods is important in practice. Nonetheless, the field experiences a lack of rigorous methodology aimed to systematically and objectively evaluate competing approaches. Simulation studies are frequently used to show that a particular method outperforms another. Often times, however, simulation studies are not well designed, and it is hard to characterize the particular conditions under which different methods perform better. In this paper we propose the adoption of well established techniques in the design of computer and physical experiments for developing effective simulation studies. By following best practices in planning of experiments we are better able to understand the strengths and weaknesses of competing algorithms leading to more informed decisions about which method to use for a particular task. We illustrate the application of our proposed simulation framework with a detailed comparison of the ridge-regression, lasso and elastic-net algorithms in a large scale study investigating the effects on predictive performance of sample size, number of features, true model sparsity, signal-to-noise ratio, and feature correlation, in situations where the number of covariates is usually much larger than sample size. Analysis of data sets containing tens of thousands of features but only a few hundred samples is nowadays routine in computational biology, where “omics” features such as gene expression, copy number variation and sequence data are frequently used in the predictive modeling of complex phenotypes such as anticancer drug response. The penalized regression approaches investigated in this study are popular choices in this setting and our simulations corroborate well established results concerning the conditions under which each one of these methods is expected to perform best while providing several novel insights. PMID:25289666

ICASE/LaRC Workshop on Adaptive Grid Methods

NASA Technical Reports Server (NTRS)

South, Jerry C., Jr. (Editor); Thomas, James L. (Editor); Vanrosendale, John (Editor)

1995-01-01

Solution-adaptive grid techniques are essential to the attainment of practical, user friendly, computational fluid dynamics (CFD) applications. In this three-day workshop, experts gathered together to describe state-of-the-art methods in solution-adaptive grid refinement, analysis, and implementation; to assess the current practice; and to discuss future needs and directions for research. This was accomplished through a series of invited and contributed papers. The workshop focused on a set of two-dimensional test cases designed by the organizers to aid in assessing the current state of development of adaptive grid technology. In addition, a panel of experts from universities, industry, and government research laboratories discussed their views of needs and future directions in this field.

Integration of Evidence into a Detailed Clinical Model-based Electronic Nursing Record System

PubMed Central

Park, Hyeoun-Ae; Jeon, Eunjoo; Chung, Eunja

2012-01-01

Objectives The purpose of this study was to test the feasibility of an electronic nursing record system for perinatal care that is based on detailed clinical models and clinical practice guidelines in perinatal care. Methods This study was carried out in five phases: 1) generating nursing statements using detailed clinical models; 2) identifying the relevant evidence; 3) linking nursing statements with the evidence; 4) developing a prototype electronic nursing record system based on detailed clinical models and clinical practice guidelines; and 5) evaluating the prototype system. Results We first generated 799 nursing statements describing nursing assessments, diagnoses, interventions, and outcomes using entities, attributes, and value sets of detailed clinical models for perinatal care which we developed in a previous study. We then extracted 506 recommendations from nine clinical practice guidelines and created sets of nursing statements to be used for nursing documentation by grouping nursing statements according to these recommendations. Finally, we developed and evaluated a prototype electronic nursing record system that can provide nurses with recommendations for nursing practice and sets of nursing statements based on the recommendations for guiding nursing documentation. Conclusions The prototype system was found to be sufficiently complete, relevant, useful, and applicable in terms of content, and easy to use and useful in terms of system user interface. This study has revealed the feasibility of developing such an ENR system. PMID:22844649

Relationship between the three kinds of healthy habits and the metabolic syndrome.

PubMed

Wada, Takashi; Fukumoto, Tsutomu; Ito, Kyoko; Hasegawa, Yasutaka; Osaki, Takanobu

2009-08-01

In 2005, the diagnostic criteria for Japan-specific metabolic syndrome were published. The representative health habits are Breslow's seven healthy practices, Morimoto's eight items and Ikeda's six healthy habits. We investigated the prevalence of metabolic syndrome related with life-style strongly among these three sets of healthy habit. Cross-sectional study was conducted for the prevalence of metabolic syndrome by practicing these healthy habits. 20,776 Japanese individuals visited the Health Science Center at Jikei University Hospital in Japan for medical check-ups. Subjects were divided into 8 groups based on gender and age (females in their 30s, 40s, 50s and 60s, and males in their 30s, 40s, 50s and 60s). Participants completed a simple, self-administered lifestyle questionnaire based on the three sets of healthy habits. Subjects were divided into three groups (poor, moderate and favorable) according to each of the healthy habit criteria. Significant differences were observed among 10 groups for Breslow's seven healthy practices, 4 groups for Morimoto's eight items, and 13 groups for Ikeda's six healthy habits. Ikeda's six healthy habits showed the most significant differences among the three sets of habits. Among the three methods tested, to practice more Ikeda's healthy habits were the most useful for metabolic syndrome. © 2009 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

Data Processing And Machine Learning Methods For Multi-Modal Operator State Classification Systems

NASA Technical Reports Server (NTRS)

Hearn, Tristan A.

2015-01-01

This document is intended as an introduction to a set of common signal processing learning methods that may be used in the software portion of a functional crew state monitoring system. This includes overviews of both the theory of the methods involved, as well as examples of implementation. Practical considerations are discussed for implementing modular, flexible, and scalable processing and classification software for a multi-modal, multi-channel monitoring system. Example source code is also given for all of the discussed processing and classification methods.

From the bush to the big smoke--development of a hybrid urban community based medical education program in the Northern Territory, Australia.

PubMed

Morgan, S; Smedts, A; Campbell, N; Sager, R; Lowe, M; Strasser, S

2009-01-01

The Northern Territory (NT) of Australia is a unique setting for training medical students. This learning environment is characterised by Aboriginal health and an emphasis on rural and remote primary care practice. For over a decade the NT Clinical School (NTCS) of Flinders University has been teaching undergraduate medical students in the NT. Community based medical education (CBME) has been demonstrated to be an effective method of learning medicine, particularly in rural settings. As a result, it is rapidly gaining popularity in Australia and other countries. The NTCS adopted this model some years ago with the implementation of its Rural Clinical School; however, urban models of CBME are much less well developed than those in rural areas. There is considerable pressure to better incorporate CBME into medical student teaching environment, particularly because of the projected massive increase in student numbers over the next few years. To date, the community setting of urban Darwin, the NT capital city, has not been well utilised for medical student training. In 2008, the NTCS enrolled its first cohort of students in a new hybrid CBME program based in urban Darwin. This report describes the process and challenges involved in development of the program, including justification for a hybrid model and the adaptation of a rural model to an urban setting. Relationships were established and formalised with key partners and stakeholders, including GPs and general practices, Aboriginal medical services, community based healthcare providers and other general practice and community organisations. Other significant issues included curriculum development and review, development of learning materials and the establishment of robust evaluation methods. Development of the CBME model in Darwin posed a number of key challenges. Although the experience of past rural programs was useful, a number of distinct differences were evident in the urban setting. Change leadership and inter-professional collaboration were key strengths in the implementation and ongoing evaluation of the program. The program will provide important information about medical student training in urban community settings, and help inform other clinical schools considering the adoption of similar models.

Twin-Twin Transfusion Syndrome: study protocol for developing, disseminating, and implementing a core outcome set.

PubMed

Khalil, Asma; Perry, Helen; Duffy, James; Reed, Keith; Baschat, Ahmet; Deprest, Jan; Hecher, Kurt; Lewi, Liesbeth; Lopriore, Enrico; Oepkes, Dick

2017-07-14

Twin-Twin Transfusion Syndrome (TTTS) is associated with an increased risk of perinatal mortality and morbidity. Several treatment interventions have been described for TTTS, including fetoscopic laser surgery, amnioreduction, septostomy, expectant management, and pregnancy termination. Over the last decade, fetoscopic laser surgery has become the primary treatment. The literature to date reports on many different outcomes, making it difficult to compare results or combine data from individual studies, limiting the value of research to guide clinical practice. With the advent and ongoing development of new therapeutic techniques, this is more important than ever. The development and use of a core outcome set has been proposed to address these issues, prioritising outcomes important to the key stakeholders, including patients. We aim to produce, disseminate, and implement a core outcome set for TTTS. An international steering group has been established to oversee the development of this core outcome set. This group includes healthcare professionals, researchers and patients. A systematic review is planned to identify previously reported outcomes following treatment for TTTS. Following completion, the identified outcomes will be evaluated by stakeholders using an international, multi-perspective online modified Delphi method to build consensus on core outcomes. This method encourages the participants towards consensus 'core' outcomes. All key stakeholders will be invited to participate. The steering group will then hold a consensus meeting to discuss results and form a core outcome set to be introduced and measured. Once core outcomes have been agreed, the next step will be to determine how they should be measured, disseminated, and implemented within an international context. The development, dissemination, and implementation of a core outcome set in TTTS will enable its use in future clinical trials, systematic reviews and clinical practice guidelines. This is likely to advance the quality of research studies and their effective use in order to guide clinical practice and improve patient care, maternal, short-term perinatal outcomes and long-term neurodevelopmental outcomes. Core Outcome Measures in Effectiveness Trials (COMET), 921 Registered on July 2016. International Prospective Register of Systematic Reviews (PROSPERO), CRD42016043999 . Registered on 2 August 2016.

A Pragmatic Guide to the Setting up of Integrated Hypnotherapy Services in Primary Care and Clinical Settings.

PubMed

Entwistle, Paul Andrew

2017-01-01

Despite the continued debate and lack of a clear consensus about the true nature of the hypnotic phenomenon, hypnosis is increasingly being utilized successfully in many medical, health, and psychological spheres as a research method, motivational tool, and therapeutic modality. Significantly, however, although hypnotherapy is widely advertised, advocated, and employed in the private medical arena for the management and treatment of many physical and emotional disorders, too little appears to be being done to integrate hypnosis into primary care and national health medical services. This article discusses some of the reasons for the apparent reluctance of medical and scientific health professionals to consider incorporating hypnosis into their medical practice, including the practical problems inherent in using hypnosis in a medical context and some possible solutions.

Multiple-Point statistics for stochastic modeling of aquifers, where do we stand?

NASA Astrophysics Data System (ADS)

Renard, P.; Julien, S.

2017-12-01

In the last 20 years, multiple-point statistics have been a focus of much research, successes and disappointments. The aim of this geostatistical approach was to integrate geological information into stochastic models of aquifer heterogeneity to better represent the connectivity of high or low permeability structures in the underground. Many different algorithms (ENESIM, SNESIM, SIMPAT, CCSIM, QUILTING, IMPALA, DEESSE, FILTERSIM, HYPPS, etc.) have been and are still proposed. They are all based on the concept of a training data set from which spatial statistics are derived and used in a further step to generate conditional realizations. Some of these algorithms evaluate the statistics of the spatial patterns for every pixel, other techniques consider the statistics at the scale of a patch or a tile. While the method clearly succeeded in enabling modelers to generate realistic models, several issues are still the topic of debate both from a practical and theoretical point of view, and some issues such as training data set availability are often hindering the application of the method in practical situations. In this talk, the aim is to present a review of the status of these approaches both from a theoretical and practical point of view using several examples at different scales (from pore network to regional aquifer).

Implementing service improvement projects within pre-registration nursing education: a multi-method case study evaluation.

PubMed

Baillie, Lesley; Bromley, Barbara; Walker, Moira; Jones, Rebecca; Mhlanga, Fortune

2014-01-01

Preparing healthcare students for quality and service improvement is important internationally. A United Kingdom (UK) initiative aims to embed service improvement in pre-registration education. A UK university implemented service improvement teaching for all nursing students. In addition, the degree pathway students conducted service improvement projects as the basis for their dissertations. The study aimed to evaluate the implementation of service improvement projects within a pre-registration nursing curriculum. A multi-method case study was conducted, using student questionnaires, focus groups with students and academic staff, and observation of action learning sets. Questionnaire data were analysed using SPSS v19. Qualitative data were analysed using Ritchie and Spencer's (1994) Framework Approach. Students were very positive about service improvement. The degree students, who conducted service improvement projects in practice, felt more knowledgeable than advanced diploma students. Selecting the project focus was a key issue and students encountered some challenges in practice. Support for student service improvement projects came from action learning sets, placement staff, and academic staff. Service improvement projects had a positive effect on students' learning. An effective partnership between the university and partner healthcare organisations, and support for students in practice, is essential. Copyright © 2013 Elsevier Ltd. All rights reserved.

Research on teaching reform and practice of applied optics design experiment

NASA Astrophysics Data System (ADS)

Geng, Tao; Tong, Chengguo; Zhang, Tao; Lu, Cunlian; Meng, Ting; Zhang, Yang; Wang, Ran; Sun, Weimin; Liu, Zhihai; Yang, Jun

2017-08-01

It is an important way to effectively improve applied optics experimental teaching effect and motivate the undergraduates' practice ability and creativity by means of scientific and systematic setting teaching contents and link. Based on the research and analysis of applied optics experiment teaching present condition at home and abroad, this paper aims to solve the existed problems and deficiencies during the experiment teaching in our university, and also puts forward some reform ideas and practice method from several aspects such as teaching thought, teaching content and mode, examination and evaluation and so on. Simultaneously, this paper also gives some suggestions on the future course development.

Practical quantification of necrosis in histological whole-slide images.

PubMed

Homeyer, André; Schenk, Andrea; Arlt, Janine; Dahmen, Uta; Dirsch, Olaf; Hahn, Horst K

2013-06-01

Since the histological quantification of necrosis is a common task in medical research and practice, we evaluate different image analysis methods for quantifying necrosis in whole-slide images. In a practical usage scenario, we assess the impact of different classification algorithms and feature sets on both accuracy and computation time. We show how a well-chosen combination of multiresolution features and an efficient postprocessing step enables the accurate quantification necrosis in gigapixel images in less than a minute. The results are general enough to be applied to other areas of histological image analysis as well. Copyright © 2013 Elsevier Ltd. All rights reserved.

Measuring and Specifying Combinatorial Coverage of Test Input Configurations

PubMed Central

Kuhn, D. Richard; Kacker, Raghu N.; Lei, Yu

2015-01-01

A key issue in testing is how many tests are needed for a required level of coverage or fault detection. Estimates are often based on error rates in initial testing, or on code coverage. For example, tests may be run until a desired level of statement or branch coverage is achieved. Combinatorial methods present an opportunity for a different approach to estimating required test set size, using characteristics of the test set. This paper describes methods for estimating the coverage of, and ability to detect, t-way interaction faults of a test set based on a covering array. We also develop a connection between (static) combinatorial coverage and (dynamic) code coverage, such that if a specific condition is satisfied, 100% branch coverage is assured. Using these results, we propose practical recommendations for using combinatorial coverage in specifying test requirements. PMID:28133442

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

Fostering interprofessional learning in a rehabilitation setting: development of an interprofessional clinical learning unit.

PubMed

Vanderzalm, Jeanne; Hall, Mark D; McFarlane, Lu-Anne; Rutherford, Laurie; Patterson, Steven K

2013-01-01

The development and implementation of interprofessional (IP) clinical learning units as a method to enhance IP clinical education and improve patient care in a rehabilitation setting are described. Using a community-based participatory research approach, academia and healthcare delivery agencies formed a partnership to create an IP clinical learning unit in a rehabilitation setting. Preimplementation data from surveys and focus group data identified areas for improvement to enhance IP understanding and collaboration. A working group developed and implemented initiatives to enhance IP practice. Preimplementation, eight themes emerged from which the working group identified goals and implemented strategies to strengthen IP learning. Goals included Creation of an IP Learning Environment, Increased Awareness of IP Practice, Role Clarification, Enhanced IP Communication, and Reflection and Evaluation. Postimplementation data revealed six themes: Communication, Informal IP Learning, Role Awareness, Positive Learning Environment, Logistics, and Challenges. The development of the IP clinical learning unit was successful and rewarding, but not without its challenges. Formal IP education was necessary to enhance collaborative practice, even in a multidisciplinary environment. Commitment and support from all participants, particularly managers and administrators from the healthcare agency, were critical to success. The focus of this unit was on a stroke rehabilitation unit; however, the development and implementation principles identified may be applicable to any team-based clinical setting. © 2013 Association of Rehabilitation Nurses.

Enhancing pediatric clinical competency with high-fidelity simulation.

PubMed

Birkhoff, Susan D; Donner, Carol

2010-09-01

In today's tertiary pediatric hospital setting, the increased complexity of patient care demands seamless coordination and collaboration among multidisciplinary team members. In an effort to enhance patient safety, clinical competence, and teamwork, simulation-based learning has become increasingly integrated into pediatric clinical practice as an innovative educational strategy. The simulated setting provides a risk-free environment where learners can incorporate cognitive, psychomotor, and affective skill acquisition without fear of harming patients. One pediatric university hospital in Southeastern Pennsylvania has enhanced the traditional American Heart Association (AHA) Pediatric Advanced Life Support (PALS) course by integrating high-fidelity simulation into skill acquisition, while still functioning within the guidelines and framework of the AHA educational standards. However, very little research with reliable standardized testing methods has been done to measure the effect of simulation-based learning. This article discusses the AHA guidelines for PALS, evaluation of PALS and nursing clinical competencies, communication among a multidisciplinary team, advantages and disadvantages of simulation, incorporation of high-fidelity simulation into pediatric practice, and suggestions for future practice. Copyright 2010, SLACK Incorporated.

The Effect of Yoga on Menstrual Disorders: A Systematic Review.

PubMed

Oates, Jennifer

2017-06-01

To summarize and evaluate evidence for the effect of yoga on menstrual disorders. PubMed, CINAHL/MEDLINE, Web of Science, AMED, and Scopus were searched for English-language literature relevant to the review question. All primary research studies were included. Fifteen studies described in 18 papers were included in the review. A range of yoga interventions were used. Some studies used a combination of Asana, Pranayama, and other yogic relaxation or meditation techniques. All included studies reported some change in their outcome measures, suggesting reduced symptoms of menstrual distress following a yoga intervention; however, the heterogeneity and intensity of the interventions and outcome measures meant that findings have limited generalizability and applicability in practice settings. Further research on the relationship between yoga practice and menstrual disorders is warranted, but there must be both consistency in the methods, measures, and quality of studies and a shift toward research on yoga practices that are replicable outside of the clinical trial setting.

Expanding services in a shrinking economy: desktop document delivery in a dental school library

PubMed Central

Gushrowski, Barbara A

2011-01-01

Question: How can library staff develop and promote a document delivery service and then expand the service to a wide audience? Setting: The setting is the library at the Indiana University School of Dentistry (IUSD), Indianapolis. Method: A faculty survey and a citation analysis were conducted to determine potential use of the service. Volume of interlibrary loan transactions and staff and equipment capacity were also studied. Main results: IUSD Library staff created a desktop delivery service (DDSXpress) for faculty and then expanded the service to practicing dental professionals and graduate students. The number of faculty using DDSXpress remains consistent. The number of practicing dental professionals using the service is low. Graduate students have been quick to adopt the service. Conclusion: Through careful analysis of capacity and need for the service, staff successfully expanded document delivery service without incurring additional costs. Use of DDSXpress is continually monitored, and opportunities to market the service to practicing dental professionals are being investigated. PMID:21753911

Life expectancy calculation in urology: Are we equitably treating older patients?

PubMed

Bhatt, Nikita R; Davis, Niall F; Breen, Kieran; Flood, Hugh D; Giri, Subhasis K

2017-01-01

The aim of our study was to determine the contemporary practice in the utilization of life expectancy (LE) calculations among urological clinicians. Members of the Irish Society of Urology (ISU) and the British Association of Urological Surgeons (BAUS) completed a questionnaire on LE utilization in urological practice. The survey was delivered to 1251 clinicians and the response rate was 17% (n = 208/1251). The majority (61%, n = 127) of urologists were aware of methods available for estimated LE calculation.Seventy-one percent (n = 148) had never utilized LE analysis in clinical practice and 81% (n = 170) routinely used 'eyeballing' (empiric prediction) for estimating LE. Life expectancy tables were utilized infrequently (12%, n = 25) in making the decision for treatment in the setting of multi-disciplinary meetings. LE is poorly integrated into treatment decision-making; not only for the management of urological patients but also in the multidisciplinary setting. Further education and awareness regarding the importance of LE is vital.

Voices from Left of the Dial:* Reflections of Practice-Based Researchers

PubMed Central

Fagnan, Lyle J.; Handley, Margaret A.; Rollins, Nancy; Mold, James

2010-01-01

Background Purpose Practice-Based Research Networks (PBRNs) provide an important approach to implementing primary care research at the community level, thus increasing the relevance and utility of research findings for routine primary care practices. PBRNs expend considerable time and energy in the recruitment, engagement, and retention of network clinicians and practices to establish this community-based primary care research laboratory. This study assessed factors motivating PBRN clinicians to participate and stay involved in practice-based research in their primary care office setting. Methods We invited practicing clinicians across the United States who are affiliated with a PBRN to share their stories regarding motivations to participate in practice-based research. Using qualitative methods, we categorized the stories into the main motivation for participation and the perceived impact of participation. Results We collected 37 stories from clinicians affiliated with 12 PBRNS located in 14 states. Motivations for participation in practice-based research included themes associated with personal satisfaction, improving local clinic-based care, and contributing to community and system level improvements. Sources of personal satisfaction corresponded to the three psychological needs postulated by Deci's and Ryan's Self-Determination Theory: competence, autonomy, and relatedness. Conclusions These PBRN clinician stories describe the values, motivations and unique paths that clinicians took as they chose to participate and stay active in a practice-based research network. Their voices have the potential to influence others to participate in practice-based research. PMID:20616286

Dengue knowledge, attitudes and practices and their impact on community-based vector control in rural Cambodia

PubMed Central

Doum, Dyna; Keo, Vanney; Sokha, Ly; Sam, BunLeng; Chan, Vibol; Alexander, Neal; Bradley, John; Liverani, Marco; Prasetyo, Didot Budi; Rachmat, Agus; Lopes, Sergio; Hii, Jeffrey; Rithea, Leang; Shafique, Muhammad; Hustedt, John

2018-01-01

Background Globally there are an estimated 390 million dengue infections per year, of which 96 million are clinically apparent. In Cambodia, estimates suggest as many as 185,850 cases annually. The World Health Organization global strategy for dengue prevention aims to reduce mortality rates by 50% and morbidity by 25% by 2020. The adoption of integrated vector management approach using community-based methods tailored to the local context is one of the recommended strategies to achieve these objectives. Understanding local knowledge, attitudes and practices is therefore essential to designing suitable strategies to fit each local context. Methods and findings A Knowledge, Attitudes and Practices survey in 600 randomly chosen households was administered in 30 villages in Kampong Cham which is one of the most populated provinces of Cambodia. KAP surveys were administered to a sub-sample of households where an entomology survey was conducted (1200 households), during which Aedes larval/pupae and adult female Aedes mosquito densities were recorded. Participants had high levels of knowledge regarding the transmission of dengue, Aedes breeding, and biting prevention methods; the majority of participants believed they were at risk and that dengue transmission is preventable. However, self-reported vector control practices did not match observed practices recorded in our surveys. No correlation was found between knowledge and observed practices either. Conclusion An education campaign regarding dengue prevention in this setting with high knowledge levels is unlikely to have any significant effect on practices unless it is incorporated in a more comprehensive strategy for behavioural change, such a COMBI method, which includes behavioural models as well as communication and marketing theory and practice. Trial registration ISRCTN85307778. PMID:29451879

Tag-KEM from Set Partial Domain One-Way Permutations

NASA Astrophysics Data System (ADS)

Abe, Masayuki; Cui, Yang; Imai, Hideki; Kurosawa, Kaoru

Recently a framework called Tag-KEM/DEM was introduced to construct efficient hybrid encryption schemes. Although it is known that generic encode-then-encrypt construction of chosen ciphertext secure public-key encryption also applies to secure Tag-KEM construction and some known encoding method like OAEP can be used for this purpose, it is worth pursuing more efficient encoding method dedicated for Tag-KEM construction. This paper proposes an encoding method that yields efficient Tag-KEM schemes when combined with set partial one-way permutations such as RSA and Rabin's encryption scheme. To our knowledge, this leads to the most practical hybrid encryption scheme of this type. We also present an efficient Tag-KEM which is CCA-secure under general factoring assumption rather than Blum factoring assumption.

Validity of Guatemalan Mother's Self-Reported Breast-Feeding Practices of 3-Month-Old Infants.

PubMed

Mazariegos, Monica; Slater, Christine; Ramirez-Zea, Manuel

2016-12-01

Breast-feeding practices (BFPs) can be assessed by interviewing the mother about current feeding practices and with a 24-hour recall. It is crucial to establish the accuracy of these methods, which are commonly used by public health decision makers to design health policies aimed at increasing exclusive breast-feeding rates. We aimed to validate 2 self-report BFP instruments using the dose-to-mother deuterium oxide turnover technique (DMDOT) as the reference method. Breast-feeding practices were assessed by interviewing the mother about current feeding practices and with a 24-hour recall in 36 Guatemalan mother-infant pairs. The validity of these instruments was assessed using DMDOT as the reference method. Both self-report instruments overestimated exclusively breast-fed (EBF) infants. Infants classified as EBF were 50% by the reported current feeding practice, 61% by the 24-hour recall, and only 36% using DMDOT. Sensitivity to detect EBF infants from the mother's self-report was 92% (95% CI: 62%-99%) while from the 24-hour recall was 100% (95% CI: 72%-100%, P < .01). However, specificity for both instruments was low, at 74% (95% CI: 51%-89%) for reported current feeding practice and at 61% (95% CI: 39%-79%) for the 24-hour recall (P < .01). Both reported current feeding practice and the 24-hour recall instruments overestimated exclusive breast-feeding. Nevertheless, the use of reported current feeding practice provided more accurate data to assess BFPs in a public health setting. Furthermore, population-based surveys should consider the overestimation of exclusive breast-feeding caused when using these BFP instruments. © The Author(s) 2016.

The diagnosis of luteal phase deficiency: a critical review.

PubMed

McNeely, M J; Soules, M R

1988-07-01

Luteal phase deficiency is an ovulatory dysfunction problem that is subtle but real. It may be the most common ovulatory problem in women. Luteal phase deficiency has been clearly demonstrated in the research setting (1) in spontaneous cycles, (2) when follicular maturation has been impeded, and (3) when luteotrophic influences have been suppressed. The diagnosis of LPD in the clinical setting remains problematic and controversial primarily because there is no practical diagnostic method that has been validated. This article has reviewed the methods that have been used to diagnose LPD. BBT charts are insensitive; these charts reliably diagnose LPD only when there are persistent short luteal phases. There is disagreement whether ovarian follicular size, as determined by ultrasonography, is decreased in LPD; however, ultrasonographic diagnosis of LPD would require daily scans through ovulation, which makes this approach impractical. Mild hyperprolactinemia is a probable cause of LPD in a minority of patients; a physician should obtain a PRL level in LPD women with the realization that there is considerable sampling variability. Determination of serum gonadotropin levels (LH or FSH or both) is not practical for the clinical diagnosis of LPD. Random serum P levels, whether single or multiple, are not helpful in the diagnosis of LPD in individual patients. The secretory pattern of P results in such wide confidence limits that P samples from individuals cannot be compared to normal in a useful manner. Most of the controversy about the diagnosis of LPD has centered around the use of individual serum P levels. The timed endometrial biopsy relies on the endometrium as a bioassay of P over time. The endometrial biopsy has not been carefully validated in terms of its sensitivity or accuracy for the diagnosis of LPD. However, it remains the best current method for the diagnosis of LPD when the standard guidelines for its use are followed. As opposed to the other tests for LPD, awareness of the usefulness of the biopsy has increased as we have learned more about CL physiology. No current research method for the diagnosis of LPD appears to be a practical method that could be applied in the clinical setting. Specific secretory proteins from the endometrium and methods to measure hormone secretion that circumvent the secretory pattern hold promise for improved methods to diagnose LPD in the future.

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.

Goal setting practice in chronic low back pain. What is current practice and is it affected by beliefs and attitudes?

PubMed

Gardner, Tania; Refshauge, Kathryn; McAuley, James; Hübscher, Markus; Goodall, Stephen; Smith, Lorraine

2018-01-18

Goal setting, led by the patient, is promising as an effective treatment for the management of chronic low back pain (CLBP); however, little is known about current practice. The aims of the study were to explore (1) current goal setting practice in CLBP among physiotherapists; (2) perceived barriers to goal setting in CLBP; and (3) relationship between clinician's attitudes and beliefs and goal setting practice. A cross-sectional observational survey. The majority of respondents used goal setting with the main aim of facilitating self-management. The greatest number of goals were set with 50% therapist/50% patient involvement. The most common perceived barriers to goal setting related to time constraints and lack of skill and confidence. A higher biomedical score for treatment orientation of the therapist was associated with a lower patient involvement score. Goal setting is common practice for CLBP and is perceived as a high priority. It is more often a collaboration between therapist and patient rather than patient-led with treatment orientation of the physiotherapist a predictor of patient involvement. Education of healthcare professionals needs to include better understanding of chronic pain to orient them away from a biomedical treatment approach, as well as to enhance skills in facilitating patient involvement in goal setting.

Development of indicators for measuring outcomes of water safety plans

PubMed Central

Lockhart, Gabriella; Oswald, William E.; Hubbard, Brian; Medlin, Elizabeth; Gelting, Richard J.

2015-01-01

Water safety plans (WSPs) are endorsed by the World Health Organization as the most effective method of protecting a water supply. With the increase in WSPs worldwide, several valuable resources have been developed to assist practitioners in the implementation of WSPs, yet there is still a need for a practical and standardized method of evaluating WSP effectiveness. In 2012, the Centers for Disease Control and Prevention (CDC) published a conceptual framework for the evaluation of WSPs, presenting four key outcomes of the WSP process: institutional, operational, financial and policy change. In this paper, we seek to operationalize this conceptual framework by providing a set of simple and practical indicators for assessing WSP outcomes. Using CDC’s WSP framework as a foundation and incorporating various existing performance monitoring indicators for water utilities, we developed a set of approximately 25 indicators of institutional, operational, financial and policy change within the WSP context. These outcome indicators hold great potential for the continued implementation and expansion of WSPs worldwide. Having a defined framework for evaluating a WSP’s effectiveness, along with a set of measurable indicators by which to carry out that evaluation, will help implementers assess key WSP outcomes internally, as well as benchmark their progress against other WSPs in their region and globally. PMID:26361540

Responsible and controlled use: Older cannabis users and harm reduction.

PubMed

Lau, Nicholas; Sales, Paloma; Averill, Sheigla; Murphy, Fiona; Sato, Sye-Ok; Murphy, Sheigla

2015-08-01

Cannabis use is becoming more accepted in mainstream society. In this paper, we use Zinberg's classic theoretical framework of drug, set, and setting to elucidate how older adult cannabis users managed health, social and legal risks in a context of normalized cannabis use. We present selected findings from our qualitative study of Baby Boomer (born 1946-1964) cannabis users in the San Francisco Bay Area. Data collection consisted of a recorded, in-depth life history interview followed by a questionnaire and health survey. Qualitative interviews were analyzed to discover the factors of cannabis harm reduction from the users' perspectives. Interviewees made harm reduction choices based on preferred cannabis derivatives and routes of administration, as well as why, when, where, and with whom to use. Most interviewees minimized cannabis-related harms so they could maintain social functioning in their everyday lives. Responsible and controlled use was described as moderation of quantity and frequency of cannabis used, using in appropriate settings, and respect for non-users. Users contributed to the normalization of cannabis use through normification. Participants followed rituals or cultural practices, characterized by sanctions that helped define "normal" or "acceptable" cannabis use. Users contributed to cannabis normalization through their harm reduction methods. These cultural practices may prove to be more effective than formal legal prohibitions in reducing cannabis-related harms. Findings also suggest that users with access to a regulated market (medical cannabis dispensaries) were better equipped to practice harm reduction. More research is needed on both cannabis culture and alternative routes of administration as harm reduction methods. Copyright © 2015 Elsevier B.V. All rights reserved.

Methods to Succeed in Effective Knowledge Translation in Clinical Practice.

PubMed

Kitson, Alison L; Harvey, Gillian

2016-05-01

To explore the evidence around facilitation as an intervention for the successful implementation of new knowledge into clinical practice. The revised version of the Promoting Action on Research Implementation in Health Services (PARIHS) framework, called the integrated or i-PARIHS framework, is used as the explanatory framework. This framework posits that evidence is a multidimensional construct embedded within innovation and operationalized by clinicians (individuals and within teams), working across multiple layers of context. Facilitation is the active ingredient that promotes successful implementation. An emerging body of evidence supports facilitation as a mechanism to getting new knowledge into clinical practice. Facilitation roles are divided into beginner, experienced, and expert facilitators. Facilitators can be internal or external to the organization they work in, and their skills and attributes complement other knowledge translation (KT) roles. Complex KT projects require facilitators who are experienced in implementation methods. Facilitation is positioned as the active ingredient to effectively introduce new knowledge into a clinical setting. Levels of facilitation experience are assessed in relation to the complexity of the KT task. Three core facilitation roles are identified, and structured interventions are established taking into account the nature and novelty of the evidence, the receptiveness of the clinicians, and the context or setting where the new evidence is to be introduced. Roles such as novice, experienced, and expert facilitators have important and complementary parts to play in enabling the successful translation of evidence into everyday practice in order to provide effective care for patients. © 2016 Sigma Theta Tau International.

Community pharmacists' views of the use of oral rehydration salt in Nigeria.

PubMed

Oyetunde, Olubukola; Williams, Veronika

2018-06-01

Background Oral rehydration salt (ORS) is an affordable and effective intervention for the management of acute watery diarrhoea (AWD), especially in children under 5 years. A knowledge/practice gap exists among community pharmacists (CPs) in Lagos, Nigeria, and in many low to middle income countries. This gap results in underutilization of ORS for diarrhoea management. Objective The objective was to explore CPs' views of the barriers and facilitators to the use of ORS in practice. Setting Community pharmacy practices, Lagos, Nigeria. Methods Qualitative methods were used to explore pharmacists' views. Recruitment of participants were mainly at zonal meetings. A total of ten CPs participated based on maximum variation and snowballing sampling. Semi-structured interviews conducted covered knowledge, experiences and contextual issues. Interviews were audiorecorded, transcribed and analysed using framework approach to thematic analysis. Main outcome measure Pharmacists' views of barriers and facilitators to the use of ORS. Results Barriers to the use of ORS include caregivers' expectation for an antimicrobial, which was often explicitly and specifically for metronidazole. Also, CPs seemed to doubt applicability of ORS alone, therefore, responded to caregivers' complaints about ORS, by dispensing metronidazole. These barriers appeared to have normalised metronidazole for AWD treatment in this setting. Current facilitators include the caregivers' improved awareness of ORS and access to primary health centers that often resulted in increased demand for ORS in pharmacies. Conclusion CPs' views showed that caregivers' expectations for an antimicrobial may be the main barrier to the use of ORS in their practices.

Using modular psychotherapy in school mental health: Provider perspectives on intervention-setting fit

PubMed Central

Lyon, Aaron R.; Ludwig, Kristy; Romano, Evalynn; Koltracht, Jane; Stoep, Ann Vander; McCauley, Elizabeth

2013-01-01

Objective The “fit” or appropriateness of well-researched interventions within usual care contexts is among the most commonly-cited, but infrequently researched, factors in the successful implementation of new practices. The current study was initiated to address two exploratory research questions: (1) How do clinicians describe their current school mental health service delivery context? and (2) How do clinicians describe the fit between modular psychotherapy and multiple levels of the school mental health service delivery context? Method Following a year-long training and consultation program in an evidence-based, modular approach to psychotherapy, semi-structured qualitative interviews were conducted with seventeen school-based mental health providers to evaluate their perspectives on the appropriateness of implementing the approach within a system of school-based health centers. Interviews were transcribed and coded for themes using conventional and directed content analysis. Results Findings identified key elements of the school mental health context including characteristics of the clinicians, their practices, the school context, and the service recipients. Specific evaluation of intervention-setting appropriateness elicited many comments about both practical and value-based (e.g., cultural considerations) aspects at the clinician and client levels, but fewer comments at the school or organizational levels. Conclusions Results suggest that a modular approach may fit well with the school mental health service context, especially along practical aspects of appropriateness. Future research focused on the development of methods for routinely assessing appropriateness at different stages of the implementation process is recommended. PMID:24134063

Practices related to postpartum uterine involution in the Western Highlands of Guatemala

PubMed Central

Radoff, K.A.; Thompson, Lisa M.; Bly, KC; Romero, Carolina

2013-01-01

Background Guatemala has the third highest level of maternal mortality in Latin America. Postpartum haemorrhage is the main cause of maternal mortality. In rural Guatemala, most women rely on Traditional Birth Attendants (TBAs) during labour, delivery, and the postpartum period. Little is known about current postpartum practices that may contribute to uterine involution provided by Mam- and Spanish-speaking TBAs in the Western Highlands of Guatemala. Methods a qualitative study was conducted with 39 women who participated in five focus groups in the San Marcos Department of Guatemala. Questions regarding postpartum practices were discussed during four focus groups of TBAs and one group of auxiliary nurses. Results three postpartum practices believed to aid postpartum uterine involution were identified: use of the chuj (Mam) (Spanish, temazcal), a traditional wood-fired sauna-bath used by Mam-speaking women; herbal baths and teas; and administration of biomedicines. Conclusions TBAs provide the majority of care to women during childbirth and the postpartum period and have developed a set of practices to prevent and treat postpartum haemorrhage. Integration of these practices may prove an effective method to reduce maternal morbidity and mortality in the Western Highlands of Guatemala. PMID:22762787

Imputation of a true endpoint from a surrogate: application to a cluster randomized controlled trial with partial information on the true endpoint.

PubMed

Nixon, Richard M; Duffy, Stephen W; Fender, Guy R K

2003-09-24

The Anglia Menorrhagia Education Study (AMES) is a randomized controlled trial testing the effectiveness of an education package applied to general practices. Binary data are available from two sources; general practitioner reported referrals to hospital, and referrals to hospital determined by independent audit of the general practices. The former may be regarded as a surrogate for the latter, which is regarded as the true endpoint. Data are only available for the true end point on a sub set of the practices, but there are surrogate data for almost all of the audited practices and for most of the remaining practices. The aim of this paper was to estimate the treatment effect using data from every practice in the study. Where the true endpoint was not available, it was estimated by three approaches, a regression method, multiple imputation and a full likelihood model. Including the surrogate data in the analysis yielded an estimate of the treatment effect which was more precise than an estimate gained from using the true end point data alone. The full likelihood method provides a new imputation tool at the disposal of trials with surrogate data.

Newborn Care Practices among Mother-Infant Dyads in Urban Uganda

PubMed Central

Kayom, Violet Okaba; Kakuru, Abel; Kiguli, Sarah

2015-01-01

Background. Most information on newborn care practices in Uganda is from rural communities which may not be generalized to urban settings. Methods. A community based cross-sectional descriptive study was conducted in the capital city of Uganda from February to May 2012. Quantitative and qualitative data on the newborn care practices of eligible mothers were collected. Results. Over 99% of the mothers attended antenatal care at least once and the majority delivered in a health facility. Over 50% of the mothers applied various substances to the cord of their babies to quicken the healing. Although most of the mothers did not bathe their babies within the first 24 hours of birth, the majority had no knowledge of skin to skin care as a thermoprotective method. The practice of bathing babies in herbal medicine was common (65%). Most of the mothers breastfed exclusively (93.2%) but only 60.7% initiated breastfeeding within the first hour of life, while a significant number (29%) used prelacteal feeds. Conclusion. The inadequate newborn care practices in this urban community point to the need to intensify the promotion of universal coverage of the newborn care practices irrespective of rural or urban communities and irrespective of health care seeking indicators. PMID:26713096

Barriers to GPs' use of evidence-based medicine: a systematic review

PubMed Central

Zwolsman, Sandra; te Pas, Ellen; Hooft, Lotty; Waard, Margreet Wieringa-de; van Dijk, Nynke

2012-01-01

Background GPs report various barriers to the use and practice of evidence-based medicine (EBM). A review of research on these barriers may help solve problems regarding the uptake of evidence in clinical outpatient practice. Aim To determine the barriers encountered by GPs in the practice of EBM and to come up with solutions to the barriers identified. Design A systematic review of the literature. Method The following databases were searched: MEDLINE® (PubMed®), Embase, CINAHL®, ERIC, and the Cochrane Library, until February 2011. Primary studies (all methods, all languages) that explore the barriers that GPs encounter in the practice of EBM were included. Results A total of 14 700 articles were identified, of which 22 fulfilled all inclusion criteria. Of the latter, nine concerned qualitative, 12 concerned quantitative, and one concerned both qualitative and quantitative research methods. The barriers described in the articles cover the categories: evidence (including the accompanying EBM steps), the GP’s preferences (experience, expertise, education), and the patient’s preferences. The particular GP setting also has important barriers to the use of EBM. Barriers found in this review, among others, include lack of time, EBM skills, and available evidence; patient-related factors; and the attitude of the GP. Conclusion Various barriers are encountered when using EBM in GP practice. Interventions that help GPs to overcome these barriers are needed, both within EBM education and in clinical practice. PMID:22781999

Development of Quadratic Programming Algorithm Based on Interior Point Method with Estimation Mechanism of Active Constraints

NASA Astrophysics Data System (ADS)

Hashimoto, Hiroyuki; Takaguchi, Yusuke; Nakamura, Shizuka

Instability of calculation process and increase of calculation time caused by increasing size of continuous optimization problem remain the major issues to be solved to apply the technique to practical industrial systems. This paper proposes an enhanced quadratic programming algorithm based on interior point method mainly for improvement of calculation stability. The proposed method has dynamic estimation mechanism of active constraints on variables, which fixes the variables getting closer to the upper/lower limit on them and afterwards releases the fixed ones as needed during the optimization process. It is considered as algorithm-level integration of the solution strategy of active-set method into the interior point method framework. We describe some numerical results on commonly-used bench-mark problems called “CUTEr” to show the effectiveness of the proposed method. Furthermore, the test results on large-sized ELD problem (Economic Load Dispatching problems in electric power supply scheduling) are also described as a practical industrial application.

Decision-making and goal-setting in chronic disease management: Baseline findings of a randomized controlled trial☆

PubMed Central

Kangovi, Shreya; Mitra, Nandita; Smith, Robyn A.; Kulkarni, Raina; Turr, Lindsey; Huo, Hairong; Glanz, Karen; Grande, David; Long, Judith A.

2017-01-01

Objective Growing interest in collaborative goal-setting has raised questions. First, are patients making the ‘right choices’ from a biomedical perspective? Second, are patients and providers setting goals of appropriate difficulty? Finally, what types of support will patients need to accomplish their goals? We analyzed goals and action plans from a trial of collaborative goal-setting among 302 residents of a high-poverty urban region who had multiple chronic conditions. Methods Patients used a low-literacy aid to prioritize one of their chronic conditions and then set a goal for that condition with their primary care provider. Patients created patient-driven action plans for reaching these goals. Results Patients chose to focus on conditions that were in poor control and set ambitious chronic disease management goals. The mean goal weight loss −16.8lbs (SD 19.5), goal HbA1C reduction was −1.3% (SD 1.7%) and goal blood pressure reduction was −9.8 mmHg (SD 19.2 mmHg). Patient-driven action plans spanned domains including health behavior (58.9%) and psychosocial (23.5%). Conclusions High-risk, low-SES patients identified high priority conditions, set ambitious goals and generate individualized action plans for chronic disease management. Practice implications Practices may require flexible personnel who can support patients using a blend of coaching, social support and navigation. PMID:27717532

Rule Extraction Based on Extreme Learning Machine and an Improved Ant-Miner Algorithm for Transient Stability Assessment.

PubMed

Li, Yang; Li, Guoqing; Wang, Zhenhao

2015-01-01

In order to overcome the problems of poor understandability of the pattern recognition-based transient stability assessment (PRTSA) methods, a new rule extraction method based on extreme learning machine (ELM) and an improved Ant-miner (IAM) algorithm is presented in this paper. First, the basic principles of ELM and Ant-miner algorithm are respectively introduced. Then, based on the selected optimal feature subset, an example sample set is generated by the trained ELM-based PRTSA model. And finally, a set of classification rules are obtained by IAM algorithm to replace the original ELM network. The novelty of this proposal is that transient stability rules are extracted from an example sample set generated by the trained ELM-based transient stability assessment model by using IAM algorithm. The effectiveness of the proposed method is shown by the application results on the New England 39-bus power system and a practical power system--the southern power system of Hebei province.

Alternative Test Methods for Electronic Parts

NASA Technical Reports Server (NTRS)

Plante, Jeannette

2004-01-01

It is common practice within NASA to test electronic parts at the manufacturing lot level to demonstrate, statistically, that parts from the lot tested will not fail in service using generic application conditions. The test methods and the generic application conditions used have been developed over the years through cooperation between NASA, DoD, and industry in order to establish a common set of standard practices. These common practices, found in MIL-STD-883, MIL-STD-750, military part specifications, EEE-INST-002, and other guidelines are preferred because they are considered to be effective and repeatable and their results are usually straightforward to interpret. These practices can sometimes be unavailable to some NASA projects due to special application conditions that must be addressed, such as schedule constraints, cost constraints, logistical constraints, or advances in the technology that make the historical standards an inappropriate choice for establishing part performance and reliability. Alternate methods have begun to emerge and to be used by NASA programs to test parts individually or as part of a system, especially when standard lot tests cannot be applied. Four alternate screening methods will be discussed in this paper: Highly accelerated life test (HALT), forward voltage drop tests for evaluating wire-bond integrity, burn-in options during or after highly accelerated stress test (HAST), and board-level qualification.

Assessing data quality and the variability of source data verification auditing methods in clinical research settings.

PubMed

Houston, Lauren; Probst, Yasmine; Martin, Allison

2018-05-18

Data audits within clinical settings are extensively used as a major strategy to identify errors, monitor study operations and ensure high-quality data. However, clinical trial guidelines are non-specific in regards to recommended frequency, timing and nature of data audits. The absence of a well-defined data quality definition and method to measure error undermines the reliability of data quality assessment. This review aimed to assess the variability of source data verification (SDV) auditing methods to monitor data quality in a clinical research setting. The scientific databases MEDLINE, Scopus and Science Direct were searched for English language publications, with no date limits applied. Studies were considered if they included data from a clinical trial or clinical research setting and measured and/or reported data quality using a SDV auditing method. In total 15 publications were included. The nature and extent of SDV audit methods in the articles varied widely, depending upon the complexity of the source document, type of study, variables measured (primary or secondary), data audit proportion (3-100%) and collection frequency (6-24 months). Methods for coding, classifying and calculating error were also inconsistent. Transcription errors and inexperienced personnel were the main source of reported error. Repeated SDV audits using the same dataset demonstrated ∼40% improvement in data accuracy and completeness over time. No description was given in regards to what determines poor data quality in clinical trials. A wide range of SDV auditing methods are reported in the published literature though no uniform SDV auditing method could be determined for "best practice" in clinical trials. Published audit methodology articles are warranted for the development of a standardised SDV auditing method to monitor data quality in clinical research settings. Copyright © 2018. Published by Elsevier Inc.

[Methods for the costing process in the field of economic evaluation of a rehabilitation program for patients with chronic obstructive lung diseases].

PubMed

Hessel, F P; Wittmann, M; Petro, W; Wasem, J

2000-07-01

Studies in health economics especially economic evaluations of health care technologies and programmes are getting more and more important. However, in Germany there are no established, validated and commonly used instruments for the costing process. For the economic evaluation of a rehabilitation programme for patients with chronic lung diseases such as asthma and chronic bronchitis we developed methods for identification, measurement and validation of resource use during the inpatient rehabilitation programme and during the outpatient follow-up period. These methods are based on methodological considerations as well as on practical experience from conducting a pilot study. With regard to the inpatient setting all relevant diagnostic and therapeutic resource uses could be measured basing on routine clinical documentation and validated by using the cost accounting of the clinic. For measuring the use of resources during the follow-up period in an outpatient setting no reliable administrative data are accessible. Hence, we compared a standardised retrospective patient questionnaire used in a 20-minute interview (n = 50) and a cost diary for the continuing documentation by the patient over a period of 4 weeks (n = 50). Both tools were useful for measuring all relevant resource uses in sufficient detail, but because of higher participation rates and lower dropouts the structured interview appears to be more suitable. Average total costs per month were 1591 DM (interview), respectively 1867 DM (cost diary). Besides productivity loss, costs for medication and GP visits caused the relatively highest resource uses. Practicable instruments were developed for the costing process as part of an economic evaluation in a German rehabilitation setting for pulmonary diseases. After individual modification, these could also be used for different indications and in other institutional settings.

Research-Practice Integration in Real Practice Settings: Issues and Suggestions

ERIC Educational Resources Information Center

Cheung, Monit; Ma, Anny K.; Thyer, Bruce A.; Webb, Ann E.

2015-01-01

At the National Bridging the Research and Practice Gap Symposium to discuss evidence-based practice (EBP) in social work, 150 participants attended five breakout groups to address real practice setting applications. These participants from social work academia and practice communities addressed issues and looked for solutions to promote…

Generalized minimum dominating set and application in automatic text summarization

NASA Astrophysics Data System (ADS)

Xu, Yi-Zhi; Zhou, Hai-Jun

2016-03-01

For a graph formed by vertices and weighted edges, a generalized minimum dominating set (MDS) is a vertex set of smallest cardinality such that the summed weight of edges from each outside vertex to vertices in this set is equal to or larger than certain threshold value. This generalized MDS problem reduces to the conventional MDS problem in the limiting case of all the edge weights being equal to the threshold value. We treat the generalized MDS problem in the present paper by a replica-symmetric spin glass theory and derive a set of belief-propagation equations. As a practical application we consider the problem of extracting a set of sentences that best summarize a given input text document. We carry out a preliminary test of the statistical physics-inspired method to this automatic text summarization problem.

“Nothing Special, Everything Is Maamuli”: Socio-Cultural and Family Practices Influencing the Perinatal Period in Urban India

PubMed Central

Raman, Shanti; Srinivasan, Krishnamachari; Kurpad, Anura; Razee, Husna; Ritchie, Jan

2014-01-01

Background Globally, India contributes the largest share in sheer numbers to the burden of maternal and infant under-nutrition, morbidity and mortality. A major gap in our knowledge is how socio-cultural practices and beliefs influence the perinatal period and thus perinatal outcomes, particularly in the rapidly growing urban setting. Methods and Findings Using data from a qualitative study in urban south India, including in-depth interviews with 36 women who had recently been through childbirth as well as observations of family life and clinic encounters, we explored the territory of familial, cultural and traditional practices and beliefs influencing women and their families through pregnancy, childbirth and infancy. We found that while there were some similarities in cultural practices to those described before in studies from low resource village settings, there are changing practices and ideas. Fertility concerns dominate women’s experience of married life; notions of gender preference and ideal family size are changing rapidly in response to the urban context; however inter-generational family pressures are still considerable. While a rich repertoire of cultural practices persists throughout the perinatal continuum, their existence is normalised and even underplayed. In terms of diet and nutrition, traditional messages including notions of ‘hot’ and ‘cold’ foods, are stronger than health messages; however breastfeeding is the cultural norm and the practice of delayed breastfeeding appears to be disappearing in this urban setting. Marriage, pregnancy and childbirth are so much part of the norm for women, that there is little expectation of individual choice in any of these major life events. Conclusions A greater understanding is needed of the dynamic factors shaping the perinatal period in urban India, including an acknowledgment of the health promoting as well as potentially harmful cultural practices and the critical role of the family. This will help plan culturally appropriate integrated perinatal health care. PMID:25369447

Predicting who will drop out of nursing courses: a machine learning exercise.

PubMed

Moseley, Laurence G; Mead, Donna M

2008-05-01

The concepts of causation and prediction are different, and have different implications for practice. This distinction is applied here to studies of the problem of student attrition (although it is more widely applicable). Studies of attrition from nursing courses have tended to concentrate on causation, trying, largely unsuccessfully, to elicit what causes drop out. However, the problem may more fruitfully be cast in terms of predicting who is likely to drop out. One powerful method for attempting to make predictions is rule induction. This paper reports the use of the Answer Tree package from SPSS for that purpose. The main data set consisted of 3978 records on 528 nursing students, split into a training set and a test set. The source was standard university student records. The method obtained 84% sensitivity, 70% specificity, and 94% accuracy on previously unseen cases. The method requires large amounts of high quality data. When such data are available, rule induction offers a way to reduce attrition. It would be desirable to compare its results with those of predictions made by tutors using more informal conventional methods.

Management of convulsive status epilepticus in children: an adapted clinical practice guideline for pediatricians in Saudi Arabia

PubMed Central

Bashiri, Fahad A.; Hamad, Muddathir H.; Amer, Yasser S.; Abouelkheir, Manal M.; Mohamed, Sarar; Kentab, Amal Y.; Salih, Mustafa A.; Nasser, Mohammad N. Al; Al-Eyadhy, Ayman A.; Othman, Mohammed A. Al; Al-Ahmadi, Tahani; Iqbal, Shaikh M.; Somily, Ali M.; Wahabi, Hayfaa A.; Hundallah, Khalid J.; Alwadei, Ali H.; Albaradie, Raidah S.; Al-Twaijri, Waleed A.; Jan, Mohammed M.; Al-Otaibi, Faisal; Alnemri, Abdulrahman M.; Al-Ansary, Lubna A.

2017-01-01

Objective: To increase the use of evidence-based approaches in the diagnosis, investigations and treatment of Convulsive Status Epilepticus (CSE) in children in relevant care settings. Method: A Clinical Practice Guideline (CPG) adaptation group was formulated at a university hospital in Riyadh. The group utilized 2 CPG validated tools including the ADAPTE method and the AGREE II instrument. Results: The group adapted 3 main categories of recommendations from one Source CPG. The recommendations cover; (i)first-line treatment of CSE in the community; (ii)treatment of CSE in the hospital; and (iii)refractory CSE. Implementation tools were built to enhance knowledge translation of these recommendations including a clinical algorithm, audit criteria, and a computerized provider order entry. Conclusion: A clinical practice guideline for the Saudi healthcare context was formulated using a guideline adaptation process to support relevant clinicians managing CSE in children. PMID:28416791

Understanding Digital Note-Taking Practice for Visualization.

PubMed

Willett, Wesley; Goffin, Pascal; Isenberg, Petra

2015-05-13

We present results and design implications from a study of digital note-taking practice to examine how visualization can support revisitation, reflection, and collaboration around notes. As digital notebooks become common forms of external memory, keeping track of volumes of content is increasingly difficult. Information visualization tools can help give note-takers an overview of their content and allow them to explore diverse sets of notes, find and organize related content, and compare their notes with their collaborators. To ground the design of such tools, we conducted a detailed mixed-methods study of digital note-taking practice. We identify a variety of different editing, organization, and sharing methods used by digital note-takers, many of which result in notes becoming "lost in the pile''. These findings form the basis for our design considerations that examine how visualization can support the revisitation, organization, and sharing of digital notes.

Characterizing multi-photon quantum interference with practical light sources and threshold single-photon detectors

NASA Astrophysics Data System (ADS)

Navarrete, Álvaro; Wang, Wenyuan; Xu, Feihu; Curty, Marcos

2018-04-01

The experimental characterization of multi-photon quantum interference effects in optical networks is essential in many applications of photonic quantum technologies, which include quantum computing and quantum communication as two prominent examples. However, such characterization often requires technologies which are beyond our current experimental capabilities, and today's methods suffer from errors due to the use of imperfect sources and photodetectors. In this paper, we introduce a simple experimental technique to characterize multi-photon quantum interference by means of practical laser sources and threshold single-photon detectors. Our technique is based on well-known methods in quantum cryptography which use decoy settings to tightly estimate the statistics provided by perfect devices. As an illustration of its practicality, we use this technique to obtain a tight estimation of both the generalized Hong‑Ou‑Mandel dip in a beamsplitter with six input photons and the three-photon coincidence probability at the output of a tritter.

Application of Guided Imagery to Facilitate the Transition of New Graduate Registered Nurses

PubMed Central

Boehm, Laura B.; Tse, Alice M.

2016-01-01

Traditionally, the new graduate registered nurse (RN) transition has included a didactic and skills-based orientation accompanied by a period of preceptored practice. However, these methods do not ensure that new RNs are in a state of reduced anxiety to fully interact with their new environment. Transition to practice may cause anxiety, and the new graduate RN may perceive moderate to severe stress. One method of stress reduction is the use of guided imagery, which has shown strong potential with a variety of populations undergoing stressful events. Today, new graduate RNs expect institutions to facilitate orientation to their new employment settings and assist in the transition to their role as a professional nurse. This article proposes a model that incorporates guided imagery for refining the new graduate RN transition process. The model can be adapted for use in the context of orienting other adult learners to unfamiliar practice situations. PMID:23330588

Clinical innovation for promoting family care in paediatric intensive care: demonstration, role modelling and reflective practice.

PubMed

Tomlinson, Patricia S; Thomlinson, Elizabeth; Peden-McAlpine, Cynthia; Kirschbaum, Mark

2002-04-01

To explore family caregiving problems in paediatric crisis care and methods that could be applied to move the abstraction of family care to development of specific family interventions. Family centred care has been accepted as the ideal philosophy for holistic health care of children, but methods for its implementation are not well established. In paediatric health crises, family care requires special sensitivity to family needs and a type of complex nursing care for which many practitioners are not sufficiently prepared. Developing family sensitive models of intervention and finding a strategy for transfer of this knowledge to clinical practice is an important challenge facing family nursing today. Social learning theory provides a rich background to explore these issues. Specific techniques of role modelling and reflective practice are suggested as effective approaches to teach family sensitive care in clinical settings where families are part of the care environment.

Solarization of reused pots is an inexpensive and efficient method to eliminate Phytophthora cactorum and other serious soilborne Phytophthora spp. found in production nurseries

Treesearch

K. Suslow; S. Sharma; K. Kosta; Kristina Weber; S. Rooney-Latham

2017-01-01

The reuse of plant pots by nursery growers has repeatedly been shown to be a method by which transfer of plant pathogens within a nursery will occur. More critically, this practice is an efficient pathway to infest landscape settings or habitat restoration sites by the out-planting of pre-symptomatic infected plant material. The transfer of water molds (oomycetes),...

Implementation in the midst of complexity: Using ethnography to study health care-associated infection prevention and control.

PubMed

Knobloch, Mary Jo; Thomas, Kevin V; Patterson, Erin; Zimbric, Michele L; Musuuza, Jackson; Safdar, Nasia

2017-10-01

Contextual factors associated with health care settings make reducing health care-associated infections (HAIs) a complex task. The aim of this article is to highlight how ethnography can assist in understanding contextual factors that support or hinder the implementation of evidence-based practices for reducing HAIs. We conducted a review of ethnographic studies specifically related to HAI prevention and control in the last 5 years (2012-2017). Twelve studies specific to HAIs and ethnographic methods were found. Researchers used various methods with video-reflexive sessions used in 6 of the 12 studies. Ethnography was used to understand variation in data reporting, identify barriers to adherence, explore patient perceptions of isolation practices and highlight the influence of physical design on infection prevention practices. The term ethnography was used to describe varied research methods. Most studies were conducted outside the United States, and authors indicate insights gained using ethnographic methods (whether observations, interviews, or reflexive video recording) as beneficial to unraveling the complexities of HAI prevention. Ethnography is well-suited for HAI prevention, especially video-reflexive ethnography, for activating patients and clinicians in infection control work. In this era of increasing pressure to reduce HAIs within complex work systems, ethnographic methods can promote understanding of contextual factors and may expedite translation evidence to practice. Published by Elsevier Inc.

Ethics and professionalism in medical physics: A survey of AAPM members

PubMed Central

Ozturk, Naim; Armato, Samuel G.; Giger, Maryellen L.; Serago, Christopher F.; Ross, Lainie F.

2013-01-01

Purpose: To assess current education, practices, attitudes, and perceptions pertaining to ethics and professionalism in medical physics. Methods: A link to a web-based survey was distributed to the American Association of Physicists in Medicine (AAPM) e-mail membership list, with a follow-up e-mail sent two weeks later. The survey included questions about ethics/professionalism education, direct personal knowledge of ethically questionable practices in clinical care, research, education (teaching and mentoring), and professionalism, respondents’ assessment of their ability to address ethical/professional dilemmas, and demographics. For analysis, reports of unethical or ethically questionable practices or behaviors by approximately 40% or more of respondents were classified as “frequent.” Results: Partial or complete responses were received from 18% (1394/7708) of AAPM members. Overall, 60% (827/1377) of the respondents stated that they had not received ethics/professionalism education during their medical physics training. Respondents currently in training were more likely to state that they received instruction in ethics/professionalism (80%, 127/159) versus respondents who were post-training (35%, 401/1159). Respondents’ preferred method of instruction in ethics/professionalism was structured periodic discussions involving both faculty and students/trainees. More than 90% (1271/1384) supported continuing education in ethics/professionalism and 75% (1043/1386) stated they would attend ethics/professionalism sessions at professional/scientific meetings. In the research setting, reports about ethically questionable authorship assignment were frequent (approximately 40%) whereas incidents of ethically questionable practices about human subjects protections were quite infrequent (5%). In the clinical setting, there was frequent recollection of incidents regarding lack of training, resources and skills, and error/incident reporting. In the educational setting, incidents of unethical or ethically questionable practices were only frequently recollected with respect to mentorship/guidance. With respect to professional conduct, favoritism, hostile work/learning environment, and maltreatment of subordinates and colleagues were frequently reported. A significantly larger proportion of women reported experiences with hostile work/learning environments, favoritism, poor mentorship, unfairness in educational settings, and concerns about student privacy and confidentiality. Conclusions: The survey found broad interest in ethics/professionalism topics and revealed that these topics were being integrated into the curriculum at many institutions. The incorporation of ethics and professionalism instruction into both graduate education and postgraduate training of medical physicists, and into their subsequent lifelong continuing education is important given the nontrivial number of medical physicists who had direct personal knowledge of unethical or ethically questionable incidents in clinical practice, research, education, and professionalism. PMID:23556930

Looking to the future: Framing the implementation of interprofessional education and practice with scenario planning.

PubMed

Forman, Dawn; Nicol, Pam; Nicol, Paul

2015-01-01

Adapting to interprofessional education and practice requires a change of perspective for many health professionals. We aimed to explore the potential of scenario planning to bridge the understanding gap and framing strategic planning for interprofessional education (IPE) and practice (IPP), as well as to implement innovative techniques and technology for large-group scenario planning. A full-day scenario planning workshop incorporating innovative methodology was designed and offered to participants. The 71 participants included academics from nine universities, as well as service providers, government, students and consumer organisations. The outcomes were evaluated by statistical and thematic analysis of a mixed method survey questionnaire. The scenario planning method resulted in a positive response as a means of collaboratively exploring current knowledge and broadening entrenched attitudes. It was perceived to be an effective instrument for framing strategy for the implementation of IPE/IPP, with 81 percent of respondents to a post-workshop survey indicating they would consider using scenario planning in their own organisations. The scenario planning method can be used by tertiary academic institutions as a strategy in developing, implementing and embedding IPE, and for the enculturation of IPP in practice settings.

Teacher Learning of Technology Enhanced Formative Assessment

NASA Astrophysics Data System (ADS)

Feldman, Allan; Capobianco, Brenda M.

2008-02-01

This study examined the integration of technology enhanced formative assessment (FA) into teachers' practice. Participants were high school physics teachers interested in improving their use of a classroom response system (CRS) to promote FA. Data were collected using interviews, direct classroom observations, and collaborative discussions. The physics teachers engaged in collaborative action research (AR) to learn how to use FA and CRS to promote student and teacher learning. Data were analyzed using open coding, cross-case analysis, and content analysis. Results from data analysis allowed researchers to construct a model for knowledge skills necessary for the integration of technology enhanced FA into teachers' practice. The model is as a set of four technologies: hardware and software; methods for constructing FA items; pedagogical methods; and curriculum integration. The model is grounded in the idea that teachers must develop these respective technologies as they interact with the CRS (i.e., hardware and software, item construction) and their existing practice (i.e., pedagogical methods, curriculum). Implications are that for teachers to make FA an integral part of their practice using CRS, they must: 1) engage in the four technologies; 2) understand the nature of FA; and 3) collaborate with other interested teachers through AR.

The learner's perspective in GP teaching practices with multi-level learners: a qualitative study.

PubMed

Thomson, Jennifer S; Anderson, Katrina; Haesler, Emily; Barnard, Amanda; Glasgow, Nicholas

2014-03-19

Medical students, junior hospital doctors on rotation and general practice (GP) registrars are undertaking their training in clinical general practices in increasing numbers in Australia. Some practices have four levels of learner. This study aimed to explore how multi-level teaching (also called vertical integration of GP education and training) is occurring in clinical general practice and the impact of such teaching on the learner. A qualitative research methodology was used with face-to-face, semi-structured interviews of medical students, junior hospital doctors, GP registrars and GP teachers in eight training practices in the region that taught all levels of learners. Interviews were audio-recorded and transcribed. Qualitative analysis was conducted using thematic analysis techniques aided by the use of the software package N-Vivo 9. Primary themes were identified and categorised by the co-investigators. 52 interviews were completed and analysed. Themes were identified relating to both the practice learning environment and teaching methods used.A practice environment where there is a strong teaching culture, enjoyment of learning, and flexible learning methods, as well as learning spaces and organised teaching arrangements, all contribute to positive learning from a learners' perspective.Learners identified a number of innovative teaching methods and viewed them as positive. These included multi-level learner group tutorials in the practice, being taught by a team of teachers, including GP registrars and other health professionals, and access to a supernumerary GP supervisor (also termed "GP consultant teacher"). Other teaching methods that were viewed positively were parallel consulting, informal learning and rural hospital context integrated learning. Vertical integration of GP education and training generally impacted positively on all levels of learner. This research has provided further evidence about the learning culture, structures and teaching processes that have a positive impact on learners in the clinical general practice setting where there are multiple levels of learners. It has also identified some innovative teaching methods that will need further examination. The findings reinforce the importance of the environment for learning and learner centred approaches and will be important for training organisations developing vertically integrated practices and in their training of GP teachers.

Development and validation of Australian aphasia rehabilitation best practice statements using the RAND/UCLA appropriateness method

PubMed Central

Power, Emma; Thomas, Emma; Worrall, Linda; Rose, Miranda; Togher, Leanne; Nickels, Lyndsey; Hersh, Deborah; Godecke, Erin; O'Halloran, Robyn; Lamont, Sue; O'Connor, Claire; Clarke, Kim

2015-01-01

Objectives To develop and validate a national set of best practice statements for use in post-stroke aphasia rehabilitation. Design Literature review and statement validation using the RAND/UCLA Appropriateness Method (RAM). Participants A national Community of Practice of over 250 speech pathologists, researchers, consumers and policymakers developed a framework consisting of eight areas of care in aphasia rehabilitation. This framework provided the structure for the development of a care pathway containing aphasia rehabilitation best practice statements. Nine speech pathologists with expertise in aphasia rehabilitation participated in two rounds of RAND/UCLA appropriateness ratings of the statements. Panellists consisted of researchers, service managers, clinicians and policymakers. Main outcome measures Statements that achieved a high level of agreement and an overall median score of 7–9 on a nine-point scale were rated as ‘appropriate’. Results 74 best practice statements were extracted from the literature and rated across eight areas of care (eg, receiving the right referrals, providing intervention). At the end of Round 1, 71 of the 74 statements were rated as appropriate, no statements were rated as inappropriate, and three statements were rated as uncertain. All 74 statements were then rated again in the face-to-face second round. 16 statements were added through splitting existing items or adding new statements. Seven statements were deleted leaving 83 statements. Agreement was reached for 82 of the final 83 statements. Conclusions This national set of 82 best practice statements across eight care areas for the rehabilitation of people with aphasia is the first to be validated by an expert panel. These statements form a crucial component of the Australian Aphasia Rehabilitation Pathway (AARP) (http://www.aphasiapathway.com.au) and provide the basis for more consistent implementation of evidence-based practice in stroke rehabilitation. PMID:26137883

Development and validation of Australian aphasia rehabilitation best practice statements using the RAND/UCLA appropriateness method.

PubMed

Power, Emma; Thomas, Emma; Worrall, Linda; Rose, Miranda; Togher, Leanne; Nickels, Lyndsey; Hersh, Deborah; Godecke, Erin; O'Halloran, Robyn; Lamont, Sue; O'Connor, Claire; Clarke, Kim

2015-07-02

To develop and validate a national set of best practice statements for use in post-stroke aphasia rehabilitation. Literature review and statement validation using the RAND/UCLA Appropriateness Method (RAM). A national Community of Practice of over 250 speech pathologists, researchers, consumers and policymakers developed a framework consisting of eight areas of care in aphasia rehabilitation. This framework provided the structure for the development of a care pathway containing aphasia rehabilitation best practice statements. Nine speech pathologists with expertise in aphasia rehabilitation participated in two rounds of RAND/UCLA appropriateness ratings of the statements. Panellists consisted of researchers, service managers, clinicians and policymakers. Statements that achieved a high level of agreement and an overall median score of 7-9 on a nine-point scale were rated as 'appropriate'. 74 best practice statements were extracted from the literature and rated across eight areas of care (eg, receiving the right referrals, providing intervention). At the end of Round 1, 71 of the 74 statements were rated as appropriate, no statements were rated as inappropriate, and three statements were rated as uncertain. All 74 statements were then rated again in the face-to-face second round. 16 statements were added through splitting existing items or adding new statements. Seven statements were deleted leaving 83 statements. Agreement was reached for 82 of the final 83 statements. This national set of 82 best practice statements across eight care areas for the rehabilitation of people with aphasia is the first to be validated by an expert panel. These statements form a crucial component of the Australian Aphasia Rehabilitation Pathway (AARP) (http://www.aphasiapathway.com.au) and provide the basis for more consistent implementation of evidence-based practice in stroke rehabilitation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A novel deep learning-based approach to high accuracy breast density estimation in digital mammography

NASA Astrophysics Data System (ADS)

Ahn, Chul Kyun; Heo, Changyong; Jin, Heongmin; Kim, Jong Hyo

2017-03-01

Mammographic breast density is a well-established marker for breast cancer risk. However, accurate measurement of dense tissue is a difficult task due to faint contrast and significant variations in background fatty tissue. This study presents a novel method for automated mammographic density estimation based on Convolutional Neural Network (CNN). A total of 397 full-field digital mammograms were selected from Seoul National University Hospital. Among them, 297 mammograms were randomly selected as a training set and the rest 100 mammograms were used for a test set. We designed a CNN architecture suitable to learn the imaging characteristic from a multitudes of sub-images and classify them into dense and fatty tissues. To train the CNN, not only local statistics but also global statistics extracted from an image set were used. The image set was composed of original mammogram and eigen-image which was able to capture the X-ray characteristics in despite of the fact that CNN is well known to effectively extract features on original image. The 100 test images which was not used in training the CNN was used to validate the performance. The correlation coefficient between the breast estimates by the CNN and those by the expert's manual measurement was 0.96. Our study demonstrated the feasibility of incorporating the deep learning technology into radiology practice, especially for breast density estimation. The proposed method has a potential to be used as an automated and quantitative assessment tool for mammographic breast density in routine practice.

Supporting Primary Care Practices in Building Capacity to Use Health Information Data

PubMed Central

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

2014-01-01

Introduction: Our objective was to describe essential support resources and strategies in order to advance the pace and scope of the use of health information technology (HIT) data. Background and Context: Primary data were collected between January 2011 and October 2012. The primary study population comprised 51 primary care practices enrolled in the Colorado Beacon Consortium in western Colorado. Methods: We used qualitative methods embedded in a mixed-method evaluation: monthly narrative reports from practices; interviews with providers and staff; and focused, group discussions with quality improvement (QI) advisors and staff from the Health Information Technology Regional Extension Center. Findings: Practices valued effective support strategies to assist with using HIT, including the following: translating rules and regulations into individual practice settings; facilitating peer-to-peer connections; providing processes and tools for practice improvement; maintaining accountability and momentum; and providing local electronic health record (EHR) technical expertise. Benefits of support included improved quality measures, operational improvements, increased provider and staff engagement, and deeper understanding of EHR data. Discussion: The findings affirm the utility of practice facilitation for HIT-focused aims with personalized attention and cross-fertilization among practices for improvements. Facilitation to sustain ongoing improvements and prepare for future HIT-intensive improvement activities was highly valued. In addition to the general practice facilitator, an EHR technical expert was critical to improving practice capacity to use electronic clinical data. Collaborative learning expands the pool of mentors and teachers, who can further translate their own lessons into practical advice for their peers, yielding the emergence of a stronger sense of community among the practices. Conclusions: Using HIT more effectively in primary care will require sustained, focused efforts by practices as regulations, incentives and HIT evolve. Ongoing support for community-based practice facilitators; collaborative learning; and local, personalized EHR advisors will help practices care for patients while more effectively deploying HIT to improve care. PMID:25848621

Integrating Social Determinants of Health into Primary Care Clinical and Informational Workflow during Care Transitions

PubMed Central

Hewner, Sharon; Casucci, Sabrina; Sullivan, Suzanne; Mistretta, Francine; Xue, Yuqing; Johnson, Barbara; Pratt, Rebekah; Lin, Li; Fox, Chester

2017-01-01

Context: Care continuity during transitions between the hospital and home requires reliable communication between providers and settings and an understanding of social determinants that influence recovery. Case Description: The coordinating transitions intervention uses real time alerts, delivered directly to the primary care practice for complex chronically ill patients discharged from an acute care setting, to facilitate nurse care coordinator led telephone outreach. The intervention incorporates claims-based risk stratification to prioritize patients for follow-up and an assessment of social determinants of health using the Patient-centered Assessment Method (PCAM). Results from transitional care are stored and transmitted to qualified healthcare providers across the continuum. Findings: Reliance on tools that incorporated interoperability standards facilitated exchange of health information between the hospital and primary care. The PCAM was incorporated into both the clinical and informational workflow through the collaboration of clinical, industry, and academic partners. Health outcomes improved at the study practice over their baseline and in comparison with control practices and the regional Medicaid population. Major Themes: Current research supports the potential impact of systems approaches to care coordination in improving utilization value after discharge. The project demonstrated that flexibility in developing the informational and clinical workflow was critical in developing a solution that improved continuity during transitions. There is additional work needed in developing managerial continuity across settings such as shared comprehensive care plans. Conclusions: New clinical and informational workflows which incorporate social determinant of health data into standard practice transformed clinical practice and improved outcomes for patients.

Diversification of Processors Based on Redundancy in Instruction Set

NASA Astrophysics Data System (ADS)

Ichikawa, Shuichi; Sawada, Takashi; Hata, Hisashi

By diversifying processor architecture, computer software is expected to be more resistant to plagiarism, analysis, and attacks. This study presents a new method to diversify instruction set architecture (ISA) by utilizing the redundancy in the instruction set. Our method is particularly suited for embedded systems implemented with FPGA technology, and realizes a genuine instruction set randomization, which has not been provided by the preceding studies. The evaluation results on four typical ISAs indicate that our scheme can provide a far larger degree of freedom than the preceding studies. Diversified processors based on MIPS architecture were actually implemented and evaluated with Xilinx Spartan-3 FPGA. The increase of logic scale was modest: 5.1% in Specialized design and 3.6% in RAM-mapped design. The performance overhead was also modest: 3.4% in Specialized design and 11.6% in RAM-mapped design. From these results, our scheme is regarded as a practical and promising way to secure FPGA-based embedded systems.

Best Practices for Use of Blended Learning

PubMed Central

Porter, Andrea L.; Pitterle, Michael E.

2017-01-01

Objective. To determine instructional best practice recommendations for use of blended learning from the students’ perspective. Methods. Three focus groups were created, one for each of the first three years at a school of pharmacy. The focus group discussions were audio recorded and transcribed for content analysis. Results. Ten instructional best practices were identified from the focus groups: setting the stage, consistency when team teaching, timeliness in posting materials, time on task, accountability for online activities, use of structured active learning, instructor use of feedback on student preparation, incorporation of student feedback into the course, short reviews of online material during class, and ensuring technologies are user friendly. Conclusion. Instructors using blended learning should consider incorporating these best practices into their course design and management. More evaluation is needed to see if implementation of these practices affects student performance. PMID:28496269

Best Practices for Use of Blended Learning.

PubMed

Margolis, Amanda R; Porter, Andrea L; Pitterle, Michael E

2017-04-01

Objective. To determine instructional best practice recommendations for use of blended learning from the students' perspective. Methods. Three focus groups were created, one for each of the first three years at a school of pharmacy. The focus group discussions were audio recorded and transcribed for content analysis. Results. Ten instructional best practices were identified from the focus groups: setting the stage, consistency when team teaching, timeliness in posting materials, time on task, accountability for online activities, use of structured active learning, instructor use of feedback on student preparation, incorporation of student feedback into the course, short reviews of online material during class, and ensuring technologies are user friendly. Conclusion. Instructors using blended learning should consider incorporating these best practices into their course design and management. More evaluation is needed to see if implementation of these practices affects student performance.

Accessing primary care: a simulated patient study

PubMed Central

Campbell, John L; Carter, Mary; Davey, Antoinette; Roberts, Martin J; Elliott, Marc N; Roland, Martin

2013-01-01

Background Simulated patient, or so-called ‘mystery-shopper’, studies are a controversial, but potentially useful, approach to take when conducting health services research. Aim To investigate the construct validity of survey questions relating to access to primary care included in the English GP Patient Survey. Design and setting Observational study in 41 general practices in rural, urban, and inner-city settings in the UK. Method Between May 2010 and March 2011, researchers telephoned practices at monthly intervals, simulating patients requesting routine, but prompt, appointments. Seven measures of access and appointment availability, measured from the mystery-shopper contacts, were related to seven measures of practice performance from the GP Patient Survey. Results Practices with lower access scores in the GP Patient Survey had poorer access and appointment availability for five out of seven items measured directly, when compared with practices that had higher scores. Scores on items from the national survey that related to appointment availability were significantly associated with direct measures of appointment availability. Patient-satisfaction levels and the likelihood that patients would recommend their practice were related to the availability of appointments. Patients’ reports of ease of telephone access in the national survey were unrelated to three out of four measures of practice call handling, but were related to the time taken to resolve an appointment request, suggesting responders’ possible confusion in answering this question. Conclusion Items relating to the accessibility of care in a the English GP patient survey have construct validity. Patients’ satisfaction with their practice is not related to practice call handling, but is related to appointment availability. PMID:23561783

A set of parallel, implicit methods for a reconstructed discontinuous Galerkin method for compressible flows on 3D hybrid grids

DOE PAGES

Xia, Yidong; Luo, Hong; Frisbey, Megan; ...

2014-07-01

A set of implicit methods are proposed for a third-order hierarchical WENO reconstructed discontinuous Galerkin method for compressible flows on 3D hybrid grids. An attractive feature in these methods are the application of the Jacobian matrix based on the P1 element approximation, resulting in a huge reduction of memory requirement compared with DG (P2). Also, three approaches -- analytical derivation, divided differencing, and automatic differentiation (AD) are presented to construct the Jacobian matrix respectively, where the AD approach shows the best robustness. A variety of compressible flow problems are computed to demonstrate the fast convergence property of the implemented flowmore » solver. Furthermore, an SPMD (single program, multiple data) programming paradigm based on MPI is proposed to achieve parallelism. The numerical results on complex geometries indicate that this low-storage implicit method can provide a viable and attractive DG solution for complicated flows of practical importance.« less

Guidelines for Developing and Reporting Machine Learning Predictive Models in Biomedical Research: A Multidisciplinary View

PubMed Central

2016-01-01

Background As more and more researchers are turning to big data for new opportunities of biomedical discoveries, machine learning models, as the backbone of big data analysis, are mentioned more often in biomedical journals. However, owing to the inherent complexity of machine learning methods, they are prone to misuse. Because of the flexibility in specifying machine learning models, the results are often insufficiently reported in research articles, hindering reliable assessment of model validity and consistent interpretation of model outputs. Objective To attain a set of guidelines on the use of machine learning predictive models within clinical settings to make sure the models are correctly applied and sufficiently reported so that true discoveries can be distinguished from random coincidence. Methods A multidisciplinary panel of machine learning experts, clinicians, and traditional statisticians were interviewed, using an iterative process in accordance with the Delphi method. Results The process produced a set of guidelines that consists of (1) a list of reporting items to be included in a research article and (2) a set of practical sequential steps for developing predictive models. Conclusions A set of guidelines was generated to enable correct application of machine learning models and consistent reporting of model specifications and results in biomedical research. We believe that such guidelines will accelerate the adoption of big data analysis, particularly with machine learning methods, in the biomedical research community. PMID:27986644

Ethical Issues Raised by Private Practice Physiotherapy Are More Diverse than First Meets the Eye: Recommendations from a Literature Review

PubMed Central

Drolet, Marie-Josée; Williams-Jones, Bryn

2015-01-01

ABSTRACT Purpose: Physiotherapy in private practice differs from physiotherapy practised in a public setting in several ways, the most evident of which is the for-profit nature of private physiotherapy clinics; these differences can generate distinct and challenging ethical issues. The objectives of this article are to identify ethical issues encountered by physiotherapists in private practice settings and to identify potential solutions and recommendations to address these issues. Method: After a literature search of eight databases, 39 studies addressing ethical issues in a private practice context were analyzed. Results: A total of 25 ethical issues emerging from the included studies were classified into three main categories: (1) business and economic issues (e.g., conflicts of interests, inequity in a managed care context, lack of time affecting quality of care); (2) professional issues (e.g., professional autonomy, clinical judgment, treatment effectiveness, professional conduct); and (3) patients' rights and welfare issues (e.g., confidentiality, power asymmetries, paternalism vs. patient autonomy, informed consent). Recommendations as to how physiotherapists could better manage these issues were then identified and categorized. Conclusions: The physiotherapy community should reflect on the challenges raised by private practice so that professionals can be supported—through education, research, and good governance—in providing the best possible care for their patients. PMID:25931663

An Investment Prospectus. Strengthening Education and Democracy through Service-Learning

ERIC Educational Resources Information Center

Gibson, Cynthia

2005-01-01

Service-learning is a teaching method that engages young people in community problem-solving as part of their education, both in school and out-of-school settings. Service-learning has the potential to be a powerful experiential education practices because it not only fosters effective learning, also prepares the next generation for democratic…

Telling Their Stories: Primary Care Practitioners' Experience Evaluating and Reporting Injuries Caused by Child Abuse

ERIC Educational Resources Information Center

Flaherty, Emalee G.; Jones, Rise; Sege, Robert

2004-01-01

Objective: To learn about primary care physicians' experiences in identifying and reporting injuries caused by physical abuse. Method: Two qualitative analysts facilitated a focus group of six Chicago area, primary care physicians. Physicians representing diverse practice settings were selected to participate in the discussion. The analysts…

An Investigation of Leadership Practices That Yield Success in Renewal Schools

ERIC Educational Resources Information Center

de Govia, Mauriciere A.

2017-01-01

The New York City Department of Education (NYCDOE) set forth the Renewal School initiative as a method of school turnaround that preserves the existing school community; with necessary leadership changes when applicable, and supplied human and operational resources. Educational research has cited that school leadership is the second leading…

Empowering Interviews: Narrative Interviews in the Study of Information Literacy in Everyday Life Settings

ERIC Educational Resources Information Center

Eckerdal, Johanna Rivano

2013-01-01

Introduction: This paper presents a way to design and conduct interviews, within a sociocultural perspective, for studying information literacy practices in everyday life. Methods: A framework was developed combining a socio-cultural perspective with a narrative interview was developed. Interviewees were invited to participate by talking and using…

Deschooling Language Study in East Africa: The Zambia Plan.

ERIC Educational Resources Information Center

Roberts, David Harrill

The second language learning methods of Southern Baptist missionaries in Zambia are described. Instead of studying the new language in a school setting, the student receives a week of orientation and is then placed in the community and expected to practice communicating with the native speakers at every opportunity. The student follows a course…

Picture It! The Use of Visual Methods in Psychology Teaching

ERIC Educational Resources Information Center

Watt, Sal; Wakefield, Caroline

2014-01-01

Photo elicitation theoretically located under Creative Analytic Practice was set as an assessment on a taught postgraduate programme. In groups of three to four, 30 students acted as both researcher and participant. Group topics were self-selected, each member took five photographs that group members reflected on. Topics chosen were varied and…

Strengthening of certain types of arch dams at broad sites

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

Kaganov, G. M.; Volkov, V. I.; Uchevatkin, A. A.

2012-01-15

The problem of strengthening defective and damaged arch dams is formulated, and methodical calculations are performed to substantiate a set of structural and production measures permitting substantial improvement in the stress-strain state and an increase in the safety factor of the structure. Feasibility of practical implementation of the results is foreseen.

Zero-Tolerance Discipline Approaches: Perspectives from Exemplary Alternative Schools

ERIC Educational Resources Information Center

Kruse, Timothy L.

2012-01-01

Scope and Method of Study: The purpose of this qualitative study was to explore alternative school administrator, teacher, and student perceptions of the factors that surround zero-tolerance discipline policies and practices, and to identify discipline alternatives that do not remove or exclude students from the school setting. A case study was…

Implementing Cognitive Behavioral Therapy for Chronic Fatigue Syndrome in a Mental Health Center: A Benchmarking Evaluation

ERIC Educational Resources Information Center

Scheeres, Korine; Wensing, Michel; Knoop, Hans; Bleijenberg, Gijs

2008-01-01

Objective: This study evaluated the success of implementing cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) in a representative clinical practice setting and compared the patient outcomes with those of previously published randomized controlled trials (RCTs) of CBT for CFS. Method: The implementation interventions were the…

The Affects of Not Reading: Hating Characters, Being Bored, Feeling Stupid

ERIC Educational Resources Information Center

Poletti, Anna; Seaboyer, Judith; Kennedy, Rosanne; Barnett, Tully; Douglas, Kate

2016-01-01

This article brings recent debates in literary studies regarding the practice of close reading into conversation with Derek Attridge's idea of "readerly hospitality" (2004) to diagnose the problem of students in undergraduate literary studies programme not completing set reading. We argue that the method of close reading depends on…

Assessing Collaborative Learning: Big Data, Analytics and University Futures

ERIC Educational Resources Information Center

Williams, Peter

2017-01-01

Assessment in higher education has focused on the performance of individual students. This focus has been a practical as well as an epistemic one: methods of assessment are constrained by the technology of the day, and in the past they required the completion by individuals under controlled conditions of set-piece academic exercises. Recent…

78 FR 22239 - Takes of Marine Mammals Incidental to Specified Activities; Marine Geophysical Survey on the Mid...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-15

... authorization must set forth the permissible methods of taking; other means of effecting the least practicable... Authorization to the Observatory. The Observatory, with research funding from the Foundation, plans to conduct... Environmental Impact Statement/ Overseas Environmental Impact Statement for Marine Seismic Research Funded by...

Health Promotion Using Life Skills Education Approach for Adolescents in Schools--Development of a Model

ERIC Educational Resources Information Center

Bharath, Srikala; Kumar, K. V. Kishore

2008-01-01

Life Skills Education (LSE) is a novel promotional program that teaches generic life skills through participatory learning methods of games, debates, role-plays, and group discussion. Conceptual understanding and practicing of the skills occurs through experiential learning in a non-threatening setting. Such initiatives provide the adolescent with…

Improving Teaching and Teachers: A "Generative Dance"?

ERIC Educational Resources Information Center

Lampert, Magdalene

2012-01-01

Working on teaching as a collective practice--understanding it, specifying it, and improving it--is crucially important and too often ignored. But setting up a choice between improving teaching and improving teachers is problematic for several reasons. To begin with, it seems that the very methods Hiebert and Morris outline for improving teaching…

The Impact of OER on Teaching and Learning Practice

ERIC Educational Resources Information Center

Weller, Martin; de los Arcos, Bea; Farrow, Rob; Pitt, Beck; McAndrew, Patrick

2015-01-01

The OER Research Hub has been investigating the impact of OER, using eleven hypotheses, and a mixed methods approach to establish an evidence base. This paper explores the findings relating to teaching and learning. The findings reveal a set of direct impacts, including an increase in factors relating to student performance, increased reflection…

Improving Instruction in the Mathematics Methods Classroom through Action Research

ERIC Educational Resources Information Center

Mostofo, Jameel; Zambo, Ron

2015-01-01

There is a continuing emphasis in the United States on improving students' mathematical abilities, and one approach is to better prepare teachers. To investigate the potential usefulness of Lesson Study to better prepare teachers, one author set out to conduct action research on his classroom practice. Specifically, he sought to determine whether…

Measuring Health Literacy in Individuals with Diabetes: A Systematic Review and Evaluation of Available Measures

ERIC Educational Resources Information Center

Al Sayah, Fatima; Williams, Beverly; Johnson, Jeffrey A.

2013-01-01

Objective: To identify instruments used to measure health literacy and numeracy in people with diabetes; evaluate their use, measurement scope, and properties; discuss their strengths and weaknesses; and propose the most useful, reliable, and applicable measure for use in research and practice settings. Methods" A systematic literature review…

Image-Based Participatory Pedagogies: Reimagining Social Justice

ERIC Educational Resources Information Center

Powell, Kimberly; Serriere, Stephanie

2013-01-01

As educators and scholars in social studies and art education respectively, we describe two visual methods from our own research and teaching in pre-K to university settings that are embedded in visual practices. We underscore their transformative potential by using Maxine Greene's (1995) ideas of the education of perception as a critical means…

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…

Perceived Norms for Interactive Teaching and Their Relationship to Instructional Decision-Making: A Mixed Methods Study

ERIC Educational Resources Information Center

Hora, Matthew T.; Anderson, Craig

2012-01-01

Normative expectations for acceptable behaviors related to undergraduate instruction are known to exist within academic settings. Yet few studies have examined disciplinary variation in norms for interactive teaching, and their relationship to teaching practice, particularly from a cognitive perspective. This study examines these problems using…

Internationalizing Educational Leadership: How a University Department Jumps the Curve from Local to International

ERIC Educational Resources Information Center

Bogotch, Ira; Maslin-Ostrowski, Patricia

2010-01-01

Purpose: This study describes how an educational leadership department transformed its regional identity and localized practices over a ten-year period (1997-2007) to become internationalized in terms of research, teaching, and service. Research Methods/Approach (e.g., Setting, Participants, Research Design, Data Collection and Analysis): A basic…

Toward Authentic Student-Centered Practices: Voices of Alternative School Students

ERIC Educational Resources Information Center

Phillips, Rachel Sophia

2013-01-01

This investigation uncovered the conditions of learning, both positive and negative, that students in an alternative school experienced both in and out of the classroom setting. Eleven students at an alternative high school in a large suburban school district in the Pacific Northwest were interviewed using methods of narrative inquiry and…

Evaluating Effectiveness of Pair Programming as a Teaching Tool in Programming Courses

ERIC Educational Resources Information Center

Faja, Silvana

2014-01-01

This study investigates the effectiveness of pair programming on student learning and satisfaction in introductory programming courses. Pair programming, used in the industry as a practice of an agile development method, can be adopted in classroom settings to encourage peer learning, increase students' social skills, and enhance student…

Exploring the Classroom: Teaching Science in Early Childhood

ERIC Educational Resources Information Center

Dejonckheere, Peter J. N.; de Wit, Nele; van de Keere, Kristof; Vervaet, Stephanie

2016-01-01

This study tested and integrated the effects of an inquiry-based didactic method for preschool science in a real practical classroom setting. Four preschool classrooms participated in the experiment (N = 57) and the children were 4-6 years old. In order to assess children's attention for causal events and their understanding at the level of…

Exploring the Classroom: Teaching Science in Early Childhood

ERIC Educational Resources Information Center

Dejonckheere, Peter J. N.; De Wit, Nele; Van de Keere, Kristof; Vervaet, Stephanie

2016-01-01

This study tested and integrated the effects of an inquiry-based didactic method for preschool science in a real practical classroom setting. Four preschool classrooms participated in the experiment (N= 57) and the children were 4-6 years old. In order to assess children's attention for causal events and their understanding at the level of…

Agile Manifesto for Teaching and Learning

ERIC Educational Resources Information Center

Krehbiel, Timothy C.; Salzarulo, Peter A.; Cosmah, Michelle L.; Forren, John; Gannod, Gerald; Havelka, Douglas; Hulshult, Andrea R.; Merhout, Jeffrey

2017-01-01

A group of faculty members representing six colleges at a public university formed a learning community to study the Agile Way of Working--a method of workplace collaboration widely used in software development--and to determine whether the concepts, practices, and benefits of Agile are applicable to higher education settings. After more than two…

Timed Writing Practice for Japanese University Students in an EFL Setting.

ERIC Educational Resources Information Center

Kresovich, Brant M.

1990-01-01

Timed writing exercises used at the University of the Ryukyus (Japan) to help alleviate common problems in English second language writing are described. It is proposed that Japanese students have difficulty writing in English because of early training in the grammar-translation method, a lack of communication skills, the overuse of bilingual…

A Study of Student Engagement in Project-Based Learning across Multiple Approaches to STEM Education Programs

ERIC Educational Resources Information Center

Hall, Alfred; Miro, Danielle

2016-01-01

Objective: In this study, we investigated the implementation of project-based learning (PBL) activities in four secondary science, technology, engineering, and mathematics (STEM) education settings to examine the impact of inquiry based instructional practices on student learning. Method: Direct classroom observations were conducted during the…

Development of Interactive Multimedia Courseware (e-CRAFT) for Craft Education

ERIC Educational Resources Information Center

Osman, Salyani; Sahari, Noraidah; Zin, Nor Azan Mat

2012-01-01

The way of teaching and learning traditional crafts have always used traditional apprenticeship learning methods where the expert facilitates transfer of practice skill sets to novices. As a craft has been taught in conventional approach, the students and experts have been facing several problems especially when expert needs to teach a group of…

A Systematic Review of the Empirical Literature on Intercessory Prayer

ERIC Educational Resources Information Center

Hodge, David R.

2007-01-01

Perhaps surprisingly, many social workers appear to use intercessory prayer in direct practice settings. To help inform practitioners' use of this intervention, this article evaluates the empirical literature on the topic using the following three methods: (a) an individual assessment of each study, (b) an evaluation of intercessory prayer as an…

Back home: a qualitative study exploring re-entering cross-cultural missionary aid workers' loss and grief.

PubMed

Selby, Susan; Moulding, Nicole; Clark, Sheila; Jones, Alison; Braunack-Mayer, Annette; Beilby, Justin

2009-01-01

Over 200 Australian, American, and British Non-Government Organizations send aid workers overseas including missionaries. On re-entry, they may suffer psychological distress; however, there is little research about their psychosocial issues and management in the family practice setting. Research suggests loss and grief as a suitable paradigm for family practitioners dealing with psychosocial issues. The aim of this study was to explore loss and grief issues for adult Australian missionary cross-cultural aid workers during their re-entry adjustment. Mixed methods were used and this study reports the qualitative method: semi-structured interviews conducted with 15 participants. Results were analyzed using framework analysis. Themes of re-entry loss and grief were identified with sub-themes of multiple varied losses, mechanisms of loss, loss of control, common grief phenomena, disenfranchised grief, and reactivation of past grief. Theoretical and clinical implications are discussed. Findings of this study suggest that loss and grief is an appropriate paradigm for the management of these workers in the family practice setting. Further research is needed to enable appropriate care.