Campus Housing: Beware!

ERIC Educational Resources Information Center

Campbell, Margaret; Bassett, Bill

1973-01-01

As a result of a survey to discover the rationale for student preference for off-campus living the following factors were indicated most often as reasons given for moving from the residence hall: (1) better study conditions; (2) expense; (3) freedom from control; and (4) new experiences. (JC)

Survey Questions Answered Only by Medication Experts.

ERIC Educational Resources Information Center

American Journal on Mental Retardation, 2000

2000-01-01

Fifty-eight tables provide a breakdown of answers to a survey responded to by 45 experts in the medication treatment of psychiatric and behavioral problems in people with mental retardation. Questions address treatment of specific disorders, ratings of various medications for specific disorders or symptoms, and preferences in mood stabilizers,…

Organ Donation in the 50+ Age Demographic: Survey Results on Decision Rationale and Information Preferences.

PubMed

Tartaglia, Alexander; Dodd-McCue, Diane; Myer, Kevin A; Mullins, Andrew

2016-09-01

The rate of organ donation by older potential donors is significantly declining even though recent studies show positive clinical outcomes with organs transplanted from older donors. This study examined the 50+ age demographic to identify the rationale for donation decisions, preferred media methods of donation information delivery, and responsiveness to an age-tailored donation message. Results from 579 surveys, 87% from the 50+ age demographic, found respondents prone to self-select themselves as medically ineligible based on current medication and health status, even though they might be medically suitable donors. Their incentive to pursue additional information on donation is limited except when motivated by personal accounts within their families and communities. In addition, even when computer literate, they continue to favor the printed or spoken word for donation information delivery. The results suggest an opportunity for those working with older adults to develop more personalized, localized donation education programs targeting this age demographic. © The Author(s) 2014.

Outline of a Twenty-Five Year Plan for Development and Deployment of A Catapult for A Third Generation Space Shuttle

NASA Technical Reports Server (NTRS)

Russell, John M.

2002-01-01

This report reviews the rationale for catapult assist in the launching a third generation space shuttle. It then furnishes lists of early design decisions, questions whose answers are prerequisite to later design decisions, preliminary inventories of carriage levitation and carriage propulsion concepts, phases of the project and major milestones, and some sources of expertise to support the project.

Outline Of A Twenty-Five Year Plan For Development And Deployment Of a Catapult For a Third Generation Space Shuttle

NASA Technical Reports Server (NTRS)

Russell, John M.

2001-01-01

This report reviews the rationale for catapult assist in the launching of a third generation space shuttle. It then furnishes lists of early design decisions, questions whose answers are prerequisite to later design decisions, preliminary inventories of carriage levitation and carriage propulsion concepts, phases of the project and major milestones, and some sources of expertise to support the project.

A systematic approach to advanced cockpit warning systems for air transport operations: Line pilot preferences

NASA Technical Reports Server (NTRS)

Williams, D. H.; Simpson, C. A.

1976-01-01

Line pilots (fifty captains, first officers, and flight engineers) from 8 different airlines were administered a structured questionnaire relating to future warning system design and solutions to current warning system problems. This was followed by a semantic differential to obtain a factor analysis of 18 different cockpit warning signals on scales such as informative/distracting, annoying/soothing. Half the pilots received a demonstration of the experimental text and voice synthesizer warning systems before answering the questionnaire and the semantic differential. A control group answered the questionnaire and the semantic differential first, thus providing a check for the stability of pilot preferences with and without actual exposure to experimental systems. Generally, the preference data obtained revealed much consistency and strong agreement among line pilots concerning advance cockpit warning system design.

Hand Preference for Writing and Associations with Selected Demographic and Behavioral Variables in 255,100 Subjects: The BBC Internet Study

ERIC Educational Resources Information Center

Peters, Michael; Reimers, Stian; Manning, John T.

2006-01-01

In an Internet study unrelated to handedness, 134,317 female and 120,783 male participants answered a graded question as to which hand they preferred for writing. This allowed determination of hand preference patterns across 7 ethnic groups. Sex differences in left-handedness were found in 4 ethnic groups, favoring males, while no significant sex…

Inventory of Motive of Preference for Conventional Paper-and-Pencil Tests: A Study of Validity and Reliability

ERIC Educational Resources Information Center

Eser, Mehmet Taha; Dogan, Nuri

2017-01-01

Purpose: The objective of this study is to develop the Inventory of Motive of Preference for Conventional Paper-And-Pencil Tests and to evaluate students' motives for preferring written tests, short-answer tests, true/false tests or multiple-choice tests. This will add a measurement tool to the literature with valid and reliable results to help…

A five-layer users' need hierarchy of computer input device selection: a contextual observation survey of computer users with cervical spinal injuries (CSI).

PubMed

Tsai, Tsai-Hsuan; Nash, Robert J; Tseng, Kevin C

2009-05-01

This article presents how the researcher goes about answering the research question, 'how assistive technology impacts computer use among individuals with cervical spinal cord injury?' through an in-depth investigation into the real-life situations among computer operators with cervical spinal cord injuries (CSI). An in-depth survey was carried out to provide an insight into the function abilities and limitation, habitual practice and preference, choices and utilisation of input devices, personal and/or technical assistance, environmental set-up and arrangements and special requirements among 20 experienced computer users with cervical spinal cord injuries. Following the survey findings, a five-layer CSI users' needs hierarchy of input device selection and use was proposed. These needs were ranked in order: beginning with the most basic criterion at the bottom of the pyramid; lower-level criteria must be met before one moves onto the higher level. The users' needs hierarchy for CSI computer users, which had not been applied by previous research work and which has established a rationale for the development of alternative input devices. If an input device achieves the criteria set up in the needs hierarchy, then a good match of person and technology will be achieved.

Residents' Yard Choices and Rationales in a Desert City: Social Priorities, Ecological Impacts, and Decision Tradeoffs

NASA Astrophysics Data System (ADS)

Larson, Kelli L.; Casagrande, David; Harlan, Sharon L.; Yabiku, Scott T.

2009-11-01

As a dominant land use in urban ecosystems, residential yards impact water and other environmental resources. Converting thirsty lawns into alternative landscapes is one approach to water conservation, yet barriers such as cultural norms reinforce the traditional lawn. Meanwhile, the complex social and ecological implications of yard choices complicate programs aimed at changing grass and other yard features for particular purposes. In order to better understand individual landscape decisions, we qualitatively examined residents’ rationales for their preferred yard types in the desert metropolis of Phoenix, Arizona. After briefly presenting landscape choices across two survey samples, the dominant reasons for preferences are discussed: appearance, maintenance, environment, recreation, microclimate, familiarity, and health/safety. Three broader analytical themes emerged from these descriptive codes: (1) residents’ desires for attractive, comfortable landscapes of leisure encompassing pluralistic tastes, lifestyles, and perceptions; (2) the association of environmental benefits and impacts with different landscape types involving complex social and ecological tradeoffs; and (3) the cultural legacies evident in modern landscape choices, especially in terms of a dichotomous human-nature worldview among long-time residents of the Phoenix oasis. Given these findings, programs aimed at landscape change must recognize diverse preferences and rationalization processes, along with the perceived versus actual impacts and tradeoffs of varying yard alternatives.

The effects of prenatal cocaine, post-weaning housing and sex on conditioned place preference in adolescent rats

PubMed Central

Dow-Edwards, Diana; Iijima, Maiko; Stephenson, Stacy; Jackson, April; Weedon, Jeremy

2014-01-01

Rationale Gestational exposure to cocaine now affects several million people including adolescents and young adults. Whether prenatal drug exposures alter an individual's tendency to take and/or abuse drugs is still a matter of debate. Objectives This study sought to answer the question does prenatal exposure to cocaine, in a dose-response fashion, alter the rewarding effects of cocaine using a conditioned place preference (CPP) procedure during adolescence in the rat. Further, we wanted to assess possible sex differences and the role of being raised in an enriched vs impoverished environment. Methods Virgin female Sprague-Dawley rats were dosed daily with cocaine at 30mg/kg (C30), 60mg/kg (C60) or vehicle intragastrically prior to mating and throughout gestation. Pups were culled, fostered and on postnatal day (PND) 23 placed into isolation cages or enriched cages with 3 same-sex littermates and stimulus objects. On PND43-47, CPP was determined across a range of cocaine doses. Results C30 exposure increased sensitivity to the rewarding effects of cocaine in adolescent males and being raised in an enriched environment further enhanced this effect. Rats exposed to C60 resembled the controls in cocaine CPP. Overall, females were modestly affected by prenatal cocaine and enrichment. Conclusions These data support the unique sensitivity of males to the effects of gestational cocaine, that moderate prenatal cocaine doses produce greater effects on developing reward circuits than high doses, and that housing condition interacts with prenatal treatment and sex such that enrichment increases cocaine CPP most in adolescent males prenatally exposed to moderate cocaine doses. PMID:24435324

Music: A Guide to Curriculum Development in the Arts.

ERIC Educational Resources Information Center

Iowa State Dept. of Public Instruction, Des Moines.

This guide was developed as a model for local music education programs. Following the preface, a unit titled, "Rationale/Philosophy/Goals," contains the philosophy and goals of music education and preferred student attitudes toward music. Goals and objectives for a multicultural, nonsexist approach to music education, and recommendations…

Allocating Resources for Learning Support: A Case Study.

ERIC Educational Resources Information Center

Sharp, Stephen

2000-01-01

Examines how learning-support resources are allocated to Scottish secondary schools, drawing on data from an Edinburgh education authority. Although a rationale for allocating resources based on socioeconomic indices can be constructed, basing decisions on a combination of standardized attainment tests and special-needs audits is preferable.…

Taking Turns

ERIC Educational Resources Information Center

Hopkins, Brian

2010-01-01

Two people take turns selecting from an even number of items. Their relative preferences over the items can be described as a permutation, then tools from algebraic combinatorics can be used to answer various questions. We describe each person's optimal selection strategies including how each could make use of knowing the other's preferences. We…

Training Aids for Basic Combat Skills: Developing Map-Reading Skills

DTIC Science & Technology

2011-03-01

types of training aids were developed for determining grid coordinates. Each training aid consisted of a set of self-study flashcards . One set of... flashcards contained scaled sections of topological maps and asked the Soldiers to find map features based on grid coordinates or to provide the grid...coordinates for a given map feature. The reverse of each flashcard provided feedback (i.e., correct answers and rationale to help the Soldier

F-16 Training System Media Report

DTIC Science & Technology

1981-03-01

practice items. 4.1.3 Use/Procedure This strategy requires the learner to apply a set of sequential steps designed to accomplish a specific task which needs...information. 6. Feedback: Provides the student with the correct answers for the practice items. 4.1.5 Use/Rule This strategy requires the learner to...provide the background and rationale for selecting and/or modifying instructional media to best meet the needs of the F-16 training program. The

Statistical Methods in Integrative Genomics

PubMed Central

Richardson, Sylvia; Tseng, George C.; Sun, Wei

2016-01-01

Statistical methods in integrative genomics aim to answer important biology questions by jointly analyzing multiple types of genomic data (vertical integration) or aggregating the same type of data across multiple studies (horizontal integration). In this article, we introduce different types of genomic data and data resources, and then review statistical methods of integrative genomics, with emphasis on the motivation and rationale of these methods. We conclude with some summary points and future research directions. PMID:27482531

The Influence of Proximity to a National Forest on Emotions and Fire-Management Decisions

NASA Astrophysics Data System (ADS)

Vining, Joanne; Merrick, Melinda S.

2008-02-01

Because American national forests are managed for all citizens, it is important that researchers explore the differences and similarities between citizens living both near and far from publicly managed land. We surveyed residents living at various distances from nationally managed land to collect resident perceptions of different forest fire-management techniques, to determine public preferences for these techniques, and to examine the motivations behind these preferences. Participants both close to and far away from national forests tended to favor a multipronged approach to fire management by preferring the use of a combination of two or more fire-management techniques. There were no significant differences by proximity in participants’ self-rated emotions, types of fire-management techniques preferred, or the reasons and rationales for their preferred fire-management technique(s), indicating that the proximity variable may not be as significant as previously thought.

The influence of proximity to a national forest on emotions and fire-management decisions.

PubMed

Vining, Joanne; Merrick, Melinda S

2008-02-01

Because American national forests are managed for all citizens, it is important that researchers explore the differences and similarities between citizens living both near and far from publicly managed land. We surveyed residents living at various distances from nationally managed land to collect resident perceptions of different forest fire-management techniques, to determine public preferences for these techniques, and to examine the motivations behind these preferences. Participants both close to and far away from national forests tended to favor a multipronged approach to fire management by preferring the use of a combination of two or more fire-management techniques. There were no significant differences by proximity in participants' self-rated emotions, types of fire-management techniques preferred, or the reasons and rationales for their preferred fire-management technique(s), indicating that the proximity variable may not be as significant as previously thought.

What men want: the role of reflective opposite-sex normative preferences in alcohol use among college women.

PubMed

Labrie, Joseph W; Cail, Jessica; Hummer, Justin F; Lac, Andrew; Neighbors, Clayton

2009-03-01

Misperceptions of peer drinking norms have been found to be strongly associated with individual drinking behavior, especially for proximal reference groups such as same-sex friends. Less studied are the effects of perceived preferences from the opposite sex on alcohol use; that is, the behaviors an individual believes the opposite sex prefers from them. Research suggests that these perceived "reflective" normative preferences may be particularly salient among college women, who may drink in pursuit of intimate relationships and positive attention from male peers. Heterosexual undergraduate students from two universities participated in this project. Females answered questions regarding the amount of alcohol they believe a typical male would like his female friends, dates, or romantic partners to drink. Males answered the same questions, stating their actual preferences. Results showed that females overestimate the amount of alcohol males want their female friends, dating partners, and sexual partners to drink, and that this misperception was associated with their drinking behavior, even after controlling for perceived same-sex norms. These results suggest that reflective normative feedback may offer a powerful new tool for female-targeted interventions. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Personality Preferences and Student Responses to Teacher Comments.

ERIC Educational Resources Information Center

Thompson, Tom

A study examined student responses to teacher comments on a student essay. First-year students at the Citadel, an all-male military school, imagined they wrote a paper on which a teacher had made 16 comments (eight positive and eight negative, eight having implied answers, eight having open-ended answers) and then rated those comments based on how…

The Internet School of Medicine: use of electronic resources by medical trainees and the reliability of those resources.

PubMed

Egle, Jonathan P; Smeenge, David M; Kassem, Kamal M; Mittal, Vijay K

2015-01-01

Electronic sources of medical information are plentiful, and numerous studies have demonstrated the use of the Internet by patients and the variable reliability of these sources. Studies have investigated neither the use of web-based resources by residents, nor the reliability of the information available on these websites. A web-based survey was distributed to surgical residents in Michigan and third- and fourth-year medical students at an American allopathic and osteopathic medical school and a Caribbean allopathic school regarding their preferred sources of medical information in various situations. A set of 254 queries simulating those faced by medical trainees on rounds, on a written examination, or during patient care was developed. The top 5 electronic resources cited by the trainees were evaluated for their ability to answer these questions accurately, using standard textbooks as the point of reference. The respondents reported a wide variety of overall preferred resources. Most of the 73 responding medical trainees favored textbooks or board review books for prolonged studying, but electronic resources are frequently used for quick studying, clinical decision-making questions, and medication queries. The most commonly used electronic resources were UpToDate, Google, Medscape, Wikipedia, and Epocrates. UpToDate and Epocrates had the highest percentage of correct answers (47%) and Wikipedia had the lowest (26%). Epocrates also had the highest percentage of wrong answers (30%), whereas Google had the lowest percentage (18%). All resources had a significant number of questions that they were unable to answer. Though hardcopy books have not been completely replaced by electronic resources, more than half of medical students and nearly half of residents prefer web-based sources of information. For quick questions and studying, both groups prefer Internet sources. However, the most commonly used electronic resources fail to answer clinical queries more than half of the time and have an alarmingly high rate of inaccurate information. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Male Mating Success: Preference or Prowess? Investigating Sexual Selection in the Laboratory Using "Drosophila melanogaster"

ERIC Educational Resources Information Center

Coleman, Seth; Jensen, Jeffrey

2007-01-01

Sexual selection is the primary force affecting the evolution of the elaborate sexual displays common in animals, yet sexual selection experiments are largely absent from introductory biology laboratories. Here we describe the rationale, methodology, and results of several experiments using "Drosophila melanogaster" to demonstrate sexual selection…

Using Acceptance and Commitment Therapy during Methadone Dose Reduction: Rationale, Treatment Description, and a Case Report

ERIC Educational Resources Information Center

Stotts, Angela L.; Masuda, Akihiko; Wilson, Kelly

2009-01-01

Many clients who undergo methadone maintenance (MM) treatment for heroin and other opiate dependence prefer abstinence from methadone. Attempts at methadone detoxification are often unsuccessful, however, due to distressing physical as well as psychological symptoms. Outcomes from an MM client who voluntarily participated in an Acceptance and…

What Can Repeated Cross-Sectional Studies Tell Us about Student Growth? Research Report. ETS RR-12-17

ERIC Educational Resources Information Center

Almond, Russell G.; Sinharay, Sandip

2012-01-01

To answer questions about how students' proficiencies are changing over time, educational researchers are looking for data sources that span many years. Clearly, for answering questions about student growth, a longitudinal study--in which a single sample is followed over many years--is preferable to repeated cross-sectional samples--in which a…

Using research evidence in mental health: user-rating and focus group study of clinicians' preferences for a new clinical question-answering service.

PubMed

Barley, Elizabeth A; Murray, Joanna; Churchill, Rachel

2009-12-01

Clinicians report difficulties using research in their practices. The aim of the study was to describe needs and preferences for a mental health clinical question-answering service designed to assist this process. Multi-disciplinary clinicians participated in a focus group; users of the service supplied feedback. Fifty-four clinicians received answers to 84 questions about mental health treatments. User ratings showed that the answers had multiple uses: informing health care (43), education (22), staff development (28) and research (12), and were considered useful, clear, relevant and helpful. Focus group participants appreciated critically appraised summaries of evidence and stressed the time-saving benefit of the service. Clinicians without a medical training were least confident in applying evidence. Attitudes to research were positive, but concern was expressed about its potential misuse for political purposes. This appeared to arise from an ambiguity around the term 'insufficient evidence', which participants felt is widely misinterpreted as 'evidence of no effect'. A highly valued, responsive service has been developed. A range of clinicians find critically appraised summaries of research useful. Education about the use of research may help clinicians to be more evidence based.

Clinical patient registry recruitment and retention: a survey of patients in two chronic disease registries.

PubMed

Solomon, Daniel H; Shadick, Nancy A; Weinblatt, Michael E; Frits, Michelle; Iannaccone, Christine; Zak, Agnes; Korzenik, Joshua R

2017-04-17

The collection of routine clinical data in the setting of research registries can serve an important role in understanding real world care. However, relatively little is known about the patient experience in registries, motivating us to survey patients enrolled in two chronic disease registries. We conducted similar surveys in two disease-based registries based at one academic medical center in the US. One group of patients with rheumatoid arthritis (RA) had been enrolled in a registry, and we focused on retention factors. In a second group of patients with inflammatory bowel disease (IBD) recently enrolled or considering enrollment, we examined factors that would influence their enrollment and willingness to answer frequent questionnaires and give biospecimens. The surveys were analyzed using descriptive statistics and the two cohorts were compared using nonparametric and chi-square tests. We received 150 (50%) completed surveys from RA and 169 (63%) from IBD patients. Mean age of subjects was 62 years in RA and 43 in IBD with more women respondents with RA (83%) than IBD (62%). The two groups described very similar factors as the top three motivations for participation: desire to help others, desire to improve care of own disease, and ease of volunteering. Preferred methods of surveying included mail, e-mail, but telephone was not favored; age was an important correlate of this preference. Respondents preferred surveys either every 1-3 months (28.7% RA and 55.0% IBD) or every 4-6 months (50.7% RA and 29.0% IBD). They differed in the preference for payment for answering surveys with 68.0% with RA answering that no payment was necessary but only 36.1% with IBD felt similarly. Patients engaged in clinical registries demonstrate a high level of commitment to improve care and many report a willingness to answer questions relatively frequently.

Perioperative fluid therapy: defining a clinical algorithm between insufficient and excessive.

PubMed

Strunden, Mike S; Tank, Sascha; Kerner, Thoralf

2016-12-01

In the perioperative scenario, adequate fluid and volume therapy is a challenging task. Despite improved knowledge on the physiology of the vascular barrier function and its respective pathophysiologic disturbances during the perioperative process, clear-cut therapeutic principles are difficult to implement. Neglecting the physiologic basis of the vascular barrier and the cardiovascular system, numerous studies proclaiming different approaches to fluid and volume therapy do not provide a rationale, as various surgical and patient risk groups, and different fluid regimens combined with varying hemodynamic measures and variable algorithms led to conflicting results. This review refers to the physiologic basis and answers questions inseparably conjoined to a rational approach to perioperative fluid and volume therapy: Why does fluid get lost from the vasculature perioperatively? Whereto does it get lost? Based on current findings and rationale considerations, which fluid replacement algorithm could be implemented into clinical routine? Copyright © 2016 Elsevier Inc. All rights reserved.

The Relationship between the Introvert and Extravert Dichotomy and Small Unit Recruiting Volume Production within the Watertown Recruiting Company

DTIC Science & Technology

2016-05-22

by adding the Judging-Perceiving dichotomy in addition to a questionnaire that would identify personal preferences based on their answers.11 The...perception. Sensing types prefer to use their five senses. Some identifiable traits among sensing types are clear focus on the task at hand, prefer ...The findings of the study revealed that there was a correlation between personality type and sales effectiveness. However this study also

The Relationship between Saudi English Major University Students' Writing Performance and Their Learning Style and Strategy Use

ERIC Educational Resources Information Center

Alkubaidi, Miriam A.

2014-01-01

This study investigates the link between writing tasks, learners' learning style preference, and writing strategy use. It also investigates if students with various proficiency levels stem from different learning style preference and use different writing strategies. This research attempts to answer the following research questions: what are the…

Electronic Resource Management 2.0: Using Web 2.0 Technologies as Cost-Effective Alternatives to an Electronic Resource Management System

ERIC Educational Resources Information Center

Murray, Adam

2008-01-01

Designed to assist with the management of e-resources, electronic resource management (ERM) systems are time- and fund-consuming to purchase and maintain. Questions of system compatibility, data population, and workflow design/redesign can be difficult to answer; sometimes those answers are not what we'd prefer to hear. The two primary functions…

Different answers to different audiences: effects of social context on the accuracy-informativeness trade-off.

PubMed

Martín-Luengo, Beatriz; Shtyrov, Yury; Luna, Karlos; Myachykov, Andriy

2018-08-01

Research on conversational exchanges shows that people attempt to optimise their responses' relevance when they definitely know the correct answer (e.g., "What time is it?"). However, such certainty is often unavailable while speakers may still be under social pressure to provide an answer. We investigated how social context influences the informativeness level when answering questions under uncertainty. In three experiments, participants answered difficult general-knowledge questions placed in different social contexts (formal vs. informal). Participants generated their answers, then they were presented with a given context, and decided on the number of alternative responses they wanted to provide (single, with one alternative vs. plural, with several alternatives) and whether the answer should be reported or withheld (report option). Participants reported more answers in the informal context. In the formal context, single answers were preferred, and they were more frequently reported. We conclude that social context influences the level of informativeness in a conversation, affecting achievable accuracy. Our results also show the joint influence of the confidence and the social context on willingness to share information.

Interactions and user-perceived helpfulness in diet information social questions & answers.

PubMed

Zhang, Yin; Wang, Peilin

2016-12-01

Online health information seeking using social questions and answers (Social Q&A) sites has been increasingly popular in recent years. It calls for better understanding of health information seeking behaviour and interactions between information seekers and information providers. The study investigates how diet information seekers interact with information providers on WebMD Answers, which is a Social Q&A site devoted to health-related topics, and examines the factors that constitute a 'helpful' answer from an information seeker's perspective. Bales' interaction process analysis was applied as the framework to analyse 568 diet-related Q&As from WebMD Answers to identify interaction patterns. Most diet information seekers post questions anonymously and without any detailed description. Individual experts or health organisations provide most answers. Overall, answers are positively received and had a high satisfaction rating. It was also found that information seeker-perceived helpfulness does not depend on who answered the question but to how an information seeker posted the question. This study indicates that answers at WebMD Answers are helpful for diet information seekers. It sheds new light on the interactions during the Q&A process, preferred site functions and important factors that contribute to perceived helpful answers. © 2016 Health Libraries Group.

Draft Final Risk Assessment Lime Settling Basins. Version 2.1

DTIC Science & Technology

1990-10-25

TABLE OF CON "S Section Page EXECUTIVE SUMMARY ...................................... v 1.0 INTRODUCTION ..................................... 1 - 1 1.1...BACKGROUND AND RATIONALE ........................ 1 - 1 1.2 SUMMARY OF APPROACH ............................. 1 -3 1.3 REPORT FORMAT... 1 -4 2.0 SITE DESCRIPTION AND HISTORY ......................... 2- 1 3.0 PREFERRED ALTERNATIVE INTERIM ACTION TECHNOLOGY ..... 3- 1 4.0

The Work Orientations of Australian University Students

ERIC Educational Resources Information Center

Taylor, Jeannette; Pick, David

2008-01-01

It is the aim of this paper to provide a better understanding of how university students in Australia are preparing for their future work in the labour market through their work orientations. It draws upon a survey of over 300 final-year undergraduates to present their rationales for engaging in paid work, and their preferences for different job…

Alternative Methods for Assessing Mediation in Multilevel Data: The Advantages of Multilevel SEM

ERIC Educational Resources Information Center

Preacher, Kristopher J.; Zhang, Zhen; Zyphur, Michael J.

2011-01-01

Multilevel modeling (MLM) is a popular way of assessing mediation effects with clustered data. Two important limitations of this approach have been identified in prior research and a theoretical rationale has been provided for why multilevel structural equation modeling (MSEM) should be preferred. However, to date, no empirical evidence of MSEM's…

Rationale for a ’Many Maps’ Phonology Machine

DTIC Science & Technology

1990-03-01

City, State, and ZIP Code) 10 SOURCE OF FUNDING NUMBERS 40005ub201/7-4-86 PROGRAM PROJECT TASK ~ WORK UNIT ELEMENT NO NO.I NO. ACCESSION NO NIA N/A NIA...seek to verify or refute. Some day, neurolinguistics may provide the decisive answer to the rationalist/empiricist debate. If so, we are confident that...linguistics program , Carnegie Mellon University. [7] Touretzky, D. S. (1989) Toward a connectionist phonology: the "many maps" ap- proach to sequencc

An international comparison study of pharmacy students' achievement goals and their relationship to assessment type and scores.

PubMed

Alrakaf, Saleh; Anderson, Claire; Coulman, Sion A; John, Dai N; Tordoff, June; Sainsbury, Erica; Rose, Grenville; Smith, Lorraine

2015-04-25

To identify pharmacy students' preferred achievement goals in a multi-national undergraduate population, to investigate achievement goal preferences across comparable degree programs, and to identify relationships between achievement goals, academic performance, and assessment type. The Achievement Goal Questionnaire was administered to second year students in 4 universities in Australia, New Zealand, England, and Wales. Academic performance was measured using total scores, multiple-choice questions, and written answers (short essay). Four hundred eighty-six second year students participated. Students showed an overall preference for the mastery-approach goal orientation across all sites. The predicted relationships between goal orientation and multiple-choice questions, and written answers scores, were significant. This study is the first of its kind to examine pharmacy students' achievement goals at a multi-national level and to differentiate between assessment type and measures of achievement motivation. Students adopting a mastery-approach goal are more likely to gain high scores in assessments that measure understanding and depth of knowledge.

An International Comparison Study of Pharmacy Students’ Achievement Goals and their Relationship to Assessment Type and Scores

PubMed Central

Anderson, Claire; Coulman, Sion A.; John, Dai N.; Tordoff, June; Sainsbury, Erica; Rose, Grenville; Smith, Lorraine

2015-01-01

Objective: To identify pharmacy students’ preferred achievement goals in a multi-national undergraduate population, to investigate achievement goal preferences across comparable degree programs, and to identify relationships between achievement goals, academic performance, and assessment type. Methods: The Achievement Goal Questionnaire was administered to second year students in 4 universities in Australia, New Zealand, England, and Wales. Academic performance was measured using total scores, multiple-choice questions, and written answers (short essay). Results: Four hundred eighty-six second year students participated. Students showed an overall preference for the mastery-approach goal orientation across all sites. The predicted relationships between goal orientation and multiple-choice questions, and written answers scores, were significant. Conclusion: This study is the first of its kind to examine pharmacy students’ achievement goals at a multi-national level and to differentiate between assessment type and measures of achievement motivation. Students adopting a mastery-approach goal are more likely to gain high scores in assessments that measure understanding and depth of knowledge. PMID:25995510

Communication Among Incident Responders-A Study

DTIC Science & Technology

2012-09-01

Determine If More Teams Prefer Water or Coca - Cola 5 2.3.1 Description 5 2.3.2 Results 6 2.3.3 Analysis 7 2.4 Task #4: Complete Email Message...participating in this study: <REDACTED> Please determine whether more of these teams prefer Coca - Cola or Water to drink with dinner. Please...needs to express a preference for either water or Coca - Cola . We also did not describe how teams should communicate and tally votes in order to answer our

The effect of pharmacy setting and pharmacist communication style on patient perceptions and selection of pharmacists.

PubMed

Perrault, Evan K; Beal, Jenny L

2018-05-08

To determine a) the impact of pharmacy setting (chain vs. independent) and b) pharmacists' communication styles on patients' pharmacist selection preferences and their perceptions of pharmacists. A 2 (pharmacy setting) × 4 (communication style of pharmacist) mixed-design experiment using online vignettes, where pharmacy setting (chain vs. independent) was the between-subjects factor and the communication style of the pharmacists (paternalistic, informative, interpretive, or deliberative) was the within-subjects factor. A total of 502 adult U.S. participants completed an online survey. Participants completed measures of perceived expertise, quality of medical care, and patient satisfaction after exposure to each vignette. They also selected which of the 4 pharmacists they would want to visit, along with answering an open-ended prompt explaining their decision. Mixed analysis of variance results revealed that pharmacy setting had no impact on the dependent variables, although pharmacists adopting more patient-centered communication (i.e., deliberative or interpretive) were perceived to have greater expertise (P < 0.001). These pharmacists were also predicted to provide a higher quality of care (P < 0.001) and greater patient satisfaction (P < 0.001). Although the majority of participants would choose to visit a patient-centered pharmacist, about 1 in 6 stated that he or she would prefer a pharmacist adopting a paternalistic communication style. Participants' rationale for their selections focused primarily on how the pharmacists would communicate or recommend treatments. Although patient-centered care is seen as a criterion standard in pharmacy practice, there is a large subset of patients who prefer pharmacists who communicate from a more biomedical perspective. Future research and interprofessional educational opportunities with colleagues in communication disciplines may be fruitful in helping pharmacists to better assess patient cues that might signal their willingness to be more or less active participants in their care. Pharmacies may also find it useful to improve how they market pharmacists so that patients can more effectively choose pharmacists who fit the style of care they would like to receive. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Black and White Children's Racial Identification and Preference

ERIC Educational Resources Information Center

Mahan, Juneau

1976-01-01

Black and white children ranging in age from three to seven were asked to answer questions pertaining to a black doll and a white doll placed in front of them in order to partially replicate Clark's and Clark's 1941 study on racial identification and preference in children, including a white group of children. It was found that black and white…

The Influence of Styles, Text Content, Sex, and Grade Level on First, Second, and Third Grade Children's Preferences for Artistic Style.

ERIC Educational Resources Information Center

Ramsey, Inez L.

This study was designed to answer the following question: which of four commonly used art styles (photographic, representational, cartoon, and expressionistic), employed in children's tradebooks, would first, second, and third grade children prefer when (a) pictures only were viewed, and (b) text content (informational or fanciful) accompanied…

Google vs. the Library: Student Preferences and Perceptions when Doing Research Using Google and a Federated Search Tool

ERIC Educational Resources Information Center

Georgas, Helen

2013-01-01

Federated searching was once touted as the library world's answer to Google, but ten years since federated searching technology's inception, how does it actually compare? This study focuses on undergraduate student preferences and perceptions when doing research using both Google and a federated search tool. Students were asked about their…

Science choices and preferences of middle and secondary school students in Utah

NASA Astrophysics Data System (ADS)

Baird, J. Hugh; Lazarowitz, Reuven; Allman, Verl

This research sought to answer two questions: (1) What are Utah junior and senior high school students' preferences and choices regarding science subjects? (2) Could preferences and choices be related to the type of school, age or gender? Two thousand students from grades six through twelve participated in this study. Findings show that zoology and human anatomy and physiology were most preferred. Ecology was least prefered. Topics in the physical sciences were also low. There was a trend among girls to prefer natural sciences such as botany while boys tended to prefer the physical sciences. Generally, students' choices were limited to those subjects presently taught in the formal school curriculum. They appeared unaware of the many science related subjects outside the texts or the approved course of study.

Strategies for Global Optimization of Temporal Preferences

NASA Technical Reports Server (NTRS)

Morris, Paul; Morris, Robert; Khatib, Lina; Ramakrishnan, Sailesh

2004-01-01

A temporal reasoning problem can often be naturally characterized as a collection of constraints with associated local preferences for times that make up the admissible values for those constraints. Globally preferred solutions to such problems emerge as a result of well-defined operations that compose and order temporal assignments. The overall objective of this work is a characterization of different notions of global preference, and to identify tractable sub-classes of temporal reasoning problems incorporating these notions. This paper extends previous results by refining the class of useful notions of global temporal preference that are associated with problems that admit of tractable solution techniques. This paper also answers the hitherto open question of whether problems that seek solutions that are globally preferred from a Utilitarian criterion for global preference can be found tractably.

Subliminal perception of complex visual stimuli.

PubMed

Ionescu, Mihai Radu

2016-01-01

Rationale: Unconscious perception of various sensory modalities is an active subject of research though its function and effect on behavior is uncertain. Objective: The present study tried to assess if unconscious visual perception could occur with more complex visual stimuli than previously utilized. Methods and Results: Videos containing slideshows of indifferent complex images with interspersed frames of interest of various durations were presented to 24 healthy volunteers. The perception of the stimulus was evaluated with a forced-choice questionnaire while awareness was quantified by self-assessment with a modified awareness scale annexed to each question with 4 categories of awareness. At values of 16.66 ms of stimulus duration, conscious awareness was not possible and answers regarding the stimulus were random. At 50 ms, nonrandom answers were coupled with no self-reported awareness suggesting unconscious perception of the stimulus. At larger durations of stimulus presentation, significantly correct answers were coupled with a certain conscious awareness. Discussion: At values of 50 ms, unconscious perception is possible even with complex visual stimuli. Further studies are recommended with a focus on a range of interest of stimulus duration between 50 to 16.66 ms.

Why teach literature and medicine? Answers from three decades.

PubMed

Jones, Anne Hudson

2013-12-01

In this essay, I look back at some of the earliest attempts by the first generation of literature-and-medicine scholars to answer the question: Why teach literature and medicine? Reviewing the development of the field in its early years, I examine statements by practitioners to see whether their answers have held up over time and to consider how the rationales they articulated have expanded or changed in the following years and why. Greater emphasis on literary criticism, narrative ethics, narrative theory, and reflective writing has influenced current work in the field in ways that could not have been foreseen in the 1970s. The extraordinary growth of interest and work in the field nationally and, especially since 1996, internationally has included practitioners in many additional areas such as disability studies, film studies, therapeutic writing, and trauma studies. Along with the emergence of narrative medicine, this diverse community of scholars and practitioners-affiliated more through their use of narrative methodologies than the teaching of literature-makes the perennial challenge of evaluation and assessment even more complicated.

Intelligent Real-Time Problem Solving

DTIC Science & Technology

1990-01-01

uncertainty, its preferences, and its attitude towards risk . 14 Control Theory This paradigm has culminated in a mature academic discipline that has produced a...systems offer the obvious advantages of evaluating against reality, but they are often cumbersome or even unavailable, may pose unacceptable risks , etc. In... return an answer. For the sorts of anytime algorithms wc are interested in, one can determine the expected utility of the answers returned by the

Domestic violence shapes Colombian women's partner choices.

PubMed

Borras-Guevara, Martha Lucia; Batres, Carlota; Perrett, David I

2017-01-01

Potential protection from violence has been suggested as an explanation for women's preferences for more masculine partners. Previous studies, however, have not considered that violence may be multi-modal, and hence come from different sources. Therefore, we tested the effect of different fears of violence (i.e. vulnerability to public crime, likelihood of within-partnership violence) on masculinity preferences of women from Colombia, a country known for its high rates of violence. Eighty-three adult heterosexual women (mean age ± SD = 26.7 ± 6.01) answered a survey that included questions about health (e.g. frequency of illnesses during the last year and during childhood), access to media (e.g. time spent watching television, frequency of internet use), education (i.e. highest level achieved) and violence perceptions. Participants' masculinity preferences for Salvadoran, European and Colombian male faces were recorded. Factor analysis revealed two different factors for the answers to questions related to violence. One factor loaded mostly on questions related to public violence and the second factor related to domestic violence. We found that women with higher scores on the domestic violence factor preferred significantly less masculine Colombian male faces. Even after controlling for participant age, education, access to media (TV and internet) and health-related factors, the domestic violence factor contributed significantly to explaining masculinity preferences. The results presented here suggest that women's preferences for masculinity may be a strategy to avoid aggressive partners and that the source of violence matters in mate choice. Women who perceive higher risks of domestic violence prefer less masculine looking partners. Using an experimental approach, we show that Colombian women who feel more in danger of violence within partnership prefer the faces of less masculine males. This was true even after controlling for women's education level, health and access to media.

Annual Progress Report FY-82. Volume II.

DTIC Science & Technology

1982-01-01

subjective judgments, binaural amplification TITLE OF PROJECT: Subjective Comparisons of Binaural vs. Monaural Amplification PRINCIPAL INVESTIGATOR(S...REPORT STUDY OBJECTIVE: The purpose of this study is to determine (1) the consis- tency of subjective differences noted between binaural and monaural...candidates seen at WRAMC have been reviewed to determine rationale for preferences of mon- aural vs. binaural amplification. Comparisons are being made of

A qualitative exploration of treatment decision-making role preference in adult asthma patients.

PubMed

Caress, Ann-Louise; Luker, Karen; Woodcock, Ashley; Beaver, Kinta

2002-09-01

To explore preferred treatment decision-making roles, and rationales for role preference, and to identify perceived facilitators to and barriers from attaining preferred role. Qualitative design. One secondary care and four primary care sites in North-west England. Purposive sample of 32 adult asthma patients with varied socio-economic backgrounds and disease severity. Tape-recorded focused-conversation style interviews. Interview topic guide derived from the literature. Sort cards employed to provide the focus for exploration of role preferences. Active (n = 7), collaborative (n = 11) and passive (n = 14) decisional role preferences were identified. Respondents cited level of knowledge; trust; duration of condition; severity of condition at the decisional juncture; lifelong nature of asthma; a perception that 'it is my body'; characteristics of the individual and their response to health professionals as influencing role preference. Perceived facilitators and barriers to participation included condition-related knowledge, practical issues (e.g. lack of time during consultation) and clinicians' interpersonal skills. Most respondents wished to contribute to or feel involved in treatment decision-making, but not necessarily to control it. Some hindrances to participation would be amenable to intervention. The quality of the provider-patient relationship is central to facilitating participation.

Opinions of Pre-Service Classroom Teachers towards Laboratory Using in Science Instruction and Their Preferences Towards Laboratory Approaches

ERIC Educational Resources Information Center

Yildirim, Nagihan

2016-01-01

This study is a descriptive study that adopts relational screening model with the aim of determining pre-service classroom teachers' opinions about laboratory use in science teaching their preferences among laboratory approaches and identifying the reasons of the answers given by the pre-service teachers. The sample of the study is 236 pre-service…

Demand management: enabling patients to use medical care appropriately.

PubMed

Vickery, D M; Lynch, W D

1995-05-01

A rationale is presented for considering demand management as well as supply management (managed care) in the current debate on health care reform. Demand management is the support of individuals so that they may make rational health and medical decisions based on a consideration of benefits and risks. The concept of demand for medical services is examined within a theoretical framework of four components: morbidity, perceived need, patient preference, and nonhealth motives. Two components, perceived need and patient preference, are suggested to offer considerable potential for making utilization more appropriate and reducing costs. Current demand services and potential hazards related to their continued expansion are discussed.

Customer awareness and preferences toward competing hospital services.

PubMed

Woodside, A; Shinn, R

1988-03-01

Does unaided awareness of a hospital affect former patients' preferences for and intention to use the medical services of that hospital? Do customer preferences toward hospitals influence their intentions to use the medical services of those hospitals? To what extent does satisfaction with previous hospital stays affect former patients' intentions to return to the same hospital? The authors provide some tentative answers to these questions. The results of an exploratory field study of former inpatients of one hospital are reported. Several recommendations for research and hospital marketing strategies are provided.

Examining ethics - developing a comprehensive exam for a bioethics master's program.

PubMed

Schonfeld, Toby; Stoddard, Hugh; Labrecque, Cory Andrew

2014-10-01

Assessing mastery of bioethics in a graduate program requires careful attention not simply to the content knowledge and skill development of students but also to the principles of sound assessment processes. In this article, we describe the rationale, development process, and features of the comprehensive exam we created as a culminating experience of a master's program in bioethics. The exam became the students' opportunity to demonstrate the way they were able to integrate course, textual, and practical knowledge gained throughout the experience of the program. Additionally, the exam assessed students' proficiency in the field of bioethics and their ability to critically and constructively analyze bioethical issues. In this article, we offer tips to other exam creators regarding our experiences with question and answer development, scoring of the exam, and relationships between coursework and exam preparation and completion. We also include a sample rubric for others to see how we determined which student answers were satisfactory.

[Ethics as first philosophy: the ethics of responsibility as a rationale for health care].

PubMed

Belli, Laura Florencia; Quadrelli, Silvia

2010-01-01

The origins of bioethics as a discipline arouse from the need to provide an answer to new ethical questions generated as a result of technological advances in the health field and the new arenas in which biomedical research began to develop. Discussions were first focused on the relevance of the applicability of new technologies and the need to redefine a number of concepts related to the beginning and end of life. Then, over the years, this discipline was shaped and reconfigured incorporating issues related to the process of decision making in daily medical care, patient rights, protection of their freedoms and obligations of medical professionals, among others. The purpose of this essay is to reflect upon the ethical foundations of health care, trying to provide an answer to the question "why movide care" in light of the thought of Emmanuel Lévinas.

Does Anyone Know the Answer to that Question? Individual Differences in Judging Answerability

PubMed Central

Karlsson, Bodil S. A.; Allwood, Carl Martin; Buratti, Sandra

2016-01-01

Occasionally people may attempt to judge whether a question can be answered today, or if not, if it can be answered in the future. For example, a person may consider whether enough is known about the dangers of living close to a nuclear plant, or to a major electricity cable, for them to be willing to do so, and state-authorities may consider whether questions about the dangers of new technologies have been answered, or in a reasonable future can be, for them to be willing to invest money in research aiming develop such technologies. A total of 476 participants, for each of 22 knowledge questions, either judged whether it was answerable today (current answerability), or judged when it could be answered (future answerability). The knowledge questions varied with respect to the expected consensus concerning their answerability: consensus questions (high expected consensus), non-consensus questions (lower expected consensus), and illusion questions (formulated to appear answerable, but with crucial information absent). The questions’ judged answerability level on the two scales was highly correlated. For both scales, consensus questions were rated more answerable than the non-consensus questions, with illusion questions falling in-between. The result for the illusion questions indicates that a feeling of answerability can be created even when it is unlikely that somebody can come up with an answer. The results also showed that individual difference variables influenced the answerability judgments. Higher levels of belief in certainty of knowledge, mankind’s knowledge, and mankind’s efficacy were related to judging the non-consensus questions as more answerable. Participants rating the illusion questions as answerable rated the other answerability questions as more, or equally, answerable compared to the other participants and showed tendencies to prefer a combination of more epistemic default processing and less intellectual processing. PMID:26793164

Laparoscopic Heller Myotomy and Dor Fundoplication for Esophageal Achalasia: Technique and Perioperative Management.

PubMed

Andolfi, Ciro; Fisichella, P Marco

2016-11-01

Surgical correction of achalasia using laparoscopic Heller myotomy with Dor fundoplication is argued to be the gold standard treatment for patients with achalasia. The goal of this technical report is to illustrate our preferred approach to patients with achalasia and to provide the reader with a detailed description of our operative technique, its rationale, and our pre and postoperative management.

Do They Get What They Want or Are They Stuck with What They Can Get? Testing Homophily against Default Selection for Friendships of Highly Aggressive Boys. The TRAILS Study

ERIC Educational Resources Information Center

Sijtsema, Jelle J.; Lindenberg, Siegwart M.; Veenstra, Rene

2010-01-01

In this study a homophily selection hypothesis was tested against a default selection hypothesis, to answer whether preferred and realized friendships of highly aggressive boys differed. In a large peer-nomination sample, we assessed who highly overt aggressive, low prosocial boys (n = 181) nominated as friends (preferred friendships) and who…

Speech and language therapists' approaches to communication intervention with children and adults with profound and multiple learning disability.

PubMed

Goldbart, Juliet; Chadwick, Darren; Buell, Susan

2014-11-01

People with profound intellectual and multiple disabilities (PMLD) have communication impairments as one defining characteristic. To explore speech and language therapists' (SLTs) decision making in communication interventions for people with PMLD, in terms of the intervention approaches used, the factors informing the decisions to use specific interventions and the extent to which the rationales underpinning these decisions related to the components of evidence based practice (EBP), namely empirical evidence, clinical experience and client/carer views and values. A questionnaire on communication assessment and intervention for people with PMLD was sent to SLTs in the UK to elicit information on: the communication intervention approaches they used; their rationales for their intervention choices; their use of published evidence to inform decision making. Intensive interaction and objects of reference were the communication interventions most often used with people with PMLD, with some differences between children and adults evident. Rationales provided conformed somewhat to the EBP framework though extension of the existing framework and addition of practical and organizational considerations led to a revised typology of rationale for decision making. Rationales most frequently related to the empowerment, development and behavioural preferences of the person with PMLD. Empirical research evidence was seldom mentioned by SLTs as informing intervention decision making leading to very diverse practice. There is a need for further research on the effectiveness of commonly used but under-evaluated interventions. There is also a need to alert SLTs to the evidence base supporting other approaches, particularly switch-based, cause and effect approaches. © 2014 Royal College of Speech and Language Therapists.

Involvement in treatment decisions: what do adults with asthma want and what do they get? Results of a cross sectional survey.

PubMed

Caress, A-L; Beaver, K; Luker, K; Campbell, M; Woodcock, A

2005-03-01

Current healthcare policy advocates patient participation in treatment decision making. However, in asthma there is little evidence regarding patients' views on such involvement. This study explored the preferred and perceived level of involvement in treatment decisions, rationales for role preference, perceived facilitators of/barriers to involvement, and the interrelationship of role preference and demographic variables in a sample of patients with asthma. A cross sectional survey was performed of 230 adults with clinician diagnosed asthma from 10 primary care sites and one specialist respiratory centre in north-west England. Preferred role in treatment decisions was assessed using the Control Preferences Scale. Fifty five (23.9%) preferred an active role, 82 (35.7%) a collaborative role, and 93 (40.4%) a passive role; 19 (8.2%) perceived their role as active compared with 45 (19.6%) collaborative and 166 (72.2%) passive. Only 33.5% (n = 77) of respondents attained their most preferred role; 55.2% (n = 127) were less involved than they preferred. Patient related, professional related, and organisational factors, especially quality and duration of consultations, facilitated or hampered involvement. Role preferences were not strongly associated with demographic variables or asthma severity. This study in patients with asthma highlights the fact that there is a need for professional and patient education regarding partnership working, skilful communication, and innovative approaches to service delivery.

Treatment modality preferences and adherence to group treatment for panic disorder with agoraphobia.

PubMed

Perreault, Michel; Julien, Dominic; White, Noé Djawn; Bélanger, Claude; Marchand, André; Katerelos, Theodora; Milton, Diana

2014-06-01

To examine the relationship between preference for group psychotherapy and adherence to group cognitive-behavioral therapy (CBT) for clients with panic disorder with agoraphobia (PDA), 109 participants experiencing PDA completed a questionnaire measuring preference for group treatment (PGTQ) before beginning CBT groups. A t test was used to compare preference scores for group treatment to investigate whether participants who completed treatment differed from those who abandoned treatment. Participants who completed group therapy expressed higher preference for group treatment than participants who dropped out of treatment (t[107] = 1.99; p < 0.05). The PGTQ-4 presented adequate psychometric properties. Reliability analyses of the items retained after factorization demonstrated an acceptable level of internal consistency (Cronbach's alpha of 0.76). Preference for individual or group therapy appears to impact treatment retention for patients with PDA. Matching patients' preferences to the type of treatment modality used appears to be pertinent, especially for the treatment of anxiety disorders. In terms of practical implications, the rationale and benefits of group therapy should be explained to participants reluctant to engage in group therapy. Individual intervention or a combination of group and individual treatment could be considered for clients who are likely to drop out of group therapy.

Spacelab Program: Conversion of Spacelab to packet data format. Flight system study

NASA Technical Reports Server (NTRS)

1981-01-01

A study of packetization of the Spacelab data handling system, including the alternate approaches considered and the supporting rationale, is described. It is concluded that it is well within today's state of the art in microelectronics to implement either a full or hybrid packet data system on board the Spacelab. Of the two, the hybrid system is preferred because of the significant cost saving.

Immersion, Relevance and Transferability: The Motivational Preferences of Lower Secondary Students towards a Newly Created Praxis-Based Class Music Program

ERIC Educational Resources Information Center

Lowe, Geoffrey; Coy, Neil

2016-01-01

The purpose of this study was to gather information on measures of motivation among year 7, 8 and 9 students enrolled in class music in a major Australian secondary school. The rationale for the study was to gain insights into why retention in the class music program had dramatically increased since the introduction of a new teaching program. A…

Developing Emergency Department–based Education About Emergency Contraception: Adolescent Preferences

PubMed Central

Mollen, Cynthia J.; Miller, Melissa K.; Hayes, Katie L.; Wittink, Marsha N.; Barg, Frances K.

2014-01-01

Objectives The objective was to identify adolescent preferences for emergency department (ED)-based education about emergency contraception. Methods This was a cross-sectional computerized survey, using adaptive conjoint analysis (ACA). Patients were eligible if they were females ages 14 through 19 years old and were seeking care in one of two urban EDs. Patients were excluded if they were too ill to participate in the survey or if they were non-English speaking. Participants completed a computerized survey that used ACA, a technique that can be used to assess patients’ relative preferences for services. ACA uses the individual’s answers to update and refine questions through trade-off comparisons, so that each respondent answers a customized set of questions. The survey assessed preferences for the following attributes of emergency contraception education: who should deliver the education, if anyone (e.g., nurse, doctor); how the education should be delivered (e.g., by a person or via video); how often the education should be offered if patients were to frequent the ED (e.g., every time or only when asking for it); length (e.g., 5 minutes, 10 minutes); and chief complaint that would trigger the education (e.g., headache or stomach pain). Results A total of 223 patients were enrolled (37.2% at Hospital 1 and 62.8% at Hospital 2). The mean (±SD) age of the participants was 16.1 (±1.3) years. Just over half (55%) reported a history of sexual activity; 8% reported a history of pregnancy. Overall, the participants preferred education that was delivered by a person, specifically a doctor or nurse. They preferred a slightly longer education session and preferred education directed at patients seeking care in the ED for complaints potentially related to sexual activity. Conclusions Adolescents have specific preferences for how education about emergency contraception would best serve their needs. This information can inform clinicians as they work to improve adolescents’ knowledge about pregnancy prevention and emergency contraception in particular. PMID:24238320

Developing emergency department-based education about emergency contraception: adolescent preferences.

PubMed

Mollen, Cynthia J; Miller, Melissa K; Hayes, Katie L; Wittink, Marsha N; Barg, Frances K

2013-11-01

The objective was to identify adolescent preferences for emergency department (ED)-based education about emergency contraception. This was a cross-sectional computerized survey, using adaptive conjoint analysis (ACA). Patients were eligible if they were females ages 14 through 19 years old and were seeking care in one of two urban EDs. Patients were excluded if they were too ill to participate in the survey or if they were non-English speaking. Participants completed a computerized survey that used ACA, a technique that can be used to assess patients' relative preferences for services. ACA uses the individual's answers to update and refine questions through trade-off comparisons, so that each respondent answers a customized set of questions. The survey assessed preferences for the following attributes of emergency contraception education: who should deliver the education, if anyone (e.g., nurse, doctor); how the education should be delivered (e.g., by a person or via video); how often the education should be offered if patients were to frequent the ED (e.g., every time or only when asking for it); length (e.g., 5 minutes, 10 minutes); and chief complaint that would trigger the education (e.g., headache or stomach pain). A total of 223 patients were enrolled (37.2% at Hospital 1 and 62.8% at Hospital 2). The mean (±SD) age of the participants was 16.1 (±1.3) years. Just over half (55%) reported a history of sexual activity; 8% reported a history of pregnancy. Overall, the participants preferred education that was delivered by a person, specifically a doctor or nurse. They preferred a slightly longer education session and preferred education directed at patients seeking care in the ED for complaints potentially related to sexual activity. Adolescents have specific preferences for how education about emergency contraception would best serve their needs. This information can inform clinicians as they work to improve adolescents' knowledge about pregnancy prevention and emergency contraception in particular. © 2013 by the Society for Academic Emergency Medicine.

Individual differences in bitter taste preferences are associated with antisocial personality traits.

PubMed

Sagioglou, Christina; Greitemeyer, Tobias

2016-01-01

In two studies, we investigated how bitter taste preferences might be associated with antisocial personality traits. Two US American community samples (total N = 953; mean age = 35.65 years; 48% females) self-reported their taste preferences using two complementary preference measures and answered a number of personality questionnaires assessing Machiavellianism, psychopathy, narcissism, everyday sadism, trait aggression, and the Big Five factors of personality. The results of both studies confirmed the hypothesis that bitter taste preferences are positively associated with malevolent personality traits, with the most robust relation to everyday sadism and psychopathy. Regression analyses confirmed that this association holds when controlling for sweet, sour, and salty taste preferences and that bitter taste preferences are the overall strongest predictor compared to the other taste preferences. The data thereby provide novel insights into the relationship between personality and the ubiquitous behaviors of eating and drinking by consistently demonstrating a robust relation between increased enjoyment of bitter foods and heightened sadistic proclivities. Copyright © 2015 Elsevier Ltd. All rights reserved.

Views of implementation approaches by top managers in health service organizations.

PubMed

Nutt, P C

1996-01-01

This study examined how top managers view the prospects of success and resistance when using four implementation approaches in participative and control cultures that foster climates more or less conducive to change. An accommodation approach was viewed as having the best prospect of success and of lowering resistance in a participative culture. Bargaining and incentive approaches were thought to have successful and low resistance outcomes, which were just below those of accommodation, in a control type of culture. A persuasion approach was thought to be the least effective implementation approach in a control-oriented culture. These preferences differ from prescriptions found in the implementation literature. Assuming that preferences influence behavior, implementation success could be improved if managers selected an implementation approach according to the demands of the situation. More research is needed to appreciate fully the rationale that lies behind the preferences uncovered in this research.

Through evolution's eyes: extracting mate preferences by linking visual attention to adaptive design.

PubMed

Krupp, Daniel Brian

2008-02-01

Information is crucial to decision-making, including mate choice decisions. Perceptual systems, such as attention, evolved in part to forage for reproductive information; consequently, these systems can be used to reveal mate preferences. Here, I consider the place of visual information in human mate choice and provide a rationale for pressing into service methods drawn from the attention literature for the study of mate choice decisions. Because visual attention is allocated automatically and selectively, it may be used to complement common methods of mate preference assessment, such as self-report questionnaires and measures of genital arousal, while avoiding some of the pitfalls of these methods. Beyond the utility of increasing confidence in extant research findings by employing relatively unobtrusive methods, visual attention paradigms can also allow researchers to explore a variety of questions that are rarely asked, such as those concerned with signal efficiency and tradeoffs in the assessment of mate value.

The self-consistency model of subjective confidence.

PubMed

Koriat, Asher

2012-01-01

How do people monitor the correctness of their answers? A self-consistency model is proposed for the process underlying confidence judgments and their accuracy. In answering a 2-alternative question, participants are assumed to retrieve a sample of representations of the question and base their confidence on the consistency with which the chosen answer is supported across representations. Confidence is modeled by analogy to the calculation of statistical level of confidence (SLC) in testing hypotheses about a population and represents the participant's assessment of the likelihood that a new sample will yield the same choice. Assuming that participants draw representations from a commonly shared item-specific population of representations, predictions were derived regarding the function relating confidence to inter-participant consensus and intra-participant consistency for the more preferred (majority) and the less preferred (minority) choices. The predicted pattern was confirmed for several different tasks. The confidence-accuracy relationship was shown to be a by-product of the consistency-correctness relationship: It is positive because the answers that are consistently chosen are generally correct, but negative when the wrong answers tend to be favored. The overconfidence bias stems from the reliability-validity discrepancy: Confidence monitors reliability (or self-consistency), but its accuracy is evaluated in calibration studies against correctness. Simulation and empirical results suggest that response speed is a frugal cue for self-consistency, and its validity depends on the validity of self-consistency in predicting performance. Another mnemonic cue-accessibility, which is the overall amount of information that comes to mind-makes an added, independent contribution. Self-consistency and accessibility may correspond to the 2 parameters that affect SLC: sample variance and sample size.

Estimates and influences of reflective opposite-sex norms on alcohol use among a high-risk sample of college students: Exploring Greek-affiliation and gender effects

PubMed Central

Hummer, Justin F.; LaBrie, Joseph W.; Lac, Andrew; Sessoms, Ashley; Cail, Jessica

2012-01-01

Reflective opposite sex norms are behavior that an individual believes the opposite sex prefers them to do. The current study extends research on this recently introduced construct by examining estimates and influences of reflective norms on drinking in a large high-risk heterosexual sample of male and female college students from two universities. Both gender and Greek-affiliation served as potential statistical moderators of the reflective norms and drinking relationship. All participants (N = 1790; 57% female) answered questions regarding the amount of alcohol they believe members of the opposite sex would like their opposite sex friends, dates, and sexual partners to drink. Participants also answered questions regarding their actual preferences for drinking levels in each of these three relationship categories. Overall, women overestimated how much men prefer their female friends and potential sexual partners to drink, whereas men overestimated how much women prefer their sexual partners to drink. Greek-affiliated males demonstrated higher reflective norms than non-Greek males across all relationship categories, and for dating partners, only Greek-affiliated males misperceived women’s actual preferences. Among women however, there were no differences between reflective norms estimates or the degree of misperception as a function of Greek status. Most importantly, over and above perceived same-sex social norms, higher perceived reflective norms tended to account for greater variance in alcohol consumption for Greeks (vs. non-Greeks) and males (vs. females), particularly within the friend and sexual partner contexts. The findings highlight that potential benefits might arise if existing normative feedback interventions were augmented with reflective normative feedback designed to target the discrepancy between perceived and actual drinking preferences of the opposite sex. PMID:22305289

Convergent validity between a discrete choice experiment and a direct, open-ended method: comparison of preferred attribute levels and willingness to pay estimates.

PubMed

Marjon van der Pol; Shiell, Alan; Au, Flora; Johnston, David; Tough, Suzanne

2008-12-01

The Discrete Choice Experiment (DCE) has become increasingly popular as a method for eliciting patient or population preferences. If DCE estimates are to inform health policy, it is crucial that the answers they provide are valid. Convergent validity is tested in this paper by comparing the results of a DCE exercise with the answers obtained from direct, open-ended questions. The two methods are compared in terms of preferred attribute levels and willingness to pay (WTP) values. Face-to-face interviews were held with 292 women in Calgary, Canada. Similar values were found between the two methods with respect to preferred levels for two out of three of the attributes examined. The DCE predicted less well for levels outside the range than for levels inside the range reaffirming the importance of extensive piloting to ensure appropriate level range in DCEs. The mean WTP derived from the open-ended question was substantially lower than the mean derived from the DCE. However, the two sets of willingness to pay estimates were consistent with each other in that individuals who were willing to pay more in the open-ended question were also willing to pay more in the DCE. The difference in mean WTP values between the two approaches (direct versus DCE) demonstrates the importance of continuing research into the different biases present across elicitation methods.

Large-scale database searching using tandem mass spectra: looking up the answer in the back of the book.

PubMed

Sadygov, Rovshan G; Cociorva, Daniel; Yates, John R

2004-12-01

Database searching is an essential element of large-scale proteomics. Because these methods are widely used, it is important to understand the rationale of the algorithms. Most algorithms are based on concepts first developed in SEQUEST and PeptideSearch. Four basic approaches are used to determine a match between a spectrum and sequence: descriptive, interpretative, stochastic and probability-based matching. We review the basic concepts used by most search algorithms, the computational modeling of peptide identification and current challenges and limitations of this approach for protein identification.

Coupling Conceptual and Quantitative Problems to Develop Expertise in Introductory Physics Students

NASA Astrophysics Data System (ADS)

Singh, Chandralekha

2008-10-01

We discuss the effect of administering conceptual and quantitative isomorphic problem pairs (CQIPP) back to back vs. asking students to solve only one of the problems in the CQIPP in introductory physics courses. Students who answered both questions in a CQIPP often performed better on the conceptual questions than those who answered the corresponding conceptual questions only. Although students often took advantage of the quantitative counterpart to answer a conceptual question of a CQIPP correctly, when only given the conceptual question, students seldom tried to convert it into a quantitative question, solve it and then reason about the solution conceptually. Even in individual interviews, when students who were only given conceptual questions had difficulty and the interviewer explicitly encouraged them to convert the conceptual question into the corresponding quantitative problem by choosing appropriate variables, a majority of students were reluctant and preferred to guess the answer to the conceptual question based upon their gut feeling.

Why are some Interfaces in Materials Stronger than others?

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

Fensin, Saryu J.; Cerreta, Ellen K.; Gray, George T.

2014-06-26

Grain boundaries (GBs) are often the preferred sites for void nucleation in ductile metals. However, it has been observed that all boundaries do not contribute equally to this process. We present a mechanistic rationale for the role of GBs in damage nucleation in copper, along with a quantitative map for predicting preferred void nucleation at GBs based on molecular dynamics simulations in copper. Simulations show a direct correlation between the void nucleation stress and the ability of a grain boundary to plastically deform by emitting dislocations, during shock compression. Plastic response of a GB, affects the development of stress concentrationsmore » believed to be responsible for void nucleation by acting as a dissipation mechanism for the applied stress.« less

Treatment of oral mucosal manifestations of chronic graft-versus-host disease: dexamethasone vs. budesonide.

PubMed

Zadik, Yehuda; Elad, Sharon; Shapira, Anat; Shapira, Michael Y

2017-02-01

The oral mucosa is commonly involved in chronic graft-versus-host disease (cGVHD). Oral mucosal cGVHD markedly affect individual's daily function and wellbeing. In some cases, it might become a life threating complication. Areas covered: This article describes the rationale for treatment, method of topical application in the oral cavity, evidence supporting the topical administration of dexamethasone and budesonide for oral cGVHD, and their adverse effects. Expert opinion: Evidence supports the use of topical dexamethasone and budesonide for treatment of oral cGVHD. Topical corticosteroid choice for oral cGVHD, takes into consideration the potency, bioavailability, preferred concentration, and possible adverse effects. Budesonide's pharmacological characteristics mark it as a preferable topical agent for oral cGVHD.

Let him pass.

PubMed

Sobel, R J; Reichlin, M

1998-01-01

Despite moral uncertainty, the physician must respond when a patient complains that "God has forgotten me". In part one of this article, I, (R.S), describe in some detail my response to the individual who prefers death to life, and I end this section with the question: "Is what I do morally acceptable?" In part two of the article a philosopher-bioethicist, (M.R.), replies to my question: his answer-one of many possible answers-centers on the Catholic concept of proportionality. Although arguments based on moral philosophy suggest that my behavior is within moral limits, my doubts remain.

Historical trends in creel limits, length-based limits, and season restrictions for black basses in the United States and Canada

USGS Publications Warehouse

Paukert, C.; McInerny, M.; Schultz, Ronald

2007-01-01

We determined for largemouth bass (Micropterus salmoides), smallmouth bass (M. dolomeui), and spotted bass (M. punctulatus) historical trends in state- and province-wide creel limits, length limits, and season closures along with the rationale justifying these regulations. Based on data gathered via mail surveys and the Internet, 55 jurisdictions had state- or province-wide creel limits, minimum length limits, or season closures, with each regulation type enacted as early as pre-1900. Most early regulations were established to protect spawning bass, but providing equitable distribution of harvest and increasing the quality of bass catch or harvest were the most common rationales for current regulations. Spatial and temporal trends in regulations were similar among species, were affected by geographic location, were not affected by angler preference except for season closures, and were frequently uninfluenced by advances in scientific knowledge of black bass biology.

The long-term demographic role of community-based family planning in rural Bangladesh.

PubMed

Phillips, J F; Hossain, M B; Arends-Kuenning, M

1996-01-01

Experimental studies demonstrating the effectiveness of nonclinical distribution of contraceptives are typically conducted in settings where contraceptive use is low and unmet need is extensive. Determining the long-term role of active outreach programs after initial demand is met represents an increasingly important policy issue in Asia, where contraceptive prevalence is high and fixed service points are conveniently available. This article examines the long-term rationale for household family planning in Bangladesh-where growing use of contraceptives, rapid fertility decline, and normative change in reproductive preferences are in progress, bringing into question the rationale for large-scale deployment of paid outreach workers. Longitudinal data are analyzed that record outreach encounters and contraceptive use dynamics in a large rural population. Findings demonstrate that outreach has a continuing impact on program effectiveness, even after a decade of household visitation. The policy implications of this finding are reviewed.

Beta-and gamma-turns in proteins revisited: a new set of amino acid turn-type dependent positional preferences and potentials.

PubMed

Guruprasad, K; Rajkumar, S

2000-06-01

The number of beta-turns in a representative set of 426 protein three-dimensional crystal structures selected from the recent Protein Data Bank has nearly doubled and the number of gamma-turns in a representative set of 320 proteins has increased over seven times since the previous analysis. Beta-turns (7153) and gamma-turns (911) extracted from these proteins were used to derive a revised set of type-dependent amino acid positional preferences and potentials. Compared with previous results, the preference for proline, methionine and tryptophan has increased and the preference for glutamine, valine, glutamic acid and alanine has decreased for beta-turns. Certain new amino acid preferences were observed for both turn types and individual amino acids showed turn-type dependent positional preferences. The rationale for new amino acid preferences are discussed in the light of hydrogen bonds and other interactions involving the turns. Where main-chain hydrogen bonds of the type NH(i + 3) --> CO(i) were not observed for some beta-turns, other main-chain hydrogen bonds or solvent interactions were observed that possibly stabilize such beta-turns. A number of unexpected isolated beta-turns with proline at i + 2 position were also observed. The NH(i + 2) --> CO(i) hydrogen bond was observed for almost all gamma-turns. Nearly 20% classic gamma-turns and 43% inverse gamma-turns are isolated turns.

Similarity in Chronotype and Preferred Time for Sex and Its Role in Relationship Quality and Sexual Satisfaction

PubMed Central

Jocz, Paulina; Stolarski, Maciej; Jankowski, Konrad S.

2018-01-01

Recently, the issue of diurnal preferences has been increasingly studied within the context of romantic relationships and sexual functioning. In the present paper we apply a dyadic design to investigate the role of romantic partners' diurnal preferences in determining a variety of relationship outcomes. A sample of 91 heterosexual couples completed a set of questionnaires measuring relationship satisfaction, sexual satisfaction, and morningness-eveningness, and answered questions regarding their actual and preferred time for sexual activity. Conducted analyses revealed that similarity in chronotype between partners and female morningness fostered relationship satisfaction in females, but not in males. Furthermore, morningness-eveningness was associated with preferred time for sex in males, but not in females, who in principle preferred evening hours. Although actual time for sex was up to the female preference, sexual satisfaction in both genders was associated with lower discrepancy in their preferred time for sex and greater frequency of intercourse. In sum, these results indicate that chronotype and time for sex are important factors affecting sexual and relationships satisfaction in heterosexual couples. PMID:29670559

A cross-cultural perspective on the preference for potential effect: an individual participant data (IPD) meta-analysis approach.

PubMed

Sun, Xiaomin; Xu, Dan; Luo, Fang; Wei, Zihan; Wei, Cong; Xue, Gang

2015-01-01

A recent paper [Tormala ZL, Jia JS, Norton MI (2012). The preference for potential. Journal of personality and social psychology, 103: 567-583] demonstrated that persons often prefer potential rather than achievement when evaluating others, because information regarding potential evokes greater interest and processing, resulting in more favorable evaluations. This research aimed to expand on this finding by asking two questions: (a) Is the preference for potential effect replicable in other cultures? (b) Is there any other mechanism that accounts for this preference for potential? To answer these two questions, we replicated Tormala et al.'s study in multiple cities (17 studies with 1,128 participants) in China using an individual participant data (IPD) meta-analysis approach to test our hypothesis. Our results showed that the preference for potential effect found in the US is also robust in China. Moreover, we also found a pro-youth bias behind the preference for potential effect. To be specific, persons prefer a potential-oriented applicant rather than an achievement-oriented applicant, partially because they believe that the former is younger than the latter.

Species-specific preferences of German recreational anglers for freshwater fishing experiences, with emphasis on the intrinsic utilities of fish stocking and wild fishes.

PubMed

Arlinghaus, R; Beardmore, B; Riepe, C; Meyerhoff, J; Pagel, T

2014-12-01

To answer the question, whether anglers have an intrinsic preference for stocking or a preference for catch outcomes (e.g. catch rates) believed to be maintained by stocking, a discrete choice experiment was conducted among a sample of anglers (n = 1335) in Lower Saxony, Germany. After controlling for catch aspects of the fishing experience, no significant influence of two stocking attributes (stocking frequency and composition of the catch in terms of wild v. hatchery fishes) on the utility gained from fishing was found for any of the freshwater species that were studied. It was concluded that the previously documented large appreciation of fish stocking by anglers may be indicative of an underlying preference for sufficiently high catches rather than reflect an intrinsic preference for stocking or the catching of wild fishes per se. © 2014 The Fisheries Society of the British Isles.

13-Helix folding of a β/γ-peptide manifold designed from a "minimal-constraint" blueprint.

PubMed

Grison, Claire M; Robin, Sylvie; Aitken, David J

2016-06-14

A bottom-up design rationale was adopted to devise β/γ-peptide foldamer manifolds which would adopt preferred 13-helix conformations, relying on minimal steric imposition brought by the constituent amino acid residues. In this way, a well-defined 13-helix conformer was revealed for short oligomers of trans-2-aminocyclobutanecarboxylic acid and γ(4)-amino acids in alternation, which gave good topological superposition upon an α-helix motif.

Providing cell phone numbers and email addresses to Patients: the physician's perspective.

PubMed

Peleg, Roni; Avdalimov, Angelika; Freud, Tamar

2011-03-23

The provision of cell phone numbers and email addresses enhances the accessibility of medical consultations, but can add to the burden of physicians' routine clinical practice and affect their free time. The objective was to assess the attitudes of physicians to providing their telephone number or email address to patients. Primary care physicians in the southern region of Israel completed a structured questionnaire that related to the study objective. The study population included 120 primary care physicians with a mean age of 41.2 ± 8.5, 88 of them women (73.3%). Physicians preferred to provide their cell phone number rather than their email address (P = 0.0007). They preferred to answer their cell phones only during the daytime and at predetermined times, but would answer email most hours of the day, including weekends and holidays (P = 0.001). More physicians (79.7%) would have preferred allotted time for email communication than allotted time for cell phone communication (50%). However, they felt that email communication was more likely to lead to miscommunication than telephone calls (P = 0.0001). There were no differences between male and female physicians on the provision of cell phone numbers or email addresses to patients. Older physicians were more prepared to provide cell phone numbers that younger ones (P = 0.039). The attitude of participating physicians was to provide their cell phone number or email address to some of their patients, but most of them preferred to give out their cell phone number.

Analysis of free online physician advice services.

PubMed

Cohen, Raphael; Elhadad, Michael; Birk, Ohad

2013-01-01

Online Consumer Health websites are a major source of information for patients worldwide. We focus on another modality, online physician advice. We aim to evaluate and compare the freely available online expert physicians' advice in different countries, its scope and the type of content provided. Using automated methods for information retrieval and analysis, we compared consumer health portals from the US, Canada, the UK and Israel (WebMD,NetDoctor,AskTheDoctor and BeOK). The evaluated content was generated between 2002 and 2011. We analyzed the different sites, looking at the distribution of questions in the various health topics, answer lengths and content type. Answers could be categorized into longer broad-educational answers versus shorter patient-specific ones, with different physicians having personal preferences as to answer type. The Israeli website BeOK, providing 10 times the number of answers than in the other three health portals, supplied answers that are shorter on average than in the other websites. Response times in these sites may be rapid with 32% of the WebMD answers and 64% of the BeOK answers provided in less than 24 hours. The voluntary contribution model used by BeOK and WebMD enables generation of large numbers of physician expert answers at low cost, providing 50,000 and 3,500 answers per year, respectively. Unlike health information in online databases or advice and support in patient-forums, online physician advice provides qualified specialists' responses directly relevant to the questions asked. Our analysis showed that high numbers of expert answers could be generated in a timely fashion using a voluntary model. The length of answers varied significantly between the internet sites. Longer answers were associated with educational content while short answers were associated with patient-specific content. Standard site-specific guidelines for expert answers will allow for more desirable content (educational content) or better throughput (patient-specific content).

Assessing the Global Potential and Regional Implications of Promoting Bioenergy

EPA Science Inventory

There is no simple answer to the question “are materials from bio-based feedstocks environmentally, and socially, preferable?” Bioenergy as an alternative energy source might be effective in reducing fossil fuel use, slowing global warming effects, and providing increased revenue...

Assessing the global potential and regional implications of promoting bio-energy

EPA Science Inventory

There is no simple answer to the question “are materials from bio-based feedstocks environmentally, and socially, preferable?” Bioenergy as an alternative energy source might be effective in reducing fossil fuel use, slowing global warming effects, and providing increased revenue...

Econophysics and individual choice

NASA Astrophysics Data System (ADS)

Bordley, Robert F.

2005-08-01

The subjectivist theory of probability specifies certain axioms of rationality which together lead to both a theory of probability and a theory of preference. The theory of probability is used throughout the sciences while the theory of preferences is used in economics. Results in quantum physics challenge the adequacy of the subjectivist theory of probability. As we show, answering this challenge requires modifying an Archimedean axiom in the subjectivist theory. But changing this axiom modifies the subjectivist theory of preference and therefore has implications for economics. As this paper notes, these implications are consistent with current empirical findings in psychology and economics. As we show, these results also have implications for pricing in securities markets. This suggests further directions for research in econophysics.

[Suicidality and musical preferences: a possible link?].

PubMed

Mikolajczak, Gladys; Desseilles, Martin

2012-01-01

Music is an important part of young people's lives. In this article, we attempt to answer two questions on the links between music et suicide. First, we examine if certain types of music favor suicidal process (ideation and acting out); and, secondly, we examine if music can constitute a tool to reduce the risk of suicide. Several factors possibly involved in links between musical preferences and the suicidal process are developed: the Velten effect and the musical mood induction procedure, the identification and the learning by imitation, the media influence as well as the individual characteristics. A multifactor approach is necessary to understand the complex and birectional links that unite musical preferences and suicide risk.

Using the animal to the last bit: Consumer preferences for different beef cuts.

PubMed

Scozzafava, Gabriele; Corsi, Armando Maria; Casini, Leonardo; Contini, Caterina; Loose, Simone Mueller

2016-01-01

Meat is expensive to produce, making it is essential to understand the importance consumers pay to different meat cuts. Previous research on consumers' meat choices has mainly focused on meat species, while consumer preferences for meat cuts has so far only received limited interest. The aim of this study is to shed some light into this relatively unexplored area by answering four research questions. First, this study intends to show the relative importance meat cuts play in relation to other extrinsic product attributes. Secondly, this paper looks into differences in choice criteria between regular and special occasions. Third, consumer segments that differ in their preferences and beef purchase are identified, and, finally, the meat purchase portfolios of these segments are revealed. A stated preference methodology of a discrete choice experiment with cut-specific prices covering several meat cuts simultaneously is proposed to answer the research questions. The sample consists of 1500 respondents representative of the Italian population in terms of age, gender and geographic location The results shows that meat cut is the most important factor when choosing bovine meat followed by quality certification (origin), production technique, the type of breed and price. In terms of consumption occasions, we observe significantly lower price sensitivity for marbled steaks and cutlets for special occasions compared to normal occasions. Segmentation analysis shows that while the choices of two segments (comprising about 40% of the sample) are mostly driven by extrinsic product attributes, the remaining segments are mostly driven by meat cuts. These varying preferences are also reflected in the purchase portfolios of the different segments, while less variability is detected from a socio-demographic perspective. Copyright © 2015 Elsevier Ltd. All rights reserved.

Error or "act of God"? A study of patients' and operating room team members' perceptions of error definition, reporting, and disclosure.

PubMed

Espin, Sherry; Levinson, Wendy; Regehr, Glenn; Baker, G Ross; Lingard, Lorelei

2006-01-01

Calls abound for a culture change in health care to improve patient safety. However, effective change cannot proceed without a clear understanding of perceptions and beliefs about error. In this study, we describe and compare operative team members' and patients' perceptions of error, reporting of error, and disclosure of error. Thirty-nine interviews of team members (9 surgeons, 9 nurses, 10 anesthesiologists) and patients (11) were conducted at 2 teaching hospitals using 4 scenarios as prompts. Transcribed responses to open questions were analyzed by 2 researchers for recurrent themes using the grounded-theory method. Yes/no answers were compared across groups using chi-square analyses. Team members and patients agreed on what constitutes an error. Deviation from standards and negative outcome were emphasized as definitive features. Patients and nurse professionals differed significantly in their perception of whether errors should be reported. Nurses were willing to report only events within their disciplinary scope of practice. Although most patients strongly advocated full disclosure of errors (what happened and how), team members preferred to disclose only what happened. When patients did support partial disclosure, their rationales varied from that of team members. Both operative teams and patients define error in terms of breaking the rules and the concept of "no harm no foul." These concepts pose challenges for treating errors as system failures. A strong culture of individualism pervades nurses' perception of error reporting, suggesting that interventions are needed to foster collective responsibility and a constructive approach to error identification.

Let's call it "aphasia": Rationales for eliminating the term "dysphasia".

PubMed

Worrall, Linda; Simmons-Mackie, Nina; Wallace, Sarah J; Rose, Tanya; Brady, Marian C; Kong, Anthony Pak Hin; Murray, Laura; Hallowell, Brooke

2016-10-01

Health professionals, researchers, and policy makers often consider the two terms aphasia and dysphasia to be synonymous. The aim of this article is to argue the merits of the exclusive use of the term aphasia and present a strategy for creating change through institutions such as the WHO-ICD. Our contention is that one term avoids confusion, speech-language pathologists prefer aphasia, scholarly publications indicate a preference for the term aphasia, stroke clinical guidelines indicate a preference for the term aphasia, consumer organizations use the title aphasia in their name and on their websites, and languages other than English use a term similar to aphasia. The use of the term dysphasia in the broader medical community may stem from the two terms being used interchangeably in the ICD10. Aphasia United http://www.shrs.uq.edu.au/aphasiaunited , an international movement for uniting the voice of all stakeholders in aphasia within an international context, will seek to eliminate the use of the term dysphasia.

Knowledge and confidence of a convenience sample of australasian emergency doctors in managing dental emergencies: results of a survey.

PubMed

Samaei, Hossein; Weiland, Tracey Joy; Dilley, Stuart; Jelinek, George Alexander

2015-01-01

Background. We aimed to determine Australasian Specialist Emergency Physicians' and Emergency Physicians in Training (Trainees') level of knowledge of common dental emergencies. We also explored confidence in managing dental emergencies; predictors of confidence and knowledge; and preferences for further dental education. Methods. A questionnaire was distributed electronically (September 2011) and directly (November 2011) to Fellows and Trainees of the Australasian College for Emergency Medicine. It explored demographics, confidence, knowledge of dental emergencies, and educational preferences. Results. Response rate was 13.6% (464/3405) and college members were proportionally represented by region. Fewer than half (186/446; 42%) had received dental training. Sixty-two percent (244/391, 95% CI 57.5-67.1) passed (>50%) a knowledge test. More than 60% incorrectly answered questions on dental fracture, periodontal abscess, tooth eruption dates, and ulcerative gingivitis. Forty percent (166/416) incorrectly answered a question about Ludwig's Angina. Eighty-three percent (360/433) were confident in the pharmacological management of toothache but only 26% (112/434) confident in recognizing periodontal disease. Knowledge was correlated with confidence (r = 0.488). Interactive workshops were preferred by most (386/415, 93%). Conclusions. The knowledge and confidence of Australasian Emergency Physicians and Trainees in managing dental emergencies are varied, yet correlated. Interactive training sessions in dental emergencies are warranted.

Information Needs and Preferences of Parents Considering Treatment of Child Anxiety.

PubMed

Mak, Leanne; Walker, John R; Hiebert-Murphy, Diane; Altman, Gary

2017-04-01

To assess the information needs and preferences of parents who were making decisions concerning treatment for their child's anxiety. Ninety-three parents were recruited from hospital-based clinics, a parent group, and a public information meeting. They completed a survey about preference for decision-making involvement, information needs, and preferences concerning source and amount of information. Most (69%) parents indicated that they prefer a collaborative decision-making role. They rated very highly the need for general information related to treatment and information related to psychosocial interventions and medication treatment. Fewer parents rated information about logistics of treatment (e.g., scheduling, cost) as highly important although this information was considered important by many parents. Direct discussions with a provider, written information, and information accessed through the internet were the most preferred sources of information. Many parents indicated a preference for substantial amounts of information about psychosocial and medication treatments. Much of the information that parents want concerning treatment is not widely available. It would be helpful to develop evidence-based brochures and web information resources that focus on answering parents' questions concerning treatment of children's anxiety.

76 FR 56107 - Requiring Use of Electronic Services by Certain Claimant Representatives

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-12

... ineligibility or personal preference, they can continue to use our paper processes and forms. Comment: A few... consider vocational factors; (3) * * * (ii) * * * This includes providing prompt and responsive answers to... need when we consider vocational factors; (3) * * * (ii) * * * This includes providing prompt and...

Solitary Learner in Online Collaborative Learning: A Disappointing Experience?

ERIC Educational Resources Information Center

Ke, Fengfeng; Carr-Chellman, Alison

2006-01-01

Research suggests that the solitary learner's learning preferences might be a mismatch with collaborative instructional settings. A question is therefore posed: "In online learning environments that require collaboration, how do solitary learners experience their own learning?" It is important to answer this question to understand and…

Which terms should be used to describe autism? Perspectives from the UK autism community.

PubMed

Kenny, Lorcan; Hattersley, Caroline; Molins, Bonnie; Buckley, Carole; Povey, Carol; Pellicano, Elizabeth

2016-05-01

Recent public discussions suggest that there is much disagreement about the way autism is and should be described. This study sought to elicit the views and preferences of UK autism community members - autistic people, parents and their broader support network - about the terms they use to describe autism. In all, 3470 UK residents responded to an online survey on their preferred ways of describing autism and their rationale for such preferences. The results clearly show that people use many terms to describe autism. The most highly endorsed terms were 'autism' and 'on the autism spectrum', and to a lesser extent, 'autism spectrum disorder', for which there was consensus across community groups. The groups disagreed, however, on the use of several terms. The term 'autistic' was endorsed by a large percentage of autistic adults, family members/friends and parents but by considerably fewer professionals; 'person with autism' was endorsed by almost half of professionals but by fewer autistic adults and parents. Qualitative analysis of an open-ended question revealed the reasons underlying respondents' preferences. These findings demonstrate that there is no single way of describing autism that is universally accepted and preferred by the UK's autism community and that some disagreements appear deeply entrenched. © The Author(s) 2015.

The Development of a Preference for Cocaine over Food Identifies Individual Rats with Addiction-Like Behaviors

PubMed Central

Perry, Adam N.; Westenbroek, Christel; Becker, Jill B.

2013-01-01

Rationale Cocaine dependence is characterized by compulsive drug taking that supercedes other recreational, occupational or social pursuits. We hypothesized that rats vulnerable to addiction could be identified within the larger population based on their preference for cocaine over palatable food rewards. Objectives To validate the choice self-administration paradigm as a preclinical model of addiction, we examined changes in motivation for cocaine and recidivism to drug seeking in cocaine-preferring and pellet-preferring rats. We also examined behavior in males and females to identify sex differences in this “addicted” phenotype. Methods Preferences were identified during self-administration on a fixed-ratio schedule with cocaine-only, pellet-only and choice sessions. Motivation for each reward was probed early and late during self-administration using a progressive-ratio schedule. Reinstatement of cocaine- and pellet-seeking was examined following exposure to their cues and non-contingent delivery of each reward. Results Cocaine preferring rats increased their drug intake at the expense of pellets, displayed increased motivation for cocaine, attenuated motivation for pellets and greater cocaine and cue-induced reinstatement of drug seeking. Females were more likely to develop cocaine preferences and recidivism of cocaine- and pellet-seeking was sexually dimorphic. Conclusions The choice self-administration paradigm is a valid preclinical model of addiction. The unbiased selection criteria also revealed sex-specific vulnerability factors that could be differentiated from generalized sex differences in behavior, which has implications for the neurobiology of addiction and effective treatments in each sex. PMID:24260227

Measuring the incentive value of escalating doses of heroin in heroin-dependent Fischer rats during acute spontaneous withdrawal

PubMed Central

Reed, Brian; Ho, Ann; Kreek, Mary Jeanne

2011-01-01

Rationale/objectives Although continued heroin use and relapse are thought to be motivated, in part, by the positive incentive-motivational value attributed to heroin, little is understood about heroin’s incentive value during the relapse-prone state of withdrawal. This study uses place preference to measure the incentive value attributed to escalating-dose heroin in the context of heroin dependence. Methods Male Fischer rats were exposed chronically to escalating doses of heroin in the homecage and during place preference conditioning sessions. Conditioned preference for the context paired with escalating-dose heroin was tested after homecage exposure was discontinued and rats entered acute spontaneous withdrawal. Individuals’ behavioral and locomotor responses to heroin and somatic withdrawal signs were recorded. Results Conditioned preference for the heroin-paired context was strong in rats that received chronic homecage exposure to escalating-dose heroin and were tested in acute withdrawal. Behavioral responses to heroin (e.g., stereotypy) varied widely across individuals, with rats that expressed stronger heroin preference also expressing stronger behavioral activation in response to heroin. Individual differences in preference were also related to locomotor responses to heroin but not to overt somatic withdrawal signs. Conclusions Escalating doses of heroin evoked place preference in rats, suggesting that positive incentive-motivational value is attributed to this clinically relevant pattern of drug exposure. This study offers an improved preclinical model for studying dependence and withdrawal and provides insight into individual vulnerabilities to addiction-like behavior. PMID:21748254

Survey of domestic food handling practices in New Zealand.

PubMed

Gilbert, S E; Whyte, R; Bayne, G; Paulin, S M; Lake, R J; van der Logt, P

2007-07-15

The purpose of this survey was to obtain information on the domestic meat and poultry handling practices of New Zealanders in order to support the development of quantitative risk models, as well as providing data to underpin food safety campaigns to consumers. A sample of 1000 New Zealand residents, over 18 years of age, were randomly selected from the electoral roll and asked to participate in a national postal food safety study during 2005. Three hundred and twenty six respondents completed and returned questionnaires containing usable answers, and most of these respondents 'always' prepared the main meal within the household. The majority of meat (84.6%) and poultry (62.9%) purchased by New Zealanders was fresh (rather than frozen), and most consumers (94.4%) claimed that the time taken from food selection to reaching their home was 1 h or less. The majority (approximately 64%) of fresh meat and poultry was frozen in the home and the most favoured method of thawing was at room temperature for up to 12 h. The most common time period for storing cooked or raw meat and poultry in domestic refrigerators was up to 2 days. Most survey respondents preferred their meat and poultry to be cooked either medium or well done. The most popular cooking method for chicken was roasting or baking, while most respondents preferred to pan-fry steak/beef cuts, minced beef or sausages/hamburgers. The potential for undercooking was greatest with pan-fried steak with 19.8% of respondents preferring to consume this meat raw or rare. In answer to questions relating to food handling hygiene practices, 52.2% of respondents selected a hand washing sequence that would help prevent cross contamination. However, it was estimated that 41% and 28% of respondents would use knives and kitchen surfaces respectively in a manner that could allow cross contamination. The data in this survey are self-reported and, particularly for the hygiene questions, respondents may report an answer that they perceive as being correct rather than reflecting their actual behaviour. Nevertheless, the data on food processing, transport, storage and cooking preferences represent useful inputs into the assessment of food safety along the meat and poultry food chains.

Quantification Scope Ambiguity Resolution: Evidence from Persian and English

ERIC Educational Resources Information Center

Asadollahfam, Hassan; Lotfi, Ahmad Reza

2010-01-01

This study investigates the interpretation of scopally ambiguous sentences containing noun phrases with double quantified constituents from a processing perspective. The questions this study tried to answer were: whether or not the preferred interpretation for doubly quantified ambiguous sentences in English was influenced by English learners' L1…

Providing cell phone numbers and email addresses to Patients: the physician's perspective

PubMed Central

2011-01-01

Background The provision of cell phone numbers and email addresses enhances the accessibility of medical consultations, but can add to the burden of physicians' routine clinical practice and affect their free time. The objective was to assess the attitudes of physicians to providing their telephone number or email address to patients. Methods Primary care physicians in the southern region of Israel completed a structured questionnaire that related to the study objective. Results The study population included 120 primary care physicians with a mean age of 41.2 ± 8.5, 88 of them women (73.3%). Physicians preferred to provide their cell phone number rather than their email address (P = 0.0007). They preferred to answer their cell phones only during the daytime and at predetermined times, but would answer email most hours of the day, including weekends and holidays (P = 0.001). More physicians (79.7%) would have preferred allotted time for email communication than allotted time for cell phone communication (50%). However, they felt that email communication was more likely to lead to miscommunication than telephone calls (P = 0.0001). There were no differences between male and female physicians on the provision of cell phone numbers or email addresses to patients. Older physicians were more prepared to provide cell phone numbers that younger ones (P = 0.039). Conclusions The attitude of participating physicians was to provide their cell phone number or email address to some of their patients, but most of them preferred to give out their cell phone number. PMID:21426591

Hand-held internet tablets for school-based data collection.

PubMed

Denny, Simon J; Milfont, Taciano L; Utter, Jennifer; Robinson, Elizabeth M; Ameratunga, Shanthi N; Merry, Sally N; Fleming, Theresa M; Watson, Peter D

2008-07-26

In the last 20 years, researchers have been using computer self-administered questionnaires to gather data on a wide range of adolescent health related behaviours. More recently, researchers collecting data in schools have started to use smaller hand-held computers for their ease of use and portability. The aim of this study is to describe a new technology with wi-fi enabled hand-held internet tablets and to compare adolescent preferences of laptop computers or hand-held internet tablets in administering a youth health and well-being questionnaire in a school setting. A total of 177 students took part in a pilot study of a national youth health and wellbeing survey. Students were randomly assigned to internet tablets or laptops at the start of the survey and were changed to the alternate mode of administration about half-way through the questionnaire. Students at the end of the questionnaire were asked which of the two modes of administration (1) they preferred, (2) was easier to use, (3) was more private and confidential, and (4) was easier to answer truthfully. Many students expressed no preference between laptop computers or internet tablets. However, among the students who expressed a preference between laptop computers or internet tablets, the majority of students found the internet tablets more private and confidential (p < 0.001) and easier to answer questions truthfully (p < 0.001) compared to laptop computers. This study demonstrates that using wi-fi enabled hand-held internet tablets is a feasible methodology for school-based surveys especially when asking about sensitive information.

Hand-held internet tablets for school-based data collection

PubMed Central

Denny, Simon J; Milfont, Taciano L; Utter, Jennifer; Robinson, Elizabeth M; Ameratunga, Shanthi N; Merry, Sally N; Fleming, Theresa M; Watson, Peter D

2008-01-01

Background In the last 20 years, researchers have been using computer self-administered questionnaires to gather data on a wide range of adolescent health related behaviours. More recently, researchers collecting data in schools have started to use smaller hand-held computers for their ease of use and portability. The aim of this study is to describe a new technology with wi-fi enabled hand-held internet tablets and to compare adolescent preferences of laptop computers or hand-held internet tablets in administering a youth health and well-being questionnaire in a school setting. Methods A total of 177 students took part in a pilot study of a national youth health and wellbeing survey. Students were randomly assigned to internet tablets or laptops at the start of the survey and were changed to the alternate mode of administration about half-way through the questionnaire. Students at the end of the questionnaire were asked which of the two modes of administration (1) they preferred, (2) was easier to use, (3) was more private and confidential, and (4) was easier to answer truthfully. Results Many students expressed no preference between laptop computers or internet tablets. However, among the students who expressed a preference between laptop computers or internet tablets, the majority of students found the internet tablets more private and confidential (p < 0.001) and easier to answer questions truthfully (p < 0.001) compared to laptop computers. Conclusion This study demonstrates that using wi-fi enabled hand-held internet tablets is a feasible methodology for school-based surveys especially when asking about sensitive information. PMID:18710505

Conducting Simulation Studies in the R Programming Environment.

PubMed

Hallgren, Kevin A

2013-10-12

Simulation studies allow researchers to answer specific questions about data analysis, statistical power, and best-practices for obtaining accurate results in empirical research. Despite the benefits that simulation research can provide, many researchers are unfamiliar with available tools for conducting their own simulation studies. The use of simulation studies need not be restricted to researchers with advanced skills in statistics and computer programming, and such methods can be implemented by researchers with a variety of abilities and interests. The present paper provides an introduction to methods used for running simulation studies using the R statistical programming environment and is written for individuals with minimal experience running simulation studies or using R. The paper describes the rationale and benefits of using simulations and introduces R functions relevant for many simulation studies. Three examples illustrate different applications for simulation studies, including (a) the use of simulations to answer a novel question about statistical analysis, (b) the use of simulations to estimate statistical power, and (c) the use of simulations to obtain confidence intervals of parameter estimates through bootstrapping. Results and fully annotated syntax from these examples are provided.

The Use of Green Leaf Membranes to Promote Appetite Control, Suppress Hedonic Hunger and Loose Body Weight.

PubMed

Erlanson-Albertsson, Charlotte; Albertsson, Per-Åke

2015-09-01

On-going research aims at answering the question, which satiety signal is the most potent or which combination of satiety signals is the most potent to stop eating. There is also an aim at finding certain food items or food additives that could be used to specifically reduce food intake therapeutically. Therapeutic attempts to normalize body weight and glycaemia with single agents alone have generally been disappointing. The success of bariatric surgery illustrates the rationale of using several hormones to treat obesity and type-2-diabetes. We have found that certain components from green leaves, the thylakoids, when given orally have a similar rationale in inducing the release of several gut hormones at the same time. In this way satiety is promoted and hunger suppressed, leading to loss of body weight and body fat. The mechanism is a reduced rate of intestinal lipid hydrolysis, allowing the lipolytic products to reach the distal intestine and release satiety hormones. The thylakoids also regulate glucose uptake in the intestine and influences microbiota composition in the intestine in a prebiotic direction. Using thylakoids is a novel strategy for treatment and prevention of obesity.

Observational studies in systematic [corrected] reviews of comparative effectiveness: AHRQ and the Effective Health Care Program.

PubMed

Norris, Susan L; Atkins, David; Bruening, Wendy; Fox, Steven; Johnson, Eric; Kane, Robert; Morton, Sally C; Oremus, Mark; Ospina, Maria; Randhawa, Gurvaneet; Schoelles, Karen; Shekelle, Paul; Viswanathan, Meera

2011-11-01

Systematic reviewers disagree about the ability of observational studies to answer questions about the benefits or intended effects of pharmacotherapeutic, device, or procedural interventions. This study provides a framework for decision making on the inclusion of observational studies to assess benefits and intended effects in comparative effectiveness reviews (CERs). The conceptual model and recommendations were developed using a consensus process by members of the methods workgroup of the Effective Health Care Program of the Agency for Healthcare Research and Quality. In considering whether to use observational studies in CERs for addressing beneficial effects, reviewers should answer two questions: (1) Are there gaps in the evidence from randomized controlled trials (RCTs)? (2) Will observational studies provide valid and useful information? The latter question involves the following: (a) refocusing the study questions on gaps in the evidence from RCTs, (b) assessing the risk of bias of the body of evidence of observational studies, and (c) assessing whether available observational studies address the gap review questions. Because it is unusual to find sufficient evidence from RCTs to answer all key questions concerning benefit or the balance of benefits and harms, comparative effectiveness reviewers should routinely assess the appropriateness of inclusion of observational studies for questions of benefit. Furthermore, reviewers should explicitly state the rationale for inclusion or exclusion of observational studies when conducting CERs. Copyright © 2011 Elsevier Inc. All rights reserved.

A method to assess relative preference for training and environmental enrichment in captive wolves (Canis lupus and Canis lupus arctos).

PubMed

Dorey, Nicole R; Mehrkam, Lindsay R; Tacey, Jay

2015-11-01

It is currently debated as to whether or not positive reinforcement training is enriching to captive animals. Although both husbandry training and environmental enrichment (EE) have been found to benefit animal welfare in captivity, to date, no systematic investigation has compared an animal's preference for performing a trained behavior to engaging freely with a stimuli provided as EE. In the current paper, we used four captive wolves to (1) test the efficacy of a paired-stimulus preference assessment to determine preference for engaging in a trained behavior as a choice; and to (2) use a paired-stimulus preference assessment to determine whether or not individuals prefer to engage in a previously trained behavior versus a previously encountered EE stimuli. Of the four subjects tested, visual inspection of the graphs revealed that two of the subjects preferred trained behavior stimuli and two of the subjects preferred EE stimuli; only one of the wolves had a statically higher preference for an EE stimulus over a trained behavior. We believe that letting the animals choose between these two events is the first step in answering the question of whether or not is training enriching, however more research needs to be done and suggestions for future research is discussed. © 2015 Wiley Periodicals, Inc.

Type of milk typically consumed, and stated preference, but not health consciousness affect revealed preferences for fat in milk.

PubMed

Bakke, Alyssa J; Shehan, Catherine V; Hayes, John E

2016-04-01

Fat is an important source of both pleasure and calories in the diet. Dairy products are a major source of fat in the diet, and understanding preferences for fat in fluid milk can potentially inform efforts to change fat consumption patterns or optimize consumer products. Here, patterns of preference for fat in milk were determined in the laboratory among 100 free living adults using rejection thresholds. Participants also answered questions relating to their health concerns, the type of fluid milk typically consumed, and their declared preference for type of milk (in terms of fat level). When revealed preferences in blind tasting were stratified by these measures, we observed striking differences in the preferred level of fat in milk. These data indicate a non-trivial number of consumers who prefer low-fat milk to full fat milk, a pattern that would have been overshadowed by the use of a group mean. While it is widely assumed and claimed that increasing fat content in fluid milk universally increases palatability, present data demonstrate this is not true for a segment of the population. These results underscore the need to go look beyond group means to understand individual differences in food preference.

Type of milk typically consumed, and stated preference, but not health consciousness affect revealed preferences for fat in milk

PubMed Central

Bakke, Alyssa J.; Shehan, Catherine V.; Hayes, John E.

2015-01-01

Fat is an important source of both pleasure and calories in the diet. Dairy products are a major source of fat in the diet, and understanding preferences for fat in fluid milk can potentially inform efforts to change fat consumption patterns or optimize consumer products. Here, patterns of preference for fat in milk were determined in the laboratory among 100 free living adults using rejection thresholds. Participants also answered questions relating to their health concerns, the type of fluid milk typically consumed, and their declared preference for type of milk (in terms of fat level). When revealed preferences in blind tasting were stratified by these measures, we observed striking differences in the preferred level of fat in milk. These data indicate a non-trivial number of consumers who prefer low-fat milk to full fat milk, a pattern that would have been overshadowed by the use of a group mean. While it is widely assumed and claimed that increasing fat content in fluid milk universally increases palatability, present data demonstrate this is not true for a segment of the population. These results underscore the need to go look beyond group means to understand individual differences in food preference. PMID:26752811

Pesticides and health: a review of evidence on health effects, valuation of risks, and benefit-cost analysis.

PubMed

Tago, Damian; Andersson, Henrik; Treich, Nicolas

2014-01-01

This study presents literature reviews for the period 2000-2013 on (i) the health effects of pesticides and on (ii) preference valuation of health risks related to pesticides, as well as a discussion of the role of benefit-cost analysis applied to pesticide regulatory measures. This study indicates that the health literature has focused on individuals with direct exposure to pesticides, i.e. farmers, while the literature on preference valuation has focused on those with indirect exposure, i.e. consumers. The discussion highlights the need to clarify the rationale for regulating pesticides, the role of risk perceptions in benefit-cost analysis, and the importance of inter-disciplinary research in this area. This study relates findings of different disciplines (health, economics, public policy) regarding pesticides, and identifies gaps for future research.

Knowledge and Confidence of a Convenience Sample of Australasian Emergency Doctors in Managing Dental Emergencies: Results of a Survey

PubMed Central

Samaei, Hossein; Weiland, Tracey Joy; Dilley, Stuart; Jelinek, George Alexander

2015-01-01

Background. We aimed to determine Australasian Specialist Emergency Physicians' and Emergency Physicians in Training (Trainees') level of knowledge of common dental emergencies. We also explored confidence in managing dental emergencies; predictors of confidence and knowledge; and preferences for further dental education. Methods. A questionnaire was distributed electronically (September 2011) and directly (November 2011) to Fellows and Trainees of the Australasian College for Emergency Medicine. It explored demographics, confidence, knowledge of dental emergencies, and educational preferences. Results. Response rate was 13.6% (464/3405) and college members were proportionally represented by region. Fewer than half (186/446; 42%) had received dental training. Sixty-two percent (244/391, 95% CI 57.5–67.1) passed (>50%) a knowledge test. More than 60% incorrectly answered questions on dental fracture, periodontal abscess, tooth eruption dates, and ulcerative gingivitis. Forty percent (166/416) incorrectly answered a question about Ludwig's Angina. Eighty-three percent (360/433) were confident in the pharmacological management of toothache but only 26% (112/434) confident in recognizing periodontal disease. Knowledge was correlated with confidence (r = 0.488). Interactive workshops were preferred by most (386/415, 93%). Conclusions. The knowledge and confidence of Australasian Emergency Physicians and Trainees in managing dental emergencies are varied, yet correlated. Interactive training sessions in dental emergencies are warranted. PMID:25821600

Formatting modifications in GRADE evidence profiles improved guideline panelists comprehension and accessibility to information. A randomized trial.

PubMed

Vandvik, Per Olav; Santesso, Nancy; Akl, Elie A; You, John; Mulla, Sohail; Spencer, Frederick A; Johnston, Bradley C; Brozek, Jan; Kreis, Julia; Brandt, Linn; Zhou, Qi; Schünemann, Holger J; Guyatt, Gordon

2012-07-01

To determine the effects of formatting alternatives in Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence profiles on guideline panelists' preferences, comprehension, and accessibility. We randomized 116 antithrombotic therapy guideline panelists to review one of two table formats with four formatting alternatives. After answering relevant questions, panelists reviewed the other format and reported their preferences for specific formatting alternatives. Panelists (88 of 116 invited [76%]) preferred presentation of study event rates over no study event rates (median 1 [interquartile range (IQR) 1] on 1-7 scale), absolute risk differences over absolute risks (median 2 [IQR 3]), and additional information in table cells over footnotes (median 1 [IQR 2]). Panelists presented with time frame information in the tables, and not only in footnotes, were more likely to correctly answer questions regarding time frame (58% vs. 11%, P<0.0001), and those presented with risk differences and not absolute risks were more likely to correctly interpret confidence intervals for absolute effects (95% vs. 54%, P<0.0001). Information was considered easy to find, easy to comprehend, and helpful in making recommendations regardless of table format (median 6, IQR 0-1). Panelists found information in GRADE evidence profiles accessible. Correct comprehension of some key information was improved by providing additional information in table and presenting risk differences. Copyright © 2012 Elsevier Inc. All rights reserved.

Science and Measurement Requirements for a Plant Physiology and Functional Types Mission: Measuring the Composition, Function and Health of Global Land and Coastal Ocean Ecosystems

NASA Technical Reports Server (NTRS)

Green, Robert O.; Rogez, Francois; Green, Rob; Ungar, Steve; Knox, Robert; Asner, Greg; Muller-Karger, Frank; Bissett, Paul; Chekalyuk, Alex; Dierssen, Heidi;

Pediatric surgeons and anesthesiologists expand the dialogue on the neurotoxicity question, rationale for early and delayed surgeries, and practice changes while awaiting definitive evidence.

PubMed

Byrne, Mary W; Casale, Pasquale; Garzon, Maria; Hyman, Joshua E; Lin, Albert Y; Lynch, Lisa R; Schleien, Charles L; Stylianos, Steven

2014-10-01

The Pediatric Anesthesia NeuroDevelopment Assessment team at Columbia University Medical Center Department of Anesthesiology convened its fourth biennial Symposium to address unresolved issues concerning potential neurotoxic effects of anesthetic agents and sedatives on young children and to assess study findings to date. Dialogue initiated at the third Symposium was continued between anesthesiologists, researchers, and a panel of expert pediatric surgeons representing general surgery and dermatology, orthopedic, and urology specialties. The panel explored the need to balance benefits of early surgery using improved technologies against potential anesthetic risks, practice changes while awaiting definitive answers, and importance of continued interprofessional dialogue.

Understanding the internet-based distance learning preferences of European respiratory specialists.

PubMed

Roberts, C M; Milon, S; Kurosinski, P

2006-08-01

We studied the learning preferences of 160 respiratory specialists from four European countries who participated in ten internet-based learning modules and answered linked survey questions. Specialists were enthusiastic for internet learning amongst all national groups and particularly wanted to access material for teaching others. The value of social interactive learning was acknowledged but British and German subjects appeared more reluctant to participate. Internet delivered distance learning is well perceived amongst respiratory specialists. There is potential for both individual and group learning that could be realized by developing Europe-wide continuing professional development communities.

Assessing Learning Styles among Students with and without Learning Disabilities at a Distance-Learning University

ERIC Educational Resources Information Center

Heiman, Tali

2006-01-01

Differences in the learning styles of students with and without learning disabilities (LD) at a distance-learning university were examined. Two hundred and twelve students answered self-report questionnaires on their learning styles. Results revealed that students with LD preferred to use more stepwise processing, including memorizing and…

A Conjoint Analysis of Reference Services in Academic Libraries.

ERIC Educational Resources Information Center

Crawford, Gregory A.

1994-01-01

Explains conjoint analysis and its use in marketing research and describes an evaluation of reference services in academic libraries that used conjoint analysis to determine user preference regarding the importance of definitiveness of answer, waiting time, service time, number of items found, hours of available service, and cost. (Contains 13…

Genres Across Cultures: Types of Acceptability Variation

ERIC Educational Resources Information Center

Shaw, Philip; Gillaerts, Paul; Jacobs, Everett; Palermo, Ofelia; Shinohara, Midori; Verckens, J. Piet

2004-01-01

One can ask four questions about genre validity across cultures. Does a certain form or configuration occur in the culture in question? Is it acceptable? If acceptable, is it in practice preferred? Is it recommended by prescriptive authorities? This paper reports the results of an attempt to answer these questions empirically by testing the…

The Intransitivity of Educational Preferences

ERIC Educational Resources Information Center

Smith, Debra Candace

2013-01-01

This study sought to answer the question of whether the existence of cycles in education are random events, or if cycles in education are likely to be expected on a regular basis due to intransitive decision-making patterns of stakeholders. This was a quantitative study, modeled after two previously conducted studies (Davis, 1958/59; May, 1954),…

Affirmative Discrimination and the Bubble

ERIC Educational Resources Information Center

Clegg, Roger

2011-01-01

In this essay, the author discusses how affirmative action contributed to an unnatural rise in enrollments in college. In considering the higher education bubble, he makes the case that as the opposition to preferences continues to build, the momentum of this trend will only increase as funding shrinks. He offers some tentative answers to a series…

A Review of Life-Cycle Based Tools Used to Assess the Environmental Sustainability of Biofuels in the United States

EPA Science Inventory

There is no simple answer to the question “are materials from bio-based feedstocks environmentally preferable?” Bioenergy, as an alternative energy source, might be effective in reducing fossil fuel use and dependence, slowing or reducing global warming effects, and providing inc...

Career and Workplace Experiences of Australian University Graduates Who Are Deaf or Hard of Hearing

ERIC Educational Resources Information Center

Punch, Renee; Hyde, Merv; Power, Des

2007-01-01

This article reports on the experiences of a group of deaf and hard-of-hearing alumni of Griffith University in south-east Queensland, Australia. Participants completed a survey answering questions about their communication patterns and preferences, working lives, career barriers or difficulties anticipated and encountered, and workplace…

Rationale for selection of a flight control system for lift cruise fan V/STOL aircraft

NASA Technical Reports Server (NTRS)

Konsewicz, R. K.

1977-01-01

Various features of the lift cruise fan V/STOL concept are briefly reviewed. The ability to operate from small ships in adverse weather, low visibility, and rough sea conditions is emphasized as is the need for a highly capable, flexible, and reliabile flight control system. A three channel control by wire, digital flight control system is suggested. The requirement for automatic flight control, the advantage of control by wire implementation, the preference for a digital computer, and the need for three channel redundancy are among the factors discussed.

Career in mental health still an unlikely career choice for nursing graduates: a replicated longitudinal study.

PubMed

Stevens, John; Browne, Graeme; Graham, Iain

2013-06-01

The lack of qualified mental health nurses is at critical level with the problem likely to worsen as the aging mental health nursing workforce retires. This study investigates the career preferences of undergraduate nursing students by comparing preferences at the start, middle, and end of the Bachelor of Nursing program. The comparison of the cohorts gave an indication of the change in preferences over the intervening years. It replicates research completed in 1992, 1997, and 2001, and develops a profile of nursing career preferences and the rationale underpinning those preferences in a cohort of students (n = 150) who began their Bachelor of Nursing studies in 2007 and completed in 2009. The main findings included that, like the previous studies, mental health nursing is one of the least desirable career choices for most nurses at the start of their course and remains so as they approach graduation. The reasons change but the outcome remains the same. The current system of using the Bachelor of Nursing award to produce mental health nurses in Australia does not encourage nurses to consider a career in mental health nursing. Which begs the question: where will mental health nurses in the future come from? © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

What is mental health? Evidence towards a new definition from a mixed methods multidisciplinary international survey.

PubMed

Manwell, Laurie A; Barbic, Skye P; Roberts, Karen; Durisko, Zachary; Lee, Cheolsoon; Ware, Emma; McKenzie, Kwame

2015-06-02

Lack of consensus on the definition of mental health has implications for research, policy and practice. This study aims to start an international, interdisciplinary and inclusive dialogue to answer the question: What are the core concepts of mental health? 50 people with expertise in the field of mental health from 8 countries completed an online survey. They identified the extent to which 4 current definitions were adequate and what the core concepts of mental health were. A qualitative thematic analysis was conducted of their responses. The results were validated at a consensus meeting of 58 clinicians, researchers and people with lived experience. 46% of respondents rated the Public Health Agency of Canada (PHAC, 2006) definition as the most preferred, 30% stated that none of the 4 definitions were satisfactory and only 20% said the WHO (2001) definition was their preferred choice. The least preferred definition of mental health was the general definition of health adapted from Huber et al (2011). The core concepts of mental health were highly varied and reflected different processes people used to answer the question. These processes included the overarching perspective or point of reference of respondents (positionality), the frameworks used to describe the core concepts (paradigms, theories and models), and the way social and environmental factors were considered to act. The core concepts of mental health identified were mainly individual and functional, in that they related to the ability or capacity of a person to effectively deal with or change his/her environment. A preliminary model for the processes used to conceptualise mental health is presented. Answers to the question, 'What are the core concepts of mental health?' are highly dependent on the empirical frame used. Understanding these empirical frames is key to developing a useful consensus definition for diverse populations. 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.

What is mental health? Evidence towards a new definition from a mixed methods multidisciplinary international survey

PubMed Central

Manwell, Laurie A; Barbic, Skye P; Roberts, Karen; Durisko, Zachary; Lee, Cheolsoon; Ware, Emma; McKenzie, Kwame

2015-01-01

Objective Lack of consensus on the definition of mental health has implications for research, policy and practice. This study aims to start an international, interdisciplinary and inclusive dialogue to answer the question: What are the core concepts of mental health? Design and participants 50 people with expertise in the field of mental health from 8 countries completed an online survey. They identified the extent to which 4 current definitions were adequate and what the core concepts of mental health were. A qualitative thematic analysis was conducted of their responses. The results were validated at a consensus meeting of 58 clinicians, researchers and people with lived experience. Results 46% of respondents rated the Public Health Agency of Canada (PHAC, 2006) definition as the most preferred, 30% stated that none of the 4 definitions were satisfactory and only 20% said the WHO (2001) definition was their preferred choice. The least preferred definition of mental health was the general definition of health adapted from Huber et al (2011). The core concepts of mental health were highly varied and reflected different processes people used to answer the question. These processes included the overarching perspective or point of reference of respondents (positionality), the frameworks used to describe the core concepts (paradigms, theories and models), and the way social and environmental factors were considered to act. The core concepts of mental health identified were mainly individual and functional, in that they related to the ability or capacity of a person to effectively deal with or change his/her environment. A preliminary model for the processes used to conceptualise mental health is presented. Conclusions Answers to the question, ‘What are the core concepts of mental health?’ are highly dependent on the empirical frame used. Understanding these empirical frames is key to developing a useful consensus definition for diverse populations. PMID:26038353

For patients with terminal chronic illness, does more face-to-face time with a healthcare provider decrease aggressive end-of-life (EOL) care such as ICU admission, feeding tube placement, CPR, or intubation?

PubMed Central

Seaberg, Preston; Hamm, Robert M.; McCarthy, Laine H.

2016-01-01

Clinical Question For patients with terminal chronic illness, does more face-to-face time with a healthcare provider decrease aggressive end-of-life (EOL) care such as ICU admission, feeding tube placement, CPR, or intubation? Answer Inconclusive. Existing evidence does not provide a conclusive answer to this particular question. While multiple prospective, randomized, controlled trials demonstrate an association between increased patient-provider contact time and decreased aggressive EOL care, interventions in those studies contain multiple confounding elements that preclude isolation of the time factor from the other elements in the interventions. There is a need for research focusing on physician-patient communication time and EOL care. Level of Evidence for the Answer A Search Terms Terminal care, palliative care, terminal illness, communication, patient-provider relations, time factors, life support care, resuscitation orders, enteral nutrition Inclusion Criteria Systematic reviews, meta-analyses, and comparative studies published between 2008 and the current date comparing EOL care or EOL care preferences of patients who spend more face-to-face time with a healthcare provider to those of patients who spend less face-to-face time with a healthcare provider. Exclusion Criteria Studies that do not report the primary outcome of interest (EOL care or EOL care preferences) or that do not measure discussion time or provide interventions that include face-to-face discussion. PMID:25796765

Prolonged conservative treatment or 'early' surgery in sciatica caused by a lumbar disc herniation: rationale and design of a randomized trial [ISRCT 26872154

PubMed Central

Peul, Wilco C; van Houwelingen, Hans C; van der Hout, Wilbert B; Brand, Ronald; Eekhof, Just AH; Tans, Joseph ThJ; Thomeer, Ralph TWM; Koes, Bart W

2005-01-01

Background The design of a randomized multicenter trial is presented on the effectiveness of a prolonged conservative treatment strategy compared with surgery in patients with persisting intense sciatica (lumbosacral radicular syndrome). Methods/design Patients presenting themselves to their general practitioner with disabling sciatica lasting less than twelve weeks are referred to the neurology outpatient department of one of the participating hospitals. After confirmation of the diagnosis and surgical indication MRI scanning is performed. If a distinct disc herniation is discerned which in addition covers the clinically expected site the patient is eligible for randomization. Depending on the outcome of the randomization scheme the patient will either be submitted to prolonged conservative care or surgery. Surgery will be carried out according to the guidelines and between six and twelve weeks after onset of complaints. The experimental therapy consists of a prolonged conservative treatment under supervision of the general practitioner, which may be followed by surgical intervention in case of persisting or progressive disability. The main primary outcome measure is the disease specific disability of daily functioning. Other primary outcome measures are perceived recovery and intensity of legpain. Secondary outcome measures encompass severity of complaints, quality of life, medical consumption, absenteeism, costs and preference. The main research question will be answered at 12 months after randomization. The total follow-up period covers two years. Discussion Evidence is lacking concerning the optimal treatment of lumbar disc induced sciatica. This pragmatic randomized trial, focusses on the 'timing' of intervention, and will contribute to the decision of the general practictioner and neurologist, regarding referral of patients for surgery. PMID:15707491

Behavioral laterality of the brain: support for the binary construct of hemisity

PubMed Central

Morton, Bruce E.

2013-01-01

Three terms define brain behavioral laterality: hemispheric dominance identifies the cerebral hemisphere producing one's first language. Hemispheric asymmetry locates the brain side of non-language skills. A third term is needed to describe a person's binary thinking, learning, and behaving styles. Since the 1950s split-brain studies, evidence has accumulated that individuals with right or left brain behavioral orientations (RPs or LPs) exist. Originally, hemisphericity sought, but failed, to confirm the existence of such individual differences, due to its assertion that each individual lay somewhere on a gradient between competing left and right brain extremes. Recently, hemisity, a more accurate behavioral laterality context, has emerged. It posits that one's behavioral laterality is binary: i.e., inherently either right or left brain-oriented. This insight enabled the quantitative determination of right or left behavioral laterality of thousands of subjects. MRI scans of right and left brain-oriented groups revealed two neuroanatomical differences. The first was an asymmetry of an executive element in the anterior cingulate cortex (ACC). This provided hemisity both a rationale and a primary standard. RPs and LPs gave opposite answers to many behavioral preference “either-or,” forced choice questions. This showed that several sex vs. hemisity traits are being conflated by society. Such was supported by the second neuroanatomical difference between the hemisity subtypes, that RPs of either sex had up to three times larger corpus callosi than LPs. Individuals of the same hemisity but opposite sex had more personality traits in common than those of the same sex but different hemisity. Although hemisity subtypes were equally represented in the general population, the process of higher education and career choice caused substantial hemisity sorting among the professions. Hemisity appears to be a valid and promising area for quantitative research of behavioral laterality. PMID:24101910

Behavioral laterality of the brain: support for the binary construct of hemisity.

PubMed

Morton, Bruce E

2013-10-01

hemispheric dominance identifies the cerebral hemisphere producing one's first language. Hemispheric asymmetry locates the brain side of non-language skills. A third term is needed to describe a person's binary thinking, learning, and behaving styles. Since the 1950s split-brain studies, evidence has accumulated that individuals with right or left brain behavioral orientations (RPs or LPs) exist. Originally, hemisphericity sought, but failed, to confirm the existence of such individual differences, due to its assertion that each individual lay somewhere on a gradient between competing left and right brain extremes. Recently, hemisity, a more accurate behavioral laterality context, has emerged. It posits that one's behavioral laterality is binary: i.e., inherently either right or left brain-oriented. This insight enabled the quantitative determination of right or left behavioral laterality of thousands of subjects. MRI scans of right and left brain-oriented groups revealed two neuroanatomical differences. The first was an asymmetry of an executive element in the anterior cingulate cortex (ACC). This provided hemisity both a rationale and a primary standard. RPs and LPs gave opposite answers to many behavioral preference "either-or," forced choice questions. This showed that several sex vs. hemisity traits are being conflated by society. Such was supported by the second neuroanatomical difference between the hemisity subtypes, that RPs of either sex had up to three times larger corpus callosi than LPs. Individuals of the same hemisity but opposite sex had more personality traits in common than those of the same sex but different hemisity. Although hemisity subtypes were equally represented in the general population, the process of higher education and career choice caused substantial hemisity sorting among the professions. Hemisity appears to be a valid and promising area for quantitative research of behavioral laterality.

Usability testing of ANSWER: a web-based methotrexate decision aid for patients with rheumatoid arthritis

PubMed Central

2013-01-01

Background Decision aids are evidence-based tools designed to inform people of the potential benefit and harm of treatment options, clarify their preferences and provide a shared decision-making structure for discussion at a clinic visit. For patients with rheumatoid arthritis (RA) who are considering methotrexate, we have developed a web-based patient decision aid called the ANSWER (Animated, Self-serve, Web-based Research Tool). This study aimed to: 1) assess the usability of the ANSWER prototype; 2) identify strengths and limitations of the ANSWER from the patient’s perspective. Methods The ANSWER prototype consisted of: 1) six animated patient stories and narrated information on the evidence of methotrexate for RA; 2) interactive questionnaires to clarify patients’ treatment preferences. Eligible participants for the usability test were patients with RA who had been prescribed methotrexate. They were asked to verbalize their thoughts (i.e., think aloud) while using the ANSWER, and to complete the System Usability Scale (SUS) to assess overall usability (range = 0-100; higher = more user friendly). Participants were audiotaped and observed, and field notes were taken. The testing continued until no new modifiable issues were found. We used descriptive statistics to summarize participant characteristics and the SUS scores. Content analysis was used to identified usability issues and navigation problems. Results 15 patients participated in the usability testing. The majority were aged 50 or over and were university/college graduates (n = 8, 53.4%). On average they took 56 minutes (SD = 34.8) to complete the tool. The mean SUS score was 81.2 (SD = 13.5). Content analysis of audiotapes and field notes revealed four categories of modifiable usability issues: 1) information delivery (i.e., clarity of the information and presentation style); 2) navigation control (i.e., difficulties in recognizing and using the navigation control buttons); 3) layout (i.e., position of the videos, text, diagrams and navigation buttons); 4) aesthetic (i.e., the colour, look and feel of the online tool). Conclusions Although the SUS score indicated high usability before and after major modification, findings from the think-aloud sessions illustrated areas that required further refinement. Our results highlight the importance of formative evaluation in usability testing. PMID:24289731

Usability testing of ANSWER: a web-based methotrexate decision aid for patients with rheumatoid arthritis.

PubMed

Li, Linda C; Adam, Paul M; Townsend, Anne F; Lacaille, Diane; Yousefi, Charlene; Stacey, Dawn; Gromala, Diane; Shaw, Chris D; Tugwell, Peter; Backman, Catherine L

2013-12-01

Decision aids are evidence-based tools designed to inform people of the potential benefit and harm of treatment options, clarify their preferences and provide a shared decision-making structure for discussion at a clinic visit. For patients with rheumatoid arthritis (RA) who are considering methotrexate, we have developed a web-based patient decision aid called the ANSWER (Animated, Self-serve, Web-based Research Tool). This study aimed to: 1) assess the usability of the ANSWER prototype; 2) identify strengths and limitations of the ANSWER from the patient's perspective. The ANSWER prototype consisted of: 1) six animated patient stories and narrated information on the evidence of methotrexate for RA; 2) interactive questionnaires to clarify patients' treatment preferences. Eligible participants for the usability test were patients with RA who had been prescribed methotrexate. They were asked to verbalize their thoughts (i.e., think aloud) while using the ANSWER, and to complete the System Usability Scale (SUS) to assess overall usability (range = 0-100; higher = more user friendly). Participants were audiotaped and observed, and field notes were taken. The testing continued until no new modifiable issues were found. We used descriptive statistics to summarize participant characteristics and the SUS scores. Content analysis was used to identified usability issues and navigation problems. 15 patients participated in the usability testing. The majority were aged 50 or over and were university/college graduates (n = 8, 53.4%). On average they took 56 minutes (SD = 34.8) to complete the tool. The mean SUS score was 81.2 (SD = 13.5). Content analysis of audiotapes and field notes revealed four categories of modifiable usability issues: 1) information delivery (i.e., clarity of the information and presentation style); 2) navigation control (i.e., difficulties in recognizing and using the navigation control buttons); 3) layout (i.e., position of the videos, text, diagrams and navigation buttons); 4) aesthetic (i.e., the colour, look and feel of the online tool). Although the SUS score indicated high usability before and after major modification, findings from the think-aloud sessions illustrated areas that required further refinement. Our results highlight the importance of formative evaluation in usability testing.

Priorities and prospect theory.

PubMed

Happich, M; Mazurek, B

2002-01-01

Whose preferences are to be used for cost-effectiveness analysis? It has been recommended that community preferences for health states are the most appropriate ones for use in a reference case analysis. However, critics maintain that persons are not able properly to judge a health state if they have not experienced the condition themselves. This problem is analyzed here in the framework of Prospect Theory. It can be argued that the differing reference points of patients and the general public are responsible for deviating results. In addition, we argue that risk attitudes with respect to health-related quality of life are an indicator of reference points. If patients and the general public refer to the same reference point, i.e., they have the same risk attitude, the hypothesis is that deviations no longer significantly differ. Evaluations of the health condition of tinnitus by 210 patients and 210 unaffected persons were compared. The Time Tradeoff and Standard Gamble methods were applied to elicit preferences. Risk attitude was measured with the question of whether participants would undergo a treatment that could either improve or worsen their health condition, both with an equal chance (five possible answers between "in no case" and "in any case"). Affected persons indicated significantly higher values for tinnitus-related quality of life according to the Standard Gamble method. The difference between Time Tradeoff values was less dramatic but still significant. In addition, nonaffected persons are more risk-averse than affected persons. However, differences in evaluations are not significant considering single risk groups (e.g., those who answered "in no case"). Prospect Theory is a reasonable framework for considering the question of whose preferences count. If this result can be generalized for other diseases as well, it allows the mathematical combination of "objective" evaluations by the general public with the illness experience of patients. These evaluations should be weighted with patients' risk attitudes, i.e., community preferences can be used if they are corrected for risk attitudes.

An information processing view of framing effects: the role of causal schemas in decision making.

PubMed

Jou, J; Shanteau, J; Harris, R J

1996-01-01

People prefer a sure gain to a probable larger gain when the two choices are presented from a gain perspective, but a probable larger loss to a sure loss when the objectively identical choices are presented from a loss perspective. Such reversals of preference due to the context of the problem are known as framing effects. In the present study, schema activation and subjects' interpretations of the problems were examined as sources of the framing effects. Results showed that such effects could be eliminated by introducing into a problem a causal schema that provided a rationale for the reciprocal relationship between the gains and the losses. Moreover, when subjects were freed from framing they were consistently risk seeking in decisions about human life, but risk averse in decisions about property. Irrationality in choice behaviors and the ecological implication of framing effects are discussed.

Avoiding Cancer Risk Information

PubMed Central

Emanuel, Amber S.; Kiviniemi, Marc T.; Howell, Jennifer L.; Hay, Jennifer L.; Waters, Erika A.; Orom, Heather; Shepperd, James A.

2015-01-01

RATIONALE Perceived risk for health problems such as cancer is a central construct in many models of health decision making and a target for behavior change interventions. However, some portion of the population actively avoids cancer risk information. The prevalence of, explanations for, and consequences of such avoidance are not well understood. OBJECTIVE We examined the prevalence and demographic and psychosocial correlates of cancer risk information avoidance preference in a nationally representative sample. We also examined whether avoidance of cancer risk information corresponds with avoidance of cancer screening. RESULTS Based on our representative sample, 39% of the population indicated that they agreed or strongly agreed that they would “rather not know [their] chance of getting cancer.” This preference was stronger among older participants, female participants, and participants with lower levels of education. Preferring to avoid cancer risk information was stronger among participants who agreed with the beliefs that everything causes cancer, that there’s not much one can do to prevent cancer, and that there are too many recommendations to follow. Finally, the preference to avoid cancer risk information was associated with lower levels of screening for colon cancer. CONCLUSION These findings suggest that cancer risk information avoidance is a multi-determined phenomenon that is associated with demographic characteristics and psychosocial individual differences and also relates to engagement in cancer screening. PMID:26560410

Correlation of the Summary Method with Learning Styles

ERIC Educational Resources Information Center

Sarikcioglu, Levent; Senol, Yesim; Yildirim, Fatos B.; Hizay, Arzu

2011-01-01

The summary is the last part of the lesson but one of the most important. We aimed to study the relationship between the preference of the summary method (video demonstration, question-answer, or brief review of slides) and learning styles. A total of 131 students were included in the present study. An inventory was prepared to understand the…

2014 Madison County, Indiana, Heartland in Motion Transportation Study |

Science.gov Websites

travel survey and a set of stated preference experiments. Households were asked to provide details of regional public schools were in session, prior to spring break. Survey Records Survey records include a households that participated in the main study and answered every survey question. Because the primary

The Impact of Years of Teaching Experience on the Classroom Management Approaches of Elementary School Teachers

ERIC Educational Resources Information Center

Unal, Zafer; Unal, Aslihan

2012-01-01

This study provided a basis for answering the following essential question: Does the years of experience affect teachers' classroom management approaches? Data were collected from 268 primary school teachers. The findings of this study demonstrated that experienced teachers are more likely to prefer to be in control in their classrooms than…

Beliefs and Practices Regarding Autism in Indian Families Now Settled Abroad: An Internet Survey

ERIC Educational Resources Information Center

Ravindran, Neeraja; Myers, Barbara J.

2013-01-01

Beliefs and practices regarding autism were explored in Indian families living outside India. Parents (N = 24) of children (3 to 15 years) with an autism spectrum disorder wrote open-ended answers in an online questionnaire regarding their beliefs about causes, treatments and services received, use of and preference for Indian medicine and…

A Framework for Gamified Activities Based on Mobile Games Played by Portuguese University Students

ERIC Educational Resources Information Center

Carvalho, Ana Amélia; Araújo, Inês; Zagalo, Nelson

2014-01-01

This paper starts by reporting the findings of a survey of Portuguese university students concerning their game habits and preferences. An online questionnaire was developed and 1101 answers were collected, 626 were mobile game players. The results from the survey indicate that the games most played by university students are essentially casual…

Effect of Display Factors on Chinese Reading Times, Comprehension Scores and Preferences

ERIC Educational Resources Information Center

Chan, A.H.S.; Lee, P.S.K.

2005-01-01

This paper presents the results of research on elemental standard reading time estimates for traditional Chinese characters on computer displays and explores the factors that may affect the time estimates. Seventy-two native Chinese readers, aged 19 to 24, were asked to read 16 simple passages and then answer four multiple-choice questions.…

Professional Development and Teacher Leadership in the Era of NCLB: A Study Exploring Elementary Music Teacher Preferences

ERIC Educational Resources Information Center

Bernard, Anthony D., Sr.

2009-01-01

Several recent studies have been conducted on teacher professional development (PD) but few have focused exclusively on elementary music teacher PD. Prominent music education researchers encourage additional research to provide generalizability across the field. In answer to this call for broadening the base of research in elementary music…

Technology Is the Answer, But What Was the Question? Audiotape vs. Videotape for Individualized Instruction.

ERIC Educational Resources Information Center

Tabachnick, Barbara Gerson; And Others

1978-01-01

In an evaluation of supplementary learning aids students were assigned to one of four learning conditions: (1) videotape plus worksheet, (2) audiotape plus worksheet, (3) combination of audio- and videotape plus worksheet, and (4) worksheet only. Results reported include test scores and ratings of helpfulness, as well as student preferences and…

Is Disgust the Driver behind the Selection of Images for UK Tobacco Packets?

ERIC Educational Resources Information Center

Humphris, Gerry; Williams, Brian

2014-01-01

Objective: The use of pictorial warning labels on tobacco packets has gained almost universal international acceptance. In a public consultation exercise in 2006, the Department of Health in England, through a web-based answering system, asked people's preferences of 42 images, asking which images might be effective to encourage tobacco cessation…

Drift: An Analysis of Outcome Framing in Intertemporal Choice

ERIC Educational Resources Information Center

Read, Daniel; Frederick, Shane; Scholten, Marc

2013-01-01

People prefer to receive good outcomes immediately rather than wait, and they must be compensated for waiting. But what influences their decision about how much compensation is required for a given wait? To give a partial answer to this question, we develop the DRIFT model, a heuristic description of how framing influences intertemporal choice. We…

No Randomization? No Problem: Experimental Control and Random Assignment in Single Case Research

ERIC Educational Resources Information Center

Ledford, Jennifer R.

2018-01-01

Randomization of large number of participants to different treatment groups is often not a feasible or preferable way to answer questions of immediate interest to professional practice. Single case designs (SCDs) are a class of research designs that are experimental in nature but require only a few participants, all of whom receive the…

Personalization of Student in Course Management Systems on the Basis Using Method of Data Mining

ERIC Educational Resources Information Center

Magdin, Martin; Turcáni, Milan

2015-01-01

Individualization of learning through ICT [Information and Communication Technology] allows to students not only the possibility choose the time and place to study, but especially pace adoption of new knowledge on the basis of preferred learning styles. Analysis of learning processes should give the answer to difficult questions from pedagogical…

Profiling Perceptual Learning Styles of Chinese as a Second Language Learners in University Settings

ERIC Educational Resources Information Center

Sun, Peijian Paul; Teng, Lin Sophie

2017-01-01

This study revisited Reid's (1987) perceptual learning style preference questionnaire (PLSPQ) in an attempt to answer whether the PLSPQ fits in the Chinese-as-a-second-language (CSL) context. If not, what are CSL learners' learning styles drawing on the PLSPQ? The PLSPQ was first re-examined through reliability analysis and confirmatory factor…

Organ Donor Registration Preferences among Hispanic Populations: Which Modes of Registration Have the Greatest Promise?

ERIC Educational Resources Information Center

Siegel, Jason T.; Alvaro, Eusebio M.; Jones, Sara Pace

2005-01-01

There is little debate over Hispanics' need for viable organs. Although organ donor registries can potentially assist in alleviating this need, the U.S. Department of Health and Human Services (DHHS) has called on researchers to investigate methods to maximize such potential. This research effort answers the aforementioned call by surveying…

Precision and Disclosure in Text and Voice Interviews on Smartphones

PubMed Central

Antoun, Christopher; Ehlen, Patrick; Fail, Stefanie; Hupp, Andrew L.; Johnston, Michael; Vickers, Lucas; Yan, H. Yanna; Zhang, Chan

2015-01-01

As people increasingly communicate via asynchronous non-spoken modes on mobile devices, particularly text messaging (e.g., SMS), longstanding assumptions and practices of social measurement via telephone survey interviewing are being challenged. In the study reported here, 634 people who had agreed to participate in an interview on their iPhone were randomly assigned to answer 32 questions from US social surveys via text messaging or speech, administered either by a human interviewer or by an automated interviewing system. 10 interviewers from the University of Michigan Survey Research Center administered voice and text interviews; automated systems launched parallel text and voice interviews at the same time as the human interviews were launched. The key question was how the interview mode affected the quality of the response data, in particular the precision of numerical answers (how many were not rounded), variation in answers to multiple questions with the same response scale (differentiation), and disclosure of socially undesirable information. Texting led to higher quality data—fewer rounded numerical answers, more differentiated answers to a battery of questions, and more disclosure of sensitive information—than voice interviews, both with human and automated interviewers. Text respondents also reported a strong preference for future interviews by text. The findings suggest that people interviewed on mobile devices at a time and place that is convenient for them, even when they are multitasking, can give more trustworthy and accurate answers than those in more traditional spoken interviews. The findings also suggest that answers from text interviews, when aggregated across a sample, can tell a different story about a population than answers from voice interviews, potentially altering the policy implications from a survey. PMID:26060991

Precision and Disclosure in Text and Voice Interviews on Smartphones.

PubMed

Schober, Michael F; Conrad, Frederick G; Antoun, Christopher; Ehlen, Patrick; Fail, Stefanie; Hupp, Andrew L; Johnston, Michael; Vickers, Lucas; Yan, H Yanna; Zhang, Chan

2015-01-01

As people increasingly communicate via asynchronous non-spoken modes on mobile devices, particularly text messaging (e.g., SMS), longstanding assumptions and practices of social measurement via telephone survey interviewing are being challenged. In the study reported here, 634 people who had agreed to participate in an interview on their iPhone were randomly assigned to answer 32 questions from US social surveys via text messaging or speech, administered either by a human interviewer or by an automated interviewing system. 10 interviewers from the University of Michigan Survey Research Center administered voice and text interviews; automated systems launched parallel text and voice interviews at the same time as the human interviews were launched. The key question was how the interview mode affected the quality of the response data, in particular the precision of numerical answers (how many were not rounded), variation in answers to multiple questions with the same response scale (differentiation), and disclosure of socially undesirable information. Texting led to higher quality data-fewer rounded numerical answers, more differentiated answers to a battery of questions, and more disclosure of sensitive information-than voice interviews, both with human and automated interviewers. Text respondents also reported a strong preference for future interviews by text. The findings suggest that people interviewed on mobile devices at a time and place that is convenient for them, even when they are multitasking, can give more trustworthy and accurate answers than those in more traditional spoken interviews. The findings also suggest that answers from text interviews, when aggregated across a sample, can tell a different story about a population than answers from voice interviews, potentially altering the policy implications from a survey.

Housing preferences of young adults in Indonesia: housing attributes and consequences

NASA Astrophysics Data System (ADS)

Farasa, N.; Kusuma, H. E.

2018-03-01

Nowadays, the housing demand of young adults in Indonesia is important issues for the sustainable development of the market. Facing differences of life phases, such as marriage, leaving home after graduation, and new job positioning, young adults become the main segment facing constant housing choice decisions in the housing market. In their particular phase of life, young adults have distinct preferences for housing attributes which bring a great influence on their lives in the future. Data was gathered from a survey questionnaire that was answered by 180 young adults in Indonesia, ranging from age 22-33 years. The findings suggest that the green area and view, location, simplicity, home design, and accessibility are the significant parts as housing attributes for young adults’ housing preferences in Indonesia. The effect of these attributes has many consequences such as security, personalization, mood/ambiance, maintenance, interaction, image, flexibility, environmental, economy, durability, convenience, comfort, and circulation. The biggest group of young adults who prefer comfort as their wanted consequences tend to have high preferences on housing attributes of the green area and view, and simplicity.

Medical students’ personal choice for mode of delivery in Santa Catarina, Brazil: a cross-sectional, quantitative study

PubMed Central

2012-01-01

Background The increase in overall rates of cesarean sections (CS) in Brazil causes concern and it appears that multiple factors are involved in this fact. In 2009, undergraduate students in the first and final years of medical school at the University of Santa Catarina answered questionnaires regarding their choice of mode of delivery. The aim of the study was to evaluate whether the education process affects decision-making regarding the waay of childbirth preferred by medical students. Methods A cross-sectional, quantitative study was conducted based on data obtained from questionnaires applied to medical students. The questions addressed four different scenarios in childbirth, as follows: under an uneventful pregnancy; the mode of delivery for a pregnant woman under their care; the best choice as a healthcare manager and lastly, choosing the birth of their own child. For each circumstance, there was an open question to explain their choice. Results A total of 189 students answered the questionnaires. For any uneventful pregnancy and for a pregnant woman under their care, 8.46% of the students would opt for CS. As a healthcare manager, only 2.64% of the students would recommend CS. For these three scenarios, the answers of the students in the first year did not differ from those given by students in the sixth year. In the case of the student’s own or a partner’s pregnancy, 41.4% of those in the sixth year and 16.8% of those in the first year would choose a CS. A positive association was found between being a sixth year student and a personal preference for CS according to logistic regression (OR = 2.91; 95%CI: 1.03–8.30). Pain associated with vaginal delivery was usually the reason for choosing a CS. Conclusions A higher number of sixth year students preferred a CS for their own pregnancy (or their partner’s) compared to first year students. Pain associated with vaginal delivery was the most common reason given for haven chosen a CS. The students’ preference for childbirth changed over time during their graduation in favor of cesarean sections. This finding deserves considerable attention when structuring medical education in Obstetrics. PMID:22818043

Monetary favors and their influence on neural responses and revealed preference

PubMed Central

Harvey, Ann H.; Kirk, Ulrich; Denfield, George H.; Montague, P. Read

2010-01-01

Favors from a sender to a receiver are known to bias decisions made by the recipient, especially when the decision relates to the sender – a feature of social exchange known as reciprocity. Using an art-viewing paradigm possessing no objectively correct answer for preferring one piece of art over another, we show that sponsorship of the experiment by a company endows the company’s logo with the capacity to bias revealed preference for art displayed next to the logo. Merely offering to sponsor the experiment similarly endowed the gesturing company’s logo with the capacity to bias revealed preferences. These effects do not depend upon the size of the displayed art or the proximity of the sponsoring logo to the piece of art. We used fMRI to show that such monetary favors do not modulate a special collection of brain responses, but instead modulate responses in neural networks normally activated by a wide range of preference judgments. The results raise the important possibility that monetary favors bias judgments in domains seemingly unrelated to the favor, but nevertheless act in an implicit way through neural networks that underlie normal, ongoing preference judgments. PMID:20631188

Patient involvement in decision-making: a cross-sectional study in a Malaysian primary care clinic

PubMed Central

Ambigapathy, Ranjini; Ng, Chirk Jenn

2016-01-01

Objective Shared decision-making has been advocated as a useful model for patient management. In developing Asian countries such as Malaysia, there is a common belief that patients prefer a passive role in clinical consultation. As such, the objective of this study was to determine Malaysian patients’ role preference in decision-making and the associated factors. Design A cross-sectional study. Setting Study was conducted at an urban primary care clinic in Malaysia in 2012. Participants Patients aged >21 years were chosen using systematic random sampling. Methods Consenting patients answered a self-administered questionnaire, which included demographic data and their preferred and actual role before and after consultation. Doctors were asked to determine patients’ role preference. The Control Preference Scale was used to assess patients’ role preference. Primary outcome Prevalence of patients’ preferred role in decision-making. Secondary outcomes (1) Actual role played by the patient in decision-making. (2) Sociodemographic factors associated with patients’ preferred role in decision-making. (3) Doctors’ perception of patients’ involvement in decision-making. Results The response rate was 95.1% (470/494). Shared decision-making was preferred by 51.9% of patients, followed by passive (26.3%) and active (21.8%) roles in decision-making. Higher household income was significantly associated with autonomous role preference (p=0.018). Doctors’ perception did not concur with patients’ preferred role. Among patients whom doctors perceived to prefer a passive role, 73.5% preferred an autonomous role (p=0.900, κ=0.006). Conclusions The majority of patients attending the primary care clinic preferred and played an autonomous role in decision-making. Doctors underestimated patients’ preference to play an autonomous role. PMID:26729393

Programming the body, planning reproduction, governing life: the '(ir-) rationality' of family planning and the embodiment of social inequalities in Salvador da Bahia (Brazil).

PubMed

De Zordo, Silvia

2012-01-01

This paper examines family planning in Brazil as biopolitics and explores how the democratization of the State and of reproductive health services after two decades of military dictatorship (1964-1984) has influenced health professionals' and family planning users' discourses and practices. Do health professionals envisage family planning as a 'right' or do they conceive it, following the old neo-Malthusian rationale, as a 'moral duty' of poor people, whose 'irrational' reproduction jeopardizes the family's and the nation's well being? And how do their patients conceptualize and embody family planning? To answer these questions, this paper draws on 13 months of multi-sited ethnographic research undertaken between 2003 and 2005 in two public family planning services in Salvador da Bahia, where participant observation was undertaken and unstructured interviews were conducted with 11 health professionals and 70 family planning users, mostly low income black women. The paper examines how different bio-political rationalities operate in these services and argues that the old neo-Malthusian rationale and the current, dominant discourse on reproductive rights, gender equality and citizenship coexist. The coalescence of different biopolitical rationalities leads to the double stigmatization of family planning users as 'victims' of social and gender inequalities and as 'irrational' patients, 'irresponsible' mothers and 'bad' citizens if they do not embody the neo-Malthusian and biomedical rationales shaping medical practice. However, these women do not behave as 'docile bodies': they tactically use medical and non-medical contraceptives not only to be good mothers and citizens, but also to enhance themselves and to attain their own goals.

Methods for the design of vasomotor symptom trials: the menopausal strategies: finding lasting answers to symptoms and health network.

PubMed

Newton, Katherine M; Carpenter, Janet S; Guthrie, Katherine A; Anderson, Garnet L; Caan, Bette; Cohen, Lee S; Ensrud, Kristine E; Freeman, Ellen W; Joffe, Hadine; Sternfeld, Barbara; Reed, Susan D; Sherman, Sheryl; Sammel, Mary D; Kroenke, Kurt; Larson, Joseph C; Lacroix, Andrea Z

2014-01-01

This report describes the Menopausal Strategies: Finding Lasting Answers to Symptoms and Health network and methodological issues addressed in designing and implementing vasomotor symptom trials. Established in response to a National Institutes of Health request for applications, the network was charged with conducting rapid throughput randomized trials of novel and understudied available interventions postulated to alleviate vasomotor and other menopausal symptoms. Included are descriptions of and rationale for criteria used for interventions and study selection, common eligibility and exclusion criteria, common primary and secondary outcome measures, consideration of placebo response, establishment of a biorepository, trial duration, screening and recruitment, statistical methods, and quality control. All trial designs are presented, including the following: (1) a randomized, double-blind, placebo-controlled clinical trial designed to evaluate the effectiveness of the selective serotonin reuptake inhibitor escitalopram in reducing vasomotor symptom frequency and severity; (2) a two-by-three factorial design trial to test three different interventions (yoga, exercise, and ω-3 supplementation) for the improvement of vasomotor symptom frequency and bother; and (3) a three-arm comparative efficacy trial of the serotonin-norepinephrine reuptake inhibitor venlafaxine and low-dose oral estradiol versus placebo for reducing vasomotor symptom frequency. The network's structure and governance are also discussed. The methods used in and the lessons learned from the Menopausal Strategies: Finding Lasting Answers to Symptoms and Health trials are shared to encourage and support the conduct of similar trials and to encourage collaborations with other researchers.

Influencing Factors on Choosing Psychiatry as a Career: An Exploration in Chinese University Students.

PubMed

Zhong, Jiawei; Zheng, Luna; Chen, Xiaoling; Gao, Qianqian; Zhang, Bingren; Wang, Wei

2016-12-01

There is a consistent need of psychiatric professionals in the world including China, and a consistent challenge to recruit more medical students into the psychiatric careers. We aimed to look for factors which have an impact on career-choosing of psychiatry in Chinese university students. We invited 508 non-medical students (NM), 304 medical students without (MO) and 123 medical students with clinical internship experience (MW), to answer a matrix of 43 questions regarding factors influencing career-choosing of psychiatry. Answers to these questions were analyzed through exploratory and confirmatory factor analyses, once the latent factors were identified and structurally-validated, their mean scores in three groups of students were calculated. Five factors with five items each were identified, namely social status inferiority, career importance, practice reward, career preference, and practice stress. NM scored lower than MO and MW did on Social Status Inferiority; NM group scored higher than MO and MW groups did on Career Importance; MW scored lower than NM and MO did on Practice Reward and on Career Preference; Regarding Practice Stress, NM scored higher than MO did, who then in turn, scored higher than MW did. In addition, Practice Stress was positively correlated with advice of the medical educators; and Social Status Inferiority and Career Preference were positively correlated with the psychiatry teaching of the medical educators. Raising career rewards, improving social status, and reinforcing psychiatric education might help to recruit more medical students to specialize in psychiatry practicing.

Usability evaluation of centered time cartograms

NASA Astrophysics Data System (ADS)

Ullah, Rehmat; Mengistu, Eskedar Zelalem; van Elzakker, C. P. J. M.; Kraak, Menno-Jan

2016-06-01

A time cartogram visualizes travelling-times between locations. It replaces the geographic distance by time distance and distorts the underlyingmap accordingly. By distorting themap, time cartogramsmay give a more intuitive and clear picture of travelling-times. The distortion of the map, however, can make time cartograms harder to recognize and use. Although cartograms are becoming widespread in use, very little is known about their usability. This study focuses on the usability of centered time cartograms: time cartograms that visualize travellingtimes from a fixed starting location to other destinations in a region. We created several centered time cartograms to answer spatio-temporal questions related to the Dutch railway network. Two experiments were performed: a laboratory test and an online survey. In the laboratory test, we used eye-tracking, thinking aloud, and video-recording to compare four different designs of centered time cartograms to find out which one (or combination) of these performs better in answering spatiotemporal questions and thus, to establish a favorable design strategy for these cartograms. In the online survey, centered time cartograms were evaluated against a geographic and schematic map for accuracy, response time, and preference. The first experiment suggested that among various designs, the centered time cartogram with emphasized railroads is the most preferred design and the centered time cartogram without railroads is the least preferred. The second experiment indicated that overall, centered time cartograms perform better than the two other solutions in performing spatio-temporal tasks, particularly when the task has a dominant time-related component.

Flower color preferences of insects and livestock: effects on Gentiana lutea reproductive success.

PubMed

Sobral, Mar; Losada, María; Veiga, Tania; Guitián, Javier; Guitián, José; Guitián, Pablo

2016-01-01

Angiosperms diversification was primarily driven by pollinator agents, but non-pollinator agents also promoted floral evolution. Gentiana lutea shows pollinator driven flower color variation in NW Spain. We test whether insect herbivores and livestock, which frequently feed in G.lutea, play a role in G. lutea flower color variation, by answering the following questions: (i) Do insect herbivores and grazing livestock show flower color preferences when feeding on G. lutea? (ii) Do mutualists (pollinators) and antagonists (seed predators, insect herbivores and livestock) jointly affect G. lutea reproductive success? Insect herbivores fed more often on yellow flowering individuals but they did not affect seed production, whereas livestock affected seed production but did not show clear color preferences. Our data indicate that flower color variation of G. lutea is not affected by insect herbivores or grazing livestock.

Commentary: freedom and function.

PubMed

Buchanan, Alec

2008-01-01

While the question of whether our actions are determined or are the result of free will is a deep one in philosophy, it does not need to be answered for forensic psychiatrists to give evidence in court. As Stephen Morse has pointed out, the absence of free will is not named as an excusing condition. The insanity defense, for instance, requires proof of functional impairment, to which psychiatrists can usefully testify. Of the approaches available to determinism, my own preference is that of Herbert Hart: until we know that determinism is true, we will continue to prefer a system that requires persons to have made proper choices to act as they did before we hold them responsible. This seems to resemble Dr. Felthous' preferred option, that mentally responsible choices are choices made in the presence of a relatively natural ability to have decided otherwise.

Flower color preferences of insects and livestock: effects on Gentiana lutea reproductive success

PubMed Central

Losada, María; Veiga, Tania; Guitián, Javier; Guitián, José; Guitián, Pablo

2016-01-01

Angiosperms diversification was primarily driven by pollinator agents, but non-pollinator agents also promoted floral evolution. Gentiana lutea shows pollinator driven flower color variation in NW Spain. We test whether insect herbivores and livestock, which frequently feed in G.lutea, play a role in G. lutea flower color variation, by answering the following questions: (i) Do insect herbivores and grazing livestock show flower color preferences when feeding on G. lutea? (ii) Do mutualists (pollinators) and antagonists (seed predators, insect herbivores and livestock) jointly affect G. lutea reproductive success? Insect herbivores fed more often on yellow flowering individuals but they did not affect seed production, whereas livestock affected seed production but did not show clear color preferences. Our data indicate that flower color variation of G. lutea is not affected by insect herbivores or grazing livestock. PMID:27014509

[Influence of gender in vocational preferences and personality traits in Medical students].

PubMed

Monleón-Moscardó, P J; Rojo-Moreno, J; Monleón-Moscardó, A; García-Merita, M L; Alonso-Fonfría, A; Valdemoro-García, C

2003-01-01

In this paper, we try to analyze he possible relationships between gender of the Medical students, their personality and their vocational preferences. A total of 1,482 2nd year medical students from the Valencia University were analyzed. They answered and anonymous survey on their sociodemographic characteristics and their vocational interests. We determined their personality profile with the 16 PF of Cattell. The data obtained were analyzed with the logistic regression techniques. Most of the population analyzed were female (62.7%) with a medium age of 20 years. The Pediatric and Gynecology-Obstetrics specialities were preferred mostly by female students and Orthopedic surgery by male students. The female students had a specific personality traits, they were more (A+), (G+), Boldness (H+), (n+) and (Q3+). While the male students were more (I+), (L+), (M+), Q2(+). Gender has a significant influence on the medical student both in their vocational preferences as well as their personality profile.

Farmers' Risk Preferences in Rural China: Measurements and Determinants.

PubMed

Jin, Jianjun; He, Rui; Gong, Haozhou; Xu, Xia; He, Chunyang

2017-06-30

This study measures farmers' risk attitudes in rural China using a survey instrument and a complementary experiment conducted in the field with the same sample of subjects. Using a question asking people about their willingness to take risks "in general", we found that the average response of our sample is slightly risk averse. Farmers' exogenous factors (age, gender, and height) and self-reported happiness have a significant impact on farmers' willingness to take risks. The experiment results show that approximately 44% of farmers in the study area are risk averse. We compare farmers' self-reported measures of risk preferences derived from the survey instrument to preferences elicited through the experimental task. Results show that answers to the general risk attitude question in the survey can predict farmers' behaviors in the experiment to a statistically significant degree. This paper can contribute to the empirical literature on comparing local farmers' risk attitudes across different risk preference measurement methods in the developing world.

Scientists at play in a field of the Lord

NASA Astrophysics Data System (ADS)

Long, David E.

2010-03-01

The Answers in Genesis Creation Museum opened in May of 2007. During the opening day, a loosely affiliated group of scientists joined in a Rally for Reason as they termed it to protest the museum's potential effect on science in the United States. This paper discusses ethnographic data collected before and during the rally. Scientist narratives disclose the rationale for their participation at the rally, unpacking their hopes, fears and social ideals vis-à-vis their perception of the Museum's impact. With these ideals, I discuss the lacking discourse between the values of ideal of science literacy, the contested authority of museums and their publics, and a lacking conception of how a valuerationality aligned towards the Museum's message continues to be culturally produced.

Galaxy Evolution Spectroscopic Explorer (GESE): Science Rationale, Optical Design, and Telescope Architecture

NASA Technical Reports Server (NTRS)

Heap, Sara R.; Gong, Qian; Hull, Tony; Purves, Lloyd

2014-01-01

One of the key goals of NASA’s astrophysics program is to answer the question: How did galaxies evolve into the spiral, elliptical, and irregular galaxies that we see today? We describe a space mission concept called Galaxy Evolution Spectroscopic Explorer (GESE) to help address this question by making a large ultraviolet spectroscopic survey of galaxies at a redshift, z approximately 1 (look-back time of approximately 8 billion years). GESE is a 1.5-m space telescope with an near-ultraviolet (NUV) multi-object slit spectrograph covering the spectral range, 0.2-0.4 micrometers (0.1-0.2 micrometers as emitted by galaxies at a redshift, z approximately 1) at a spectral resolution of delta lambda=6 A.

`Does it answer the question or is it French fries?': an exploration of language supports for scientific argumentation

NASA Astrophysics Data System (ADS)

González-Howard, María; McNeill, Katherine L.; Marco-Bujosa, Lisa M.; Proctor, C. Patrick

2017-03-01

Reform initiatives around the world are reconceptualising science education by stressing student engagement in science practices. Yet, science practices are language-intensive, requiring students to have strong receptive and productive language proficiencies. It is critical to address these rigorous language demands to ensure equitable learning opportunities for all students, including English language learners (ELLs). Little research has examined how to specifically support ELL students' engagement in science practices, such as argumentation. Using case-study methodology, we examined one middle school science teacher's instructional strategies as she taught an argumentation-focused curriculum in a self-contained ELL classroom. Findings revealed that three trends characterized the teacher's language supports for the structural and dialogic components of argumentation: (1) more language supports focused on argument structure, (2) dialogic interactions were most often facilitated by productive language supports, and (3) some language supports offered a rationale for argumentation. Findings suggest a need to identify and develop supports for the dialogic aspects of argumentation. Furthermore, engaging students in argumentation through productive language functions could be leveraged to support dialogic interactions. Lastly, our work points to the need for language supports that make the rationale for argumentation explicit since such transparency could further increase access for all students.

The ethics of and the appropriate legislation concerning killing people and letting them die: a response to Merkel.

PubMed

McLachlan, Hugh V

2017-07-01

With regard to ethics and legislation, what is the significant difference between a doctor terminating the life-supporting treatment of a patient in the course of his job and a greedy relative of the patient doing the same thing to inherit his wealth? Merkel offers an interesting and inventive answer to this question in terms of the improper violation of personal boundaries. However, despite Merkel's claim to the contrary, his answer does not directly address the question of the relevant ethical similarities and differences between killing and letting die in general. Furthermore, it does not provide the basis a plausible rationale for legislation concerning killing and letting die. The questions of whether letting someone die is ethically the same as killing someone and whether it should be treated the same way by the criminal law are not the same as or tantamount to the question of whether or not it involves the transgression of another person's boundaries. 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/.

An Exploratory Study of Risk-Taking and Attitudes in a Girls-Only Middle School Math Class.

ERIC Educational Resources Information Center

Streitmatter, Janice

1997-01-01

Studied attitudes of girls, toward themselves and their classmates, and their behavior in a girls-only math classroom. Found girls were more likely to ask and answer questions in the math classroom than in coeducational classes and that the girls-only setting enhanced their ability to learn. The girls-only environment was overwhelmingly preferred.…

Music Preferences in the U.S.: 1982-2002

ERIC Educational Resources Information Center

Mizell, Lee

2005-01-01

Music is everywhere. People listen to compact discs while relaxing at home, MP3s while jogging in the park, live music concerts in their free time, and internet radio on the computer. What are people listening to? Who is doing the listening? How have listening patterns changed over time? This report aims to answer those questions by using data…

A Content Analysis of Officer Perceptions of Detailing.

DTIC Science & Technology

1981-03-01

answer was "No Way"! Told me needs of service were in Philippine Island CNSG WESTPAC as OPS, three year tour. I wrote letter saying O.K. Was detailed as...off to them as it has to be least preferred of all tasks...personnel detailer. 2 I regret the tardiness of this reply - New Zealand is a long way

Who Knows Best? Preschoolers Sometimes Prefer Child Informants over Adult Informants

ERIC Educational Resources Information Center

VanderBorght, Mieke; Jaswal, Vikram K.

2009-01-01

Do preschoolers think adults know more about everything than children? Or do they recognize that there are some things that children might know more about than adults? Three-, four-, and five-year olds (N = 65) were asked to decide whether an adult or child informant would better be able to answer a variety of questions about the nutritional value…

Quantum-mechanical machinery for rational decision-making in classical guessing game

NASA Astrophysics Data System (ADS)

Bang, Jeongho; Ryu, Junghee; Pawłowski, Marcin; Ham, Byoung S.; Lee, Jinhyoung

2016-02-01

In quantum game theory, one of the most intriguing and important questions is, “Is it possible to get quantum advantages without any modification of the classical game?” The answer to this question so far has largely been negative. So far, it has usually been thought that a change of the classical game setting appears to be unavoidable for getting the quantum advantages. However, we give an affirmative answer here, focusing on the decision-making process (we call ‘reasoning’) to generate the best strategy, which may occur internally, e.g., in the player’s brain. To show this, we consider a classical guessing game. We then define a one-player reasoning problem in the context of the decision-making theory, where the machinery processes are designed to simulate classical and quantum reasoning. In such settings, we present a scenario where a rational player is able to make better use of his/her weak preferences due to quantum reasoning, without any altering or resetting of the classically defined game. We also argue in further analysis that the quantum reasoning may make the player fail, and even make the situation worse, due to any inappropriate preferences.

Quantum-mechanical machinery for rational decision-making in classical guessing game

PubMed Central

Bang, Jeongho; Ryu, Junghee; Pawłowski, Marcin; Ham, Byoung S.; Lee, Jinhyoung

2016-01-01

In quantum game theory, one of the most intriguing and important questions is, “Is it possible to get quantum advantages without any modification of the classical game?” The answer to this question so far has largely been negative. So far, it has usually been thought that a change of the classical game setting appears to be unavoidable for getting the quantum advantages. However, we give an affirmative answer here, focusing on the decision-making process (we call ‘reasoning’) to generate the best strategy, which may occur internally, e.g., in the player’s brain. To show this, we consider a classical guessing game. We then define a one-player reasoning problem in the context of the decision-making theory, where the machinery processes are designed to simulate classical and quantum reasoning. In such settings, we present a scenario where a rational player is able to make better use of his/her weak preferences due to quantum reasoning, without any altering or resetting of the classically defined game. We also argue in further analysis that the quantum reasoning may make the player fail, and even make the situation worse, due to any inappropriate preferences. PMID:26875685

Quantum-mechanical machinery for rational decision-making in classical guessing game.

PubMed

Bang, Jeongho; Ryu, Junghee; Pawłowski, Marcin; Ham, Byoung S; Lee, Jinhyoung

2016-02-15

In quantum game theory, one of the most intriguing and important questions is, "Is it possible to get quantum advantages without any modification of the classical game?" The answer to this question so far has largely been negative. So far, it has usually been thought that a change of the classical game setting appears to be unavoidable for getting the quantum advantages. However, we give an affirmative answer here, focusing on the decision-making process (we call 'reasoning') to generate the best strategy, which may occur internally, e.g., in the player's brain. To show this, we consider a classical guessing game. We then define a one-player reasoning problem in the context of the decision-making theory, where the machinery processes are designed to simulate classical and quantum reasoning. In such settings, we present a scenario where a rational player is able to make better use of his/her weak preferences due to quantum reasoning, without any altering or resetting of the classically defined game. We also argue in further analysis that the quantum reasoning may make the player fail, and even make the situation worse, due to any inappropriate preferences.

Analysis of medical student's book reports on Cronin's The Citadel: would young doctors give up ideals for prestige and wealth?

PubMed

Hwang, Se Won; Kim, Hun; Kim, Ae Yang; Hwang, Kun

2016-06-01

The purpose of this study is to find what medical students think the reward for their future work should be and whether they would keep their ideals or abandon them for prestige and wealth by analyzing the book reports of Cronin's The Citadel. Participants were 50 medical students of junior class. A month before the classroom lecture, the book and digital video disk were provided. Students had discussions in groups of seven and wrote book reports which include answers of three questions. Regarding what should be the reward for the medical doctor, two-thirds of students (66.7%) answered with spiritual compensation, while one-third (33.3%) chose material reward. In the situation presented to Manson, three-fifths (60.0%) answered they would keep their ideals (idealist), while the remaining two-fifths (40.0%) decided they would abandon them. Less than one-third of students (30.0%) answered they would reveal the corruptions of the doctor's society, while two-thirds (64.0%) would not. The larger number of idealists who prefer spiritual reward rather than a material reward represents the innocence of youth as in portrayed in The Citadel.

Different Reward Structures to Motivate Student Interaction with Electronic Response Systems in Astronomy

NASA Astrophysics Data System (ADS)

Len, Patrick M.

Electronic response systems ("clickers") are used in introductory astronomy classes as a real-time assessment tool. Different reward structures for student responses to clicker questions are used to motivate individual participation or group collaboration before responding. The impact of two reward structures on student behavior and learning is investigated. This study finds that a success-bonus incentive (in which individual participation points are doubled when the class attains a threshold success rate) strongly motivated students to collaborate, whereas a participation-only credit (no success-bonus) incentive resulted in one-third of the students answering individually without collaboration. With a participation-only incentive, students who answered individually ("self-testers") were found to have more positive attitudes toward astronomy and science, and higher self-confidence in their learning than students who interacted before answering without a success-bonus incentive ("collaborators"). These collaborators experienced downward shifts in attitudes and self-confidence, in contrast to the static attitudes and self-confidence of self-testers. The implication is that students with little or no background in science prefer to answer collaboratively rather than independently and that these students are also negatively impacted by a one-semester introductory astronomy course.

Contraceptive needs of the adolescent.

PubMed

Steyn, Petrus S; Goldstuck, Norman D

2014-08-01

The provision of contraception to adolescents requires specific attention. Adolescents require contraceptive methods which are safe, effective and simple to use. While long-acting reversible contraceptive methods are preferable, they should have a choice and not be forced or mandated especially in situations where this may compromise safety. After counselling they should have the ability to choose any method of contraception. Under the appropriate circumstances, each method of contraception may have a place. This chapter will be devoted to evaluating the most current scientific rationale for the indication for use of each method of contraception in adolescents. Copyright © 2014. Published by Elsevier Ltd.

Distinction between Externally vs. Internally Guided Decision-Making: Operational Differences, Meta-Analytical Comparisons and Their Theoretical Implications

PubMed Central

Nakao, Takashi; Ohira, Hideki; Northoff, Georg

2012-01-01

Most experimental studies of decision-making have specifically examined situations in which a single less-predictable correct answer exists (externally guided decision-making under uncertainty). Along with such externally guided decision-making, there are instances of decision-making in which no correct answer based on external circumstances is available for the subject (internally guided decision-making). Such decisions are usually made in the context of moral decision-making as well as in preference judgment, where the answer depends on the subject’s own, i.e., internal, preferences rather than on external, i.e., circumstantial, criteria. The neuronal and psychological mechanisms that allow guidance of decisions based on more internally oriented criteria in the absence of external ones remain unclear. This study was undertaken to compare decision-making of these two kinds empirically and theoretically. First, we reviewed studies of decision-making to clarify experimental–operational differences between externally guided and internally guided decision-making. Second, using multi-level kernel density analysis, a whole-brain-based quantitative meta-analysis of neuroimaging studies was performed. Our meta-analysis revealed that the neural network used predominantly for internally guided decision-making differs from that for externally guided decision-making under uncertainty. This result suggests that studying only externally guided decision-making under uncertainty is insufficient to account for decision-making processes in the brain. Finally, based on the review and results of the meta-analysis, we discuss the differences and relations between decision-making of these two types in terms of their operational, neuronal, and theoretical characteristics. PMID:22403525

Evidence-based medicine Training: Kazakhstan experience.

PubMed

Kamalbekova, G; Kalieva, M

2015-01-01

Understanding principles of evidence-based medicine is of vital importance for improving quality of care, promoting public health and health system development. Understanding principles of evidence-based medicine allows using the most powerful information source, which have ever existed in medicine. To evaluate the effectiveness of teaching Evidence-Based Medicine, including long-term outcomes of training. The study was conducted at the Medical University of Astana, where the Scientific and Educational Center of Evidence-Based Medicine was established in 2010 with the help of the corresponding project of the World Bank. The participants of the study were the faculty trained in Evidence-Based Medicine at the workshop "Introduction to Evidence-Based Medicine" for the period of 2010-2015 years. There were a total of 16 workshops during the period, and 323 employees were trained. All participants were asked to complete our questionnaire two times: before the training - pre-training (to determine the initial level of a listener) and after the training - post-training (to determine the acquired level and get the feedback). Questionnaires were prepared in such a way, that the majority of questions before and after training were identical. Thus, it provided a clear picture of the effectiveness of training. Questions in the survey were open-ended so that the respondents had the opportunity to freely and fully express their views. The main part of the questionnaires included the following questions: "Do you understand what evidence-based medicine is", "how do you understand what the study design means", "what is randomization", "how research is classified", "do you know the steps of decision-making according to Evidence-Based Medicine, list them", "what literature do you prefer to use when searching for information (print, electronic, etc.)", "what resources on the Internet do you prefer to use". Only 30-35% of respondents gave correct answers to the questions on understanding EBM, understanding study designs, randomization. There were no correct or complete answers to the question on study classification. Again, 35% of respondents provided correct answer to the question about the stages of decision-making process from the perspective of EBM, 65% - provided no answer. One fourth (25%) of the respondents preferred using printed literature. Only very few respondents indicated Cochrane Library, Medline (PubMed), Tripdatabasa as preferred Internet sources of information, with 40% indicating Google and 60% - other sources.The results of post-training survey showed that nearly 90% of the respondents gave correct answers to all the questions.With the aim to identify knowledge survival (the long-term training outcomes) we conducted the third survey in May 2014 in previously trained people at the seminar "Introduction to Evidence-Based Medicine". The respondents were asked to answer 4 questions, and to assess previously obtained information on the basics of Evidence-Based Medicine on a 10-point scale.We found that 100% of the respondents answered «Yes» to the question: «Have you changed your behavior after the seminar?» To the question: «Have you encountered difficulties in implementing the principles of evidence-based medicine in the educational process?» 56% of the respondents answered that they had not encountered any difficulties. The other 44% faced the difficulties associated with implementation of Evidence-Based Medicine: lack of understanding by students, low knowledge survival rate among students, too many questions from the students, difficult disputes and discussions.To the question: «Have you encountered difficulties in implementing the principles of Evidence-Based Medicine in practical health-care?» only 37.5% of the respondents answered that they had not encountered difficulties. But the remaining 62.5% of the respondents faced the problems and difficulties in implementing the principles of evidence-based medicine in their practice. These were: failure in implementing, lack of understanding on the part of colleagues, commitment to traditional obsolete methods of treatment, discrepancy between some of the existing standards of diagnosis and treatment and principles of evidence-based medicine.To the question: «Are there any end products after listening to the seminar?» 67% of the respondents answered in affirmative. The end products were mainly marked by the publication of articles and abstracts, including international publications, and participation in the working group on the revision and development of clinical protocols. Barriers to implementation of Evidence-Based Medicine in education and practice are lack of funding to provide access to reliable sources of information, websites; outdated research methodology skills in medical education, lack of skills in critical evaluation of medical information; tradition of authoritarian relationships, use of past experience stencils; failure to comply with continuing education programs ("from training to professional development"). Knowledge of Evidence-Based Medicine, skills to perform searches for scientific data, to evaluate their validity and to transform scientific data into practical solutions are necessary for health workers in their daily activities. This culture needs to be rooted in modern medical education.

Perceptions of smokers influence nonsmoker attitudes and preferences for interactions

PubMed Central

Dillard, Amanda J.; Magnan, Renee E.; Köblitz, Amber R.; McCaul, Kevin D.

2012-01-01

In two studies, we examined nonsmokers’ perceptions of smokers and consequences of the perceptions. In Study 1, smokers answered questions about their sense of self, dependence on smoking, and motivation to quit. Nonsmokers answered questions about their perceptions of these characteristics. Differences between smokers’ self-descriptions and nonsmokers’ perceptions were observed. Study 2 asked nonsmokers to judge two types of smokers for which the descriptions were based on Study 1 findings. Results showed that nonsmokers held a more negative attitude about and were less willing to engage in different close relationships with the smoker who was described in terms of nonsmokers’ perceptions rather than smokers’ reports. Attitude mediated the relationship between type of smoker and willingness to date a smoker. PMID:23734065

Automatically updating predictive modeling workflows support decision-making in drug design.

PubMed

Muegge, Ingo; Bentzien, Jörg; Mukherjee, Prasenjit; Hughes, Robert O

2016-09-01

Using predictive models for early decision-making in drug discovery has become standard practice. We suggest that model building needs to be automated with minimum input and low technical maintenance requirements. Models perform best when tailored to answering specific compound optimization related questions. If qualitative answers are required, 2-bin classification models are preferred. Integrating predictive modeling results with structural information stimulates better decision making. For in silico models supporting rapid structure-activity relationship cycles the performance deteriorates within weeks. Frequent automated updates of predictive models ensure best predictions. Consensus between multiple modeling approaches increases the prediction confidence. Combining qualified and nonqualified data optimally uses all available information. Dose predictions provide a holistic alternative to multiple individual property predictions for reaching complex decisions.

Use of local anesthesia during dental rehabilitation with general anesthesia: a survey of dentist anesthesiologists.

PubMed

Townsend, Janice A; Hagan, Joseph L; Smiley, Megann

2014-01-01

The purpose of this study was to document current practices of dentist anesthesiologists who are members of the American Society of Dentist Anesthesiologists regarding the supplemental use of local anesthesia for children undergoing dental rehabilitation under general anesthesia. A survey was administered via e-mail to the membership of the American Society of Dentist Anesthesiologists to document the use of local anesthetic during dental rehabilitations under general anesthesia and the rationale for its use. Seventy-seven (42.1%) of the 183 members responded to this survey. The majority of dentist anesthesiologists prefer use of local anesthetic during general anesthesia for dental rehabilitation almost always or sometimes (90%, 63/70) and 40% (28/70) prefer its use with rare exception. For dentist anesthesiologists who prefer the administration of local anesthesia almost always, they listed the following factors as very important: "stabilization of vital signs/decreased depth of general anesthesia" (92.9%, 26/28) and "improved patient recovery" (82.1%, 23/28). There was a significant association between the type of practice and who determines whether or not local anesthesia is administered during cases. The majority of respondents favor the use of local anesthesia during dental rehabilitation under general anesthesia.

Interpretive versus didactic learning approach towards oral biology: a student's perspective.

PubMed

Farooq, Imran

2014-10-01

This study analyzed the preference of dental students for oral biology questions that require either an interpretive or a descriptive approach to answer and to compare the preferences with their final examination result retrospectively. A questionnaire requiring student academic number and containing two questions (one asked with an interpretive approach/the other asked with a descriptive approach) from random topics of oral biology course was distributed among students who have already appeared in the final examination. Majority of the students who had achieved good grades (A+, A, B+, B) preferred interpretive questions whereas majority of the students with average grades (C+, C, D+, D) selected descriptive questions. Common reason for picking interpretive question was that it enhances critical thinking. The descriptive questions were argued to provide students with a chance to explain more. Hence, students should be encouraged to learn interpretively to promote enquiry based learning (EBL) and critical thinking.

Public preferences and organized interests in health policy: state pharmacy assistance programs as innovations.

PubMed

Gray, Virginia; Lowery, David; Godwin, Erik K

2007-02-01

While Congress debated prescription drug coverage for more than a decade before amending the Medicare program in 2003, thirty-one states provided such benefits to their citizens. Why were the same special interests that were reputedly so effective in delaying prescription drug coverage at the national level seemingly incapable of stopping the majority of states from passing the same kinds of legislation? To answer this question, we develop and test a number of hypotheses about the determinants of health policy using Heckman models with data on the adoption, revision, and generosity of state prescription drug programs from 1990 through 2001. We find strong evidence that organized interests had little influence on the adoption of state pharmaceutical assistance programs but can influence their likelihood of revision and the generosity of their benefits. We conclude by discussing the balance of public preferences and organized interests' preferences on state health policy.

Point-of-Care Knowledge-Based Resource Needs of Clinicians: A Survey from a Large Academic Medical Center.

PubMed

Ellsworth, M A; Homan, J M; Cimino, J J; Peters, S G; Pickering, B W; Herasevich, V

2015-01-01

To better understand the literature searching preferences of clinical providers we conducted an institution-wide survey assessing the most preferred knowledge searching techniques. A survey regarding literature searching preferences was sent to 1862 unique clinical providers throughout Mayo Clinic. The survey consisted of 25 items asking respondents to select which clinical scenarios most often prompt literature searches as well as identify their most preferred knowledge resources. A total of 450 completed surveys were returned and analyzed (24% response rate). 48% of respondents perform literature searches for more than half of their patient interactions with 91% of all searches occurring either before or within 3 hours of the patient interaction. When a search is performed 57% of respondents prefer synthesized information sources as compared to only 13% who prefer original research. 82% of knowledge searches are performed on a workstation or office computer while just 10% occur on a mobile device or at home. Providers in our survey demonstrate a need to answer clinical questions on a regular basis, especially in the diagnosis and therapy domains. Responses suggest that most of these searches occur using synthesized knowledge sources in the patient care setting within a very short time from the patient interaction.

Patients' self-interested preferences: empirical evidence from a priority setting experiment.

PubMed

Alvarez, Begoña; Rodríguez-Míguez, Eva

2011-04-01

This paper explores whether patients act according to self-interest in priority setting experiments. The analysis is based on a ranking experiment, conducted in Galicia (Spain), to elicit preferences regarding the prioritization of patients on a waiting list for an elective surgical intervention (prostatectomy for benign prostatic hyperplasia). Participants were patients awaiting a similar intervention and members of the general populations. All of them were asked to rank hypothetical patients on a waiting list. A rank-ordered logit was then applied to their responses in order to obtain a prioritization scoring system. Using these estimations, we first test for differences in preferences between patients and general population. Second, we implement a procedure based on the similarity between respondents (true patients) and the hypothetical scenarios they evaluate (hypothetical patients) to analyze whether patients provide self-interested rankings. Our results show that patient preferences differ significantly from general population preferences. The findings also indicate that, when patients rank the hypothetical scenarios on the waiting list, they consider not only the explicit attributes but also the similarity of each scenario to their own. In particular, they assign a higher priority to scenarios that more closely match their own states. We also find that such a preference structure increases their likelihood of reporting "irrational" answers. Copyright © 2011 Elsevier Ltd. All rights reserved.

Older males signal more reliably.

PubMed Central

Proulx, Stephen R; Day, Troy; Rowe, Locke

2002-01-01

The hypothesis that females prefer older males because they have higher mean fitness than younger males has been the centre of recent controversy. These discussions have focused on the success of a female who prefers males of a particular age class when age cues, but not quality cues, are available. Thus, if the distribution of male quality changes with age, such that older males have on average genotypes with higher fitness than younger males, then a female who mates with older males has fitter offspring, which allows the female preference to spread through a genetic correlation. We develop a general model for male display in a species with multiple reproductive bouts that allows us to identify the conditions that promote reliable signalling within an age class. Because males have opportunities for future reproduction, they will reduce their levels of advertising compared with a semelparous species. In addition, because higher-quality males have more future reproduction, they will reduce their advertising more than low-quality males. Thus, the conditions for reliable signalling in a semelparous organism are generally not sufficient to produce reliable signalling in species with multiple reproductive bouts. This result is due to the possibility of future reproduction so that, as individuals age and the opportunities for future reproduction fade, signalling becomes more reliable. This provides a novel rationale for female preference for older mates; older males reveal more information in their sexual displays. PMID:12495495

Factors influencing preferences for alternative medicine by Korean Americans.

PubMed

Kim, Jeongseon; Chan, Mabel M

2004-01-01

Use of alternative medicine among the public has increased rapidly over the last few decades. Studies on alternative health care have been conducted on the general public and on major ethnic groups, but not on Korean Americans, who are one of the fastest growing Asian populations in the United States. This study was a cross-sectional survey of 143 Korean Americans in the Greater New York Metropolitan area; all of them were users of alternative medicine. Inter-correlations of hypothetical demographic predictors and preferences for alternative medicine were obtained. Multiple logistic regression analyses were used to identify factors influencing alternative medicine preferences. Most of the respondents answered that they preferred alternative medicine because of philosophical congruence, i.e. they found alternative therapies compatible with their values, world views, spiritual/religious philosophies, and beliefs regarding the nature and meaning of health and illness. The results show that younger, well-educated respondents, with significant acculturation level, and have stayed in the US for a relatively short period of time preferred alternative medicine. The information derived from this and similar studies may be of potential value to the biomedical community, governmental agencies, insurance companies and managed care organizations.

Single-Spot Yellow Laser Versus Conventional Green Laser on Panretinal Photocoagulation: Patient Pain Scores and Preferences.

PubMed

González-Saldivar, Gerardo; Rojas-Juárez, Sergio; Espinosa-Soto, Itzel; Sánchez-Ramos, Jorge; Jaurieta-Hinojosa, Noel; Ramírez-Estudillo, Abel

2017-11-01

Panretinal photocoagulation (PRP) is the mainstay therapy for proliferative diabetic retinopathy. Pain during and after its application is a complication that affects patients' therapeutic adherence. This study aimed to compare pain perception and patient preference for the 577-nm yellow laser (YL-577) (LIGHTL as 577; LIGHTMED, San Clemente, CA) and the conventional 532-nm green laser (GL-532) (Purepoint Laser; Alcon, Fort Worth, TX) with PRP. A total of 92 patient eyes with proliferative diabetic retinopathy treated with PRP were randomly assigned to receive both GL-532 and YL-577 (184 eyes) - one on each eye, with the order of application randomized, as well. Afterward, verbal rapid answer and visual analogue scale (VAS) scores for pain perception and patient preference were evaluated. VAS score was 7 ± 2 for the GL-532 group compared to 5 ± 3 in the YL-577 group (P = .001). Overall, 75% of the patients preferred YL-577 therapy if they were to receive a second PRP session. The use of YL-577 as an alternative approach for PRP reduces pain perception and is preferred by patients. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:902-905.]. Copyright 2017, SLACK Incorporated.

Translations on Eastern Europe, Political, Sociological and Military Affairs, Number 1591

DTIC Science & Technology

1978-09-29

Blazevic Discusses LC Weaknesses, Dangers of Consumer Society (Jakov Blazevic Interview; VJESNIK, 27 Jul 78) 38 Accused Croatian Terrorist... relationships with Yugo- slavia. If these great powers improved their relations with Yugoslavia, Albania immediately broke with them. This...in your view, a gradation of journalistic genres or is each genre valuable by itself? What are your personal preferences? [Answer] There should be

State-Dependent Risk Preferences in Evolutionary Games

NASA Astrophysics Data System (ADS)

Roos, Patrick; Nau, Dana

There is much empirical evidence that human decision-making under risk does not correspond the decision-theoretic notion of "rational" decision making, namely to make choices that maximize the expected value. An open question is how such behavior could have arisen evolutionarily. We believe that the answer to this question lies, at least in part, in the interplay between risk-taking and sequentiality of choice in evolutionary environments.

What Does It Mean to Educate?

ERIC Educational Resources Information Center

Knausz, Imre

2016-01-01

This paper focuses on the most abstract and most boring question of pedagogy or, as I prefer to call my field of interest, the theory of pedagogy. My aim is to try to rehash and re-pose this question--maybe even answer it? In this regard, Ottó Mihály advises us to be careful; in the preface to his notes on the philosophy of pedagogy he asserts…

Going Green and Using Less Paper to Print Exams: Student Performance, Completion Time, and Preference

ERIC Educational Resources Information Center

O'Connor, Kevin J.

2014-01-01

Two studies measured the impact on student exam performance and exam completion time of strategies aimed to reduce the amount of paper used for printing multiple-choice course exams. Study 1 compared single-sided to double-sided printed exams. Study 2 compared a single-column arrangement of multiple-choice answer options to a space (and paper)…

What explains willingness to pay for smoking-cessation treatments - addiction level, quit-rate effectiveness or the opening bid?

PubMed

Olsen, Jan Abel; Røgeberg, Ole J; Stavem, Knut

2012-11-01

Several countries have now passed laws that place limitations on where smokers may smoke. A range of smoking-cessation treatments have become available, many of which have documented increased quit rates. Population surveys show that most smokers wish to quit, and most non-smokers would prefer to reduce the prevalence of smoking in society. The strengths of these preferences, however, as measured by their willingness to pay (WTP), have not yet been investigated. This study aims to identify variables that explain variations in people's answers to WTP questions on smoking-cessation treatments. A representative sample of the Norwegian population was asked their WTP in terms of an earmarked contribution to a public smoking-cessation programme. A sub-group of daily smokers was, in addition, asked about their WTP for a hypothetical treatment that would remove their urge to smoke. The impact of variation in the question format (different opening bids) on stated WTP was compared with that of factors suggested by economic theory, such as quit-rate effectiveness, degree of addiction as measured by the 12-item Cigarette Dependence Scale (CDS-12), and degree of peer group influence as measured by the proportion of one's friends who smoke. In both programmes, the most important determinant for explaining variations in WTP was the size of the opening bid. Differences in quit-rate effectiveness did not matter for people's WTP for the smoking-cessation programme. Addiction, and having a small proportion of friends who smoke, were positively associated with smokers' WTP to quit smoking. Variations in WTP were influenced more by how the question was framed in terms of differences in opening bids, than by variables reflecting the quality (effectiveness) and need (addiction level) for the good in question. While the WTP method is theoretically attractive, the findings that outcomes in terms of different quit rates did not affect WTP, and that WTP answers can be manipulated by the chosen opening bid, should raise further doubts on the ability of this method to provide valid and reliable answers that reflect true preferences for health and healthcare.

Dermatology Life Quality Index: influence of an illustrated version.

PubMed

Loo, W J; Diba, V; Chawla, M; Finlay, A Y

2003-02-01

An illustrated version of the Dermatology Life Quality Index (DLQI) was developed in order to improve the ease with which this standard questionnaire is answered. To compare the illustrated version with the text-only version of the DLQI. The two versions were administered to 206 patients attending Dermatology outpatient clinics. The time taken to complete either the illustrated or the text-only version was noted in 52 additional patients. One hundred and ninety-one of 206 patients completed both questionnaires satisfactorily. Their mean DLQI scores were 6.4 (median 4.0, lower quartile 1.0, upper quartile 11.0) for the illustrated version and 6.3 (median 4.0, lower quartile 1.0, upper quartile 10.0) for the text-only version. For the 98 patients who answered the illustrated version first, the mean DLQI scores were 6.9 (median 4.0, lower quartile 1.9, upper quartile 11.9) for the illustrated version and 6.4 (median 4.0, lower quartile 1.8, upper quartile 11.0) for the text-only version. For the 93 patients who answered the text-only version first, the mean DLQI scores were 5.9 (median 4.0, lower quartile 1.7, upper quartile 10.2) for the illustrated version and 6.2 (median 5.0, lower quartile 0.5, upper quartile 9.5) for the text-only version. The median time taken to complete the text-only version was 124 s (mean +/- SD 126 +/- 65, n = 27) and 88 s (mean +/- SD 101 +/- 52, n = 25) for the illustrated version (P = 0.08). There was a very close correlation (r = 0.98) between the scores of the text-only and the illustrated versions; 82.2% of patients either scored the same or had a DLQI score difference of only 1. One hundred and seven (59.8%) patients preferred using the illustrated version and 66 (36.9%) preferred the text-only version. One hundred and four (57.5%) found the illustrated version easier to use. The illustrated version was superior to the text-only version in terms of patient preference and ease of use, but it was not possible to demonstrate exact equivalence between the two versions.

Origins of the Tactical Nuclear Weapons Modernization Program: 1969-1979

NASA Astrophysics Data System (ADS)

Yaffe, Michael David

On December 12, 1979, the North Atlantic Treaty Organization decided to deploy new long-range theater nuclear forces, Pershing II and Ground-Launched Cruise Missiles. This marked the first major change in NATO's nuclear stockpile since the adoption of the flexible response strategy in 1967. The decision was controversial inasmuch as the Allies disagreed on the fundamental role of nuclear weapons in this strategy and, thereby, the types and number of weapons required for an effective deterrent posture. Europeans generally preferred long-range weapons capable of striking the Soviet Union and small conventional forces while Americans preferred shorter-range nuclear weapons and a stalwart conventional defense. Thus, the December decision is often described as purely politically motivated, in which the Americans reluctantly acquiesced to a European initiative for long-range weapons, prominently expressed by West German Chancellor Helmut Schmidt in 1977. Recently declassified US government documents reveal, however, that long-range missiles were part of a long-term comprehensive nuclear modernization program conceived in the Pentagon under Defense Secretary James Schlesinger during the period of 1973 through 1975, and presented to skeptical European elites who favored arms control negotiations over costly new deployments. This program was motivated as much by changes in the American national security culture as by an increase in the Soviet military threat to Europe. It was grounded on a clear military rationale: "that a feasible and affordable conventional defense is only possible if NATO has modern nuclear forces" that can effectively hold at risk Warsaw Pact ground and air forces throughout the depth of their employment from the inner-German border to the western military districts of the Soviet Union. When the new US administration in 1977 disagreed with the modernization plan and its rationale, opting instead for more conventional forces, the Allies in a reversal of roles lobbied the US President to deploy the long-range weapons being developed by the Defense Department. In the course of deliberations, political preferences suppressed military considerations of deterrence and only a small portion of the original modernization program was implemented.

Public preferences for establishing nephrology facilities in Greenland: estimating willingness-to-pay using a discrete choice experiment.

PubMed

Kjær, Trine; Bech, Mickael; Kronborg, Christian; Mørkbak, Morten Raun

2013-10-01

At present there are no nephrology facilities in Greenland. Greenlandic patients with renal failure needing dialysis thus have to travel to Denmark to obtain treatment. For patients in haemodialysis this necessitates a permanent residence in Denmark. Our study was aimed at examining Greenlanders' preferences for establishing nephrology facilities in Greenland at Queen Ingrid's Hospital in Nuuk, and to estimate the associated change in welfare. Preferences were elicited using a discrete choice experiment (DCE). A random sample of 500 individuals of the general population was sent a postal questionnaire in which they were asked to consider the trade-offs of establishing nephrology facilities in Greenland as opposed to the current situation. This involved trading off the benefits of having such facilities in their home country against the costs of the intervention. Besides including a payment attribute described in terms of incremental tax payment, the DCE included two interventions attributes related to (1) the organisation of labour, and (2) the physical settings of the patients. Respondents succeeded in answering the DCE despite cultural and linguistic disparity. We found that all the included attributes had a significant effect on respondents' choices, and that respondents' answers to the DCE were in keeping with their values as stated in the questionnaire. DCE data was analyzed using a random parameter logit model reparametrized in willingness-to-pay space. The results showed that establishing facilities in Greenland were preferred to the current treatment in Denmark. The welfare estimate from the DCE, at DKK 18.74 million, exceeds the estimated annual costs of establishing treatment facilities for patients with chronic renal failure. Given the estimated confidence interval this result seems robust. Establishing facilities in Greenland therefore would appear to be welfare-improving, deriving positive net benefits. Despite the relatively narrow policy focus, we believe that our findings provide some insight into individuals' preferences for decentralization of public services and on citizens' views of 'self-governance' that go beyond the case of Greenland. More generally, this paper illustrates how DCE can be applied successfully to developing countries with culturally, demographically, and geographically distinct features.

Addressing challenges to MMPI-2-RF-based testimony: questions and answers.

PubMed

Ben-Porath, Yossef S

2012-11-01

Introduction of a new version of a psychological test brings with it challenges that can be accentuated by the adversarial nature of the legal process. In the case of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF), these challenges can be addressed by becoming familiar with the rationale for and the methods used in revising the inventory, the information contained in the test manuals, and the growing peer-reviewed literature on the test. Potential challenges to MMPI-2-RF-based testimony are identified in this article and discussed in question and answer format. The questions guiding this discussion are based on the Daubert factors, established in 1993 by the US Supreme Court as criteria for gauging the scientific validity of proffered expert testimony. The answers to these questions apply more broadly to testimony in depositions, pre-trial hearings, and at trial. Consideration of the MMPI-2-RF in light of the Daubert factors indicates that the instrument has been subjected to extensive empirical testing and that a substantial peer-reviewed literature is available to guide and support its use. Information about the known and potential rate of error associated with MMPI-2-RF scores is available, and standard procedures for administration, scoring, and interpretation of the inventory are detailed in the test administration manual. Indicators of MMPI-2-RF acceptance can be cited, and criticisms of the MMPI-2-RF can be addressed with information available in the test documents and an extensive, modern, and actively growing peer-reviewed literature.

Accent and television journalism: evidence for the practice of speech language pathologists and audiologists.

PubMed

Lopes, Leonardo Wanderley; Lima, Ivonaldo Leidson Barbosa; Silva, Eveline Gonçalves; Almeida, Larissa Nadjara Alves de; Almeida, Anna Alice Figueiredo de

2013-01-01

To analyze the preferences and attitudes of listeners in relation to regional (RA) and softened accents (SA) in television journalism. Three television news presenters recorded carrier phrases and a standard text using RA and SA. The recordings were presented to 105 judges who listened to the word pairs and answered whether they perceived differences between the RA and SA, and the type of pronunciation that they preferred in the speech of television news presenters. Afterwards, they listened to the sentences and judged seven attributes in the contexts of RA and SA using a semantic differential scale. The listeners perceived the difference between the regional and softened pronunciation (p<0.0001). They preferred the SA in the presenters' speech in all variants studied (p<0.0001). There was an association between linguistic variants and the judgment of attitudes (p=0.002). The listeners regarded the presence of SA in the presenters' speech as positive in all variants studied (p<0.0001). The listeners prefer and assign positive values to the SA in the speech of television journalists in all linguistic variants studied.

Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement.

PubMed

Moher, David; Shamseer, Larissa; Clarke, Mike; Ghersi, Davina; Liberati, Alessandro; Petticrew, Mark; Shekelle, Paul; Stewart, Lesley A

2015-01-01

Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.

Suppression of Cocaine Self-Administration in Monkeys: Effects of Delayed Punishment

PubMed Central

Woolverton, William L.; Freeman, Kevin B.; Myerson, Joel; Green, Leonard

2014-01-01

Rationale Delaying presentation of a drug can decrease its effectiveness as a reinforcer, but the effect of delaying punishment of drug self-administration is unknown. Objective This study examined whether a histamine injection could punish cocaine self-administration in a drug-drug choice, whether delaying histamine would decrease its effectiveness, and whether the effects of delay could be described within a delay discounting framework. Methods Monkeys were implanted with double-lumen catheters to allow separate injection of cocaine and histamine. In discrete trials, subjects first chose between cocaine (50 or 100 μg/kg/inj) alone and an injection of the same dose of cocaine followed immediately by an injection of histamine (0.37–50 μg/kg). Next, they chose between cocaine followed immediately by histamine and cocaine followed by an equal but delayed dose of histamine. Results When choosing between cocaine alone and cocaine followed immediately by histamine, preference increased with histamine dose from indifference to > 80% choice of cocaine alone. When choosing between cocaine followed by immediate histamine and cocaine followed by delayed histamine, monkeys showed strong position preferences. When delayed histamine was associated with the non-preferred position, preference for that option increased with delay from ≤ 30% to > 85%. The corresponding decrease in choice of the preferred position was well described by a hyperboloid discounting function. Conclusions Histamine can function as a punisher in the choice between injections of cocaine and delay can decrease its effectiveness as a punisher. The effects of delaying punishment of drug self-administration can be conceptualized within the delay discounting framework. PMID:21956240

Analysis of medical student’s book reports on Cronin’s The Citadel: would young doctors give up ideals for prestige and wealth?

PubMed Central

2016-01-01

Purpose: The purpose of this study is to find what medical students think the reward for their future work should be and whether they would keep their ideals or abandon them for prestige and wealth by analyzing the book reports of Cronin’s The Citadel. Methods: Participants were 50 medical students of junior class. A month before the classroom lecture, the book and digital video disk were provided. Students had discussions in groups of seven and wrote book reports which include answers of three questions. Results: Regarding what should be the reward for the medical doctor, two-thirds of students (66.7%) answered with spiritual compensation, while one-third (33.3%) chose material reward. In the situation presented to Manson, three-fifths (60.0%) answered they would keep their ideals (idealist), while the remaining two-fifths (40.0%) decided they would abandon them. Less than one-third of students (30.0%) answered they would reveal the corruptions of the doctor’s society, while two-thirds (64.0%) would not. Conclusion: The larger number of idealists who prefer spiritual reward rather than a material reward represents the innocence of youth as in portrayed in The Citadel. PMID:27240894

How do primary care physicians seek answers to clinical questions? A literature review.

PubMed

Coumou, Herma C H; Meijman, Frans J

2006-01-01

The authors investigated the extent to which changes occurred between 1992 and 2005 in the ways that primary care physicians seek answers to clinical problems. What search strategies are used? How much time is spent on them? How do primary care physicians evaluate various search activities and information sources? Can a clinical librarian be useful to a primary care physician? Twenty-one original research papers and three literature reviews were examined. No systematic reviews were identified. Primary care physicians seek answers to only a limited number of questions about which they first consult colleagues and paper sources. This practice has basically not changed over the years despite the enormous increase in and better accessibility to electronic information sources. One of the major obstacles is the time it takes to search for information. Other difficulties primary care physicians experience are related to formulating an appropriate search question, finding an optimal search strategy, and interpreting the evidence found. Some studies have been done on the supporting role of a clinical librarian in general practice. However, the effects on professional behavior of the primary care physician and on patient outcome have not been studied. A small group of primary care physicians prefer this support to developing their own search skills. Primary care physicians have several options for finding quick answers: building a question-and-answer database, consulting filtered information sources, or using an intermediary such as a clinical librarian.

How do primary care physicians seek answers to clinical questions? A literature review

PubMed Central

Coumou, Herma C. H.; Meijman, Frans J.

2006-01-01

Objectives: The authors investigated the extent to which changes occurred between 1992 and 2005 in the ways that primary care physicians seek answers to clinical problems. What search strategies are used? How much time is spent on them? How do primary care physicians evaluate various search activities and information sources? Can a clinical librarian be useful to a primary care physician? Methods: Twenty-one original research papers and three literature reviews were examined. No systematic reviews were identified. Results: Primary care physicians seek answers to only a limited number of questions about which they first consult colleagues and paper sources. This practice has basically not changed over the years despite the enormous increase in and better accessibility to electronic information sources. One of the major obstacles is the time it takes to search for information. Other difficulties primary care physicians experience are related to formulating an appropriate search question, finding an optimal search strategy, and interpreting the evidence found. Some studies have been done on the supporting role of a clinical librarian in general practice. However, the effects on professional behavior of the primary care physician and on patient outcome have not been studied. A small group of primary care physicians prefer this support to developing their own search skills. Discussion: Primary care physicians have several options for finding quick answers: building a question-and-answer database, consulting filtered information sources, or using an intermediary such as a clinical librarian. PMID:16404470

Can anesthetic treatment worsen outcome in status epilepticus?

PubMed

Sutter, Raoul; Kaplan, Peter W

2015-08-01

Status epilepticus refractory to first-line and second-line antiepileptic treatments challenges neurologists and intensivists as mortality increases with treatment refractoriness and seizure duration. International guidelines advocate anesthetic drugs, such as continuously administered high-dose midazolam, propofol, and barbiturates, for the induction of therapeutic coma in patients with treatment-refractory status epilepticus. The seizure-suppressing effect of anesthetic drugs is believed to be so strong that some experts recommend using them after benzodiazepines have failed. Although the rationale for the use of anesthetic drugs in patients with treatment-refractory status epilepticus seems clear, the recommendation of their use in treating status epilepticus is based on expert opinions rather than on strong evidence. Randomized trials in this context are lacking, and recent studies provide disturbing results, as the administration of anesthetics was associated with poor outcome independent of possible confounders. This calls for caution in the straightforward use of anesthetics in treating status epilepticus. However, there are still more questions than answers, and current evidence for the adverse effects of anesthetic drugs in patients with status epilepticus remains too limited to advocate a change of treatment algorithms. In this overview, the rationale and the conflicting clinical implications of anesthetic drugs in patients with treatment-refractory status epilepticus are discussed, and remaining questions are elaborated. This article is part of a Special Issue entitled "Status Epilepticus". Copyright © 2015 Elsevier Inc. All rights reserved.

China's one-child policy, a policy without a future. Pitfalls of the “common good” argument and the authoritarian model.

PubMed

Nie, Jing-Bao

2014-07-01

The Chinese Communist Party government has been forcefully promoting its jihua shengyu (planned fertility) program, known as the "one-child policy," for more than three decades. A distinctive authoritarian model of population governance has been developed. A pertinent question to be asked is whether China's one-child policy and the authoritarian model of population governance have a future. The answer must be no; they do not. Although there are many demographic, economic, and social rationales for terminating the one-child policy, the most fundamental reason for opposing its continuation is drawn from ethics. The key ethical rationale offered for the policy is that it promotes the common social good, not only for China and the Chinese people but for the whole human family. The major irony associated with this apparently convincing justification is that, although designed to improve living standards and help relieve poverty and underdevelopment, the one-child policy and the application of the authoritarian model have instead caused massive suffering to Chinese people, especially women, and made them victims of state violence. A lesson from China--one learned at the cost of individual and social suffering on an enormous scale--is that an essential prerequisite for the pursuit of the common good is the creation of adequate constraints on state power.

A Comparison of CAL with a Conventional Method of Delivery of Cell Biology to Undergraduate Nursing Students Using an Experimental Design.

ERIC Educational Resources Information Center

Wharrad, Heather J.; Kent, Christine; Allcock, Nick; Wood, Barry

2001-01-01

In study 1, 12 nursing students attended slide lectures on cell biology; 13 used interactive computer-assisted learning (CAL). Study 2 surveyed 38 students who used CAL to study immunology. Students preferred CAL and felt confident in their grasp of the material, even without the presence of lecturers to answer questions. (Contains 16 references.)…

Disarmament Education, Education for International Understanding, Global Education, Peace Education and Other Related Terms: Comments and Preferences in a Group of Experts. Peace Education Miniprints No. 61.

ERIC Educational Resources Information Center

Bjerstedt, Ake

Fifty experts, representing 22 countries provide their comments and views on the use of terms such as "disarmament education" and "peace education" in international debates. Part 1 of the report presents a summarization of the major characteristics of the answers. Some of the interviewees emphasize that the terms are not…

Hand preference for writing and associations with selected demographic and behavioral variables in 255,100 subjects: the BBC internet study.

PubMed

Peters, Michael; Reimers, Stian; Manning, John T

2006-11-01

In an Internet study unrelated to handedness, 134,317 female and 120,783 male participants answered a graded question as to which hand they preferred for writing. This allowed determination of hand preference patterns across 7 ethnic groups. Sex differences in left-handedness were found in 4 ethnic groups, favoring males, while no significant sex differences were found in three of the groups. Prevalence of left-handedness in the largest of the ethnic groups (self-labelled as "White") was comparable to contemporary hand preference data for this group [Gilbert, A. N., & Wysocki, C. J. (1992). Hand preference and age in the United states. Neuropsychologia, 30, 601-608] but the prevalence of left-handedness in individuals >70 years of age was considerably higher in the present study. Individuals who indicated "either" hand for writing preference had significantly lower spatial performance (mental rotation task) and significantly higher prevalence of hyperactivity, dyslexia, asthma than individuals who had clear left or right hand preferences, in support of Crow et al. [Crow, T., Crow, L., Done, D., & Leask, S. (1998). Relative hand skill predicts academic ability: global deficits at the point of hemispheric indecision. Neuropsychologia, 36, 1275-1282]. Similarly, an association of writing hand preference and non-heterosexual orientation was clearest for individuals with "either" writing hand responses. We conclude that contradictions in the literature as to whether or not these variables are linked to handedness stem largely from different definitions of hand preference. Due to a lack of statistical power in most studies in the literature, the "either" hand writing preference group that yielded the most salient results in this study is not normally available for analysis.

Language acquisition: hesitations in the question/answer dialogic pair.

PubMed

Chacon, Lourenço; Villega, Cristyane de Camargo Sampaio

2015-01-01

(1) To verify the existence (or not) of hesitation marks in the beginning of utterances in children's discourse; and (2) to determine to what extent the presence/absence of these marks could be explained by retrievable facts in the production conditions of their discourses. Interview situations with four children aged 5-6 years attending Kindergarten level II in a public preschool at the time of the data collection were analyzed. The interviews were recorded on audio and video, inside a soundproof booth, with high fidelity equipment. Afterwards, the recordings were transcribed by six transcribers that were specially trained for this task. Transcription rules that prioritized the analyses of hesitations were used. For the analysis of retrievable facts in the production conditions of children's discourse, the dialogic pair question-answer was adopted. A correlation between presence/absence of hesitation in the beginning of utterances in children and type of question (open/closed) made by the collocutor was observed. When the question was closed ended, the utterances were preferably initiated without hesitation marks, and when the question was open ended, the utterances were preferably initiated with hesitation marks. The presence/absence of hesitation marks in the beginning of utterances in children was found to be dependent on the production conditions of their discourses.

Extracting similar terms from multiple EMR-based semantic embeddings to support chart reviews.

PubMed

Cheng Ye, M S; Fabbri, Daniel

2018-05-21

Word embeddings project semantically similar terms into nearby points in a vector space. When trained on clinical text, these embeddings can be leveraged to improve keyword search and text highlighting. In this paper, we present methods to refine the selection process of similar terms from multiple EMR-based word embeddings, and evaluate their performance quantitatively and qualitatively across multiple chart review tasks. Word embeddings were trained on each clinical note type in an EMR. These embeddings were then combined, weighted, and truncated to select a refined set of similar terms to be used in keyword search and text highlighting. To evaluate their quality, we measured the similar terms' information retrieval (IR) performance using precision-at-K (P@5, P@10). Additionally a user study evaluated users' search term preferences, while a timing study measured the time to answer a question from a clinical chart. The refined terms outperformed the baseline method's information retrieval performance (e.g., increasing the average P@5 from 0.48 to 0.60). Additionally, the refined terms were preferred by most users, and reduced the average time to answer a question. Clinical information can be more quickly retrieved and synthesized when using semantically similar term from multiple embeddings. Copyright © 2018. Published by Elsevier Inc.

Young children's impressionable use of teleology: the influence of question wording and questioned topic on teleological explanations for natural phenomena

NASA Astrophysics Data System (ADS)

Halls, Jonathan Grant; Ainsworth, Shaaron Elizabeth; Oliver, Mary Collette

2018-05-01

There is a significant body of research on children's preconceptions concerning scientific concepts and the impact this has upon their science education. One active issue concerns the extent to which young children's explanations for the existence of natural kinds rely on a teleological rationale: for example, rain is for watering the grass, or tigers' stripes are for camouflage. It has been argued that this teleological tendency hampers children's ability to learn about causality in the natural world. This paper investigates two factors (question wording and topic) which it is argued have led to a misestimation of children's teleological tendencies within the area natural phenomena: i.e. those that are time-constrained, natural events or process such as snow, clouds or night. Sixty-six (5-8 years old) children took part in a repeated-measures experiment, answering both open and leading questions across 10 topics of natural phenomena. The findings indicate that children's teleological reasoning may have been overestimated as open-question forms significantly reduced their tendency to answer teleologically. Moreover, the concept of teleology is more nuanced than often suggested. Consequently, young children may be more able to learn about causal explanations for the existence of natural phenomena than the literature implies.

Factors Influencing Choices for Colorectal Cancer Screening Among Previously Unscreened African and Caucasian Americans: Findings from a Triangulation Mixed Methods Investigation

PubMed Central

Ruffin, Mack T.; Creswell, John W.; Jimbo, Masahito

2014-01-01

We investigated factors that influence choice of colorectal cancer (CRC) screening test and assessed the most- and least-preferred options among fecal occult blood testing (FOBT), flexible sigmoidoscopy, colonoscopy, and double contrast barium enema among adults with varied race, gender, and geographic region demographics. Mixed methods data collection consisted of 10 focus group interviews and a survey of the 93 focus group participants. Participants were ≥50 years of age and reported not having been screened for colorectal cancer in the last ten years. Analyses examined differences by race, gender, and geographic location. Participants had modest knowledge about CRC and there were fewer correct answers to knowledge questions by African Americans. Participants recognized value of early detection, and identified health symptoms and their doctor's recommendation as influential for obtaining CRC screening. They chose colonoscopy and FOBT as the most preferred tests, while barium enema was least preferred. The analysis revealed intra-group variations in preference, though there were no significant differences by race, gender, or location. Openness of discussing this sensitive topic, lack of knowledge about colorectal cancer and screening costs, and diversity of preferences expressed within study groups suggest the importance of patient-physician dialogue about colorectal cancer screening options. New approaches to promoting colorectal cancer screening need to explore methods to facilitate patients establishing and expressing preferences among the screening options. PMID:19082695

Resource format preferences across the medical curriculum.

PubMed

Pickett, Keith M

2016-07-01

This research study sought to determine the formats (print or electronic) of articles and book chapters most-preferred by first-year medical students, third-year medical students entering clinical clerkships, and incoming residents and to determine if these preferences change during the course of the medical curriculum. These trends will enable academic health sciences libraries to make appropriate collection development decisions to best cater to their user populations. First-year medical students, third-year medical students, and incoming medical residents were asked to complete a paper survey from September 2014 to June 2015. The survey consisted of five multiple-choice questions, with two questions given space for optional short answers. Quantitative and qualitative responses were collected and calculated using Microsoft Excel. First-year students, third-year students, and incoming residents all preferred to read journal articles and book chapters in print, except in cases where the article or book chapter is under ten pages in length. Although print is preferred, demand for electronic articles and book chapters increases as students progress from undergraduate medical education into residency. The only category where a majority of incoming residents chose an electronic resource was which format they would give to a colleague, if the article or book chapter was critical to the care of an individual patient. The preference for print resources is strong across the medical curriculum, although residents show an increased preference for electronic materials when compared to first- and third-year students. Academic health sciences libraries should take these preferences into account when making decisions regarding collection development.

Use of Local Anesthesia During Dental Rehabilitation With General Anesthesia: A Survey of Dentist Anesthesiologists

PubMed Central

Townsend, Janice A.; Hagan, Joseph L.; Smiley, Megann

2014-01-01

The purpose of this study was to document current practices of dentist anesthesiologists who are members of the American Society of Dentist Anesthesiologists regarding the supplemental use of local anesthesia for children undergoing dental rehabilitation under general anesthesia. A survey was administered via e-mail to the membership of the American Society of Dentist Anesthesiologists to document the use of local anesthetic during dental rehabilitations under general anesthesia and the rationale for its use. Seventy-seven (42.1%) of the 183 members responded to this survey. The majority of dentist anesthesiologists prefer use of local anesthetic during general anesthesia for dental rehabilitation almost always or sometimes (90%, 63/70) and 40% (28/70) prefer its use with rare exception. For dentist anesthesiologists who prefer the administration of local anesthesia almost always, they listed the following factors as very important: “stabilization of vital signs/decreased depth of general anesthesia” (92.9%, 26/28) and “improved patient recovery” (82.1%, 23/28). There was a significant association between the type of practice and who determines whether or not local anesthesia is administered during cases. The majority of respondents favor the use of local anesthesia during dental rehabilitation under general anesthesia. PMID:24697820

A Gaze-Driven Evolutionary Algorithm to Study Aesthetic Evaluation of Visual Symmetry

PubMed Central

Bertamini, Marco; Jones, Andrew; Holmes, Tim; Zanker, Johannes M.

2016-01-01

Empirical work has shown that people like visual symmetry. We used a gaze-driven evolutionary algorithm technique to answer three questions about symmetry preference. First, do people automatically evaluate symmetry without explicit instruction? Second, is perfect symmetry the best stimulus, or do people prefer a degree of imperfection? Third, does initial preference for symmetry diminish after familiarity sets in? Stimuli were generated as phenotypes from an algorithmic genotype, with genes for symmetry (coded as deviation from a symmetrical template, deviation–symmetry, DS gene) and orientation (0° to 90°, orientation, ORI gene). An eye tracker identified phenotypes that were good at attracting and retaining the gaze of the observer. Resulting fitness scores determined the genotypes that passed to the next generation. We recorded changes to the distribution of DS and ORI genes over 20 generations. When participants looked for symmetry, there was an increase in high-symmetry genes. When participants looked for the patterns they preferred, there was a smaller increase in symmetry, indicating that people tolerated some imperfection. Conversely, there was no increase in symmetry during free viewing, and no effect of familiarity or orientation. This work demonstrates the viability of the evolutionary algorithm approach as a quantitative measure of aesthetic preference. PMID:27433324

Wine consumption habits and consumer preferences between wines aged in barrels or with chips.

PubMed

Pérez-Magariño, Silvia; Ortega-Heras, Miriam; González-Sanjosé, María Luisa

2011-03-30

The use of oak wood pieces in winemaking is increasing, but the acceptance of this technique by consumers is unknown. For that reason, the main aim of this study was to measure consumers' opinion of red wines made with this new technique, their acceptance of them and their intention to purchase these wines. A preference ranking test was also carried out. A specific questionnaire was drawn up for this study and 65 frequent red wine consumers tasted four wines, two aged traditionally in barrels and two macerated with chips, and a forced choice preference test was carried out. Fifty-five per cent of respondents said that they would not buy wines made using oak chips, although most respondents would buy these wines if, after tasting them, they were as pleasant and had the same quality as the wines aged traditionally in barrels. Wines obtained with oak wood fragments were not significantly rejected either by consumers who answered the questionnaire or by consumer tasters, which could be due to the large disparity of preferences found among tasters. The results clearly indicate that producers should develop each wine taking into account the specific preferences of each consumer group. Copyright © 2011 Society of Chemical Industry.

Examining the relative effectiveness of different message framing strategies for child passenger safety: recommendations for increased comprehension and compliance.

PubMed

Will, Kelli England; Decina, Lawrence E; Maple, Erin L; Perkins, Amy M

2015-06-01

Age-appropriate child restraints and rear seating dramatically reduce injury in vehicle crashes. Yet parents and caregivers struggle to comply with child passenger safety (CPS) recommendations, and frequently make mistakes when choosing and installing restraints. The purpose of this research was to evaluate various methods of framing CPS recommendations, and to examine the relative effectiveness on parents' knowledge, attitudes, and behavioral intentions related to best practices and proper use of child restraints. Emphasis framing is a persuasion technique that involves placing focus on specific aspects of the content in order to encourage or discourage certain interpretations of the content. A 5 (flyer group) X 2 (time) randomized experiment was conducted in which 300 parent participants answered a pre-survey, viewed one of four flyer versions or a no-education control version, and completed a post-survey. Surveys measured CPS knowledge, attitudes, perceptions of efficacy and risk, and behavioral intentions. The four flyers compared in this study all communicated the same CPS recommendations, but several versions were tested which each employed a different emphasis frame: (1) recommendations organized by the natural progression of seat types; (2) recommendations which focused on avoiding premature graduation; (3) recommendations which explained the risk-reduction rationale behind the information given; or (4) recommendations which were organized by age. In a fifth no-education (control) condition, participants viewed marketing materials. Analyses of covariance and pairwise comparisons indicated the risk-reduction rationale flyer outperformed other flyers for many subscales, and significantly differed from no-education control for the most subscales, including restraint selection, back seat knowledge, rear-facing knowledge and attitudes, total efficacy, overall attitudes, and stated intentions. This research provides insight for increasing caregiver understanding and compliance with CPS information. Recommendations for the field include communicating the rationale behind the information given, using behavior-based directives in headers, avoiding age-based headers, and incorporating back-seat positioning directives throughout. Copyright © 2015 Elsevier Ltd. All rights reserved.

Acceptability of reactors in space

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

Buden, D.

1981-04-01

Reactors are the key to our future expansion into space. However, there has been some confusion in the public as to whether they are a safe and acceptable technology for use in space. The answer to these questions is explored. The US position is that when reactors are the preferred technical choice, that they can be used safely. In fact, it dies not appear that reactors add measurably to the risk associated with the Space Transportation System.

Probing Initial Conditions and Outcomes: Star and Planet Formation Programs within the NIRCam GTO Program

NASA Astrophysics Data System (ADS)

Meyer, Michael; NIRCam Star and Planet Formation Theme Team

2017-06-01

With its extraordinary sensitivity, wavelength coverage from < 1 to 5 microns, 2.2x4.4 arc minute field of view, and diversity of observing modes, NIRCam on JWST offers very powerful capabilities to explore the origins of stars and planets. Here we describe programs planned within the NIRCam GTO Program including: i) extinction mapping of pre-stellar cores; ii) massive star formation; iii) embedded clusters and the end of the IMF; iv) imaging and spectroscopy of young stellar objects; and v) excitation of PAH features. We will describe the scope of each program, selection of observing modes and rationale, as well as provide some explicit examples of program design. We will also review the expected outcomes, illustrating the power of NIRCam to answer questions fundamental to understanding the origins of stars and planets.

Estimating the Cost of NASA's Space Launch Initiative: How SLI Cost Stack Up Against the Shuttle

NASA Technical Reports Server (NTRS)

Hamaker, Joseph H.; Roth, Axel (Technical Monitor)

2002-01-01

NASA is planning to replace the Space Shuttle with a new completely reusable Second Generation Launch System by approximately 2012. Numerous contracted and NASA in-house Space Transportation Architecture Studies and various technology maturation activities are proceeding and have resulted in scores of competing architecture configurations being proposed. Life cycle cost is a key discriminator between all these various concepts. However, the one obvious analogy for costing purposes remains the current Shuttle system. Are there credible reasons to believe that a second generation reusable launch system can be accomplished at less cost than the Shuttle? The need for a credible answer to this question is critical. This paper reviews the cost estimating approaches being used by the contractors and the government estimators to address this issue and explores the rationale behind the numbers.

Effects of pramipexole on the acquisition of responding with opioid-conditioned reinforcement in the rat

PubMed Central

Bertz, Jeremiah W.; Chen, Jianyong; Woods, James H.

2014-01-01

Rationale Dopamine D3 receptor-preferring ligands may be able to modify the conditioned reinforcing effects of drug-associated stimuli. In evaluating the effects of these compounds, it is important to clarify the extent to which responding depends on (1) conditioned reinforcement vs. other behavioral mechanisms and (2) dopamine D3 vs. D2 receptor activity. Objectives Use behaviorally stringent new-response acquisition procedures to characterize the effects of the D3-preferring agonist, pramipexole, on the conditioned reinforcing effects of a stimulus paired with the opioid agonist, remifentanil. Methods First, in Pavlovian conditioning (PAV) sessions, rats received response-independent IV injections of remifentanil and presentations of a light–noise stimulus. In separate groups, injections and stimuli either always co-occurred (“paired PAV”) or occurred with no consistent relationship (“random PAV” control). Next, in instrumental acquisition (ACQ) sessions, all animals could respond in two nose-poke manipulanda: an active nose-poke, which produced the stimulus alone, or an inactive nose-poke. Pramipexole was injected SC prior to ACQ sessions with or without pretreatments of the D3-preferring antagonist, SB-277011A, or the dopamine D2-preferring antagonist, L-741,626. Results After paired PAV, but not random PAV, rats acquired nose-poke responding during ACQ (i.e., active > inactive). Pramipexole dose-dependently increased active responding without changing inactive responding. Pramipexole-induced increases in responding were blocked by pretreatment with L-741,626, but not SB-277011A. Conclusions Pramipexole specifically enhanced remifentanil-conditioned reinforcement: active responding was selectively increased only after the stimulus was paired with remifentanil. Although pramipexole is D3-preferring, the antagonist effects obtained presently suggest an important role for the D2 receptor in opiod-conditioned reinforcement. PMID:24985891

Breaking bad news in spinal cord injury; a qualitative study assessing the perspective of spinal cord injury survivors in Turkey.

PubMed

Ozyemisci-Taskiran, Ozden; Coskun, Ozlem; Budakoglu, Isil Irem; Demirsoy, Nesrin

2018-05-01

Prior abstract publication: 2 nd Medical Rehabilitation Congress; Nov 4-7, 2010; Ankara, Turkey Objective: This study aims to investigate the process of breaking bad news from the perspective of spinal cord injury survivors. A cross sectional, qualitative study. Community. Fourteen spinal cord injury survivors. Subjects participated in a semi-structured interview about 'when', 'where' 'by whom' and 'how' they received and 'would' prefer to receive bad news. Answers to 'how' questions were coded according to SPIKES protocol (Setting, Perception, Invitation, Knowledge, Empathizing, Summary). Eight participants (57%) reported that they received bad news from a physician, mostly during rehabilitation. All would prefer to be informed by a physician and majority preferred to be gradually informed during rehabilitation. Half were not satisfied with the content of information. Only half felt that his/her physiatrist understood his/her emotional distress. Majority of participants who received bad news from physicians reported that the setting was private and their family members accompanied them. Most spinal cord injury survivors were unsatisfied with knowledge and emotional support provided by rehabilitation physicians. Participants would prefer to receive bad news by a senior physiatrist in a planned meeting during rehabilitation.

Preferences of orthopedic surgeons for treating midshaft clavicle fracture in adults

PubMed Central

de Oliveira, Adilson Sanches; Roberto, Bruno Braga; Lenza, Mario; Pintan, Guilherme Figueiredo; Ejnisman, Benno; Schor, Breno; Carrera, Eduardo da Frota; Murachovsky, Joel

2017-01-01

ABSTRACT Objective To determine the current clinical practice in Latin America for treating midshaft clavicle fractures, including surgical and non-surgical approaches. Methods A cross-sectional study using a descriptive questionnaire. Shoulder and elbow surgeons from the Brazilian Society of Shoulder and Elbow Surgery and from the Latin American Society of Shoulder and Elbow were contacted and asked to complete a short questionnaire (SurveyMonkey®) on the management of midshaft fractures of the clavicle. Incomplete or inconsistent answers were excluded. Results The type of radiographic classification preferably used was related to description of fracture morphology, according to 41% of participants. Allman classification ranked second and was used by 24.1% of participants. As to indications for surgical treatment, only the indications with shortening and imminence of skin exposure were statistically significant. Conservative treatment was chosen in cortical contact. Regarding immobilization method, the simple sling was preferred, and treatment lasted from 4 to 6 weeks. Although the result was not statistically significant, the blocked plate was the preferred option in surgical cases. Conclusion The treatment of midshaft clavicle fractures in Latin America is in accordance with the current literature. PMID:29091151

Medical students' preparation for the transition to postgraduate training through final year elective rotations.

PubMed

van den Broek, W E Sjoukje; Wijnen-Meijer, Marjo; Ten Cate, Olle; van Dijk, Marijke

2017-01-01

Objectives: This study adds to the ongoing discussion on how to ease the transition from undergraduate medical training to postgraduate training. In the Netherlands there is no central matching system for admission to residency. Medical school graduates just apply for a position in an open job market. Many choose to acquire general or specialty-specific clinical experiences after the medical degree before residency, to further explore career opportunities and to increase their chances to get into their preferred specialty. To shorten this gap between undergraduate and the start of postgraduate training, the sixth and final year of most Dutch medical schools is designed as a "transitional year". Students work with more clinical responsibilities than in the earlier clerkships, and this year includes many elective options. Our study focuses on these elective options and explores how medical students use these transitional year electives to prepare for transition to postgraduate training. Methods: In 2012-2013 we asked all 274 graduating students at one Dutch medical school to complete an open-answer questionnaire with the following topics: their preferred specialty at the start of the transitional year, electives they chose during this year and reasons for these choices, and whether the transitional year electives changed their career considerations. Questionnaire results were coded by two researchers and were discussed with all members of the research team. Results: A total of 235 students responded (86%). Answers about motivation for choices revealed that most electives where chosen for career orientation and to optimize chances to get into a residency program. Students also focused on additional experiences in specialties related to their preferred specialty. Many students chose electives logically related to each other, e.g. combinations of surgery and radiology. About two-thirds of the respondents stated that their elective experiences did confirm their specialty preferences or resulted in a more clear insight. Conclusion: We conclude that students use the transitional year electives to focus on their future postgraduate training program, i.e. for orientation and to align their curriculum vitae with their preferred specialty, resulting in spontaneous early specialty streaming. To take advantages of this streaming, and to make sure students can transfer their experiences to other specialties if their career preferences change, individual elective Entrustable Professional Activities (EPAs), next to the core EPAs for all medical students, may serve to prepare a smooth transition to a specialty of choice and should be fully documented.

Antiepileptic Drug Monotherapy: The Initial Approach in Epilepsy Management

PubMed Central

St. Louis, Erik K; Rosenfeld, William E; Bramley, Thomas

2009-01-01

Antiepileptic drug (AED) monotherapy is the preferred initial management approach in epilepsy care, since most patients may be successfully managed with the first or second monotherapy utilized. This article reviews the rationale and evidence supporting preferential use of monotherapy when possible and guidelines for initiating and successfully employing AED monotherapy. Suggested approaches to consider when patients fail monotherapy include substituting a new AED monotherapy, initiating chronic maintenance AED polytherapy, or pursuit of non-pharmacologic treatments such as epilepsy surgery or vagus nerve stimulation. Reducing AED polytherapy to monotherapy frequently reduces the burden of adverse effects and may also improve seizure control. AED monotherapy remains the optimal approach for managing most patients with epilepsy. PMID:19949565

How to make deposition of images a reality

PubMed Central

Guss, J. Mitchell; McMahon, Brian

2014-01-01

The IUCr Diffraction Data Deposition Working Group is investigating the rationale and policies for routine deposition of diffraction images (and other primary experimental data sets). An information-management framework is described that should inform policy directions, and some of the technical and other issues that need to be addressed in an effort to achieve such a goal are analysed. In the near future, routine data deposition could be encouraged at one of the growing number of institutional repositories that accept data sets or at a generic data-publishing web repository service. To realise all of the potential benefits of depositing diffraction data, specialized archives would be preferable. Funding such an initiative will be challenging. PMID:25286838

Intra-household work time synchronization: Togetherness or material benefits?

PubMed

van Klaveren, Chris; van den Brink, Henriette Maassen

2007-10-01

If partners derive utility from joint leisure time, it is expected that they will coordinate their work schedules in order to increase the amount of joint leisure. In order to control for differences in constraints and selection effects, this paper uses a new matching procedure, providing answers to the following questions: (1) Do partners coordinate their work schedules and does this result in work time synchronization?; (2) which partners synchronize more work hours?; and (3) is there a preference for togetherness? We find that coordination results in more synchronized work hours. The presence of children in the household is the main cause why some partners synchronize their work times less than other partners. Finally, partners coordinate their work schedules in order to have more joint leisure time, which is evidence for togetherness preferences.

Effects of Role and Assignment Rationale on Attitudes Formed During Peer Tutoring

PubMed Central

Bierman, Karen Linn; Furman, Wyndol

2012-01-01

This study examined the role of contextual factors, such as assignment rationale, on the attitudinal effects of peer tutoring. Fourth-grade children engaged in brief tutoring experiences as either a tutor or tutee. Subjects received four rationales for being selected as tutor or tutee: (a) a competence rationale, (b) a physical characteristic rationale, (c) a chance rationale, or (d) no rationale. As predicted, tutors had more positive attitudes than tutees when they had been given a competence or physical characteristic rationale but not when the tutors were provided a chance rationale or no rationale. Additionally, the tutors’ and tutees’ attitudes were enhanced when no rationale was provided. Results are discussed in terms of their implications for a role-theory analysis of tutoring and their implications for applied programs. PMID:23946549

Effects of Role and Assignment Rationale on Attitudes Formed During Peer Tutoring.

PubMed

Bierman, Karen Linn; Furman, Wyndol

1981-02-01

This study examined the role of contextual factors, such as assignment rationale, on the attitudinal effects of peer tutoring. Fourth-grade children engaged in brief tutoring experiences as either a tutor or tutee. Subjects received four rationales for being selected as tutor or tutee: (a) a competence rationale, (b) a physical characteristic rationale, (c) a chance rationale, or (d) no rationale. As predicted, tutors had more positive attitudes than tutees when they had been given a competence or physical characteristic rationale but not when the tutors were provided a chance rationale or no rationale. Additionally, the tutors' and tutees' attitudes were enhanced when no rationale was provided. Results are discussed in terms of their implications for a role-theory analysis of tutoring and their implications for applied programs.

Acceptability of Financial Incentives for Health Behaviours: A Discrete Choice Experiment.

PubMed

Giles, Emma L; Becker, Frauke; Ternent, Laura; Sniehotta, Falko F; McColl, Elaine; Adams, Jean

2016-01-01

Healthy behaviours are important determinants of health and disease, but many people find it difficult to perform these behaviours. Systematic reviews support the use of personal financial incentives to encourage healthy behaviours. There is concern that financial incentives may be unacceptable to the public, those delivering services and policymakers, but this has been poorly studied. Without widespread acceptability, financial incentives are unlikely to be widely implemented. We sought to answer two questions: what are the relative preferences of UK adults for attributes of financial incentives for healthy behaviours? Do preferences vary according to the respondents' socio-demographic characteristics? We conducted an online discrete choice experiment. Participants were adult members of a market research panel living in the UK selected using quota sampling. Preferences were examined for financial incentives for: smoking cessation, regular physical activity, attendance for vaccination, and attendance for screening. Attributes of interest (and their levels) were: type of incentive (none, cash, shopping vouchers or lottery tickets); value of incentive (a continuous variable); schedule of incentive (same value each week, or value increases as behaviour change is sustained); other information provided (none, written information, face-to-face discussion, or both); and recipients (all eligible individuals, people living in low-income households, or pregnant women). Cash or shopping voucher incentives were preferred as much as, or more than, no incentive in all cases. Lower value incentives and those offered to all eligible individuals were preferred. Preferences for additional information provided alongside incentives varied between behaviours. Younger participants and men were more likely to prefer incentives. There were no clear differences in preference according to educational attainment. Cash or shopping voucher-type financial incentives for healthy behaviours are not necessarily less acceptable than no incentives to UK adults.

Learning styles in otolaryngology fellowships.

PubMed

Varela, David A Diaz Voss; Malik, Mohammad U; Laeeq, Kulsoom; Pandian, Vinciya; Brown, David J; Weatherly, Robert A; Cummings, Charles W; Bhatti, Nasir I

2011-12-01

Previous studies have identified a predominant learning style in trainees from different specialties, more recently in otolaryngology residents. The purpose of our study was to determine a predominant learning style within otolaryngology fellowships and to identify any differences between otolaryngology fellows and residents. We conducted a survey of otolaryngology fellows at 25 otolaryngology fellowship programs accredited by the Accreditation Council for Graduate Medical Education. We emailed Kolb's Learning Style Index version 3.1 to 16 pediatric otolaryngology (PO) and 24 otology/neurotology (ON) fellows. This index is a widely used 12-item questionnaire. The participants answered each item in the questionnaire as it applied to their preferred learning style: accommodating, converging, diverging, or assimilating. Results were then analyzed and compared between each subspecialty and the previously reported preferred styles of otolaryngology residents. Ten PO and 20 ON fellows completed the survey, with an overall response rate of 75%. PO and ON fellows (60% of each group) preferred a learning style that was "balanced" across all four styles. For ON fellows, 35% preferred converging and 5% preferred accommodating styles. For PO fellows, converging and accommodating styles accounted for 20% each. It was previously reported that 74.4% of otolaryngology residents prefer either converging or accommodating styles. We believe that the fellowship training environment calls for fellows to use more than one learning style to become proficient physicians, hence the trend toward potentially developing a balanced style when at this level. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

Practice and payment preferences of newly practising family physicians in British Columbia

PubMed Central

Brcic, Vanessa; McGregor, Margaret J.; Kaczorowski, Janusz; Dharamsi, Shafik; Verma, Serena

2012-01-01

Abstract Objective To examine the remuneration model preferences of newly practising family physicians. Design Mixed-methods study comprising a cross-sectional, Web-based survey, as well as qualitative content analysis of answers to open-ended questions. Setting British Columbia. Participants University of British Columbia family practice residents who graduated between 2000 and 2009. Main outcome measures Preferred remuneration models of newly practising physicians. Results The survey response rate was 31% (133 of 430). Of respondents, 71% (93 of 132) preferred non–fee-for-service practice models and 86% (110 of 132) identified the payment model as very or somewhat important in their choice of future practice. Three principal themes were identified from content analysis of respondents’ open-ended comments: frustrations with fee-for-service billing, which encompassed issues related to aggravations with “the business side of things” and was seen as impeding “the freedom to focus on medicine”; quality of patient care, which embraced the importance of a payment model that supported “comprehensive patient care” and “quality rather than quantity”; and freedom to choose, which supported the plurality of practice preferences among providers who strived to provide quality care for patients, “whatever model you happen to be working in.” Conclusion Newly practising physicians in British Columbia preferred alternatives to fee-for-service payment models, which were perceived as contributing to fewer frustrations with billing systems, improved quality of work life, and better quality of patient care. PMID:22586205

AHRQ series on complex intervention systematic reviews-paper 7: PRISMA-CI elaboration and explanation.

PubMed

Guise, Jeanne-Marie; Butler, Mary; Chang, Christine; Viswanathan, Meera; Pigott, Terri; Tugwell, Peter

2017-10-01

Complex interventions are widely used in health care, public health, education, criminology, social work, business, and welfare. They have increasingly become the subject of systematic reviews and are challenging to effectively report. The Complex Interventions Methods Workgroup developed an extension to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Complex Interventions (PRISMA-CI). Following the EQUATOR Network guidance for Preferred Reporting Items for Systematic Reviews and Meta-Analysis extensions, this Explanation and Elaboration (EE) document accompanies the PRISMA-CI checklist to promote consistency in reporting of systematic reviews of complex interventions. The EE document explains the meaning and rationale for each unique PRISMA-CI checklist item and provides examples to assist systematic review authors in operationalizing PRISMA-CI guidance. The Complex Interventions Workgroup developed PRISMA-CI as an important start toward increased consistency in reporting of systematic reviews of complex interventions. Because the field is rapidly expanding, the Complex Interventions Methods Workgroup plans to re-evaluate periodically for the need to add increasing specificity and examples as the field matures. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Transition of Care from the Emergency Department to the Outpatient Setting: A Mixed-Methods Analysis

PubMed Central

Kessler, Chad S.; Schwarz, Whitney W.; Schmitz, Gillian R.; Oh, Laura; Smith, Michael D.; Gross, Eric A.; House, Hans; Wadman, Michael C.; Lo, Bruce M.

2018-01-01

Introduction The goal of this study was to characterize current practices in the transition of care between the emergency department and primary care setting, with an emphasis on the use of the electronic medical record (EMR). Methods Using literature review and modified Delphi technique, we created and tested a pilot survey to evaluate for face and content validity. The final survey was then administered face-to-face at eight different clinical sites across the country. A total of 52 emergency physicians (EP) and 49 primary care physicians (PCP) were surveyed and analyzed. We performed quantitative analysis using chi-square test. Two independent coders performed a qualitative analysis, classifying answers by pre-defined themes (inter-rater reliability > 80%). Participants’ answers could cross several pre-defined themes within a given question. Results EPs were more likely to prefer telephone communication compared with PCPs (30/52 [57.7%] vs. 3/49 [6.1%] P < 0.0001), whereas PCPs were more likely to prefer using the EMR for discharge communication compared with EPs (33/49 [67.4%] vs. 13/52 [25%] p < 0.0001). EPs were more likely to report not needing to communicate with a PCP when a patient had a benign condition (23/52 [44.2%] vs. 2/49 [4.1%] p < 0.0001), but were more likely to communicate if the patient required urgent follow-up prior to discharge from the ED (33/52 [63.5%] vs. 20/49 [40.8%] p = 0.029). When discussing barriers to effective communication, 51/98 (52%) stated communication logistics, followed by 49/98 (50%) who reported setting/environmental constraints and 32/98 (32%) who stated EMR access was a significant barrier. Conclusion Significant differences exist between EPs and PCPs in the transition of care process. EPs preferred telephone contact synchronous to the encounter whereas PCPs preferred using the EMR asynchronous to the encounter. Providers believe EP-to-PCP contact is important for improving patient care, but report varied expectations and multiple barriers to effective communication. This study highlights the need to optimize technology for an effective transition of care from the ED to the outpatient setting. PMID:29560050

Comparing continuous and dichotomous scoring of the balanced inventory of desirable responding.

PubMed

Stöber, Joachim; Dette, Dorothea E; Musch, Jochen

2002-04-01

The Balanced Inventory of Desirable Responding (BIDR; Paulhus, 1994) is a widely used instrument to measure the 2 components of social desirability: self-deceptive enhancement and impression management. With respect to scoring of the BIDR, Paulhus (1994) authorized 2 methods, namely continuous scoring (all answers on the continuous answer scale are counted) and dichotomous scoring (only extreme answers are counted). In this article, we report 3 studies with student samples, and continuous and dichotomous scoring of BIDR subscales are compared with respect to reliability, convergent validity, sensitivity to instructional variations, and correlations with personality. Across studies, the scores from continuous scoring (continuous scores) showed higher Cronbach's alphas than those from dichotomous scoring (dichotomous scores). Moreover, continuous scores showed higher convergent correlations with other measures of social desirability and more consistent effects with self-presentation instructions (fake-good vs. fake-bad instructions). Finally, continuous self-deceptive enhancement scores showed higher correlations with those traits of the Five-factor model for which substantial correlations were expected (i.e., Neuroticism, Extraversion, and Conscientiousness). Consequently, these findings indicate that continuous scoring may be preferable to dichotomous scoring when assessing socially desirable responding with the BIDR.

Left and right brain-oriented hemisity subjects show opposite behavioral preferences.

PubMed

Morton, Bruce E

2012-01-01

Recently, three independent, intercorrelated biophysical measures have provided the first quantitative measures of a binary form of behavioral laterality called "Hemisity," a term referring to inherent opposite right or left brain-oriented differences in thinking and behavioral styles. Crucially, the right or left brain-orientation of individuals assessed by these methods was later found to be essentially congruent with the thicker side of their ventral gyrus of the anterior cingulate cortex (vgACC) as revealed by a 3 min MRI procedure. Laterality of this putative executive structural element has thus become the primary standard defining individual hemisity. Here, the behavior of 150 subjects, whose hemisity had been calibrated by MRI, was assessed using five MRI-calibrated preference questionnaires, two of which were new. Right and left brain-oriented subjects selected opposite answers (p > 0.05) for 47 of the 107 "either-or," forced choice type preference questionnaire items. The resulting 30 hemisity subtype preference differences were present in several areas. These were: (1) in logical orientation, (2) in type of consciousness, (3) in fear level and sensitivity, (4) in social-professional orientation, and (5) in pair bonding-spousal dominance style. The right and left brain-oriented hemisity subtype subjects, sorted on the anatomical basis of upon which brain side their vgACC was thickest, showed 30 significant differences in their "either-or" type of behavioral preferences.

Do orangutans (Pongo pygmaeus) know when they do not remember?

PubMed

Suda-King, Chikako

2008-01-01

Metacognition refers to the ability to monitor and control one's own cognitive activities such as memory. Although recent studies have raised an interesting possibility that some species of nonhuman animals might possess such skills, subjects often required a numerous number of training trials to acquire the effective use of metacognitive responses. Here, five orangutans (Pongo pygmaeus) were tested whether they were able to escape spatial memory tests when they did not remember the location of preferred reward in a relatively small number of trials. The apes were presented with two identical cups, under one of which the experimenter hid a preferred reward (e.g., two grapes). The subjects were then presented with a third container, "escape response", with which they could receive a less preferred but secure reward (e.g., one grape). The orangutans as a group significantly more likely selected the escape response when the baiting of the preferred reward was invisible (as compared to when it was visible) and when the hiding locations of the preferred reward were switched (as compared to when they remained unchanged). Even when the escape response was presented before the final presentation of the memory test, one orangutan successfully avoided the test in which she would likely err. These findings indicate that some orangutans appear to tell when they do not remember correct answers in memory tests.

Cultural Variables Underlying Obesity in Latino Men: Design, Rationale and Participant Characteristics from the Latino Men's Health Initiative.

PubMed

Sanchez-Johnsen, Lisa; Craven, Meredith; Nava, Magdalena; Alonso, Angelica; Dykema-Engblade, Amanda; Rademaker, Alfred; Xie, Hui

2017-08-01

Overweight and obesity are associated with significant health problems and rates of obesity are high among Latino men. This paper describes the design, rationale and participant characteristics of the key demographic variables assessed in an NIH-funded study (R21-CA143636) addressing culture and several obesity-related variables (diet, physical activity, and body image) among Mexican and Puerto Rican men using a community-based participatory research framework. Participants completed objective measures (height, weight, body fat, hip, waist), a health and culture interview, a diet questionnaire, and used an accelerometer to measure their level of physical activity. A total of 203 participants completed the measures and the health and culture interview and 193 completed all study components. Puerto Ricans were older than Mexicans (p < .0001) and there were significant differences in marital status (p < .05), country of birth (p < .05), smoking (p < .05) and work status (p < .001). There were no significant differences in religion, education, health insurance, Body Mass Index, body fat, hip and waist measurements, and the language preference of the interview. Results have implications for the development of a future intervention that incorporates the role of cultural factors into a community participatory obesity intervention for Latino men.

Substantial Goodness and Nascent Human Life.

PubMed

Floyd, Shawn

2015-09-01

Many believe that moral value is--at least to some extent--dependent on the developmental states necessary for supporting rational activity. My paper rejects this view, but does not aim simply to register objections to it. Rather, my essay aims to answer the following question: if a human being's developmental state and occurrent capacities do not bequeath moral standing, what does? The question is intended to prompt careful consideration of what makes human beings objects of moral value, dignity, or (to employ my preferred term) goodness. Not only do I think we can answer this question, I think we can show that nascent human life possesses goodness of precisely this sort. I appeal to Aquinas's metaethics to establish the conclusion that the goodness of a human being--even if that being is an embryo or fetus--resides at the substratum of her existence. If she possesses goodness, it is because human existence is good.

Extinction of Conditioned Responses to Methamphetamine-Associated Stimuli in Healthy Humans

PubMed Central

Cavallo, Joel S.; Ruiz, Nicholas A.; de Wit, Harriet

2016-01-01

Rationale Contextual stimuli present during drug experiences become associated with the drug through Pavlovian conditioning, and are thought to sustain drug-seeking behavior. Thus, extinction of conditioned responses is an important target for treatment. To date, acquisition and extinction to drug-paired cues have been studied in animal models or drug-dependent individuals, but rarely in non drug-users. Objective We have recently developed a procedure to study acquisition of conditioned responses after single doses of methamphetamine (MA) in healthy volunteers. Here we examined extinction of these responses and their persistence after conditioning. Methods Healthy adults (18–35 yrs; N=20) received two pairings of audio-visual stimuli with MA (20 mg oral) or placebo. Responses to stimuli were assessed before and after conditioning, using three tasks: behavioral preference, attentional bias, and subjective ‘liking.’ Results Subjects exhibited behavioral preference for the drug-paired stimuli at the first post-conditioning test, but this declined rapidly on subsequent extinction tests. They also exhibited a bias to initially look towards the drug-paired stimuli at the first post-test session, but not thereafter. Subjects who experienced more positive subjective drug effects during conditioning exhibited a smaller decline in preference during the extinction phase. Further, longer inter-session intervals during the extinction phase were associated with less extinction of the behavioral preference measure. Conclusions Conditioned responses after two pairings with MA extinguish quickly, and are influenced by both subjective drug effects and the extinction interval. Characterizing and refining this conditioning procedure will aid in understanding the acquisition and extinction processes of drug-related conditioned responses in humans. PMID:27113223

The Behavioral Effects of a Mixed Efficacy Antinociceptive Peptide, VRP26, Following Chronic Administration in Mice

PubMed Central

Anand, Jessica P.; Boyer, Brett T.; Mosberg, Henry I.; Jutkiewicz, Emily M.

2016-01-01

Rationale VRP26 displays mu opioid receptor agonist and delta opioid receptor antagonist activity in vitro, a pharmacological profile purported to produce reduced tolerance, dependence, and rewarding effects. We hypothesized that VRP26 would display reduced adverse effects after chronic administration as compared with the traditional opioid analgesic fentanyl. Objective To explore the development of tolerance, dependence and conditioned place preference of VRP26 as compared with the traditional opioid analgesic fentanyl. Methods The antinociceptive effects of VRP26 and fentanyl were assessed using the mouse warm water tail withdrawal (WWTW) assay. Measurement of antinociceptive tolerance and physical dependence occurred after seven days of continuous administration of either fentanyl (0.3 mg/kg/day) or VRP26 (10 mg/kg/day); tolerance was measured by a shift in the antinociceptive dose response curve in the WWTW assay. Physical dependence was determined by observation of withdrawal symptoms after precipitated withdrawal. Rewarding effects were measured by the ability of VRP26 or fentanyl to produce conditioned place preference. Results Fentanyl produced significant tolerance and dependence, as well as significant conditioned place preference. VRP26 produced neither tolerance nor physical dependence, nor did it produce significant conditioned place preference. Conclusions These results suggest that chronic treatment with VRP26 may produce less tolerance or physical dependence than chronic treatment with clinically available mu opioid analgesics such as fentanyl. Additionally, VRP26 produces less rewarding effects than fentanyl. This desirable in vivo profile may be due to the mixed efficacy nature of VRP26 and could provide the framework for safer opioid analgesics. PMID:27117141

Effects of Acute Withdrawal on Ethanol-Induced Conditioned Place Preference in DBA/2J mice

PubMed Central

Dreumont, Sarah E.; Cunningham, Christopher L.

2013-01-01

Rationale Re-exposure to ethanol during acute withdrawal might facilitate the transition to alcoholism by enhancing the rewarding effect of ethanol. Objective The conditioned place preference (CPP) procedure was used to test whether ethanol reward is enhanced during acute withdrawal. Methods DBA/2J mice were exposed to an unbiased one-compartment CPP procedure. Ethanol (0.75, 1.0 or 1.5 g/kg IP) was paired with a distinctive floor cue (CS+), whereas saline was paired with a different floor cue (CS−). The Withdrawal (W) group received CS+ trials during acute withdrawal produced by a large dose of ethanol (4 g/kg) given 8 h before each trial. The No Withdrawal (NW) group did not experience acute withdrawal during conditioning trials, but was matched for acute withdrawal experience. Floor preference was tested in the absence of ethanol or acute withdrawal. Results All groups eventually showed a dose-dependent preference for the ethanol-paired cue, but development of CPP was generally more rapid and stable in the W groups than in the NW groups. Acute withdrawal suppressed the normal activating effect of ethanol during CS+ trials, but there were no group differences in test activity. Conclusions Acute withdrawal enhanced ethanol’s rewarding effect as indexed by CPP. Since this effect depended on ethanol exposure during acute withdrawal, the enhancement of ethanol reward was likely mediated by the alleviation of acute withdrawal, i.e., negative reinforcement. Enhancement of ethanol reward during acute withdrawal may be a key component in the shift from episodic to chronic ethanol consumption that characterizes alcoholism. PMID:24096534

Choice between delayed food and immediate oxycodone in rats

PubMed Central

Secci, Maria E.; Factor, Julie A.; Schindler, Charles W.; Panlilio, Leigh V.

2016-01-01

Rationale The choice to seek immediate drug effects instead of more meaningful but delayed rewards is a defining feature of addiction. Objectives To develop a rodent model of this behavior, we allowed rats to choose between immediate intravenous delivery of the prescription opioid oxycodone (50 μg/kg) and delayed delivery of palatable food pellets. Results Rats preferred food at delays up to 30 s, but they chose oxycodone and food equally at 60-s delay and preferred oxycodone over food at 120-s delay. Comparison of food-drug choice, food-only, and drug-only conditions indicated that food availability decreased drug intake, but drug availability increased food intake. In the food-only condition, food was effective as a reinforcer even when delayed by 120 s. Pre-session feeding with chow slowed acquisition of food and drug self-administration, but did not affect choice. To establish procedures for testing potential anti-addiction medications, noncontingent pretreatment with oxycodone or naltrexone (analogous to substitution and antagonist therapies, respectively) were tested on a baseline in which oxycodone was preferred over delayed food. Naltrexone pretreatment decreased drug intake and increased food intake. Oxycodone pretreatment decreased drug intake, but also produced extended periods with no food or drug responding. Conclusions These findings show that the contingencies that induce preference for drugs over more meaningful but less immediate rewards in humans can be modeled in rodents, and they suggest that the model could be useful for assessing the therapeutic potential of treatments and exploring the underlying behavioral and neural mechanisms involved in addiction. PMID:27678551

On the persistence of cocaine-induced place preferences and aversions in rats

PubMed Central

Su, Zu-In; Santoostaroam, Ashley; Wenzel, Jennifer; Ettenberg, Aaron

2013-01-01

Rationale Rats develop preferences for places associated with the immediate rewarding effects of cocaine and aversions for places paired with the drug’s delayed negative effects. The motivation to seek cocaine should therefore depend upon the relative magnitude of these two opposing effects of the drug. Objective The current study tested this notion by assessing the relative persistence of the positive and negative associations formed between environmental cues and the immediate or delayed effects of cocaine. Methods Rats were administered 1.0 mg/kg intravenous cocaine and placed into a distinctive environment either immediately or 15-min after injection, alternating daily with pairings of a second environment with saline. After 4 drug- and 4 saline-place pairings, rats were returned to their home cages for 1, 7 or 21 days after which a 15-min place preference test was conducted. In a second experiment, the effectiveness of a single reconditioning session (one drug-place and one saline-place pairing) to reactivate learned cocaine-place associations was assessed after 1- or 3-weeks of drug abstinence. Results Places associated with the immediate effects of cocaine were preferred (CPP), while places associated with the delayed effects of cocaine were avoided (CPA). The persistence of these effects differed with CPP remaining viable at 3-weeks of withdrawal while CPA was no longer present after 1-week. Reconditioning with an additional cocaine-place pairing failed to reinstate the CPA. Conclusions Cue-induced “relapse” of cocaine-seeking behavior may be fueled in part by an increased persistence of positive relative to negative associations with drug-paired stimuli. PMID:23568579

Bayesian data analysis in observational comparative effectiveness research: rationale and examples.

PubMed

Olson, William H; Crivera, Concetta; Ma, Yi-Wen; Panish, Jessica; Mao, Lian; Lynch, Scott M

2013-11-01

Many comparative effectiveness research and patient-centered outcomes research studies will need to be observational for one or both of two reasons: first, randomized trials are expensive and time-consuming; and second, only observational studies can answer some research questions. It is generally recognized that there is a need to increase the scientific validity and efficiency of observational studies. Bayesian methods for the design and analysis of observational studies are scientifically valid and offer many advantages over frequentist methods, including, importantly, the ability to conduct comparative effectiveness research/patient-centered outcomes research more efficiently. Bayesian data analysis is being introduced into outcomes studies that we are conducting. Our purpose here is to describe our view of some of the advantages of Bayesian methods for observational studies and to illustrate both realized and potential advantages by describing studies we are conducting in which various Bayesian methods have been or could be implemented.

How and why should we implement genomics into conservation?

PubMed Central

McMahon, Barry J; Teeling, Emma C; Höglund, Jacob

2014-01-01

Conservation genetics has provided important information into the dynamics of endangered populations. The rapid development of genomic methods has posed an important question, namely where do genetics and genomics sit in relation to their application in the conservation of species? Although genetics can answer a number of relevant questions related to conservation, the argument for the application of genomics is not yet fully exploited. Here, we explore the transition and rationale for the move from genetic to genomic research in conservation biology and the utility of such research. We explore the idea of a ‘conservation prior’ and how this can be determined by genomic data and used in the management of populations. We depict three different conservation scenarios and describe how genomic data can drive management action in each situation. We conclude that the most effective applications of genomics will be to inform stakeholders with the aim of avoiding ‘emergency room conservation’. PMID:25553063

Cost Structure and Life Cycle Costs for Military Systems

DTIC Science & Technology

2003-09-01

LCC 1-1 Chapter 2 – Scope of the Study 2-1 2.1 Contribution of other NATO Entities 2-1 2.2 Review of National Practises and CBS 2-1 2.3 Development...Office – NCO) gave a positive answer and designated a representative in the working group. 2.2 REVIEW OF NATIONAL PRACTISES AND CBS The two first...time preference when spending money obtained through taxation ) with the effectiveness of alternate ways of meeting an objective. By combining the

Understanding the intersections between metabolism and cancer biology

PubMed Central

Heiden, Matthew G. Vander; DeBerardinis, Ralph J.

2017-01-01

Transformed cells adapt metabolism to support tumor initiation and progression. Specific metabolic activities can participate directly in the process of transformation or support the biological processes that enable tumor growth. Exploiting cancer metabolism for clinical benefit requires defining the pathways that are limiting for cancer progression and understanding the context specificity of metabolic preferences and liabilities in malignant cells. Progress towards answering these questions is providing new insight into cancer biology and can guide the more effective targeting of metabolism to help patients. PMID:28187287

L'Education et l'information juridiques dans un contexte bilingue. Etude exploratrice sur la comprehension populaire des lois (Legal Education and Information in a Bilingual Context. Exploratory Study on the Popular Understanding of Laws).

ERIC Educational Resources Information Center

Ribordy, Francois-Xavier; And Others

A study investigated the readability of current laws for Canadian francophones and anglophones. The 63 subjects were asked to read a variety of brief legal texts available in parallel styles in both languages and to answer questions about the texts' content. Subjects were also surveyed about their preference for a formal or vulgarized style of…

A cross-sectional comparison between the perception of physicians and pharmacists concerning the role of the pharmacist in physician training.

PubMed

Béchet, C; Pichon, R; Giordan, A; Bonnabry, P

2018-05-22

This study aimed to identify and compare physician-pharmacist perceptions concerning drug teaching to physicians by pharmacists in Swiss hospital settings. Questionnaires were emailed to all French-speaking physicians (survey A) and pharmacists (survey B) working in Swiss hospitals where medical directors/chief-pharmacists had approved the study. Questions were developed based on previous physician interviews. Most questions used four Likert-type response alternatives. A Mann-Whitney U test was used to compare answers to survey A and B. Fourteen out of 18 medical directors and 16/16 chief-pharmacists gave permission for the study. In total, 244 (11%) physicians answered survey A, and 115 (74%) pharmacists answered survey B. Nearly all participants agreed that pharmacists should take part in both medical student and physician postgraduate training. Most physicians answered wanting additional training and pharmacists are unaware of this need. Only two thirds of physicians reported having acquired knowledge about drugs thanks to pharmacists; document diffusion and direct answers to their questions having contributed the most to their training. Participants agreed that physician training by pharmacists needs a clearer delineation regarding the type of training, its aim, its targeted public, when and what pharmaceutical benefits are used. Physicians' priority-training topics are high-risk drugs, novelties and areas in which they consider their basic training was insufficient. Methods preferred for training are: case studies; exercises with individual corrections; and group work. Improved resources and planning are needed to meet physicians' expectations. Training is often carried out implicitly, through activities with various other aims, and needs to be better defined and formalized collaboratively. Copyright © 2018 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Art in the inclusion of children with special needs in dentistry.

PubMed

dos Santos, Marcio José Possari; de Aguiar, Sandra Maria Herondina Coelho Ávila

2011-01-01

The purpose of this study was to report the use of art and its segments as a source for inclusion of the children with special needs in dentistry. The application of the Art in social therapy activities and workshops was divided in modules: Session of Socialization, Complementary Workshops of Art and Activities, aiming at the cultural anamnesis and artistic preferences of the 313 participants, prior to their dental care treatment at CAOE (Center of Odontological Assistance to patients with special needs) FOA Unesp. According to preference of the participants that answered the questionnaires, the music and the painting are the artistic segments that proved to be most helpful in the activities of inclusion and adaptation. The authors concluded that the use of art in the adaptation and environmental inclusion of the patient, prior to dental procedures is favorable and efficient.

Relation of success and nontraditional career choice to selection for dating and friendship.

PubMed

Kapoor, Usha; Pfost, Karen S; House, Alvin E; Pierson, Eric

2010-08-01

Women who succeed in traditionally male-dominated fields have previously been found to experience lower social acceptance, both from men in romantic contexts and from women in platonic contexts. The present study examined whether such preferences continue to exist. Participants were 256 university students (110 men, 146 women) with an average age of 21.4 yr. (SD = 3.6). They answered the Bem Sex Role Inventory and the Modern Sexism Scale and also responded to four descriptions of stimulus persons which represented the variables of traditional versus nontraditional field and successful versus nondescribed academic performance. Results indicated that men preferred to date women in traditional careers (independent of their success). This finding was unrelated to men's scores on sex role orientation or egalitarianism and sexism. However, in platonic relationships, women favored women in nontraditional careers as friends.

The Use of Avatar Counseling for HIV/AIDS Health Education: The Examination of Self-Identity in Avatar Preferences.

PubMed

Canidate, Shantrel; Hart, Mark

2017-12-01

The number of adults using the Internet to obtain health information is on the rise. An estimated 66% of the adults reportedly use the Internet to obtain health information related to a specific disease (ie, human immunodeficiency virus and acquired immunodeficiency syndrome, HIV/AIDS). Previous research has demonstrated that health information seekers use the Internet to seek answers to stigma-laden questions from health avatars. The objective of this study was to identify patterns in the choice of avatar among health information seekers (patients or public health workers) using the Internet to obtain HIV/AIDS information and to describe the demographic characteristics (age, gender, and ethnicity) of health information seekers to determine whether they preferred an avatar that was similar to their own gender and ethnicity. The Rural South Public Health Training Center (RSPHTC) partnered with the New York State Department of Health to create the HIV/AIDS Avatar project. The avatar project was created to serve as an educational resource for public health workers by providing relevant and accurate information about HIV/AIDS. First, the user was instructed to choose one of the 8 avatars that voiced responses to 100 common questions and answers about HIV/AIDS. Next, the website gave users the option to complete a brief 3-question demographic survey. Finally, the demographic characteristics of each user were compared with the chosen avatar to determine whether they preferred an avatar that was similar to their own gender and ethnicity. The avatar project website was loaded with 800 videos that included the answers to the top 100 questions about HIV/AIDS voiced by 8 avatars. A total of 1119 Web-based health information seekers completed the demographic survey upon accessing the website. Of these, 55.14% (617/1119) users were female. A total of 49.96% (559/1119) users were aged between 30 and 49 years. The ethnicity of the user and the avatar was found to have the strongest connection. All the users choose the female avatar matching their own ethnicity, followed by the male avatar. Additionally, the white female avatar was chosen the most by all users regardless of the age group or gender. Web-based health information seekers using the Internet to access medical research information may feel more comfortable receiving the answers to HIV stigma-laden questions from avatars, rather than receiving information directly from a health care provider. Additionally, providers seeking to utilize avatars to deliver interventions in health care settings may benefit from offering individuals choices in how they receive health information. Having the ability to choose whom you seek information from may lead to an increase in knowledge and awareness and could motivate HIV-positive individuals to seek care. ©Shantrel Canidate, Mark Hart. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.12.2017.

The effect of case-based discussion of topics with experts on learners' opinions: implications for spinal education and training.

PubMed

Berjano, Pedro; Villafañe, Jorge Hugo; Vanacker, Gerard; Cecchinato, Riccardo; Ismael, Maryem; Gunzburg, Robert; Marruzzo, Daniele; Lamartina, Claudio

2018-02-01

This investigation aimed to examine the extent to which case-based discussion with experts could influence the audience's opinions on the treatment of patients during a continuing medical education event for spine surgeons. We conducted a prospective controlled crossover study of 90 surgeons. During a continuing medical education activity using case-based discussion, quiz questions were used which asked participants (attendants and faculty group) their opinions on the best choices about diagnosis and treatment in a number of cases. No answer was considered correct, but we evaluated the number of participants choosing each specific answer among a number of valid options. Quiz questions were collected with an automated response system at the entry and at the end of each case discussion. Change in participant's opinions was estimated from the change in the preferred answers between the entry and exit quizzes. Chi-square analysis was performed to determine significance. Sixty-two attendants out of eighty three (75%) and six faculties out of twelve (50%) responded to the survey. After the case discussion, 68.2% (p < 0.04, Chi-square test) of the attendants changed their opinion on the appropriate treatment. The faculty answers, however, showed no significant change in opinions regarding the identification of the appropriate treatment. On the basis of our results, case-based discussion driven by experts, as a form of teaching, has a measurable effect in terms of changes in the learners' opinions.

The effect of case-based discussion of topics with experts on learners' opinions: implications for spinal education and training.

PubMed

Berjano, Pedro; Villafañe, Jorge Hugo; Vanacker, Gerard; Cecchinato, Riccardo; Ismael, Maryem; Gunzburg, Robert; Marruzzo, Daniele; Lamartina, Claudio

2017-10-01

This investigation aimed to examine the extent to which case-based discussion with experts could influence the audience's opinions on the treatment of patients during a continuing medical education event for spine surgeons. We conducted a prospective controlled crossover study of 90 surgeons. During a continuing medical education activity using case-based discussion, quiz questions were used which asked participants (attendants and faculty group) their opinions on the best choices about diagnosis and treatment in a number of cases. No answer was considered correct, but we evaluated the number of participants choosing each specific answer among a number of valid options. Quiz questions were collected with an automated response system at the entry and at the end of each case discussion. Change in participant's opinions was estimated from the change in the preferred answers between the entry and exit quizzes. Chi-square analysis was performed to determine significance. Sixty-two attendants out of eighty three (75%) and six faculties out of twelve (50%) responded to the survey. After the case discussion, 68.2% (p < 0.04, Chi-square test) of the attendants changed their opinion on the appropriate treatment. The faculty answers, however, showed no significant change in opinions regarding the identification of the appropriate treatment. On the basis of our results, case-based discussion driven by experts, as a form of teaching, has a measurable effect in terms of changes in the learners' opinions.

Health-Related Information-Seeking Behaviors and Preferences Among Mexican Patients with Cancer.

PubMed

Soto-Perez-de-Celis, Enrique; Perez-Montessoro, Viridiana; Rojo-Castillo, Patricia; Chavarri-Guerra, Yanin

2018-06-01

Understanding the preferred sources of health-related information among patients with cancer is essential for designing successful cancer education and prevention strategies. However, little is known about health-related information-seeking practices among patients living in low- and middle-income countries. We studied the preferred sources of health-related information among Mexican patients with cancer and explored which factors influence these choices. The health-related information-seeking practices among patients with cancer treated at a public hospital in Mexico City were evaluated using questions from the Spanish Version of the Health Information National Trends Survey. The characteristics of patients who sought health-related information, and of those who chose the internet as their preferred source of information, were analyzed. Fisher's exact test and logistic regression were used for statistical analyses. One hundred forty-eight patients answered the survey (median age 60 years, 70% female), of which 88 (59%) had sought for health-related information. On multivariate analysis, the only characteristic associated with lower odds of seeking health-related information was increasing age (OR 0.93, 95% CI 0.90-0.97). Sixty-one respondents (69%) listed the internet as their preferred source of health-related information. On multivariate analysis, only being of the female gender (OR 4.9, 95% CI 1.3-18.3) was related with higher odds of preferring other sources of information over the internet. Among Mexican patients with cancer, the Internet is the most widely used information source. Older age was the characteristic most strongly associated with not seeking health-related information, while being female was strongly associated with preferring other sources of information over the Internet.

[Preferences in the format of questionnaires and use of the Internet by schoolchildren].

PubMed

Rajmil, L; Robles, N; Murillo, M; Rodríguez-Arjona, D; Azuara, M; Ballester, A; Codina, F

2015-07-01

To describe the preferences to complete questionnaires via the internet by schoolchildren, as well as to analyze the attitude towards the use of internet to communicate with health professionals. Cross-sectional study of a school population in Palafolls (Barcelona, n=923) was conducted in October and November 2013. Participants completed both internet and paper versions on a single school day, in random order, and with at least an interval of 2 hours. Preferences to answer internet vs paper version were recorded, along with the willingness to share information with health professionals. Percentages of use preferences and attitudes were estimated, and logistic regression models were fitted to analyze the association with the preferences and willingness to share information with health professionals. Participation rates were 77% (n=715), of whom 42.4% (38.7 to 46.0) preferred the internet version, and 20.6% (17.6 to 23.6) the paper version. Older children (odds ratio [OR]=0.89, 0.84 to 0.95 for age), and those from families with secondary school (OR=0.63, 0.43 to 0.93), and university degree (OR=0.61, 0.38 to 0.97) were less likely to prefer the internet version, while boys (OR=1.55, 1.10 to 2.16) and those children reporting sedentary habits (OR=1.78, 1.06 to 3.0) were more likely to prefer the internet version. Those scoring higher quality of life (OR=1.03, 1.01-1.05) and not reporting sedentary habits (OR=0.33, 0.15 to 0.73) were factors associated with a positive attitude to share information with health professionals. Younger children prefer to use the internet. Although Internet use is very widespread, it is less used to communicate with health professionals. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Study of a comet rendezvous mission, volume 1

NASA Technical Reports Server (NTRS)

1972-01-01

The feasibility, scientific objectives, modes of exploration and implementation alternatives of a rendezvous mission to Encke's comet in 1984 are considered. Principal emphasis is placed on developing the scientific rationale for such a mission, based on available knowledge and best estimates of this comet's physical characteristics, including current theories of its origin, evolution and composition. Studied are mission profile alternatives, performance tradeoffs, preferred exploration strategy, and a spacecraft design concept capable of performing this mission. The study showed that the major scientific objectives can be met by a Titan IIID/Centaur-launched 17.5 kw solar electric propulsion spacecraft which carries 60 kg of scientific instruments and is capable of extensive maneuvering within the comet envelope to explore the coma, tail and nucleus.

Positive weighing of the other's collective narrative among Jewish and Bedouin-Palestinian teachers in Israel and its correlates.

PubMed

Lazar, Alon; Braun-Lewensohn, Orna; Litvak Hirsch, Tal

2016-06-01

Teachers play a pivotal role in the educational discourse around collective narratives, and especially the other's narrative. The study assumed that members of groups entangled in a conflict approach the different modules of the other's narrative distinctively. Jewish and Palestinian teachers, Israeli citizens, answered questionnaires dealing with the narrative of the other, readiness for interethnic contact, negative between-group emotions and preferences for resolutions of the Israeli-Palestinian (I-P) conflict. Positive weighing of the other's narrative among Jewish teachers correlated with high levels of readiness for interethnic contact and low levels of negative between-group emotions, across the various modules of the Palestinian narrative. Preferences for a peaceful resolution of the I-P conflict and rejection of a violent one were noted in two of the modules. Among Palestinian teachers, positive weighing of the other's collective narrative was exclusively noted for the Israeli narrative of the Holocaust, and this stance negatively related to negative between-group emotions and preference for a violent solution of the I-P conflict, and positively related to readiness for interethnic contact and preference of a peaceful resolution of the conflict. Practical implications of these findings for peace education are discussed. © 2015 International Union of Psychological Science.

Religious care required for Japanese terminally ill patients with cancer from the perspective of bereaved family members.

PubMed

Okamoto, Takuya; Ando, Michiyo; Morita, Tatsuya; Hirai, Kei; Kawamura, Ryo; Mitsunori, Miyashita; Sato, Kazuki; Shima, Yasuo

2010-02-01

The aim of this study was to explore the most suitable religious care for Japanese terminally ill patients with cancer based on the opinions of bereaved family members. A multicenter questionnaire survey on palliative care service was sent to 592 bereaved family members of patients with cancer who were admitted to palliative care units in Japan, and 430 responded by mail. In the section of the questionnaire about religious care, 382 responses were used for quantitative analysis, and 71 responses about religious care for qualitative analysis. In the current study, the 71 responses were grouped into families with and without a religion and were analyzed qualitatively. Families with a religion (N = 28) chose answers such as ''Instrumental care'' such as music or a religious event, ''Freedom of choice of kinds for religious care,'' ''Staff involvement of religious care,'' ''Meeting with a pastoral care workers,'' and ''Burden of offering a different kind of personal religion.'' In contrast, families without a religion (N = 44) chose answers such as ''Instrumental care,'' ''Freedom of choice whether patients receive religious care or not,'' ''Spiritual care,'' ''Not being able to accept religious care,'' and ''Burden of thinking about a religion and nuisance.'' These findings suggest that Japanese bereaved families with a religion generally regard religious care positively and prefer care through their own religion, whereas some families without a religion require religious care but some do not prefer it.

Use of Diabetes Data Management Software Reports by Health Care Providers, Patients With Diabetes, and Caregivers Improves Accuracy and Efficiency of Data Analysis and Interpretation Compared With Traditional Logbook Data

PubMed Central

Hinnen, Deborah A.; Buskirk, Ann; Lyden, Maureen; Amstutz, Linda; Hunter, Tracy; Parkin, Christopher G.; Wagner, Robin

2014-01-01

Background: We assessed users’ proficiency and efficiency in identifying and interpreting self-monitored blood glucose (SMBG), insulin, and carbohydrate intake data using data management software reports compared with standard logbooks. Method: This prospective, self-controlled, randomized study enrolled insulin-treated patients with diabetes (PWDs) (continuous subcutaneous insulin infusion [CSII] and multiple daily insulin injection [MDI] therapy), patient caregivers [CGVs]) and health care providers (HCPs) who were naïve to diabetes data management computer software. Six paired clinical cases (3 CSII, 3 MDI) and associated multiple-choice questions/answers were reviewed by diabetes specialists and presented to participants via a web portal in both software report (SR) and traditional logbook (TL) formats. Participant response time and accuracy were documented and assessed. Participants completed a preference questionnaire at study completion. Results: All participants (54 PWDs, 24 CGVs, 33 HCPs) completed the cases. Participants achieved greater accuracy (assessed by percentage of accurate answers) using the SR versus TL formats: PWDs, 80.3 (13.2)% versus 63.7 (15.0)%, P < .0001; CGVs, 84.6 (8.9)% versus 63.6 (14.4)%, P < .0001; HCPs, 89.5 (8.0)% versus 66.4 (12.3)%, P < .0001. Participants spent less time (minutes) with each case using the SR versus TL formats: PWDs, 8.6 (4.3) versus 19.9 (12.2), P < .0001; CGVs, 7.0 (3.5) versus 15.5 (11.8), P = .0005; HCPs, 6.7 (2.9) versus 16.0 (12.0), P < .0001. The majority of participants preferred using the software reports versus logbook data. Conclusions: Use of the Accu-Chek Connect Online software reports enabled PWDs, CGVs, and HCPs, naïve to diabetes data management software, to identify and utilize key diabetes information with significantly greater accuracy and efficiency compared with traditional logbook information. Use of SRs was preferred over logbooks. PMID:25367012

Influenza vaccination in healthcare workers; comparison of side effects and preferred route of administration of intradermal versus intramuscular administration.

PubMed

Meijer, W J; Wensing, A M J; Bos, A A; Kuiphuis, J C F; Hagelen, E M M; Wilschut, J C; de Vries, M J T; Riezebos-Brilman, A

2017-03-13

To explore the nature and severity of side effects and future preference of intradermal versus intramuscular influenza vaccination in healthcare workers. Prospective cohort study. Two University Medical Centers in The Netherlands. Healthcare workers receiving an influenza vaccination. Healthcare workers that were vaccinated during the influenza vaccination season of 2012-2013 were approached for participation in a questionnaire study. The questionnaire was divided into two parts. The first part had to be answered directly after vaccination and the second part two weeks after vaccination. The motivation for vaccine uptake, whether or not the HCWs had direct contact with patients and the prevalence and severity of local and systemic side effects of influenza vaccination were explored. In addition, it was assessed how participants experienced the vaccination and which type of administration they preferred for future vaccination. Side effects of vaccination were more prevalent in the intradermal group versus the intramuscular group (56% versus 26%, p<0.001). Local side effects were perceived as more severe in healthcare workers receiving the intradermal vaccine. Directly after vaccination, healthcare workers preferred the intradermal vaccination. Two weeks after vaccination both types of vaccine were equally appreciated. This study shows that there are significant differences in the nature and severity of side effects upon intramuscular and intradermal influenza vaccination. This difference did not result in a preference among the vaccinated subjects for one type of vaccine. Copyright © 2017 Elsevier Ltd. All rights reserved.

Tourniquet use in orthopedic surgery: a descriptive survey study among Turkish orthopedic surgeons and residents in Istanbul.

PubMed

Yalçınkaya, Merter; Sökücü, Sami; Erdoğan, Sinan; Kabukçuoğlu, Yavuz S

2014-01-01

The aim of this study was to investigate and interpret the trends in tourniquet use and the accuracy of knowledge among Turkish orthopedic physicians through face-to-face survey. Turkish orthopedic physicians actively practicing operative orthopedics were questioned in a 12 question face-to-face survey. Personal information of physicians, preferred cuff pressure (CP) and tourniquet inflation time (TIT) and the source of the information for these preferences were questioned. Answers gathered were analyzed statistically. The survey was completed by 211 orthopedic physicians. Mean preferred CP and TIT was 247.1 mmHg and 108.6 minutes, respectively, in the upper limb (UL) and 345.02 mmHg and 122.4 minutes, respectively, in the lower limb (LL). A statistically significant correlation was found between the amount of pressure preferred in the LL and the years of practice; longer the years in practice, higher the amount of pressure preferred (r=0.144, p=0.04). Tourniquets were used for a maximum period of 120 minutes for the UL by 95.7% of participants and for the LL by 84.8%. The amount of CP used by the orthopedic physicians surveyed is inconsistent with the literature with frequent use of CP higher than those scientifically recommended. The outcomes of the survey should be cautionary for orthopedic physicians to review the current utilization and replace personal teachings and experience-based methods with evidence-based best practices for tourniquet application.

Factors that influence career choice in primary care among medical students starting social service in Honduras.

PubMed

Puertas, E Benjamín; Rivera, Tamara Y

2016-11-01

To 1) describe patterns of specialty choice; 2) investigate relationships between career selection and selected demographic indicators; and 3) identify salary perception, factors that influence career choice in primary care, and factors that influence desired location of future medical practice. The study used a mixed-methods approach that included a cross-sectional questionnaire survey applied to 234 last-year medical students in Honduras (September 2014), and semi-structured interviews with eight key informants (October 2014). Statistical analysis included chi-square and factor analysis. An alpha level of 0.05 was used to determine significance. In the qualitative analysis, several codes were associated with each other, and five major themes emerged. Primary care careers were the preferred choice for 8.1% of students, who preferred urban settings for future practice location. The perceived salary of specialties other than primary care was significantly higher than those of general practitioners, family practitioners, and pediatricians (P < 0.001). Participants considered "making a difference," income, teaching, prestige, and challenging work the most important factors influencing career choice. Practice in ambulatory settings was significantly associated with a preference for primary care specialties (P = < 0.05). Logistic regression analysis found that factors related to patient-based care were statistically significant for selecting primary care (P = 0.006). The qualitative analysis further endorsed the survey findings, identifying additional factors that influence career choice (future work option; availability of residency positions; and social factors, including violence). Rationales behind preference of a specialty appeared to be based on a combination of ambition and prestige, and on personal and altruistic considerations. Most factors that influence primary care career choice are similar to those found in the literature. There are several factors distinctive to medical students in Honduras-most of them barriers to primary care career choice.

Intra-accumbens injections of the adenosine A2A agonist CGS 21680 affect effort-related choice behavior in rats

PubMed Central

Font, Laura; Mingote, Susana; Farrar, Andrew M.; Pereira, Mariana; Worden, Lila; Stopper, Colin; Port, Russell G.

2009-01-01

Rationale Nucleus accumbens dopamine (DA) participates in the modulation of instrumental behavior, including aspects of behavioral activation and effort-related choice behavior. Rats with impaired accumbens DA transmission reallocate their behavior away from food-reinforced activities that have high response requirements and instead select less-effortful types of food-seeking behavior. Although accumbens DA is considered a critical component of the brain circuitry regulating effort-related processes, emerging evidence also implicates adenosine A2A receptors. Objective The present work was undertaken to test the hypothesis that accumbens A2A receptor stimulation would produce effects similar to those produced by DA depletion or antagonism. Materials and methods Three experiments assessed the effects of the adenosine A2A agonist CGS 21680 on performance of a concurrent choice task (lever pressing for preferred food vs. intake of less preferred chow) that is known to be sensitive to DA antagonists and accumbens DA depletions. Results Systemic injections of CGS 21680 reduced lever pressing but did not increase feeding. In contrast, bilateral infusions of the adenosine A2A receptor agonist CGS 21680 (6.0–24.0 ng) into the nucleus accumbens decreased lever pressing for the preferred food but substantially increased consumption of the less preferred chow. Injections of CGS 21680 into a control site dorsal to the accumbens were ineffective. Conclusions Taken together, these results are consistent with the hypothesis that local stimulation of adenosine A2A receptors in nucleus accumbens produces behavioral effects similar to those induced by accumbens DA depletions. Accumbens adenosine A2A receptors appear to be a component of the brain circuitry regulating effort-related choice behavior. PMID:18491078

Long-term follow-up of HIV seroconverters in microbicide trials - rationale, study design, and challenges in MTN-015.

PubMed

Riddler, Sharon A; Husnik, Marla; Gorbach, Pamina M; Levy, Lisa; Parikh, Urvi; Livant, Edward; Pather, Arendevi; Makanani, Bonus; Muhlanga, Felix; Kasaro, Margaret; Martinson, Francis; Elharrar, Vanessa; Balkus, Jennifer E

2016-09-01

As the effect of biomedical prevention interventions on the natural history of HIV-1 infection in participants who seroconvert is unknown, the Microbicide Trials Network (MTN) established a longitudinal study (MTN-015) to monitor virologic, immunological, and clinical outcomes, as well as behavioral changes among women who become HIV-infected during MTN trials. We describe the rationale, study design, implementation, and enrollment of the initial group of participants in the MTN seroconverter cohort. Initiated in 2008, MTN-015 is an ongoing observational cohort study enrolling participants who acquire HIV-1 infection during effectiveness studies of candidate microbicides. Eligible participants from recently completed and ongoing MTN trials are enrolled after seroconversion and return for regular follow-up visits with clinical and behavioral data collection. Biologic samples including blood and genital fluids are stored for future testing. MTN-015 was implemented initially at six African sites and enrolled 100/139 (72%) of eligible women who seroconverted in HIV Prevention Trials Network protocol 035 (HPTN 035, conducted by the MTN). The median time from seroconversion in HPTN 035 to enrollment in MTN-015 was 18 months. Retention was good with >70% of visits completed. Implementation challenges included regulatory reviews, translation, and testing of questionnaires, and site readiness. Enrollment of HIV-seroconverters into a longitudinal observational follow-up study is feasible and acceptable to participants. Data and samples collected in this protocol will be used to assess safety of investigational HIV microbicides and answer other important public health questions for HIV infected women.

Parents and children with cerebral palsy discuss communication needs in hospital.

PubMed

Hemsley, Bronwyn; Kuek, Melissa; Bastock, Kaely; Scarinci, Nerina; Davidson, Bronwyn

2013-12-01

The aim of this study was to understand the communication needs and experiences of parents and children with cerebral palsy (CP) and complex communication needs (CCN) in hospital. Focus groups with 10 parents and interviews with seven children with CP and CCN were analysed for content themes. Results demonstrated that children often want to communicate directly with hospital staff to: gain attention, answer yes/no, convey basic physical needs, give and receive information, control their environment and participate in preferred activities. Barriers to communication included lack of access to augmentative and alternative communication (AAC), staff preferring to communicate with parents and lack of time to communicate. Results highlight strategies for successful communication, the role of the parents in supporting communication and provision of AAC systems for children in hospital. Policy and practice implications in the preparation of children with CP and CCN for communication in hospital are discussed.

A model for making project funding decisions at the National Cancer Institute.

PubMed

Hall, N G; Hershey, J C; Kessler, L G; Stotts, R C

1992-01-01

This paper describes the development of a model for making project funding decisions at The National Cancer Institute (NCI). The American Stop Smoking Intervention Study (ASSIST) is a multiple-year, multiple-site demonstration project, aimed at reducing smoking prevalence. The initial request for ASSIST proposals was answered by about twice as many states as could be funded. Scientific peer review of the proposals was the primary criterion used for funding decisions. However, a modified Delphi process made explicit several criteria of secondary importance. A structured questionnaire identified the relative importance of these secondary criteria, some of which we incorporated into a composite preference function. We modeled the proposal funding decision as a zero-one program, and adjusted the preference function and available budget parametrically to generate many suitable outcomes. The actual funding decision, identified by our model, offers significant advantages over manually generated solutions found by experts at NCI.

Comparative Study of Three Different Personal Response Systems with Fourth-Year Undergraduate Veterinary Students.

PubMed

Duret, Denis; Senior, Avril

2015-01-01

The purpose of this study was to compare three different Personal Response Systems that have been used in recent years at the School of Veterinary Science, University of Liverpool: a technology-free system (Communicubes), a handset delivery device (TurningPoint), and a cloud-based technology (Poll Everywhere) that allows students to use a range of personal computing devices to register their answer. All three systems offer a method to promote active learning, and lecturers were encouraged to use them. However, there are cost and logistical implications for each. The authors found that both staff and students did have particular preferences for a specific system. This preference was not the same for both groups. The outcome of the comparison is that further research is needed into cloud-based technology as it offers benefits to the students but is also a distraction.

Mortality salience, martyrdom, and military might: the great satan versus the axis of evil.

PubMed

Pyszczynski, Tom; Abdollahi, Abdolhossein; Solomon, Sheldon; Greenberg, Jeff; Cohen, Florette; Weise, David

2006-04-01

Study 1 investigated the effect of mortality salience on support for martyrdom attacks among Iranian college students. Participants were randomly assigned to answer questions about either their own death or an aversive topic unrelated to death and then evaluated materials from fellow students who either supported or opposed martyrdom attacks against the United States. Whereas control participants preferred the student who opposed martyrdom, participants reminded of death preferred the student who supported martyrdom and indicated they were more likely to consider such activities themselves. Study 2 investigated the effect of mortality salience on American college students' support for extreme military interventions by American forces that could kill thousands of civilians. Mortality salience increased support for such measures among politically conservative but not politically liberal students. The roles of existential fear, cultural worldviews, and construing one's nation as pursing a heroic battle against evil in advocacy of violence were discussed.

A Combination of Hand-held Models and Computer Imaging Programs Helps Students Answer Oral Questions about Molecular Structure and Function: A Controlled Investigation of Student Learning

PubMed Central

Peck, Ronald F.; Colton, Shannon; Morris, Jennifer; Chaibub Neto, Elias; Kallio, Julie

2009-01-01

We conducted a controlled investigation to examine whether a combination of computer imagery and tactile tools helps introductory cell biology laboratory undergraduate students better learn about protein structure/function relationships as compared with computer imagery alone. In all five laboratory sections, students used the molecular imaging program, Protein Explorer (PE). In the three experimental sections, three-dimensional physical models were made available to the students, in addition to PE. Student learning was assessed via oral and written research summaries and videotaped interviews. Differences between the experimental and control group students were not found in our typical course assessments such as research papers, but rather were revealed during one-on-one interviews with students at the end of the semester. A subset of students in the experimental group produced superior answers to some higher-order interview questions as compared with students in the control group. During the interview, students in both groups preferred to use either the hand-held models alone or in combination with the PE imaging program. Students typically did not use any tools when answering knowledge (lower-level thinking) questions, but when challenged with higher-level thinking questions, students in both the control and experimental groups elected to use the models. PMID:19255134

Smooth-pursuit eye-movement-related neuronal activity in macaque nucleus reticularis tegmenti pontis.

PubMed

Suzuki, David A; Yamada, Tetsuto; Yee, Robert D

2003-04-01

Neuronal responses that were observed during smooth-pursuit eye movements were recorded from cells in rostral portions of the nucleus reticularis tegmenti pontis (rNRTP). The responses were categorized as smooth-pursuit eye velocity (78%) or eye acceleration (22%). A separate population of rNRTP cells encoded static eye position. The sensitivity to pursuit eye velocity averaged 0.81 spikes/s per degrees /s, whereas the average sensitivity to pursuit eye acceleration was 0.20 spikes/s per degrees /s(2). Of the eye-velocity cells with horizontal preferences for pursuit responses, 56% were optimally responsive to contraversive smooth-pursuit eye movements and 44% preferred ipsiversive pursuit. For cells with vertical pursuit preferences, 61% preferred upward pursuit and 39% preferred downward pursuit. The direction selectivity was broad with 50% of the maximal response amplitude observed for directions of smooth pursuit up to +/-85 degrees away from the optimal direction. The activities of some rNRTP cells were linearly related to eye position with an average sensitivity of 2.1 spikes/s per deg. In some cells, the magnitude of the response during smooth-pursuit eye movements was affected by the position of the eyes even though these cells did not encode eye position. On average, pursuit centered to one side of screen center elicited a response that was 73% of the response amplitude obtained with tracking centered at screen center. For pursuit centered on the opposite side, the average response was 127% of the response obtained at screen center. The results provide a neuronal rationale for the slow, pursuit-like eye movements evoked with rNRTP microstimulation and for the deficits in smooth-pursuit eye movements observed with ibotenic acid injection into rNRTP. More globally, the results support the notion of a frontal and supplementary eye field-rNRTP-cerebellum pathway involved with controlling smooth-pursuit eye movements.

Advising on Preferred Reporting Items for patient-reported outcome instrument development: the PRIPROID.

PubMed

Hou, Zheng-Kun; Liu, Feng-Bin; Fang, Ji-Qian; Li, Xiao-Ying; Li, Li-Juan; Lin, Chu-Hua

2013-03-01

The reporting of patient-reported outcomes (PRO) instrument development is vital for both researchers and clinicians to determine its validity, thus, we propose the Preferred Reporting Items for PRO Instrument Development (PRIPROID) to improve the quality of reports. Abiding by the guidance published by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network, we had performed 6 steps for items development: identified the need for a guideline, performed a literature review, obtained funding for the guideline initiative, identified participants, conducted a Delphi exercise and generated a list of PRIPROID items for consideration at the face-to-face meeting. Twenty three items subheadings under 7 topics were included: title and structured abstract, rationale, objectives, intention, eligibility criteria, conceptual framework, items generation, response options, scoring, times, administrative modes, burden assessment, properties assessment, statistical methods, participants, main results, and additional analysis, summary of evidence, limitations, clinical attentions, and conclusions, item pools or final form, and funding. The PRIPROID contains many elements of the PRO research, and this assists researchers to report their results more accurately and to a certain degree use this instrument to evaluate the quality of the research methods.

Discounting the future: influence of the economic model.

PubMed Central

West, R R

1996-01-01

OBJECTIVE: To consider the effect of the economic discount rate on health care policy and the rationale for discounting the collective future of society generally. DESIGN: A review of the concept of discounting the future vis à vis the present from the points of view of individuals (who pass on) and of societies (that continue) and reconsideration of the application of discounting to typical public health scenarios. SETTING: A public health service, within a basically stable society, which can reasonably anticipate a nearly certain future. RESULTS: Discounting necessarily overvalues the "here and now" compared with the future. While applications of discount rates, typical of those employed in health economic studies in recent years, may seem rational in health care programmes directed at middle aged employed people, they do not for the young and the elderly, important recipients of health care. The consequences of discounting do not accord with the aims and objectives of public health. CONCLUSIONS: The "time preferences" of transient individuals within a stable society do not provide a rational basis for time preference of a stable society collectively. Discounting inevitably encourages "short termism" and hence biases public policy decision making. The neoclassical theory that gave rise to the concept of discounting requires revision. PMID:8935452

Discounting the future: influence of the economic model.

PubMed

West, R R

1996-06-01

To consider the effect of the economic discount rate on health care policy and the rationale for discounting the collective future of society generally. A review of the concept of discounting the future vis à vis the present from the points of view of individuals (who pass on) and of societies (that continue) and reconsideration of the application of discounting to typical public health scenarios. A public health service, within a basically stable society, which can reasonably anticipate a nearly certain future. Discounting necessarily overvalues the "here and now" compared with the future. While applications of discount rates, typical of those employed in health economic studies in recent years, may seem rational in health care programmes directed at middle aged employed people, they do not for the young and the elderly, important recipients of health care. The consequences of discounting do not accord with the aims and objectives of public health. The "time preferences" of transient individuals within a stable society do not provide a rational basis for time preference of a stable society collectively. Discounting inevitably encourages "short termism" and hence biases public policy decision making. The neoclassical theory that gave rise to the concept of discounting requires revision.

Trends in public perceptions and preferences on energy and environmental policy

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

Farhar, B.C.

1993-02-01

This report presents selected results from a secondary analysis of public opinion surveys, taken at the national and state/local levels, relevant to energy and environmental policy choices. The data base used in the analysis includes about 2000 items from nearly 600 separate surveys conducted between 1979 and 1992. Answers to word-for-word questions were traced over time, permitting trend analysis. Patterns of response were also identified for findings from similarly worded survey items. The analysis identifies changes in public opinion concerning energy during the past 10 to 15 years.

The Astronomical Orientation of Ancient Greek Temples

PubMed Central

Salt, Alun M.

2009-01-01

Despite its appearing to be a simple question to answer, there has been no consensus as to whether or not the alignments of ancient Greek temples reflect astronomical intentions. Here I present the results of a survey of archaic and classical Greek temples in Sicily and compare them with temples in Greece. Using a binomial test I show strong evidence that there is a preference for solar orientations. I then speculate that differences in alignment patterns between Sicily and Greece reflect differing pressures in the expression of ethnic identity. PMID:19936239

The astronomical orientation of ancient Greek temples.

PubMed

Salt, Alun M

2009-11-19

Despite its appearing to be a simple question to answer, there has been no consensus as to whether or not the alignments of ancient Greek temples reflect astronomical intentions. Here I present the results of a survey of archaic and classical Greek temples in Sicily and compare them with temples in Greece. Using a binomial test I show strong evidence that there is a preference for solar orientations. I then speculate that differences in alignment patterns between Sicily and Greece reflect differing pressures in the expression of ethnic identity.

An objective rationale for the choice of regularisation parameter with application to global multiple-frequency S-wave tomography

NASA Astrophysics Data System (ADS)

Zaroli, C.; Sambridge, M.; Lévêque, J.-J.; Debayle, E.; Nolet, G.

2013-06-01

In a linear ill-posed inverse problem, the regularisation parameter (damping) controls the balance between minimising both the residual data misfit and the model norm. Poor knowledge of data uncertainties often makes the selection of damping rather arbitrary. To go beyond that subjectivity, an objective rationale for the choice of damping is presented, which is based on the coherency of delay-time estimates in different frequency bands. Our method is tailored to the problem of global Multiple-Frequency Tomography (MFT), using a data set of 287 078 S-wave delay-times measured in five frequency bands (10, 15, 22, 34, 51 s central periods). Whereas for each ray path the delay-time estimates should vary coherently from one period to the other, the noise most likely is not coherent. Thus, the lack of coherency of the information in different frequency bands is exploited, using an analogy with the cross-validation method, to identify models dominated by noise. In addition, a sharp change of behaviour of the model ℓ∞-norm, as the damping becomes lower than a threshold value, is interpreted as the signature of data noise starting to significantly pollute at least one model component. Models with damping larger than this threshold are diagnosed as being constructed with poor data exploitation. Finally, a preferred model is selected from the remaining range of permitted model solutions. This choice is quasi-objective in terms of model interpretation, as the selected model shows a high degree of similarity with almost all other permitted models (correlation superior to 98% up to spherical harmonic degree 80). The obtained tomographic model is displayed in mid lower-mantle (660-1910 km depth), and is shown to be compatible with three other recent global shear-velocity models. A wider application of the presented rationale should permit us to converge towards more objective seismic imaging of the Earth's mantle.

An objective rationale for the choice of regularisation parameter with application to global multiple-frequency S-wave tomography

NASA Astrophysics Data System (ADS)

Zaroli, C.; Sambridge, M.; Lévêque, J.-J.; Debayle, E.; Nolet, G.

2013-10-01

In a linear ill-posed inverse problem, the regularisation parameter (damping) controls the balance between minimising both the residual data misfit and the model norm. Poor knowledge of data uncertainties often makes the selection of damping rather arbitrary. To go beyond that subjectivity, an objective rationale for the choice of damping is presented, which is based on the coherency of delay-time estimates in different frequency bands. Our method is tailored to the problem of global multiple-frequency tomography (MFT), using a data set of 287 078 S-wave delay times measured in five frequency bands (10, 15, 22, 34, and 51 s central periods). Whereas for each ray path the delay-time estimates should vary coherently from one period to the other, the noise most likely is not coherent. Thus, the lack of coherency of the information in different frequency bands is exploited, using an analogy with the cross-validation method, to identify models dominated by noise. In addition, a sharp change of behaviour of the model ℓ∞-norm, as the damping becomes lower than a threshold value, is interpreted as the signature of data noise starting to significantly pollute at least one model component. Models with damping larger than this threshold are diagnosed as being constructed with poor data exploitation. Finally, a preferred model is selected from the remaining range of permitted model solutions. This choice is quasi-objective in terms of model interpretation, as the selected model shows a high degree of similarity with almost all other permitted models (correlation superior to 98% up to spherical harmonic degree 80). The obtained tomographic model is displayed in the mid lower-mantle (660-1910 km depth), and is shown to be compatible with three other recent global shear-velocity models. A wider application of the presented rationale should permit us to converge towards more objective seismic imaging of Earth's mantle.

The use of the analytic hierarchy process to aid decision making in acquired equinovarus deformity.

PubMed

van Til, Janine A; Renzenbrink, Gerbert J; Dolan, James G; Ijzerman, Maarten J

2008-03-01

To increase the transparency of decision making about treatment in patients with equinovarus deformity poststroke. The analytic hierarchy process (AHP) was used as a structured methodology to study the subjective rationale behind choice of treatment. An 8-hour meeting at a centrally located rehabilitation center in The Netherlands, during which a patient video was shown to all participants (using a personal computer and a large screen) and the patient details were provided on paper. A panel of 10 health professionals from different backgrounds. Not applicable. The performance of the applicable treatments on outcome, impact, comfort, cosmetics, daily effort, and risks and side effects of treatment, as well as the relative importance of criteria in the choice of treatment. According to the model, soft-tissue surgery (.413) ranked first as the preferred treatment, followed by orthopedic footwear (.181), ankle-foot orthosis (.147), surface electrostimulation (.137), and finally implanted electrostimulation (.123). Outcome was the most influential consideration affecting treatment choice (.509), followed by risk and side effects (.194), comfort (.104), daily effort (.098), cosmetics (.065), and impact of treatment (.030). Soft-tissue surgery was judged best on outcome, daily effort, comfortable shoe wear, and cosmetically acceptable result and was thereby preferred as a treatment alternative by the panel in this study. In contrast, orthosis and orthopedic footwear are usually preferred in daily practice. The AHP method was found to be suitable methodology for eliciting subjective opinions and quantitatively comparing treatments in the absence of scientific evidence.

[Patients' preferences for information in health care decision-making].

PubMed

Borracci, Raúl A; Manente, Diego; Giorgi, Mariano A; Calderón, Gustavo; Ciancio, Alejandro; Doval, Hernán C

2012-01-01

A survey was carried out among patients who concurred to cardiologic services to know how patients preferred to be informed about their health status, and the demographic characteristics associated to these preferences, considering the following items: knowledge about the disease, information about different therapeutic options and decision-making. From 770 people surveyed, 738 (95.8%) answered the form completely. A trend to trust only in the doctor's knowledge to obtain information (81.7%), in wanting to know the options of treatment and express one's point of view (85.9%), and to involve the family in the decisions (63.2%) was observed. 9.6% preferred to receive the minimum necessary information or "to know nothing" about an alleged serious disease. Males tended less to request options and give opinion on the subject (or: 0.64), giving less freedom to family involvement (or: 1.31). people with a lower social and economical level claim fewer options (or: 0.48) and gave less family participation (or = 1.79). Natives from other South American countries had a minor tendency to demand for options and express their thoughts (or: 0.60); and the ones with lower education level trusted less in the doctor's knowledge (or: 1.81), demanded fewer options (or: 0.45) and chose not to know the severity of the disease (or: 0.56). the analysis of the demographical variables allowed to define preferences associated to age, sex, origin, education, religion and health status. In conclusion, although it is imperative to promote the patient's autonomy, individual preferences must be taken into account before informing and compromising the patient in decision-making about his disease.

[Polymeric hearing protectors in sport shooting].

PubMed

Lwow, Felicja; Szmigiero, Leszek

2007-01-01

Using hearing protectors during exposition to noise is fundamental to hearing loss prevention. The optimal choice of hearing protectors should take into consideration not only the physical characteristics of the acoustic environment which imply the traumatic action of noise, but also some individual preferences of the user. All contemporary produced hearing protectors both earmuffs as well as earplugs are made of synthetic polymers e.g. ABS, polyvinylchloride, polyethylene, polyurethathane, silicone rubbers. The type of the material used determines hardness, incompressibility and plasticity of the hear protector and may cause some discomfort. A special group of individuals exposed to noise are sport shooters in which (whose) case the exposition to impact noise is several times higher above standards. The aim of this work was an appraisal of the individual preferences in the choice of hearing protectors. The properties of polymers used for the production of hearing protectors were also taken into consideration. 104 females and 93 males representing master class were interviewed in this study. The analysis of the answers indicated that abandoning of hearing protectors by some shooters is due to the frequent skin irritations, overheating in the ear canal and allergy. Shooters linked these problems with the materials used for the production of hearing protectors. Earplugs were preferred by females, whereas males indicated earmuffs as their preferred choice. Females preferred earplugs made of soft materials which can be easily fitted to ear canal. Those males who used earplugs preferred protectors made of hard plastics as they thought this make better insulation. It can be concluded that the choice of the hearing protectors should not be done on the basis acoustic signal characteristics only, but also should reduce some discomforts resulting from properties of the materials used for their production.

Context effects and the temporal stability of stated preferences.

PubMed

Liebe, Ulf; Hundeshagen, Cordula; Beyer, Heiko; Cramon-Taubadel, Stephan von

2016-11-01

In stated preference studies it is assumed that individuals' answers reflect true preferences and are stable over time. We test these two assumptions of validity and reliability using as an example a choice experiment study on ethical consumption that measures preferences for a Peace Product jointly produced by Israeli and Palestinian producers as well as for organic products. In a web survey conducted in Germany, we investigate the validity assumption by manipulating the question context and presenting one group of respondents with questions on anti-Semitic and anti-Arabic attitudes before the choice tasks, and presenting another group with these questions after the choice tasks. In order to test the assumption of temporal stability, the same experimental set-up was repeated in a second survey based on a new sample ten months after the first. However, prior to the second survey an external event, a major violent dispute between Israelis and the Palestinians occurred. Overall, we find evidence for a context effect but not for temporal instability. In both surveys, the placement of the attitudinal questions before the choice tasks has a positive effect on the valuation of products from Israel, Palestinian products and the Peace Product (i.e. a directional context effect). The respondents seem to act according to an anti-discrimination norm. In line with this reasoning, we find an attention shift caused by the attitudinal questions. Organic products are valued much less positively if discriminatory attitudes are surveyed before the choice tasks. Furthermore, despite the violent dispute, stated preferences are very stable over time. This indicates high reliability of stated preference studies and encourages the use of study results by private and public decision makers. Copyright © 2016 Elsevier Inc. All rights reserved.

The metaphysics of quantum mechanics: Modal interpretations

NASA Astrophysics Data System (ADS)

Gluck, Stuart Murray

2004-11-01

This dissertation begins with the argument that a preferred way of doing metaphysics is through philosophy of physics. An understanding of quantum physics is vital to answering questions such as: What counts as an individual object in physical ontology? Is the universe fundamentally indeterministic? Are indiscernibles identical? This study explores how the various modal interpretations of quantum mechanics answer these sorts of questions; modal accounts are one of the two classes of interpretations along with so-called collapse accounts. This study suggests a new alternative within the class of modal views that yields a more plausible ontology, one in which the Principle of the Identity of Indisceribles is necessarily true. Next, it shows that modal interpretations can consistently deny that the universe must be fundamentally indeterministic so long as they accept certain other metaphysical commitments: either a perfect initial distribution of states in the universe or some form of primitive dispositional properties. Finally, the study sketches out a future research project for modal interpretations based on developing quantified quantum logic.

Spreading disease: a controversy concerning the metaphysics of disease.

PubMed

D'Amico, R

1998-01-01

This article concerns the metaphysics of disease. Is disease a fixed feature of the world or a social value or preference? I argue that disease is not a value-laden concept and thus debates concerning it differ fundamentally from debates concerning health, harm, or suffering where evaluative judgements are central. I show how the so-called social constructionist view of disease has been motivated both by ethical concerns with medical practices and general theoretical doubts about scientific naturalism. If I can show that ethical concerns about medical treatment can be answered without adopting social constructionism, that leaves only the broader theoretical question of naturalism. I cannot completely answer those theoretical doubts, but I show that the theoretical motivation is less convincing when it is separated from the moral challenge often accompanying it. I conclude that a convincing defense of the non-naturalistic conception of disease is rarely attempted and proves more difficult and counter-intuitive than its proponents assume.

Patients' Priorities Regarding Female-to-Male Gender Affirmation Surgery of the Genitalia-A Pilot Study of 47 Patients in Sweden.

PubMed

Jacobsson, Josephine; Andréasson, My; Kölby, Lars; Elander, Anna; Selvaggi, Gennaro

2017-06-01

No surgical technique is reported to be the best option for gender-affirmation surgery (GAS) of the genitalia in transmen. Although patients' preferences are central when choosing a surgical technique, no studies have evaluated this factor. To investigate transmen's priorities and preferences regarding GAS of the genitalia. From November 2015 to March 2016, 54 transmen with the diagnosis of gender dysphoria who were referred to Sahlgrenska University Hospital for discussion of therapeutic steps (surgery and hormonal treatments) were asked to complete a questionnaire on different attributes achievable with GAS, such as sexual and urinary function and appearance. Forty-seven patients (87%) completed the questionnaire. Age ranged from 18 to 52 years (mean = 26 years, SD = 7.4 years). At the time of interview, no patient had undergone GAS of the genitalia. Answers to completed questionnaires. Seventy-six percent of patients identified themselves as male, and 24% wrote other terms such as "mostly male," "inter-gender" and "non-binary." Gender identity had a significant impact on patients' preferences for two questions: the importance of vaginal removal and the importance of having a penis that would be passable in places such as male dressing rooms. These items were more important to patients identifying themselves as male. The most important attributes requested were preserved orgasm ability and tactile sensation. The least important attribute was removal of the vagina, followed by having a penis of human material, minimal scarring, and size. The ability to urinate while standing was considered a high priority by some and a low priority by others. All answers ranged from "unimportant" to "imperative." This series of patients demonstrates a considerable heterogeneity among transmen in their gender identity and preferences regarding GAS of the genitalia, which supports the need for several techniques. Patients must be accurately informed on the different techniques and their specific benefits and limitations to make an informed choice. Jacobsson J, Andréasson M, Kölby L, et al. Patients' Priorities Regarding Female-to-Male Gender Affirmation Surgery of the Genitalia-A Pilot Study of 47 Patients in Sweden. J Sex Med 2017;14:857-864. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Self-expanding stent for spontaneous coronary artery dissection: a rational choice.

PubMed

Mele, Marco; Langialonga, Tommaso; Maggi, Alessandro; Villella, Massimo; Villella, Alessandro

2016-12-01

: Spontaneous coronary artery dissection (SCAD) is a rare and poorly understood cause of acute coronary syndrome in relatively young patients. Nowadays, the optimal treatment of SCAD is uncertain. A conservative approach seems to be preferable, but in particular conditions, an invasive strategy is necessary. The poor rate of procedural success, the high risk of procedural complications and the uncertain long and mid-term results make the interventional treatment of SCAD a challenge. We report a case of a young male patient presenting with SCAD successfully treated with a sirolimus-eluting self-expanding coronary stent. To our knowledge, the use of self-expanding coronary stent for SCAD has never been described yet and we discuss about the rationale of a possible larger use in clinical practice.

Shared Decision-Making in Youth Mental Health Care: Using the Evidence to Plan Treatments Collaboratively.

PubMed

Langer, David A; Jensen-Doss, Amanda

2016-12-02

The shared decision-making (SDM) model is one in which providers and consumers of health care come together as collaborators in determining the course of care. The model is especially relevant to youth mental health care, when planning a treatment frequently entails coordinating both youth and parent perspectives, preferences, and goals. The present article first provides the historical context of the SDM model and the rationale for increasing our field's use of SDM when planning psychosocial treatments for youth and families. Having established the potential utility of SDM, the article then discusses how to apply the SDM model to treatment planning for youth psychotherapy, proposing a set of steps consistent with the model and considerations when conducting SDM with youth and families.

Shared Decision-Making in Youth Mental Health Care: Using the Evidence to Plan Treatments Collaboratively

PubMed Central

Langer, David A.; Jensen-Doss, Amanda

2017-01-01

The shared decision-making (SDM) model is one in which providers and consumers of health care come together as collaborators in determining the course of care. The model is especially relevant to youth mental health care, when planning a treatment frequently entails coordinating both youth and parent perspectives, preferences, and goals. The present paper first provides the historical context of the SDM model and the rationale for increasing our field's use of SDM when planning psychosocial treatments for youth and families. Having established the potential utility of SDM, the paper then discusses how to apply the SDM model to treatment planning for youth psychotherapy, proposing a set of steps consistent with the model and considerations when conducting SDM with youth and families. PMID:27911081

Modulating Mimetic Preference with Theta Burst Stimulation of the Inferior Parietal Cortex

PubMed Central

Ticini, Luca F.; Urgesi, Cosimo; Kotz, Sonja A.

2017-01-01

We like an object more when we see someone else reaching for it. To what extent is action observation causally linked to object valuation? In this study, we set out to answer to this question by applying continuous theta burst stimulation (cTBS) over the left inferior parietal lobule (IPL). Previous studies pointed to this region as critical in the representation of others' actions and in tool manipulation. However, it is unclear to what extent IPL's involvement simply reflects action observation, rather than a casual role in objects' valuation. To clarify this issue, we measured cTBS-dependent modulations of participants' “mimetic preference ratings”, i.e., the difference between the ratings of pairs of familiar objects that were (vs. were not) reached out for by other individuals. Our result shows that cTBS increased mimetic preference ratings for tools, when compared to a control condition without stimulation. This effect was selective for items that were reached for or manipulated by another individual, whilst it was not detected in non-tool objects. Although preliminary, this finding suggests that the automatic and covert simulation of an observed action, even when there is no intention to act on an object, influences explicit affective judgments for objects. This work supports embodied cognition theories by substantiating that our subjective preference is grounded in action. PMID:29250021

Rural women and osteoporosis: awareness and educational needs.

PubMed

Matthews, Hollie L; Laya, Mary; DeWitt, Dawn E

2006-01-01

Little is known about rural women's knowledge about osteoporosis. To explore what women from high-prevalence rural communities know about osteoporosis and to assess their learning preferences. We surveyed 437 women in rural Washington and Oregon. The response rate was 93% (N = 406). The mean age of respondents was 63 years (range 16-95) and 74% (n = 301) of women were postmenopausal. While 27% over age 40 (n = 111) reported having a fracture as an adult, less than half of this group (42%, n = 47) considered themselves at risk for osteoporosis. Of the 42% (n = 171) who rated their knowledge of osteoporosis good or excellent, only 18% (n = 30) answered calcium and vitamin D questions correctly. About half (53%; n = 214) exercised 3 or more times per week. Reported sources of osteoporosis information included television, magazines, health care providers, and personal contacts. Over half of the women in this study wanted more information about osteoporosis, most wanted it before age 50, and health care providers were a preferred source. Less than half of participants reported having Internet access. While many participants underestimated their osteoporosis risk, most women wanted to learn more about osteoporosis and health care providers remain a preferred source of information.

What consumers don't know about genetically modified food, and how that affects beliefs.

PubMed

McFadden, Brandon R; Lusk, Jayson L

2016-09-01

In the debates surrounding biotechnology and genetically modified (GM) food, data from consumer polls are often presented as evidence for precaution and labeling. But how much do consumers actually know about the issue? New data collected from a nationwide U.S. survey reveal low levels of knowledge and numerous misperceptions about GM food. Nearly equal numbers of consumers prefer mandatory labeling of foods containing DNA as do those preferring mandatory labeling of GM foods. When given the option, the majority of consumers prefer that decisions about GM food be taken out of their hands and be made by experts. After answering a list of questions testing objective knowledge of GM food, subjective, self-reported knowledge declines somewhat, and beliefs about GM food safety increase slightly. Results suggest that consumers think they know more than they actually do about GM food, and queries about GM facts cause respondents to reassess how much they know. The findings question the usefulness of results from opinion polls as a motivation for creating public policy surrounding GM food.-McFadden, B. R., Lusk, J. L. What consumers don't know about genetically modified food, and how that affects beliefs. © FASEB.

Pharmacists' knowledge and interest in developing counseling skills relating to oral contraceptives.

PubMed

Amin, Mohamed E K

2016-04-01

Possessing correct therapeutic information on oral contraceptives is an important prerequisite for the provision of sound advice to women who are using these products. This study examines Egyptian pharmacists' knowledge of pharmacotherapeutic aspects of oral contraceptives as well as interest in developing skills in providing counseling on oral contraceptive pills. Community pharmacies throughout Alexandria, Egypt. A cross-sectional survey was self-administered by a random sample of community pharmacists in Alexandria, Egypt. Five multiple choice questions likely to arise when counseling women on oral contraceptives were constructed. Questions covered compatibility with breastfeeding, precautions, health risks and managing missed pills of oral contraceptives. Using ordered logistic regression, a model was estimated to predict pharmacists' interest in developing skills in providing counseling on oral contraceptives. Pharmacists' aggregate scores for knowledge questions and pharmacists' interest in developing skills in providing counseling on oral contraceptive pills. Of the 181 approached pharmacists, 92 % participated. Twenty one pharmacists (13 %) did not know the correct answer to any question, 122 (73 %) answered one-two correctly, 23 (14 %) answered three-four correctly. No pharmacist answered all five questions correctly. For pharmacists' interest in developing skills in providing counseling on oral contraceptives, the percentage values for answers were: not interested at all (10.2 %), slightly interested (27.0 %), somewhat interested (23.4 %), interested (30.0 %) and extremely interested (9.6 %). Pharmacists' interest in developing skills in providing counseling on oral contraceptives was significantly associated with the number of women who requested advice from the pharmacists on oral contraceptives (OR 1.54, CI 1.24-1.91). In terms of the learning method of preference, percentage values for answers were: attending a workshop (4 %), online course (18 %), publications distributed to pharmacy (44 %), other methods (1 %) and more than one method (23 %). Ten percent were not interested in developing their skills on oral contraceptives. This study identifies considerable gaps among community pharmacists' knowledge of oral contraceptives. It also shows variation in willingness and choice of learning strategies among pharmacists to develop their skills in providing counseling on oral contraceptives.

Rejection thresholds in solid chocolate-flavored compound coating.

PubMed

Harwood, Meriel L; Ziegler, Gregory R; Hayes, John E

2012-10-01

Classical detection thresholds do not predict liking, as they focus on the presence or absence of a sensation. Recently however, Prescott and colleagues described a new method, the rejection threshold, where a series of forced choice preference tasks are used to generate a dose-response function to determine hedonically acceptable concentrations. That is, how much is too much? To date, this approach has been used exclusively in liquid foods. Here, we determined group rejection thresholds in solid chocolate-flavored compound coating for bitterness. The influences of self-identified preferences for milk or dark chocolate, as well as eating style (chewers compared to melters) on rejection thresholds were investigated. Stimuli included milk chocolate-flavored compound coating spiked with increasing amounts of sucrose octaacetate, a bitter and generally recognized as safe additive. Paired preference tests (blank compared to spike) were used to determine the proportion of the group that preferred the blank. Across pairs, spiked samples were presented in ascending concentration. We were able to quantify and compare differences between 2 self-identified market segments. The rejection threshold for the dark chocolate preferring group was significantly higher than the milk chocolate preferring group (P= 0.01). Conversely, eating style did not affect group rejection thresholds (P= 0.14), although this may reflect the amount of chocolate given to participants. Additionally, there was no association between chocolate preference and eating style (P= 0.36). Present work supports the contention that this method can be used to examine preferences within specific market segments and potentially individual differences as they relate to ingestive behavior. This work makes use of the rejection threshold method to study market segmentation, extending its use to solid foods. We believe this method has broad applicability to the sensory specialist and product developer by providing a process to identify how much is too much when formulating products, even in the context of specific market segments. We illustrate this in solid chocolate-flavored compound coating, identifying substantial differences in the amount of acceptable bitterness in those who prefer milk chocolate compared to dark chocolate. This method provides a direct means to answer the question of how much is too much. © 2012 Institute of Food Technologists®

Health Literacy and Preferences for Sources of Child Health Information of Mothers With Infants in the Neonatal Intensive Care Unit.

PubMed

Skeens, Kristen; Logsdon, M Cynthia; Stikes, Reetta; Ryan, Lesa; Sparks, Kathryn; Hayes, Pauline; Myers, John; Davis, Deborah Winders

2016-08-01

Parents of infants hospitalized in the neonatal intensive care unit (NICU) frequently need guidance to prepare them for the care and health promotion of their child after hospital discharge. The health literacy of the parents should be considered so that education can be tailored to meet their needs. It is also important to understand the parents' preferences for how, and from whom, they receive education. The purpose of this study was to identify health literacy levels of parents of infants in an NICU and preferences for who they want to provide them with education. An exploratory, descriptive design was used to assess participant health literacy and preferences for obtaining child health information. Only mothers (no fathers) with babies in the NICU were available to complete the survey. Mean participant age was 26.4 years (SD = 6.7). Participants had a mean Rapid Estimate of Adult Literacy in Medicine, Revised, score of 5.64 (SD = 2.4), indicating a low level of health literacy. Questions regarding when to administer medication were correctly answered by 69% of participants. Proper medication dosage was understood by 92% of participants; however, only 30% were able to correctly convert measurements. One-on-one discussions with a physician were the preferred source of health information for 80% of participants. The current exploratory study provides new information that will help inform the development of future studies and increase awareness of nurses regarding health literacy and the specific types of skills for which parents need the most help.

'Chronophilia': Entries of Erotic Age Preference into Descriptive Psychopathology.

PubMed

Janssen, Diederik F

2015-10-01

A scientific nomenclature of erotic age preferences informed the mid- through late nineteenth century joint appearance of homosexuality and sexual abuse of minors on the medico-legal scene. Yet, even in the twenty-first century, legal, psychiatric and culture-critical dimensions of related terms are rarely cleanly distinguished. Review of primary sources shows the ongoing Western suspension of notions of 'sick desire', alongside and beyond the medicalisation of homosexuality, between metaphor, legal interdiction and postulated psychopathology. Virtually all early attention to erotic age preference occurred in the context of emergent attention to erotic gender preference. Age of attraction and age difference centrally animate modern homosexuality's pre-modern past; its earliest psychiatric nomenclature and typologies (1844-69); its early aetiologies stipulating degrees of sexual differentiation (1890 s); its concomitant sub-classification (1896-1914); its earliest psychophysiological tests (1950s); and, finally, its post-psychiatric, social scientific typologies (1980s). Several identifications of 'paedophilia' were seen throughout the 1890 s but as a trope it gained cultural momentum only during, and as a seemingly intriguing corollary of, the progressive depsychiatricisation of homosexuality across the Anglo-European world (late 1950s through 1980s). Early twentieth century sources varied in having it denote (1) a distinct perversion, thus possible 'complication' of sexual inversion (2) a discrete corollary of psychosexual differentiation akin to gender preference (3) a distinct subtype of fetishism, thus a likely imprint of early seduction (4) a more intricate expression of erotic symbolism or psychosexual complex or (5) a taste answering to culture, a lack of it, or a libertine disregard for it.

Partner notification of sexually transmitted diseases: practices and preferences.

PubMed

Gursahaney, Priya R; Jeong, Kwonho; Dixon, Bruce W; Wiesenfeld, Harold C

2011-09-01

Timely notification and treatment of sex partners exposed to a sexually transmitted disease (STD) is essential to reduce reinfection and transmission. Our objectives were to determine factors associated with patient-initiated notification of sex partners and preferences regarding standard partner referral versus expedited partner therapy (EPT). Participants diagnosed with gonorrhea, chlamydia, trichomoniasis, or nongonococcal urethritis within the previous year were administered a baseline survey asking about demographics, sexual history, and partner treatment preferences (standard partner referral vs. EPT). They identified up to 4 sex partners within the past 2 months, and answered questions on relationship characteristics, quality, and notification self-efficacy. At follow-up, participants with a current STD were asked whether they notified their partners. Generalized estimating equations were used to evaluate the associations between predictor variables and partner notification. Of the 201 subjects enrolled, 157 had a current STD diagnosis, and 289 sex partners were identified. The rate of successful partner notification was 77.3% (157/203 sex partners). Partner notification was increased if the subject had a long-term relationship with a sex partner (odds ratio: 3.07; 95% confidence interval: 1.43, 6.58), considered the partner to be a main partner (odds ratio: 2.53; 95% confidence interval: 1.43, 6.58), or had increased notification self-efficacy. Overall, participants did not prefer EPT over standard referral; however, females, those with higher education levels, and those with a prior STD preferred EPT. Patient-initiated partner referral is more successful in patients with increased self-efficacy who have stronger interpersonal relationships with their sex partners.

Is bad living better than good death? Impact of demographic and cultural factors on health state preference.

PubMed

Jin, Xuejing; Liu, Gordon Guoen; Luo, Nan; Li, Hongchao; Guan, Haijing; Xie, Feng

2016-04-01

The aim of this study was to examine the impact of demographic and cultural factors on health preferences among Chinese general population. The Chinese EQ-5D-5L valuation study was conducted between December 2012 and January 2013. A total of 1296 participants were recruited from the general public at Beijing, Chengdu, Guiyang, Nanjing, and Shenyang. Each participant was interviewed to measure preferences for ten EQ-5D-5L health states using composite time trade-off and seven pairs of states using discrete choice experiment (data were not included in this study). At the end of the interview, each participant was also asked to provide their demographic information and answers to two questions about their attitudes towards whether bad living is better than good death (LBD) and whether they believe in an afterlife. Generalized linear model and random effects logistic models were used to examine the impact of demographic and cultural factors on health preferences. Participants who had serious illness experience received college or higher education, or agree with LBD were more likely to value health states positively and have a narrower score range. Participants at Beijing were more likely to be non-traders, value health states positively, less likely to reach the lowest possible score, and have narrower score range compared with all other four cities after controlling for all other demographic and culture factors. Health state preference is significantly affected by factors beyond demographics. These factors should be considered in achieving a representative sample in valuation studies in China.

Surgeon-authored Virtual Laparoscopic Adrenalectomy Module is Judged Effective and Preferred over Traditional Teaching Tools

PubMed Central

Kurenov, Sergei; Cendan, Juan; Dindar, Sahel; Attwood, Kristopher; Hassett, James; Nawotniak, Ruth; Cherr, Gregory; Cance, William G.; Peters, Jörg

2018-01-01

Objective The study assesses user acceptance and effectiveness of a surgeon-authored virtual reality training module authored by surgeons using the Toolkit for Illustration Procedures in Surgery (TIPS). Methods Laparoscopic adrenalectomy was selected to test the TIPS framework on an unusual and complex procedure. No commercial simulation module exists to teach this procedure. A specialist surgeon authored the module, including force-feedback interactive simulation and designed a quiz to test knowledge of the key procedural steps. Five practicing surgeons with 15 to 24 years of experience peer-reviewed and tested the module. Fourteen residents and nine fellows trained with the module and answered the quiz, pre-use and post-use. Participants received an overview during Surgical Grand Rounds session and a 20-minute one- on-one tutorial followed by a 30 minute of instruction in addition to a force-feedback interactive simulation session. Additionally, in answering questionnaires, the trainees reflected on their learning experience and their experience with the TIPS framework. Results Correct quiz response rates on procedural steps improved significantly post-use over pre-use. In the questionnaire, 96% of the respondents stated that the TIPS module prepares them well or very well for the adrenalectomy, and 87% indicated that the module successfully teaches the steps of the procedure. All subjects indicated that they preferred the module compare to training using purely physical props, one-on-one teaching, medical atlases, and video recordings. Conclusions Improved quiz scores and endorsement by the participants of the TIPS adrenalectomy module establish the viability of surgeons authoring virtual reality training. PMID:27758896

Energy balance related behaviour: personal, home- and friend-related factors among schoolchildren in Europe studied in the ENERGY-project.

PubMed

te Velde, Saskia J; Singh, Amika; Chinapaw, Mai; De Bourdeaudhuij, Ilse; Jan, Natasa; Kovacs, Eva; Bere, Elling; Vik, Froydis N; Bringolf-Isler, Bettina; Manios, Yannis; Moreno, Luis; Brug, Johannes

2014-01-01

To design interventions that target energy balance-related behaviours, knowledge of primary schoolchildren's perceptions regarding soft drink intake, fruit juice intake, breakfast consumption, TV viewing and physical activity (PA) is essential. The current study describes personal beliefs and attitudes, home- and friend-related variables regarding these behaviours across Europe. Cross-sectional study in which personal, family and friend -related variables were assessed by validated questionnaires, and dichotomized as favourable versus unfavourable answers. Logistic regression analyses were conducted to estimate proportions of children giving unfavourable answers and test between-country differences. A survey in eight European countries. A total of 7903 10-12 year old primary schoolchildren. A majority of the children reported unfavourable attitudes, preferences and subjective norms regarding soft drink, fruit juice intake and TV viewing accompanied with high availability and accessibility at home. Few children reported unfavourable attitudes and preferences regarding breakfast consumption and PA. Many children reported unfavourable health beliefs regarding breakfast consumption and TV viewing. Substantial differences between countries were observed, especially for variables regarding soft drink intake, breakfast consumption and TV viewing. The surveyed children demonstrated favourable attitudes to some healthy behaviours (PA, breakfast intake) as well as to some unhealthy behaviours (soft drink consumption, TV viewing). Additionally, many children across Europe have personal beliefs and are exposed to social environments that are not supportive to engagement in healthy behaviours. Moreover, the large differences in personal, family and friend-related variables across Europe argue for implementing different strategies in the different European countries.

Remote transmission of live endoscopy over the Internet: Report from the 87th Congress of the Japan Gastroenterological Endoscopy Society.

PubMed

Shimizu, Shuji; Ohtsuka, Takao; Takahata, Shunichi; Nagai, Eishi; Nakashima, Naoki; Tanaka, Masao

2016-01-01

Live demonstration of endoscopy is one of the most attractive and useful methods for education and is often organized locally in hospitals. However, problems have been apparent in terms of cost, preparation, and potential risks to patients. Our aim was to evaluate a new approach to live endoscopy whereby remote hospitals are connected by the Internet for live endoscopic demonstrations. Live endoscopy was transmitted to the Congress of the Japan Gastroenterological Endoscopic Society by 13 domestic and international hospitals. Patients with upper and lower gastrointestinal diseases and with pancreatobiliary disorders were the subjects of a live demonstration. Questionnaires were distributed to the audience and were sent to the demonstrators. Questions concerned the quality of transmitted images and sound, cost, preparations, programs, preference of style, and adverse events. Of the audience, 91.2% (249/273) answered favorably regarding the transmitted image quality and 93.8% (259/276) regarding the sound quality. All demonstrators answered favorably regarding image quality and 93% (13/14) regarding sound quality. Preparations were completed without any outsourcing at 11 sites (79%) and were evaluated as 'very easy' or 'easy' at all but one site (92.3%). Preparation cost was judged as 'very cheap' or 'cheap' at 12 sites (86%). Live endoscopy connecting multiple international centers was satisfactory in image and sound quality for both audience and demonstrators, with easy and inexpensive preparation. The remote transmission of live endoscopy from demonstrators' own hospitals was preferred to the conventional style of locally organized live endoscopy. © 2015 The Authors Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

Has Their Son Been Vaccinated? Beliefs About Other Parents Matter for Human Papillomavirus Vaccine.

PubMed

Schuler, Christine L; Coyne-Beasley, Tamera

2016-07-01

The goal of this study was to determine if parents' beliefs about social norms of human papillomavirus (HPV) vaccination for sons were associated with knowledge of HPV, intention to vaccinate sons, or beliefs about side effects. A cross-sectional, survey-based study of parents with sons was performed in 2010. Fisher's exact tests were used to examine associations between demographics and responses about social norms. Multivariate logistic regression models examined beliefs about social norms of male HPV vaccination and primary outcomes. Few parents agreed that others were vaccinating sons (n = 31/267, 12%), including 1% responding strongly agree and 11% responding agree. Most parents, 52%, disagreed that others were vaccinating (40% disagree, 11% strongly disagree), and 37% chose prefer not to answer regarding others' vaccination practices. Hispanic parents and those with a high school education or less were significantly more likely to choose prefer not to answer than their respective counterparts regarding vaccination norms. In multivariate models, parents agreeing others were vaccinating sons had greater odds of having high knowledge of HPV (adjusted odds ratio [aOR] high vs low knowledge 3.15, 95% confidence interval [CI] 1.13, 8.77) and increased intention to vaccinate sons (n = 243, aOR = 4.41, 95% CI = 1.51, 12.89). Beliefs about side effects were not significantly associated with beliefs about social norms. Parents' beliefs about others' vaccination practices are important with regard to knowledge of HPV and intention to vaccinate sons. Studying how various public messages about HPV vaccine may influence normative beliefs could be relevant to improving vaccination coverage. © The Author(s) 2015.

Negatively-marked MCQ assessments that reward partial knowledge do not introduce gender bias yet increase student performance and satisfaction and reduce anxiety.

PubMed

Bond, A Elizabeth; Bodger, Owen; Skibinski, David O F; Jones, D Hugh; Restall, Colin J; Dudley, Edward; van Keulen, Geertje

2013-01-01

Multiple-choice question (MCQ) examinations are increasingly used as the assessment method of theoretical knowledge in large class-size modules in many life science degrees. MCQ-tests can be used to objectively measure factual knowledge, ability and high-level learning outcomes, but may also introduce gender bias in performance dependent on topic, instruction, scoring and difficulty. The 'Single Answer' (SA) test is often used in which students choose one correct answer, in which they are unable to demonstrate partial knowledge. Negatively marking eliminates the chance element of guessing but may be considered unfair. Elimination testing (ET) is an alternative form of MCQ, which discriminates between all levels of knowledge, while rewarding demonstration of partial knowledge. Comparisons of performance and gender bias in negatively marked SA and ET tests have not yet been performed in the life sciences. Our results show that life science students were significantly advantaged by answering the MCQ test in elimination format compared to single answer format under negative marking conditions by rewarding partial knowledge of topics. Importantly, we found no significant difference in performance between genders in either cohort for either MCQ test under negative marking conditions. Surveys showed that students generally preferred ET-style MCQ testing over SA-style testing. Students reported feeling more relaxed taking ET MCQ and more stressed when sitting SA tests, while disagreeing with being distracted by thinking about best tactics for scoring high. Students agreed ET testing improved their critical thinking skills. We conclude that appropriately-designed MCQ tests do not systematically discriminate between genders. We recommend careful consideration in choosing the type of MCQ test, and propose to apply negative scoring conditions to each test type to avoid the introduction of gender bias. The student experience could be improved through the incorporation of the elimination answering methods in MCQ tests via rewarding partial and full knowledge.

Integrated city as a model for a new wave urban tourism

NASA Astrophysics Data System (ADS)

Ariani, V.

2018-03-01

Cities are a major player for an urban tourism destination. Massive tourism movement for urban tourism gains competitiveness to the city with similar characteristic. The new framework model for new wave urban tourism is crucial to give more experience to the tourist and valuing for the city itself. The integrated city is the answer for creating a new model for an urban tourism destination. The purpose of this preliminary research is to define integrated city framework for urban tourism development. It provides a rationale for tourism planner pursuing an innovative approach, competitive advantages, and general urban tourism destination model. The methodology applies to this research includes desk survey, literature review and focus group discussion. A conceptual framework is proposed, discussed and exemplified. The framework model adopts a place-based approach to tourism destination and suggests an integrated city model for urban tourism development. This model is a tool for strategy making in re-invention integrated city as an urban tourism destination.

Towards a Quantitative Endogenous Network Theory of Cancer Genesis and Progression: beyond ``cancer as diseases of genome''

NASA Astrophysics Data System (ADS)

Ao, Ping

2011-03-01

There has been a tremendous progress in cancer research. However, it appears the current dominant cancer research framework of regarding cancer as diseases of genome leads impasse. Naturally questions have been asked that whether it is possible to develop alternative frameworks such that they can connect both to mutations and other genetic/genomic effects and to environmental factors. Furthermore, such framework can be made quantitative and with predictions experimentally testable. In this talk, I will present a positive answer to this calling. I will explain on our construction of endogenous network theory based on molecular-cellular agencies as dynamical variable. Such cancer theory explicitly demonstrates a profound connection to many fundamental concepts in physics, as such stochastic non-equilibrium processes, ``energy'' landscape, metastability, etc. It suggests that neneath cancer's daunting complexity may lie a simplicity that gives grounds for hope. The rationales behind such theory, its predictions, and its initial experimental verifications will be presented. Supported by USA NIH and China NSF.

Communication and Decision Making in Cancer Care: Setting Research Priorities for Decision Support/Patients’ Decision Aids

PubMed Central

Barnato, Amber E.; Llewellyn-Thomas, Hilary A.; Peters, Ellen M.; Siminoff, Laura; Collins, E. Dale; Barry, Michael J.

2013-01-01

The following is a summary report from a special symposium, entitled “Translating Research into Practice: Setting a Research Agenda for Clinical Decision Tools in Cancer Prevention, Early Detection, and Treatment”, that was held on October 23, 2005 in San Francisco at the Annual Meeting of the Society for Medical Decision Making (SMDM). The symposium was designed to answer the question: “What are the top two research priorities in the field of patients’ cancer-related decision aids?” After introductory remarks by Dr. Barry, each of four panelists–Drs. Hilary Llewellyn-Thomas, Ellen Peters, Laura Siminoff, and Dale Collins–addressed the question and provided their rationale during prepared remarks. The moderator, Dr. Michael Barry, then facilitated a discussion between the panelists, with input from the audience, to further explore and add to the various proposed research questions. Finally, Dr. Amber Barnato conducted a simple vote count (see Table 1) to prioritize the panelists’ and the audience’s recommendations. PMID:17873249

LAWS (Laser Atmospheric Wind Sounder) earth observing system

NASA Technical Reports Server (NTRS)

1988-01-01

Wind profiles can be measured from space using current technology. These wind profiles are essential for answering many of the interdisciplinary scientific questions to be addressed by EOS, the Earth Observing System. This report provides guidance for the development of a spaceborne wind sounder, the Laser Atmospheric Wind Sounder (LAWS), discussing the current state of the technology and reviewing the scientific rationale for the instrument. Whether obtained globally from the EOS polar platform or in the tropics and subtropics from the Space Station, wind profiles from space will provide essential information for advancing the skill of numerical weather prediction, furthering knowledge of large-scale atmospheric circulation and climate dynamics, and improving understanding of the global biogeochemical and hydrologic cycles. The LAWS Instrument Panel recommends that it be given high priority for new instrument development because of the pressing scientific need and the availability of the necessary technology. LAWS is to measure wind profiles with an accuracy of a few meters per second and to sample at intervals of 100 km horizontally for layers km thick.

The Challenges of First-in-Human Stem Cell Clinical Trials: What Does This Mean for Ethics and Institutional Review Boards?

PubMed

Barker, Roger A; Carpenter, Melissa K; Forbes, Stuart; Goldman, Steven A; Jamieson, Catriona; Murry, Charles E; Takahashi, Jun; Weir, Gordon

2018-05-08

Stem cell-based clinical interventions are increasingly advancing through preclinical testing and approaching clinical trials. The complexity and diversity of these approaches, and the confusion created by unproven and untested stem cell-based "therapies," create a growing need for a more comprehensive review of these early-stage human trials to ensure they place the patients at minimal risk of adverse events but are also based on solid evidence of preclinical efficacy with a clear scientific rationale for that effect. To address this issue and supplement the independent review process, especially that of the ethics and institutional review boards who may not be experts in stem cell biology, the International Society for Stem Cell Research (ISSCR) has developed a set of practical questions to cover the major issues for which clear evidence-based answers need to be obtained before approving a stem cell-based trial. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Back to our future? The Consensus Conference and Combined-Integrated model of doctoral training in professional psychology.

PubMed

Shealy, Craig N; Cobb, Harriet C; Crowley, Susan L; Nelson, Paul; Peterson, Gary

2004-09-01

Is it possible and advisable for the profession of psychology to articulate and endorse a common, generalist, and integrative framework for the education and training of its students? At the Consensus Conference on Combined and Integrated Doctoral Training in Psychology, held at James Madison University in Harrisonburg, VA (USA), May 2 to 4, 2003, participants from across the spectrum of education and training in professional psychology ultimately answered "yes." This article, the first in this special series on the Consensus Conference and Combined-Integrated (C-I) model of doctoral training in professional psychology, essentially provides an overview of the conference rationale, participants, goals, proceedings, and results. Because the other 12 articles in this series all reference the Consensus Conference and C-I model, this overview provides a good starting point for understanding what occurred at the conference, what it means to educate and train from a C-I perspective, and what the potential implications of such a model might be for the profession of psychology.

Diagnostic reasoning by hospital pharmacists: assessment of attitudes, knowledge, and skills.

PubMed

Chernushkin, Kseniya; Loewen, Peter; de Lemos, Jane; Aulakh, Amneet; Jung, Joanne; Dahri, Karen

2012-07-01

Hospital pharmacists participate in activities that may be considered diagnostic. Two reasoning approaches to diagnosis have been described: non-analytic and analytic. Of the 6 analytic traditions, the probabilistic tradition has been shown to improve diagnostic accuracy and reduce unnecessary testing. To the authors' knowledge, pharmacists' attitudes toward having a diagnostic role and their diagnostic knowledge and skills have never been studied. To describe pharmacists' attitudes toward the role of diagnosis in pharmacotherapeutic problem-solving and to characterize the extent of pharmacists' knowledge and skills related to diagnostic literacy. Pharmacists working within Lower Mainland Pharmacy Services (British Columbia) who spent at least 33% of their time in direct patient care were invited to participate in a prospective observational survey. The survey sought information about demographic characteristics and attitudes toward diagnosis. Diagnostic knowledge and skills were tested by means of 3 case scenarios. The analysis included simple descriptive statistics and inferential statistics to evaluate relationships between responses and experience and training. Of 266 pharmacists invited to participate, 94 responded. The attitudes section of the survey was completed by 90 pharmacists; of these, 80 (89%) agreed with the definition of "diagnosis" proposed in the survey, and 83 (92%) agreed that it is important for pharmacists to have diagnosis-related skills. Respondents preferred an analytic to a non-analytic approach to diagnostic decision-making. The probabilistic tradition was not the preferred method in any of the 3 cases. In evaluating 5 clinical scenarios that might require diagnostic skills, on average 84% of respondents agreed that they should be involved in assessing such problems. Respondents' knowledge of and ability to apply probabilistic diagnostic tools were highest for test sensitivity (average of 61% of respondents with the correct answers) and lower for test specificity (average of 48% with correct answers) and likelihood ratios (average of 39% with correct answers). Respondents to this survey strongly believed that diagnostic skills were important for solving drug-related problems, but they demonstrated low levels of knowledge and ability to apply concepts of probabilistic diagnostic reasoning. Opportunities to expand pharmacists' knowledge of diagnostic reasoning exist, and the findings reported here indicate that pharmacists would consider such professional development valuable.

Successful learning of surgical liver anatomy in a computer-based teaching module.

PubMed

Nickel, Felix; Hendrie, Jonathan D; Bruckner, Thomas; Kowalewski, Karl F; Kenngott, Hannes G; Müller-Stich, Beat P; Fischer, Lars

2016-12-01

To analyze factors influencing the learning of surgical liver anatomy in a computer-based teaching module (TM). Medical students in their third to fifth year of training (N [Formula: see text] 410) participated in three randomized trials, each with a different primary hypothesis, comparing two- (2D) and three-dimensional (3D) presentation modes in a TM for surgical liver anatomy. Computed tomography images were presented according to the study and allocation group. Students had to answer eleven questions on surgical liver anatomy and four evaluative questions. Scores and time taken to answer the questions were automatically recorded. Since the three studies used the same 15 questions in the TM, a pooled analysis was performed to compare learning factors across studies. 3D groups had higher scores (7.5 ± 1.7 vs. 5.6 ± 2.0; p < 0.001) and needed less time (503.5 ± 187.4 vs. 603.1 ± 246.7 s; p < 0.001) than 2D groups. Intensive training improved scores in 2D (p < 0.001). Men gave more correct answers than women, independent of presentation mode (7.2 ± 2.0 vs. 6.5 ± 2.1; p [Formula: see text] 0.003). An overall association was found between having fun and higher scores in 11 anatomical questions (p < 0.001). In subgroup analysis, 3D groups had more fun than 2D groups (84.7 vs. 65.1 %; p < 0.001). If given the option, more students in the 2D groups (58.9 %) would have preferred a 3D presentation than students in the 3D group (35.9 %) would have preferred 2D (p  < 0.001). 3D was superior to 2D for learning of surgical liver anatomy. With training 2D showed similar results. Fun and gender were relevant factors for learning success.

Mobile Software as a Medical Device (SaMD) for the Treatment of Epilepsy: Development of Digital Therapeutics Comprising Behavioral and Music-Based Interventions for Neurological Disorders

PubMed Central

Afra, Pegah; Bruggers, Carol S.; Sweney, Matthew; Fagatele, Lilly; Alavi, Fareeha; Greenwald, Michael; Huntsman, Merodean; Nguyen, Khanhly; Jones, Jeremiah K.; Shantz, David; Bulaj, Grzegorz

2018-01-01

Digital health technologies for people with epilepsy (PWE) include internet-based resources and mobile apps for seizure management. Since non-pharmacological interventions, such as listening to specific Mozart's compositions, cognitive therapy, psychosocial and educational interventions were shown to reduce epileptic seizures, these modalities can be integrated into mobile software and delivered by mobile medical apps as digital therapeutics. Herein, we describe: (1) a survey study among PWE about preferences to use mobile software for seizure control, (2) a rationale for developing digital therapies for epilepsy, (3) creation of proof-of-concept mobile software intended for use as an adjunct digital therapeutic to reduce seizures, and (4) broader applications of digital therapeutics for the treatment of epilepsy and other chronic disorders. A questionnaire was used to survey PWE with respect to preferred features in a mobile app for seizure control. Results from the survey suggested that over 90% of responders would be interested in using a mobile app to manage their seizures, while 75% were interested in listening to specific music that can reduce seizures. To define digital therapeutic for the treatment of epilepsy, we designed and created a proof-of-concept mobile software providing digital content intended to reduce seizures. The rationale for all components of such digital therapeutic is described. The resulting web-based app delivered a combination of epilepsy self-care, behavioral interventions, medication reminders and the antiseizure music, such as the Mozart's sonata K.448. To improve long-term patient engagement, integration of mobile medical app with music and multimedia streaming via smartphones, tablets and computers is also discussed. This work aims toward development and regulatory clearance of software as medical device (SaMD) for seizure control, yielding the adjunct digital therapeutic for epilepsy, and subsequently a drug-device combination product together with specific antiseizure medications. Mobile medical apps, music, therapeutic video games and their combinations with prescription medications present new opportunities to integrate pharmacological and non-pharmacological interventions for PWE, as well as those living with other chronic disorders, including depression and pain. PMID:29780310

Mobile Software as a Medical Device (SaMD) for the Treatment of Epilepsy: Development of Digital Therapeutics Comprising Behavioral and Music-Based Interventions for Neurological Disorders.

PubMed

Afra, Pegah; Bruggers, Carol S; Sweney, Matthew; Fagatele, Lilly; Alavi, Fareeha; Greenwald, Michael; Huntsman, Merodean; Nguyen, Khanhly; Jones, Jeremiah K; Shantz, David; Bulaj, Grzegorz

2018-01-01

Digital health technologies for people with epilepsy (PWE) include internet-based resources and mobile apps for seizure management. Since non-pharmacological interventions, such as listening to specific Mozart's compositions, cognitive therapy, psychosocial and educational interventions were shown to reduce epileptic seizures, these modalities can be integrated into mobile software and delivered by mobile medical apps as digital therapeutics. Herein, we describe: (1) a survey study among PWE about preferences to use mobile software for seizure control, (2) a rationale for developing digital therapies for epilepsy, (3) creation of proof-of-concept mobile software intended for use as an adjunct digital therapeutic to reduce seizures, and (4) broader applications of digital therapeutics for the treatment of epilepsy and other chronic disorders. A questionnaire was used to survey PWE with respect to preferred features in a mobile app for seizure control. Results from the survey suggested that over 90% of responders would be interested in using a mobile app to manage their seizures, while 75% were interested in listening to specific music that can reduce seizures. To define digital therapeutic for the treatment of epilepsy, we designed and created a proof-of-concept mobile software providing digital content intended to reduce seizures. The rationale for all components of such digital therapeutic is described. The resulting web-based app delivered a combination of epilepsy self-care, behavioral interventions, medication reminders and the antiseizure music, such as the Mozart's sonata K.448. To improve long-term patient engagement, integration of mobile medical app with music and multimedia streaming via smartphones, tablets and computers is also discussed. This work aims toward development and regulatory clearance of software as medical device (SaMD) for seizure control, yielding the adjunct digital therapeutic for epilepsy, and subsequently a drug-device combination product together with specific antiseizure medications. Mobile medical apps, music, therapeutic video games and their combinations with prescription medications present new opportunities to integrate pharmacological and non-pharmacological interventions for PWE, as well as those living with other chronic disorders, including depression and pain.

Evaluation of quality of life using a tablet PC-based survey in cancer patients treated with radiotherapy: a multi-institutional prospective randomized crossover comparison of paper and tablet PC-based questionnaires (KROG 12-01).

PubMed

Kim, Haeyoung; Park, Hee Chul; Yoon, Sang Min; Kim, Tae Hyun; Kim, Jinsung; Kang, Min Kyu; Jung, Jinhong; Kim, Sang-Won; Yea, Ji Woon; Park, Sung Ho; Park, Young Suk

2016-10-01

This study compared a tablet PC questionnaire with a paper method for reliability and patient preferences in the acquisition of patient-reported outcomes (PROs) for patients treated with radiotherapy. By comparing the two modes of PRO administration, we aimed to evaluate the adequacy of using tablet PC questionnaires in future clinical use. Patients were randomized in a crossover study design using two different methods for PRO entry. A group of 89 patients answered a paper questionnaire followed by the tablet PC version, whereas 89 patients in another group completed the tablet PC questionnaire followed by the paper version. Surveys were performed four times per patient throughout the course of the radiotherapy. The Korean versions of the M.D. Anderson Symptom Inventory (MDASI-K) and the Brief Fatigue Inventory (BFI-K) were used. The primary endpoint of our current study was an assessment of patient preference for the survey method. The proportions of patients preferring each mode of questionnaire were evaluated. The proportion of patients who preferred the tablet PC version, paper form, or who had no preference was 52.2, 22.1, and 25.7 %, respectively. More than half of the patients preferred the tablet PC to the paper version in all four surveys. Age, gender, educational status, prior experience of using a tablet PC, and the order of paper to tablet PC administration did not impact patient preferences. Inter-class correlation coefficients (ICCs) between the modes were 0.92 for MDASI-K and 0.94 for BFI-K and ranged from 0.91 to 0.96 on both instruments during the four surveys. A tablet PC-based PRO is an acceptable and reliable method compared with paper-based data collection for Korean patients receiving radiotherapy.

Effects of licensed characters on children's taste and snack preferences in Guatemala, a low/middle income country.

PubMed

Letona, P; Chacon, V; Roberto, C; Barnoya, J

2014-11-01

Marketing of high-energy, low-nutrient foods is one of the contributing factors to the obesity-promoting environment. Licensed characters are typically used to market these foods to children because they increase brand recognition and sales, and data suggest that they affect the taste and snack preferences of children in high-income countries, but it has not yet been explored in low/middle income countries (LMICs). We sought to examine how licensed characters on food packaging influence children's taste and snack preferences in Guatemala, a LMIC. One hundred twenty-one children (mean ± s.d. age, 7.4 ± 1.9 years) from four (two preschool and two elementary) public schools in Guatemala tasted three food types: potato chips, crackers and carrots. Each was presented in two identical packages, except that one had a licensed character and the other did not. Children tasted the foods (six total) in each package and answered whether they tasted the same or one tasted better. Snack preference was also evaluated. Children were significantly (P<0.001) more likely to prefer the taste of the foods inside the package with the licensed character compared with the one with no character (mean ± s.d., 0.24 ± 0.54). Most (66%) chose the food in the package with the character for a snack. Younger children (P < 0.001) were more likely to prefer the taste of the food inside the package with the character. Licensed characters on food packaging influence Guatemalan children's taste and snack preferences. Given that these characters are typically used to promote high-energy, low-nutrient foods, their influence could contribute toward overconsumption of these foods and consequently increased risk of obesity in Guatemalan children. Therefore, public health advocates, in Guatemala and elsewhere, might explore restricting the use of licensed characters on food packaging as a public health strategy.

Rationales for Commonly "Challenged" Taught Books.

ERIC Educational Resources Information Center

Shugert, Diane P., Ed.; And Others

1983-01-01

Intended for teachers, this focused journal issue contains separate rationales for teaching books that have been challenged as appropriate instructional materials. Following a discussion of the purpose for rationales and suggestions for using them, the journal presents rationales for teaching the following books: "To Kill a Mockingbird,""The Diary…

Career Preparation: An Often Omitted Element of the Advisor-Graduate Student Relationship

NASA Astrophysics Data System (ADS)

McManus, D. A.

2001-05-01

Most graduate research advisors care about the education of their graduate students. However, they often define "graduate education" so narrowly that it consists only of solving a research problem. This narrow definition is consistent with their principal goal as geoscientists, to understand the Earth better, and with the reward system typical of research universities, with its emphasis on research. As a result, most advisors usually well prepare students to be researchers in research universities. Research, however, is only part of a faculty member's duties. Commonly omitted is mentoring in the teaching and service duties of a faculty member. Students interested in teaching, in positions in other academic institutions, or in careers outside of academia may be perceived as questioning the advisors' career values and may not be encouraged in these interests. Graduate students should take an active role in their education. In addition to seeking information on career preparation from the campus career center and teaching center and from books, newsmagazines, newspapers, and seminars, students should also seek mentors who have demonstrated an interest in what the student is interested in: teaching and service, as well as research, or in careers outside academia. These mentors may be the students' committee members, other faculty members, or other professional geoscientists. With a broad base of information and some personal decisions, students will have a rationale for exploring careers. The questions students ask can now be more specific: How do they gain the requisite breadth in knowledge and the beneficial skills, beyond the depth of the research experience, and how do they gain opportunities to practice these skills? In short, how can they experience, and preferably practice, what professional geoscientists do in particular careers? If necessary, graduate students can work together to answer these questions by inviting experts to offer workshops in the department. In addition, change can occur within a department if enough graduate students express a need for this information directly to the graduate school. Selecting a career path is a major life decision, deserving of deliberation though open to serendipity. Graduate students deserve the benefits of all the university's resources in making this decision.

When, why and how foot orthoses (FOs) should be prescribed for children with flexible pes planus: a Delphi survey of podiatrists

PubMed Central

Uden, Hayley; Kumar, Saravana; Banwell, Helen A.

2018-01-01

Background Flexible pes planus (flat feet) in children is a common reason parents and caregivers seek health professionals consult and a frequent reason podiatrists prescribe foot orthoses. Yet no universal agreement exists on the diagnosis of this condition, or when and how foot orthoses should be prescribed. The aim of this study was to garner consensus and agreement among podiatrists on the use of FOs for paediatric flexible pes planus. Methods A three round Delphi consensus survey was undertaken with 15 podiatry experts from Australia, New Zealand and the United Kingdom. Round One gathered consensus on the diagnosis and intervention into paediatric pes planus with specific questions on types of FOs and prescription variables used. Round Two and Three were based on answers from Round One and gathered agreement (rationale for choices) on a five point Likert scale. 70% of respondents had to agree to a statement for it to be accepted as consensus or agreement. Results Consensus and agreement was achieved for 83 statements directing the diagnosis of pes planus (using FPI-6 and/or rearfoot measures), common signs and symptoms (e.g., pain, fatigue, abnormal gait and other functional concerns) that direct when to intervene into paediatric flexible pes planus. Prefabricated orthoses were the preferred intervention where adequate control is gained with their use. When customised orthoses are prescribed, a vertical [heel] cast pour (71.4%) and minimal arch fill (76.9%) are the prescription variables of choice, plus or minus additional variables (i.e., medial heel (Kirby) skive, the use of a University of California Biomechanical Laboratory device or a medial flange) dependent on level of disorder and plane of excessive motion. Conclusions This study identified consensus and agreement on a series of diagnosis methods and interventions for the paediatric flexible pes planus. A clinical protocol was developed from the resultant consensus statements which provides clinicians with a series of evidenced-informed statements to better guide them on when, how and why FOs are used specific to this population. PMID:29682429

Using Simulation for Clinical Practice Hours in Nurse Practitioner Education in The United States: A Systematic Review.

PubMed

Rutherford-Hemming, Tonya; Nye, Carla; Coram, Cathy

2016-02-01

The National Organization for Nurse Practitioner Faculty (NONPF) does not allow simulation to be used in lieu of traditional clinical hours. The NONPF cites a lack of empirical evidence related to learning outcomes with simulation as rationale for its stance. The purpose of this systematic review was to search, extract, appraise, and synthesize research related to the use of simulation in Nurse Practitioner (NP) education in order to answer the two following questions: 1) What research related to simulation in NP education has emerged in the literature between 2010 and April 2015?, and 2) Of the research studies that have emerged, what level of Kirkpatrick's Training Evaluation Model (1994) is evaluated? This review was reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A literature search was completed in PubMed and CINAHL using a combination of medical subject headings, or Mesh terms, as well as keywords to retrieve non-indexed citations. The inclusion criteria for this review were broad in order to disseminate information on future research needed. The review considered studies related to NP education that included any form of simulation intervention, e.g. role-playing and standardized patients. The review considered studies that described original research, but no other design restrictions were imposed. The review was limited to studies published in the English language. The database search strategy yielded 198 citations. These results were narrowed down to 15 studies based on identified inclusion criteria. There is a lack of empirical evidence in the literature to support using simulation in lieu of direct patient care clinical hours in NP education. The evidence in this systematic review affirms NONPF's statement. Five years after the inception of NONPF's position statement, research to support learning outcomes with simulation in nurse practitioner education remains lacking. There is a need to produce rigorous scientific studies in the future in order to provide quantitative support to allow simulation to be counted as clinical hours in NP programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

What determines the preference for future living arrangements of middle-aged and older people in urban China?

PubMed

Meng, Dijuan; Xu, Guihua; He, Ling; Zhang, Min; Lin, Dan

2017-01-01

Living arrangements are important to the elderly. However, it is common for elderly parents in urban China to not have a living situation that they consider ideal. An understanding of their preferences assists us in responding to the needs of the elderly as well as in anticipating future long-term care demands. The aim of this study is to provide a clear understanding of preferences for future living arrangements and their associated factors among middle-aged and older people in urban China. Data were extracted from the CHARLS 2011-2012 national baseline survey of middle-aged and elderly people. In the 2011 wave of the CHARLS, a total of 17,708 individual participants (10,069 main respondents and 7,638 spouses) were interviewed; 2509 of the main respondents lived in urban areas. In this group, 41 people who were younger than 45 years old and 162 who had missing data in the variable "living arrangement preference" were excluded. Additionally, 42 people were excluded because they chose "other" for the variable "living arrangement preference" (which was a choice with no specific answer). Finally, a total of 2264 participants were included in our study. The most popular preference for future living arrangements was living close to their children in the same community/neighborhoods, followed by living with adult children. The degree of community handicapped access, number of surviving children, age, marital status, access to community-based elderly care centers and number of years lived in the same community were significantly associated with the preferences for future living arrangements among the respondents. There is a trend towards preference for living near adult children in urban China. Additionally, age has a positive effect on preference for living close to their children. Considerations should be made in housing design and urban community development plans to fulfill older adults' expectations. In addition, increasing the accessibility of public facilities in the residential area was important to the elderly, especially for those who preferred living in proximity to their children rather than co-residing with their children. We found that more surviving children were associated with a lower likelihood of choosing "institutionalization", and it positively contributed to preference for intergenerational living arrangements in our study. As expected, compared with their married counterparts, people who were separated/divorced/widowed preferred living with adult children rather than living independently. A relatively shorter length of residence in the same community was an important indicator of preference for independent living; this finding might require further research.

Evaluation of five full-text drug databases by pharmacy students, faculty, and librarians: do the groups agree?

PubMed

Kupferberg, Natalie; Jones Hartel, Lynda

2004-01-01

The purpose of this study is to assess the usefulness of five full-text drug databases as evaluated by medical librarians, pharmacy faculty, and pharmacy students at an academic health center. Study findings and recommendations are offered as guidance to librarians responsible for purchasing decisions. Four pharmacy students, four pharmacy faculty members, and four medical librarians answered ten drug information questions using the databases AHFS Drug Information (STAT!Ref); DRUGDEX (Micromedex); eFacts (Drug Facts and Comparisons); Lexi-Drugs Online (Lexi-Comp); and the PDR Electronic Library (Micromedex). Participants noted whether each database contained answers to the questions and evaluated each database on ease of navigation, screen readability, overall satisfaction, and product recommendation. While each study group found that DRUGDEX provided the most direct answers to the ten questions, faculty members gave Lexi-Drugs the highest overall rating. Students favored eFacts. The faculty and students found the PDR least useful. Librarians ranked DRUGDEX the highest and AHFS the lowest. The comments of pharmacy faculty and students show that these groups preferred concise, easy-to-use sources; librarians focused on the comprehensiveness, layout, and supporting references of the databases. This study demonstrates the importance of consulting with primary clientele before purchasing databases. Although there are many online drug databases to consider, present findings offer strong support for eFacts, Lexi-Drugs, and DRUGDEX.

Evaluation of five full-text drug databases by pharmacy students, faculty, and librarians: do the groups agree?

PubMed Central

Kupferberg, Natalie; Hartel, Lynda Jones

2004-01-01

Objectives: The purpose of this study is to assess the usefulness of five full-text drug databases as evaluated by medical librarians, pharmacy faculty, and pharmacy students at an academic health center. Study findings and recommendations are offered as guidance to librarians responsible for purchasing decisions. Methods: Four pharmacy students, four pharmacy faculty members, and four medical librarians answered ten drug information questions using the databases AHFS Drug Information (STAT!Ref); DRUGDEX (Micromedex); eFacts (Drug Facts and Comparisons); Lexi-Drugs Online (Lexi-Comp); and the PDR Electronic Library (Micromedex). Participants noted whether each database contained answers to the questions and evaluated each database on ease of navigation, screen readability, overall satisfaction, and product recommendation. Results: While each study group found that DRUGDEX provided the most direct answers to the ten questions, faculty members gave Lexi-Drugs the highest overall rating. Students favored eFacts. The faculty and students found the PDR least useful. Librarians ranked DRUGDEX the highest and AHFS the lowest. The comments of pharmacy faculty and students show that these groups preferred concise, easy-to-use sources; librarians focused on the comprehensiveness, layout, and supporting references of the databases. Conclusion: This study demonstrates the importance of consulting with primary clientele before purchasing databases. Although there are many online drug databases to consider, present findings offer strong support for eFacts, Lexi-Drugs, and DRUGDEX. PMID:14762464

The Impact of 3-Option Responses to Multiple-Choice Questions on Guessing Strategies and Cut Score Determinations

PubMed Central

ROYAL, KENNETH D.; STOCKDALE, MYRAH R.

2017-01-01

Introduction: Research has asserted MCQ items using three response options (one correct answer with two distractors) is comparable to, and possibly preferable over, traditional MCQ item formats consisting of four response options (e.g., one correct answer with three distractors), or five response options (e.g., one correct answer with four distractors). Some medical educators have also adopted the practice of using 3-option responses on MCQ exams as a response to the difficulty experienced in generating additional plausible distractors. To date, however, little work has explored how 3-option responses might impact validity threats stemming from random guessing strategies, and what impact 3-option responses might have on cut-score determinations, particularly in the context of medical education classroom assessments. The purpose of this work is to further explore these critically important considerations that largely have gone ignored in the medical education literature to this point. Methods: A cumulative binomial distribution formula was used to calculate the probability that an examinee will answer at random a given number of items correctly on any exam (of any length). By way of a demonstration, a variety of scenarios were presented to illustrate how examination length and the number of response options impact examinees’ chances of passing a given examination, and how subsequent cut-score decisions may be impacted by these factors. Results: As a general rule, classroom assessments containing fewer items should utilize traditional 4-option or 5-option responses, whereas assessments of greater length are afforded greater flexibility in potentially utilizing 3-option responses. Conclusions: More research on items with 3-option responses is needed to better understand what value, if any, 3-option responses truly add to classroom assessments, and in what contexts potential benefits might be discernible. PMID:28367465

The Impact of 3-Option Responses to Multiple-Choice Questions on Guessing Strategies and Cut Score Determinations.

PubMed

Royal, Kenneth D; Stockdale, Myrah R

2017-04-01

Research has asserted MCQ items using three response options (one correct answer with two distractors) is comparable to, and possibly preferable over, traditional MCQ item formats consisting of four response options (e.g., one correct answer with three distractors), or five response options (e.g., one correct answer with four distractors). Some medical educators have also adopted the practice of using 3-option responses on MCQ exams as a response to the difficulty experienced in generating additional plausible distractors. To date, however, little work has explored how 3-option responses might impact validity threats stemming from random guessing strategies, and what impact 3-option responses might have on cut-score determinations, particularly in the context of medical education classroom assessments. The purpose of this work is to further explore these critically important considerations that largely have gone ignored in the medical education literature to this point. A cumulative binomial distribution formula was used to calculate the probability that an examinee will answer at random a given number of items correctly on any exam (of any length). By way of a demonstration, a variety of scenarios were presented to illustrate how examination length and the number of response options impact examinees' chances of passing a given examination, and how subsequent cut-score decisions may be impacted by these factors. As a general rule, classroom assessments containing fewer items should utilize traditional 4-option or 5-option responses, whereas assessments of greater length are afforded greater flexibility in potentially utilizing 3-option responses. More research on items with 3-option responses is needed to better understand what value, if any, 3-option responses truly add to classroom assessments, and in what contexts potential benefits might be discernible.

Teaching Economics to Young Adolescents: A Research-Based Rationale.

ERIC Educational Resources Information Center

Davis, James E.

This booklet presents a research-based rationale for teaching economics at the middle/junior high school level in the United States. Chapter 1, "Introduction," describes the project in which the rationale was developed and outlines the remainder of the document. Chapter 2, "Elements of a Rationale for Middle School Economic Education," presents…

The credibility of exposure therapy: Does the theoretical rationale matter?

PubMed

Arch, Joanna J; Twohig, Michael P; Deacon, Brett J; Landy, Lauren N; Bluett, Ellen J

2015-09-01

Little is understood about how the public perceives exposure-based therapy (ET) for treating anxiety and trauma-related disorders or how ET rationales affect treatment credibility. Distinct approaches to framing ET are practiced, including those emphasized in traditional cognitive behavioral therapy, acceptance and commitment therapy, and the more recent inhibitory learning model. However, their relative effect on ET's credibility remains unknown. A final sample of 964 U.S. adults provided baseline views of ET. Participants rated ET treatment credibility following a simple ET definition (pre-rationale) and following randomization to rationale modules addressing ET goals, fear, and cognitive strategies from distinct theoretical perspectives (post-rationale). Baseline ET views, symptoms, and sociodemographic characteristics were examined as putative moderators and predictors. At baseline, the majority had never heard of ET. From pre- to post-rationale, ET treatment credibility significantly increased but the rationales' theoretical perspective had little impact. More negative baseline ET views, specific ethnic/racial minority group status, and lower education moderated or predicted greater increases in treatment credibility following the rationale. ET remains relatively unknown as a treatment for anxiety or trauma, supporting the need for direct-to-consumer marketing. Diverse theory-driven rationales similarly increased ET credibility, particularly among those less likely to use ET. Copyright © 2015 Elsevier Ltd. All rights reserved.

Virtue ethics - an old answer to a new dilemma? Part 1. Problems with contemporary medical ethics.

PubMed

Misselbrook, David

2015-02-01

The commonest practical model used in contemporary medical ethics is Principlism. Yet, while Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges in its attempt to provide a coherent and accepted system of moral analysis. This inevitably challenges the stability of such a consensus statement and makes it vulnerable to attack by competitors such as preference consequentialism. This two-part paper proposes an inclusive version of virtue theory as a more grounded system of moral analysis. © The Royal Society of Medicine.

Virtue ethics – an old answer to a new dilemma? Part 1. Problems with contemporary medical ethics

PubMed Central

2015-01-01

The commonest practical model used in contemporary medical ethics is Principlism. Yet, while Principlism is a widely accepted consensus statement for ethics, the moral theory that underpins it faces serious challenges in its attempt to provide a coherent and accepted system of moral analysis. This inevitably challenges the stability of such a consensus statement and makes it vulnerable to attack by competitors such as preference consequentialism. This two-part paper proposes an inclusive version of virtue theory as a more grounded system of moral analysis. PMID:25721113

Value of audio-enhanced handheld computers over paper surveys with adolescents.

PubMed

Trapl, Erika S; Taylor, H Gerry; Colabianchi, Natalie; Litaker, David; Borawski, Elaine A

2013-01-01

To examine the impact of 3 data collection modes on the number of questions answered, data quality, and student preference. 275 urban seventh-grade students were recruited and randomly assigned to complete a paper survey (SAQ), PDA survey (PDA), or PDA survey with audio (APDA). Students completed a paper debriefing survey. APDA respondents completed significantly more questions compared to SAQ and PDA. PDA and APDA had significantly less missing data than did SAQ. No differences were found for student evaluation. Strong benefits may be gained by the use of APDA for adolescent school-based data collection.

Organic dairy farmers put more emphasis on production traits than conventional farmers.

PubMed

Slagboom, M; Kargo, M; Edwards, D; Sørensen, A C; Thomasen, J R; Hjortø, L

2016-12-01

The overall aim of this research was to characterize the preferences of Danish dairy farmers for improvements in breeding goal traits. The specific aims were (1) to investigate the presence of heterogeneity in farmers' preferences by means of cluster analysis, and (2) to associate these clusters with herd characteristics and production systems (organic or conventional). We established a web-based survey to characterize the preferences of farmers for improvements in 10 traits, by means of pairwise rankings. We also collected a considerable number of herd characteristics. Overall, 106 organic farmers and 290 conventional farmers answered the survey, all with Holstein cows. The most preferred trait improvement was cow fertility, and the least preferred was calving difficulty. By means of cluster analysis, we identified 4 distinct clusters of farmers and named them according to the trait improvements that were most preferred: Health and Fertility, Production and Udder Health, Survival, and Fertility and Production. Some herd characteristics differed between clusters; for example, farmers in the Survival cluster had twice the percentage of dead cows in their herds compared with the other clusters, and farmers that gave the highest ranking to cow and heifer fertility had the lowest conception rate in their herds. This finding suggests that farmers prefer to improve traits that are more problematic in their herd. The proportion of organic and conventional farmers also differed between clusters; we found a higher proportion of organic farmers in the production-based clusters. When we analyzed organic and conventional data separately, we found that organic farmers ranked production traits higher than conventional farmers. The herds of organic farmers had lower milk yields and lower disease incidences, which might explain the high ranking of milk production and the low ranking of disease traits. This study shows that heterogeneity exists in farmers' preferences for improvements in breeding goal traits, that organic and conventional farmers differ in their preferences, and that herd characteristics can be linked to different farmer clusters. The results of this study could be used for the future development of breeding goals in Danish Holstein cows and for the development of customized total merit indices based on farmer preferences. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Current state and challenges in developing oral vaccines.

PubMed

Vela Ramirez, Julia E; Sharpe, Lindsey A; Peppas, Nicholas A

2017-05-15

While vaccination remains the most cost effective strategy for disease prevention, communicable diseases persist as the second leading cause of death worldwide. There is a need to design safe, novel vaccine delivery methods to protect against unaddressed and emerging diseases. Development of vaccines administered orally is preferable to traditional injection-based formulations for numerous reasons including improved safety and compliance, and easier manufacturing and administration. Additionally, the oral route enables stimulation of humoral and cellular immune responses at both systemic and mucosal sites to establish broader and long-lasting protection. However, oral delivery is challenging, requiring formulations to overcome the harsh gastrointestinal (GI) environment and avoid tolerance induction to achieve effective protection. Here we address the rationale for oral vaccines, including key biological and physicochemical considerations for next-generation oral vaccine design. Copyright © 2017 Elsevier B.V. All rights reserved.

The global roadmap for advancing development of vaccines against sexually transmitted infections: Update and next steps.

PubMed

Gottlieb, Sami L; Deal, Carolyn D; Giersing, Birgitte; Rees, Helen; Bolan, Gail; Johnston, Christine; Timms, Peter; Gray-Owen, Scott D; Jerse, Ann E; Cameron, Caroline E; Moorthy, Vasee S; Kiarie, James; Broutet, Nathalie

2016-06-03

In 2014, the World Health Organization, the US National Institutes of Health, and global technical partners published a comprehensive roadmap for development of new vaccines against sexually transmitted infections (STIs). Since its publication, progress has been made in several roadmap activities: obtaining better epidemiologic data to establish the public health rationale for STI vaccines, modeling the theoretical impact of future vaccines, advancing basic science research, defining preferred product characteristics for first-generation vaccines, and encouraging investment in STI vaccine development. This article reviews these overarching roadmap activities, provides updates on research and development of individual vaccines against herpes simplex virus, Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum, and discusses important next steps to advance the global roadmap for STI vaccine development. Copyright © 2016 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

How to make deposition of images a reality

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

Guss, J. Mitchell, E-mail: mitchell.guss@sydney.edu.au; McMahon, Brian; School of Molecular Bioscience, The University of Sydney, Sydney, NSW 2006

2014-10-01

An analysis is performed of the technical and financial challenges to be overcome if deposition of primary experimental data is to become routine. The IUCr Diffraction Data Deposition Working Group is investigating the rationale and policies for routine deposition of diffraction images (and other primary experimental data sets). An information-management framework is described that should inform policy directions, and some of the technical and other issues that need to be addressed in an effort to achieve such a goal are analysed. In the near future, routine data deposition could be encouraged at one of the growing number of institutional repositoriesmore » that accept data sets or at a generic data-publishing web repository service. To realise all of the potential benefits of depositing diffraction data, specialized archives would be preferable. Funding such an initiative will be challenging.« less

Real and virtual robotics in mathematics education at the school-university transition

NASA Astrophysics Data System (ADS)

Samuels, Peter; Haapasalo, Lenni

2012-04-01

LOGO and turtle graphics were an influential movement in primary school mathematics education in the 1980s and 1990s. Since then, technology has moved forward, both in terms of its sophistication and pedagogical potential; and learner experiences, preferences and ways of thinking have changed dramatically. Based on the authors' previous work and a literature review, this article revisits the subject of enhancing mathematics education through educational robotics kits and virtual robotic animations by proposing their simultaneous deployment at the school-university transition. The rationale for such an application is argued and an evaluation framework for these technologies is proposed. Two educational robotic kits and a virtual environment supporting robotic animations are evaluated both in terms of their feasibility of deployment and their educational effectiveness. Finally, the evaluation of learning experiences when deploying the proposed pedagogical approach is discussed.

Priority setting in the Austrian healthcare system: results from a discrete choice experiment and implications for mental health.

PubMed

Mentzakis, Emmanouil; Paolucci, Francesco; Rubicko, Georg

2014-06-01

The impact of mental conditions is expected to be among the highest ranked causes of illness in high income countries by 2020. With changing health needs, policy makers have to make choices in an environment with increasingly constrained resources and competing demands. Discrete choice experiments have been identified as a useful approach to inform and support decision-making in health care systems and, in particular, its rationing. Policymakers, researchers and health practitioners from Austria participated in an experiment designed to elicit preferences for efficiency and equity in a generic priority setting framework. Using aggregate criteria an empirical measure of the efficiency/equity trade-off is calculated and a selection of health care interventions, including mental health, are ranked in composite league tables (CLTs). With the exception of severity of the condition, all equity parameters decrease attractiveness of an intervention, whereas the opposite holds for all three efficiency criteria. The efficiency/equity ratio (i.e. decision-makers' preference for efficiency over equity) is 3.5 and 5 for interventions targeted at younger and middle age populations, respectively, while for older populations this ratio is negative implying a rejection of all equity criteria. Irrespective of such differences interventions targeting mental health rank highly on all CLTs. Based on system-wide generic decision making criteria, mental health is shown to be a top priority for Austria. Preference-based approaches might offer complementary information to policymakers in priority setting decisions and a useful tool to support rationale rather than ad hoc decision-making.

HIV testing of pregnant women: an ethical analysis.

PubMed

Johansson, Kjell Arne; Pedersen, Kirsten Bjerkreim; Andersson, Anna-Karin

2011-12-01

Recent global advances in available technology to prevent mother-to-child HIV transmission necessitate a rethinking of contemporary and previous ethical debates on HIV testing as a means to preventing vertical transmission. In this paper, we will provide an ethical analysis of HIV-testing strategies of pregnant women. First, we argue that provider-initiated opt-out HIV testing seems to be the most effective HIV test strategy. The flip-side of an opt-out strategy is that it may end up as involuntary testing in a clinical setting. We analyse this ethical puzzle from a novel perspective, taking into account the moral importance of certain hypothetical preferences of the child, as well as the moral importance of certain actual preferences of the mother. Finally, we balance the conflicting concerns and try to arrive at an ethically sound solution to this dilemma. Our aim is to introduce a novel perspective from which to analyse testing strategies, and to explore the implications and possible benefits of our proposal. The conclusion from our analysis is that policies that recommend provider-initiated opt-out HIV testing of pregnant mothers, with a risk of becoming involuntary testing in a clinical setting, are acceptable. The rationale behind this is that the increased availability of very effective and inexpensive life-saving drugs makes the ethical problems raised by the possible intrusiveness of HIV testing less important than the child's hypothetical preferences to be born healthy. Health care providers, therefore, have a duty to offer both opt-out HIV testing and available PMTCT (preventing mother-to-child transmission) interventions. © 2011 Blackwell Publishing Ltd.

Combined use of calcium-channel and beta-adrenergic blockers for the treatment of chronic stable angina. Rationale, efficacy, and adverse effects.

PubMed

Strauss, W E; Parisi, A F

1988-10-01

During the past decade, the therapy for stable angina pectoris has greatly expanded with the introduction of the calcium-channel blockers. Initially studied as monotherapy, these agents have been regularly used in combination with other antianginal medications, most notably the beta-adrenergic blockers. Although there are pharmacologic rationales for combining these agents, in daily practice, the major impetus for combination therapy is continuing angina during monotherapy. At least one well-conducted double-blind study was done to confirm that diltiazem, verapamil, and nifedipine each can markedly improve both subjective and objective measures of efficacy when used in combination with a beta-blocker. However, individual patient responses are of chief importance. Many persons do better with monotherapy than with combination treatment. The offsetting hemodynamic effects of nifedipine and a beta-blocker generally work well together; however, minor side effects are not infrequent. In the patient with underlying conduction system disease, this combination is clearly preferable. Diltiazem with a beta-blocker is usually well-tolerated, with a low incidence of adverse effects, similar to the experience with diltiazem monotherapy. Verapamil in conjunction with a beta-blocker warrants the greatest concern; approximately 10% to 15% of patients will have significant bradycardia, heart block, hypotension, or congestive failure. When these agents are used concurrently, reduced dosages, especially of the beta-blocker, will likely result in a lower incidence of adverse effects with maintained efficacy.

Effects of Providing a Rationale for Learning a Lesson on Students' Motivation and Learning in Online Learning Environments

ERIC Educational Resources Information Center

Shin, Tae Seob

2010-01-01

This study examined whether providing a rationale for learning a particular lesson influences students' motivation and learning in online learning environments. A mixed-method design was used to investigate the effects of two types of rationales (former student vs. instructor rationales) presented in an online introductory educational psychology…

Why Do Higher Education Institutions Internationalize? An Investigation of the Multilevel Determinants of Internationalization Rationales

ERIC Educational Resources Information Center

Seeber, Marco; Cattaneo, Mattia; Huisman, Jeroen; Paleari, Stefano

2016-01-01

In recent decades internationalization has risen to prominence in higher education institutions (HEIs). Scholars have identified several rationales for internationalization. There is however a lack of conceptual understanding and empirical evidence for which rationale(s) for internationalization are chosen by a given HEI and why. The goal of this…

Practices and preferences: Exploring the relationships between food-related parenting practices and child food preferences for high fat and/or sugar foods, fruits, and vegetables.

PubMed

Vollmer, Rachel L; Baietto, Jamey

2017-06-01

The purpose of this study was to determine the relationship between food-related parenting practices and child fruit, vegetable, and high fat/sugar food preferences. Parents (n = 148) of children (3-7 years old) completed the Comprehensive Feeding Practices Questionnaire (CFPQ), the Preschool Adapted Food Liking Scale (PALS), and answered demographic questions. Separate linear regressions were conducted to test relationships between the different food categories on PALS (fruits, vegetables, and high fat/sugar foods) and each food-related parenting practice using race, ethnicity, and income level, and child age and gender as covariates. It was found that when a parent allows a child to control eating, it was negatively associated with a child's preference for fruit (β = -0.15, p = 0.032) and parent encouragement of child involvement in meal preparation was positively related to child preference for vegetables (β = 0.14, p = 0.048). Children preferred high fat and sugar foods more if parents used food to regulate child emotions (β = 0.24, p = 0.007), used food as a reward (β = 0.32, p < 0.001), pressured the child to eat more food (β = 0.16, p = 0.045), and restricted unhealthy food (β = 0.20, p = 0.024). Conversely, children preferred high fat and sugar foods less if parents made healthy food available in the home (β = -0.13, p = 0.05), modeled healthy eating in front of the child (β = -0.21, p = 0.021), and if parents explained why healthy foods should be consumed (β = -0.24, p = 0.011). Although it cannot be determined if the parent is influencing the child or vice versa, this study provides some evidence that coercive feeding practices are detrimental to a child's food preferences. Copyright © 2017 Elsevier Ltd. All rights reserved.

An online survey of chiropractors' opinions of continuing education

PubMed Central

Stuber, Kent J; Grod, Jaroslaw P; Smith, Dean L; Powers, Paul

2005-01-01

Background Continuing Education (CE) for chiropractors is mandatory for licensure in most North American jurisdictions. Numerous chiropractic colleges have begun collaborating with universities to offer master's degree programs. Distance education master's degree programs may be desirable to allow full-time practicing doctors to further their post-graduate education. The present survey sought to answer three questions. First, what is the level of satisfaction of chiropractors with their continuing education? Second, what is the level of interest of chiropractors in online master's degree programs? Lastly, what is the response rate of chiropractors to an online survey? Methods An online survey consisting of 22 multiple choice questions was e-mailed to 1000 chiropractors randomly selected from the mailing list of an online chiropractic newsletter. Upon completion of the questionnaire, participants' answers were saved on a secure site. Data analysis included evaluation of the demographic characteristics of the respondents, their opinions of and patterns of taking CE including online education, preferred learning formats, and their interest in proposed online master's degree programs. A survey response rate was determined. Results Nearly 86% of respondents felt their previously completed CE courses were either somewhat or extremely satisfactory. Over ninety percent of respondents who had completed online or distance CE coursesfound them to be somewhat or extremelysatisfactory. Almost half the respondents indicated that they most preferred online distance learning, while 34.08% most preferred face-to-face interaction. Fifty-three percent of respondents indicated an interest in starting a master's degree program; however 70.46% of respondents were interested in an online master's degree program that would offer CE credit. A response rate of 35.8% was obtained. Conclusion Satisfaction among chiropractors with CE programs is high. The notion of completing a part-time online master's degree (or online combined with face-to-face interaction) appears to be popular among respondents, with a M.Sc. in Chiropractic Sciences being the most popular of those mentioned. Online surveys are a viable method of obtaining opinion in a cost and time efficient manner; there are some sources of bias involved in this type of research, and numerous steps need to be taken to obtain a suitable response rate. PMID:16242035

Use of diabetes data management software reports by health care providers, patients with diabetes, and caregivers improves accuracy and efficiency of data analysis and interpretation compared with traditional logbook data: first results of the Accu-Chek Connect Reports Utility and Efficiency Study (ACCRUES).

PubMed

Hinnen, Deborah A; Buskirk, Ann; Lyden, Maureen; Amstutz, Linda; Hunter, Tracy; Parkin, Christopher G; Wagner, Robin

2015-03-01

We assessed users' proficiency and efficiency in identifying and interpreting self-monitored blood glucose (SMBG), insulin, and carbohydrate intake data using data management software reports compared with standard logbooks. This prospective, self-controlled, randomized study enrolled insulin-treated patients with diabetes (PWDs) (continuous subcutaneous insulin infusion [CSII] and multiple daily insulin injection [MDI] therapy), patient caregivers [CGVs]) and health care providers (HCPs) who were naïve to diabetes data management computer software. Six paired clinical cases (3 CSII, 3 MDI) and associated multiple-choice questions/answers were reviewed by diabetes specialists and presented to participants via a web portal in both software report (SR) and traditional logbook (TL) formats. Participant response time and accuracy were documented and assessed. Participants completed a preference questionnaire at study completion. All participants (54 PWDs, 24 CGVs, 33 HCPs) completed the cases. Participants achieved greater accuracy (assessed by percentage of accurate answers) using the SR versus TL formats: PWDs, 80.3 (13.2)% versus 63.7 (15.0)%, P < .0001; CGVs, 84.6 (8.9)% versus 63.6 (14.4)%, P < .0001; HCPs, 89.5 (8.0)% versus 66.4 (12.3)%, P < .0001. Participants spent less time (minutes) with each case using the SR versus TL formats: PWDs, 8.6 (4.3) versus 19.9 (12.2), P < .0001; CGVs, 7.0 (3.5) versus 15.5 (11.8), P = .0005; HCPs, 6.7 (2.9) versus 16.0 (12.0), P < .0001. The majority of participants preferred using the software reports versus logbook data. Use of the Accu-Chek Connect Online software reports enabled PWDs, CGVs, and HCPs, naïve to diabetes data management software, to identify and utilize key diabetes information with significantly greater accuracy and efficiency compared with traditional logbook information. Use of SRs was preferred over logbooks. © 2014 Diabetes Technology Society.

When does "economic man" dominate social behavior?

PubMed

Camerer, Colin F; Fehr, Ernst

2006-01-06

The canonical model in economics considers people to be rational and self-regarding. However, much evidence challenges this view, raising the question of when "Economic Man" dominates the outcome of social interactions, and when bounded rationality or other-regarding preferences dominate. Here we show that strategic incentives are the key to answering this question. A minority of self-regarding individuals can trigger a "noncooperative" aggregate outcome if their behavior generates incentives for the majority of other-regarding individuals to mimic the minority's behavior. Likewise, a minority of other-regarding individuals can generate a "cooperative" aggregate outcome if their behavior generates incentives for a majority of self-regarding people to behave cooperatively. Similarly, in strategic games, aggregate outcomes can be either far from or close to Nash equilibrium if players with high degrees of strategic thinking mimic or erase the effects of others who do very little strategic thinking. Recently developed theories of other-regarding preferences and bounded rationality explain these findings and provide better predictions of actual aggregate behavior than does traditional economic theory.

Pet Food Palatability Evaluation: A Review of Standard Assay Techniques and Interpretation of Results with a Primary Focus on Limitations

PubMed Central

Aldrich, Gregory C.; Koppel, Kadri

2015-01-01

Simple Summary Palatability of pet foods is typically measured using a single-bowl or a two-bowl test. While these tests give a general understanding of the liking or preference of one food over another, opportunities exist for further method development. Abstract The pet food industry continues to grow steadily as a result of new innovative products. Quality control and product development tests for pet foods are typically conducted through palatability testing with dogs and cats. Palatability is the measure of intake of a food that indicates acceptance or the measure of preference of one food over another. Pet food palatability is most commonly measured using a single-bowl or a two-bowl assay. While these tests answer some questions about the animals’ perception of the food, there are many limitations as well. This review addresses some of these limitations and indicates opportunities for future research. PMID:26479136

The utilization of poisons information resources in Australasia.

PubMed

Fountain, J S; Reith, D M; Holt, A

2014-02-01

To identify poisons information resources most commonly utilized by Australasian Emergency Department staff, and examine attitudes regarding the benefits and user experience of the electronic products used. A survey tool was mailed to six Emergency Departments each in New Zealand and Australia to be answered by medical and nursing staff. Eighty six (71.7%) responses were received from the 120 survey forms sent: 70 (81%) responders were medical staff, the remainder nursing. Electronic resources were the most accessed poisons information resource in New Zealand; Australians preferring discussion with a colleague; Poisons Information Centers were the least utilized resource in both countries. With regard to electronic resources, further differences were recognized between countries in: ease of access, ease of use, quality of information and quantity of information, with New Zealand better in all four themes. New Zealand ED staff favored electronic poisons information resources while Australians preferred discussion with a colleague. That Poisons Information Centers were the least utilized resource was surprising. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Medical students' preferences in radiology education a comparison between the Socratic and didactic methods utilizing powerpoint features in radiology education.

PubMed

Zou, Lily; King, Alexander; Soman, Salil; Lischuk, Andrew; Schneider, Benjamin; Walor, David; Bramwit, Mark; Amorosa, Judith K

2011-02-01

The Socratic method has long been a traditional teaching method in medicine and law. It is currently accepted as the standard of teaching in clinical wards, while the didactic teaching method is widely used during the first 2 years of medical school. There are arguments in support of both styles of teaching. After attending a radiology conference demonstrating different teaching methods, third-year and fourth-year medical students were invited to participate in an online anonymous survey. Of the 74 students who responded, 72% preferred to learn radiology in an active context. They preferred being given adequate time to find abnormalities on images, with feedback afterward from instructors, and they thought the best approach was a volunteer-based system of answering questions using the Socratic method in the small group. They desired to be asked questions in a way that was constructive and not belittling, to realize their knowledge deficits and to have daily pressure to come prepared. The respondents thought that pimping was an effective teaching tool, supporting previous studies. When teaching radiology, instructors should use the Socratic method to a greater extent. Combining Socratic teaching with gentle questioning by an instructor through the use of PowerPoint is a preferred method among medical students. This information is useful to improve medical education in the future, especially in radiology education. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Breaking bad news-what patients want and what they get: evaluating the SPIKES protocol in Germany.

PubMed

Seifart, C; Hofmann, M; Bär, T; Riera Knorrenschild, J; Seifart, U; Rief, W

2014-03-01

Evaluation of the SPIKES protocol, a recommended guideline for breaking bad news, is sparse, and information about patients' preferences for bad-news delivery in Germany is lacking. Being the first actual-theoretical comparison of a 'breaking bad news' guideline, the present study evaluates the recommended steps of the SPIKES protocol. Moreover, emotional consequences and quality of bad-news delivery are investigated. A total of 350 cancer patients answered the MABBAN (Marburg Breaking Bad News Scale), a questionnaire representing the six SPIKES subscales, asking for the procedure, perception and satisfaction of the first cancer disclosure and patient's assign to these items. Only 46.2% of the asked cancer patients are completely satisfied with how bad news had been broken to them. The overall quality is significantly related to the emotional state after receiving bad news (r = -0.261, P < 0.001). Patients' preferences differ highly significantly from the way bad news were delivered, and the resulting rang list of patients' preferences indicates that the SPIKES protocol do not fully meet the priorities of cancer patients in Germany. It could be postulated that the low satisfaction of patients observed in this study reflects the highly significant difference between patients' preferences and bad-news delivery. Therefore, some adjunctions to the SPIKES protocol should be considered, including a frequent reassurance of listeners' understanding, the perpetual possibility to ask question, respect for prearrangement needs and the conception of bad-news delivery in a two-step procedure.

Analysis of consumers' preferences and behavior with regard to horse meat using a structured survey questionnaire.

PubMed

Oh, Woon Yong; Lee, Ji Woong; Lee, Chong Eon; Ko, Moon Seok; Jeong, Jae Hong

2009-12-01

In this study, a structured survey questionnaire was used to determine consumers' preferences and behavior with regard to horse meat at a horse meat restaurant located in Jeju, Korea, from October 1 to December 24, 2005. The questionnaire employed in this study consisted of 20 questions designed to characterize six general attributes: horse meat sensory property, physical appearance, health condition, origin, price, and other attributes. Of the 1370 questionnaires distributed, 1126 completed questionnaires were retained based on the completeness of the answers, representing an 82.2% response rate. Two issues were investigated that might facilitate the search for ways to improve horse meat production and marketing programs in Korea. The first step was to determine certain important factors, called principal components, which enabled the researchers to understand the needs of horse meat consumers via principal component analysis. The second step was to define consumer segments with regard to their preferences for horse meat, which was accomplished via cluster analysis. The results of the current study showed that health condition, price, origin, and leanness were the most critical physical attributes affecting the preferences of horse meat consumers. Four segments of consumers, with different demands for horse meat attributes, were identified: origin-sensitive consumers, price-sensitive consumers, quality and safety-sensitive consumers, and non-specific consumers. Significant differences existed among segments of consumers in terms of age, nature of work, frequency of consumption, and general level of acceptability of horse meat.

What lies behind crop decisions?Coming to terms with revealing farmers' preferences

NASA Astrophysics Data System (ADS)

Gomez, C.; Gutierrez, C.; Pulido-Velazquez, M.; López Nicolás, A.

2016-12-01

The paper offers a fully-fledged applied revealed preference methodology to screen and represent farmers' choices as the solution of an optimal program involving trade-offs among the alternative welfare outcomes of crop decisions such as profits, income security and management easiness. The recursive two-stage method is proposed as an alternative to cope with the methodological problems inherent to common practice positive mathematical program methodologies (PMP). Differently from PMP, in the model proposed in this paper, the non-linear costs that are required for both calibration and smooth adjustment are not at odds with the assumptions of linear Leontief technologies and fixed crop prices and input costs. The method frees the model from ad-hoc assumptions about costs and then recovers the potential of economic analysis as a means to understand the rationale behind observed and forecasted farmers' decisions and then to enhance the potential of the model to support policy making in relevant domains such as agricultural policy, water management, risk management and climate change adaptation. After the introduction, where the methodological drawbacks and challenges are set up, section two presents the theoretical model, section three develops its empirical application and presents its implementation to a Spanish irrigation district and finally section four concludes and makes suggestions for further research.

Barriers, facilitators and preferences for the physical activity of school children. Rationale and methods of a mixed study

PubMed Central

2012-01-01

Background Physical activity interventions in schools environment seem to have shown some effectiveness in the control of the current obesity epidemic in children. However the complexity of behaviors and the diversity of influences related to this problem suggest that we urgently need new lines of insight about how to support comprehensive population strategies of intervention. The aim of this study was to know the perceptions of the children from Cuenca, about their environmental barriers, facilitators and preferences for physical activity. Methods/Design We used a mixed-method design by combining two qualitative methods (analysis of individual drawings and focus groups) together with the quantitative measurement of physical activity through accelerometers, in a theoretical sample of 121 children aged 9 and 11 years of schools in the province of Cuenca, Spain. Conclusions Mixed-method study is an appropriate strategy to know the perceptions of children about barriers and facilitators for physical activity, using both qualitative methods for a deeply understanding of their points of view, and quantitative methods for triangulate the discourse of participants with empirical data. We consider that this is an innovative approach that could provide knowledges for the development of more effective interventions to prevent childhood overweight. PMID:22978490

Clay modeling versus written modules as effective interventions in understanding human anatomy.

PubMed

Bareither, Mary Lou; Arbel, Vered; Growe, Meghan; Muszczynski, Emily; Rudd, Adam; Marone, Jane R

2013-01-01

The effectiveness of clay modeling to written modules is examined to determine the degree of improvement in learning and retention of anatomical 3D relationships among students with different learning preferences. Thirty-nine undergraduate students enrolled in a cadaver dissection course completed a pre-assessment examination and the VARK questionnaire, classifying learning preference as visual, auditory, read/write, or kinesthetic. Students were divided into clay, module, and control groups with preference for learning style distributed among groups. The clay and module groups participated in weekly one-hour classes using either clay models or answering written questions (modules) about anatomical relationships, respectively. The control group received no intervention. Post-assessment and retention examinations were administered at the end of the semester, and three months later, respectively. Two variables (Δ1, Δ2) represented examination score differences between pre- and post-assessment and between post-assessment and retention examinations, respectively. The Δ1 for clay and module groups were each significantly higher than controls (21.46 ± 8.2 vs. 15.70 ± 7.5, P ≤ 0.05; and 21.31 ± 6.9 vs. 15.70 ± 7.5, P ≤0.05, respectively). The Δ2 for clay and module groups approached but did not achieve significance over controls (-6.09 ± 5.07 vs. -8.80 ± 4.60, P = 0.16 and -5.73 ± 4.47 vs. -8.80 ± 4.60, P = 0.12, respectively). No significant differences were seen between interventions or learning preferences in any group. However, students of some learning styles tended to perform better when engaging in certain modalities. Multiple teaching modalities may accommodate learning preferences and improve understanding of anatomy. Copyright © 2012 American Association of Anatomists.

Emergency preparedness training preferences and perceived barriers to training among various healthcare providers and public health practitioners in Massachusetts.

PubMed

Broach, John; Smith, Mary-Elise

2017-01-01

Emergency preparedness training is vital to a wide range of healthcare and public health disciplines. Although agencies may try to tailor their training efforts based on perceived need, the topics and methods of instruction may be misguided, resulting in wasted effort and poor participation in training events. The objective of this study was to understand in a rigorous way, the training preferences and barriers to training among practitioners in Massachusetts. In August 2013, the Massachusetts Department of Public Health distributed an online survey to health professionals in Massachusetts regarding their emergency preparedness training topic preferences and any perceived barriers and challenges associated with obtaining this training. A total of 796 healthcare and public health professionals responded to the survey and answered some or all of the questions asked. The results of the survey identified important differences in preference for some topics based on a provider's practice location and discipline. However, Community Recovery and Community Preparedness were seen as desirable by all disciplines with more than 80 percent of respondents rating each of these issues as being highly important. Barriers to training were also assessed. Time spent away from work was the most commonly identified barrier (77.41 percent). Travel distance and financial constraints were also rated highly with scores of 65.48 and 63.71 percent, respectively. This study demonstrates important areas of agreement with respect to desired training topics and points out areas where providers in different disciplines and from different geographic areas may have differing educational preferences. Even within the limitation of this investigation, we expect that this study will be a valuable tool for those attempting to effectively target emergency preparedness training and structure course offerings in ways that minimize the impact of barriers to training.

Man versus machine: the preferred modality.

PubMed

Sanko, Jill; Shekhter, Ilya; Rosen, Lisa; Arheart, Kristopher; Birnbach, David

2012-12-01

When learning objectives do not specifically dictate the use of one simulation modality over another, we sought to answer the question of which modality is preferred. We also assessed the impact of debriefing, and the frequency of participants asserting their leadership, as well as self-reported comfort and competence, and the ability to generate differential diagnoses when either a standardised patient (SP) or high-technology simulator (HTS) was used. One hundred and forty medical students participated in a simulation-based activity focusing on teamwork, task delegation, role clarity and effective communication. Two similar clinical scenarios were presented, and either an HTS or an SP was used. Following each scenario, participants were surveyed on the realism of the simulation and the patient, and also on their self-assessed comfort and competence. They were also asked to indicate which role they played, to list possible differential diagnoses for the case and, following the second scenario, which modality they preferred. The surveys indicated that 91 per cent (127) of students preferred the SP. The perceived realism of the simulation was higher for the second scenario than for the first. Scenarios with an SP were found to be significantly more realistic than the scenarios where the HTS was used. Comfort and competence scores were higher following the second scenario. No differences in the ability of participants to generate a list of differentials were found, and nearly twice as many participants reported taking the leadership role during their second simulation. We have found low and high technology to have similar effectiveness for achieving learning objectives and for the demonstration of skills; however, students clearly preferred the SPs. © Blackwell Publishing Ltd 2012.

‘Chronophilia’: Entries of Erotic Age Preference into Descriptive Psychopathology

PubMed Central

Janssen, Diederik F.

2015-01-01

A scientific nomenclature of erotic age preferences informed the mid- through late nineteenth century joint appearance of homosexuality and sexual abuse of minors on the medico-legal scene. Yet, even in the twenty-first century, legal, psychiatric and culture-critical dimensions of related terms are rarely cleanly distinguished. Review of primary sources shows the ongoing Western suspension of notions of ‘sick desire’, alongside and beyond the medicalisation of homosexuality, between metaphor, legal interdiction and postulated psychopathology. Virtually all early attention to erotic age preference occurred in the context of emergent attention to erotic gender preference. Age of attraction and age difference centrally animate modern homosexuality’s pre-modern past; its earliest psychiatric nomenclature and typologies (1844–69); its early aetiologies stipulating degrees of sexual differentiation (1890s); its concomitant sub-classification (1896–1914); its earliest psychophysiological tests (1950s); and, finally, its post-psychiatric, social scientific typologies (1980s). Several identifications of ‘paedophilia’ were seen throughout the 1890s but as a trope it gained cultural momentum only during, and as a seemingly intriguing corollary of, the progressive depsychiatricisation of homosexuality across the Anglo-European world (late 1950s through 1980s). Early twentieth century sources varied in having it denote (1) a distinct perversion, thus possible ‘complication’ of sexual inversion (2) a discrete corollary of psychosexual differentiation akin to gender preference (3) a distinct subtype of fetishism, thus a likely imprint of early seduction (4) a more intricate expression of erotic symbolism or psychosexual complex or (5) a taste answering to culture, a lack of it, or a libertine disregard for it. PMID:26352305

A video to improve patient and surrogate understanding of cardiopulmonary resuscitation choices in the ICU: a randomized controlled trial.

PubMed

Wilson, Michael E; Krupa, Artur; Hinds, Richard F; Litell, John M; Swetz, Keith M; Akhoundi, Abbasali; Kashyap, Rahul; Gajic, Ognjen; Kashani, Kianoush

2015-03-01

To determine if a video depicting cardiopulmonary resuscitation and resuscitation preference options would improve knowledge and decision making among patients and surrogates in the ICU. Randomized, unblinded trial. Single medical ICU. Patients and surrogate decision makers in the ICU. The usual care group received a standard pamphlet about cardiopulmonary resuscitation and cardiopulmonary resuscitation preference options plus routine code status discussions with clinicians. The video group received usual care plus an 8-minute video that depicted cardiopulmonary resuscitation, showed a simulated hospital code, and explained resuscitation preference options. One hundred three patients and surrogates were randomized to usual care. One hundred five patients and surrogates were randomized to video plus usual care. Median total knowledge scores (0-15 points possible for correct answers) in the video group were 13 compared with 10 in the usual care group, p value of less than 0.0001. Video group participants had higher rates of understanding the purpose of cardiopulmonary resuscitation and resuscitation options and terminology and could correctly name components of cardiopulmonary resuscitation. No statistically significant differences in documented resuscitation preferences following the interventions were found between the two groups, although the trial was underpowered to detect such differences. A majority of participants felt that the video was helpful in cardiopulmonary resuscitation decision making (98%) and would recommend the video to others (99%). A video depicting cardiopulmonary resuscitation and explaining resuscitation preference options was associated with improved knowledge of in-hospital cardiopulmonary resuscitation options and cardiopulmonary resuscitation terminology among patients and surrogate decision makers in the ICU, compared with receiving a pamphlet on cardiopulmonary resuscitation. Patients and surrogates found the video helpful in decision making and would recommend the video to others.

Client cognitive responses to counselor paradoxical and nonparadoxical directives.

PubMed

Lee, D Y; Rossiter, B; Martin, J; Uhlemann, M R

1990-09-01

Client cognitive responses to counselor paradoxical and nonparadoxical directives were examined. It was predicted (a) that clients who received paradoxical symptom prescriptions would display a greater negativity toward the counselor and counseling than those who received nonparadoxical directives; and (b) that clients who received no rationale for the paradoxical directives would display a greater negativity than those who received a rationale. Thirty clients who had reported performance anxiety received one 45-minute counseling interview. Ten clients received paradoxical directives with a rationale, 10 received paradoxical directives with no rationale, and 10 received nonparadoxical directives. Results showed no significant differences in either client in-session negativity or out-of-session implementation of directives between the paradoxical and nonparadoxical conditions and between the rationale and no rationale paradoxical conditions. Possible implications of the findings are discussed.

Integrating student feedback during "Dental Curriculum Hack-A-thon".

PubMed

Saffari, Shawheen S; Frederick Lambert, R; Dang, Lucy; Pagni, Sarah; Dragan, Irina F

2018-05-02

The future of dental education is at crossroads. This study used the parameter of the 2016 Dental Curriculum Hack-a-Thon to assess intra- and inter-institutional agreement between student and faculty views regarding dental curriculums to determine if there is an impact in student perceptions towards dental education from before and after the event. This exploratory, cross-sectional study involved two surveys, with Survey 1 being distributed among four faculty-student pairs of the four participating dental schools answering 14 questions. Survey 2 assessed the views of 20 participating dental students through 26 questions in a pre- and post- event survey design. Descriptive statistics were used to explore differences in perceptions towards dental education across both instrument surveys. The results revealed valuable student insights regarding intra- and inter-institutional agreement relevant for the change in dental curriculum that needs to occur. Survey 2 revealed that mandatory attendance in didactic courses, electronic based examination preferences, and the preference of preclinical courses being held in the first and second years of a four-year dental curriculum were of particular importance to student participants. The results of this study indicate that exposure and participation in subjects pertaining to dental education can be influential on student preferences and opinions on how dental education should be delivered in a four-year curriculum.

Assessing learning styles of Saudi dental students using Kolb's Learning Style Inventory.

PubMed

ALQahtani, Dalal A; Al-Gahtani, Sara M

2014-06-01

Experiential learning theory (ELT), a theory developed by David Kolb that considers experience to be very important for learning, classifies learners into four categories: Divergers, Assimilators, Convergers, and Accommodators. Kolb used his Learning Style Inventory (LSI) to validate ELT. Knowing the learning styles of students facilitates their understanding of themselves and thereby increases teaching efficiency. Few studies have been conducted that investigate learning preferences of students in the field of dentistry. This study was designed to distinguish learning styles among Saudi dental students and interns utilizing Kolb's LSI. The survey had a response rate of 62 percent (424 of 685 dental students), but surveys with incomplete answers or errors were excluded, resulting in 291 usable surveys (42 percent of the student population). The independent variables of this study were gender, clinical experience level, academic achievement as measured by grade point average (GPA), and specialty interest. The Diverging learning style was the dominant style among those in the sample. While the students preferred the Assimilating style during their early preclinical years, they preferred the Diverging style during their later clinical years. No associations were found between students' learning style and their gender, GPA, or specialty interest. Further research is needed to support these findings and demonstrate the impact of learning styles on dental students' learning.

Interactive lectures: Clickers or personal devices?

PubMed

Morrell, Lesley J; Joyce, Domino A

2015-01-01

Audience response systems ('clickers') are frequently used to promote participation in large lecture classes, and evidence suggests that they convey a number of benefits to students, including improved academic performance and student satisfaction. The limitations of these systems (such as limited access and cost) can be overcome using students' personal electronic devices, such as mobile phones, tablets and laptops together with text message, web- or app-based polling systems. Using questionnaires, we compare student perceptions of clicker and smartphone based polling systems. We find that students prefer interactive lectures generally, but those that used their own device preferred those lectures over lectures using clickers. However, device users were more likely to report using their devices for other purposes (checking email, social media etc.) when they were available to answer polling questions. These students did not feel that this distracted them from the lecture, instead, concerns over the use of smartphones centred around increased battery usage and inclusivity for students without access to suitable technology. Our results suggest that students generally preferred to use their own devices over clickers, and that this may be a sensible way to overcome some of the limitations associated with clickers, although issues surrounding levels of distraction and the implications for retention and recall of information need further investigation.

Interactive lectures: Clickers or personal devices?

PubMed Central

Morrell, Lesley J.; Joyce, Domino A.

2015-01-01

Audience response systems (‘clickers’) are frequently used to promote participation in large lecture classes, and evidence suggests that they convey a number of benefits to students, including improved academic performance and student satisfaction. The limitations of these systems (such as limited access and cost) can be overcome using students’ personal electronic devices, such as mobile phones, tablets and laptops together with text message, web- or app-based polling systems. Using questionnaires, we compare student perceptions of clicker and smartphone based polling systems. We find that students prefer interactive lectures generally, but those that used their own device preferred those lectures over lectures using clickers. However, device users were more likely to report using their devices for other purposes (checking email, social media etc.) when they were available to answer polling questions. These students did not feel that this distracted them from the lecture, instead, concerns over the use of smartphones centred around increased battery usage and inclusivity for students without access to suitable technology. Our results suggest that students generally preferred to use their own devices over clickers, and that this may be a sensible way to overcome some of the limitations associated with clickers, although issues surrounding levels of distraction and the implications for retention and recall of information need further investigation. PMID:26594327

[Shared decision making in patients with diabetes mellitus].

PubMed

Serrano, Valentina; Larrea-Mantilla, Laura; Rodríguez-Gutiérrez, René; Spencer-Bonilla, Gabriela; Málaga, Germán; Hargraves, Ian; Montori, Víctor M

2017-05-01

Patients with diabetes mellitus often have several medical problems and carry a burden imposed by their illness and treatment. Health care often ignores the values, preferences and context of patients, leading to treatments that do not fit into patients’ overwhelmed lives. Shared Decision Making (SDM) emerges as a way to answer the question: “What’s best for the patient?”. SDM promotes an empathic conversation between patients and clinicians that integrates the best evidence available with their values, preferences and context. We discuss three SDM approaches for patients with diabetes: one focused on sharing information, another on making choices, and a third one on helping patients and clinicians to talk about how to address the problems of living with diabetes and its comorbidities. Despite the benefits demonstrated in studies conducted in the U.S. and Europe, the implementation of SDM continues to be a challenge. In Latin America, healthcare and socio-economic conditions render the implementation of SDM more challenging. Research aimed to respond to this challenge is necessary. Meanwhile, clinicians can practice SDM by sharing evidence-based information, giving voice to patients’ values and preferences in making choices, and creating empathic conversations aimed at decisions aligned with patients’ context, dreams, goals, and life expectations.

A Survey on Oocyte Donation: Turkish Fertile and Infertile Women’s Opinions

PubMed Central

Akyuz, Aygul; Sever, Nese; Karasahin, Emre; Guvenc, Gulten; Cek, Suzan

2014-01-01

Background There are various treatment options for infertility, and new techniques are also being developed as it is an important healthcare problem affecting approximately 15-20% of married couples. The purpose of this study was to evaluate the level of infor- mation of fertile and infertile Turkish women on oocyte donation in order to understand their awareness of the legal, ethical, social and religious issues regarding this technique and to compare these two groups in terms of these variables. Materials and Methods This cross-sectional study included infertile women being treated at the assisted reproductive technologies (ART) program of a university hos- pital and women who had presented at the gynecology outpatients department of the same university for routine check-ups and who had no previous history of infertility. After consulting with specialists in the field and searching the related literature, a data collection form having 22 questions for infertile women and 18 questions for fertile women was prepared. Results The women were asked whether they would use the oocytes of another woman if necessary. The results showed that 67.6% of the fertile women said they would never want to use this method, while 63.9% of the infertile women stated they may accept to use this method under certain conditions (two distinct answers appeared in the answers, some women stated they would prefer donated oocytes from close relatives, while others stated they would prefer oocytes from total strangers), such as from a close relative or from someone they do not know at all. Conclusion Infertile women mentioned that they could use illegal routes if necessary to have a child at much higher rates than stated by fertile women. This shows that desire to have a child is a strong source of motivation in Turkey. PMID:25379158

Communicating projected survival with treatments for chronic kidney disease: patient comprehension and perspectives on visual aids.

PubMed

Dowen, Frances; Sidhu, Karishma; Broadbent, Elizabeth; Pilmore, Helen

2017-09-21

Mortality in end stage renal disease (ESRD) is higher than many malignancies. There is no data about the optimal way to present information about projected survival to patients with ESRD. In other areas, graphs have been shown to be more easily understood than narrative. We examined patient comprehension and perspectives on graphs in communicating projected survival in chronic kidney disease (CKD). One hundred seventy-seven patients with CKD were shown 4 different graphs presenting post transplantation survival data. Patients were asked to interpret a Kaplan Meier curve, pie chart, histogram and pictograph and answer a multi-choice question to determine understanding. We measured interpretation, usefulness and preference for the graphs. Most patients correctly interpreted the graphs. There was asignificant difference in the percentage of correct answers when comparing different graph types (p = 0.0439). The pictograph was correctly interpreted by 81% of participants, the histogram by 79%, pie chart by 77% and Kaplan Meier by 69%. Correct interpretation of the histogram was associated with educational level (p = 0.008) and inversely associated with age > 65 (p = 0.008). Of those who interpreted all four graphs correctly, there was an association with employment (p = 0.001) and New Zealand European ethnicity (p = 0.002). 87% of patients found the graphs useful. The pie chart was the most preferred graph (p 0.002). The readability of the graphs may have been improved with an alternative colour choice, especially in the setting of visual impairment. Visual aids, can be beneficial adjuncts to discussing survival in CKD.

Multilayered and digitally structured presentation formats of trustworthy recommendations: a combined survey and randomised trial

PubMed Central

Vandvik, Per Olav; Alonso-Coello, Pablo; Akl, Elie A; Thornton, Judith; Rigau, David; Adams, Katie; O'Connor, Paul; Guyatt, Gordon; Kristiansen, Annette

2017-01-01

Objectives To investigate practicing physicians' preferences, perceived usefulness and understanding of a new multilayered guideline presentation format—compared to a standard format—as well as conceptual understanding of trustworthy guideline concepts. Design Participants attended a standardised lecture in which they were presented with a clinical scenario and randomised to view a guideline recommendation in a multilayered format or standard format after which they answered multiple-choice questions using clickers. Both groups were also presented and asked about guideline concepts. Setting Mandatory educational lectures in 7 non-academic and academic hospitals, and 2 settings involving primary care in Lebanon, Norway, Spain and the UK. Participants 181 practicing physicians in internal medicine (156) and general practice (25). Interventions A new digitally structured, multilayered guideline presentation format and a standard narrative presentation format currently in widespread use. Primary and secondary outcome measures Our primary outcome was preference for presentation format. Understanding, perceived usefulness and perception of absolute effects were secondary outcomes. Results 72% (95% CI 65 to 79) of participants preferred the multilayered format and 16% (95% CI 10 to 22) preferred the standard format. A majority agreed that recommendations (multilayered 86% vs standard 91%, p value=0.31) and evidence summaries (79% vs 77%, p value=0.76) were useful in the context of the clinical scenario. 72% of participants randomised to the multilayered format vs 58% for standard formats reported correct understanding of the recommendations (p value=0.06). Most participants elected an appropriate clinical action after viewing the recommendations (98% vs 92%, p value=0.10). 82% of the participants considered absolute effect estimates in evidence summaries helpful or crucial. Conclusions Clinicians clearly preferred a novel multilayered presentation format to the standard format. Whether the preferred format improves decision-making and has an impact on patient important outcomes merits further investigation. PMID:28188149

Educational attainment, time preference, and health-related behaviors: A mediation analysis from the J-SHINE survey.

PubMed

Takagi, Daisuke; Kondo, Naoki; Takada, Misato; Hashimoto, Hideki

2016-03-01

Evidence consistently shows that low education is associated with unhealthy behaviors. A recent study in behavioral economics argued that high time preferences - the tendency to prefer immediate gain to later reward - explain the limited self-control of individuals in making preventive health-related choices. The aim of this study was to examine the mediating effect of time preference on the associations between education and smoking, binge drinking and overweight in young and middle-aged adults living in a Japanese metropolitan area, using a quantitatively measured time discount rate. A population-based probabilistic sample of residents of 25-50 years of age living in four municipalities within Japanese metropolitan areas where economic disparity is relatively large was obtained from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE). Respondents answered the questionnaire items using a computer-aided personal instrument (CAPI). Data from 3457 respondents were used in this study. Time preferences measured as categorical responses were converted into a continuous number of time discount rates by using the maximum likelihood method. Smoking habit, binge drinking, and body mass index were regressed on educational attainment with demographics and other confounders. The mediating effects of the time discount rate were examined with the bootstrapping method. Results showed that the time discount rate did not mediate the association between education and binge drinking and BMI. Even for smoking, the mediating effect of time discount rate was quite limited, indicating that the proportion of total effect of education mediated was only 4.3% for men and 3.0% for women. The results suggest that modifying time preferences through educational intervention has only limited efficacy in closing disparities in health-related behaviors, and that other mediators fostered by schooling, such as knowledge/skills, group norms and supportive peers/networks, may be more important as modifiable mediators in the link between education and smoking. Copyright © 2016 Elsevier Ltd. All rights reserved.

Consumer preferences for food labels on tomatoes in Germany - A comparison of a quasi-experiment and two stated preference approaches.

PubMed

Meyerding, Stephan G H

2016-08-01

In many studies, consumer preferences are determined by using direct surveys. For this method social desirability is problematic. This leads to the effect that participants answer in a way that they perceive as desired by society. This leads to the stated importance of certain features in these studies not being reflected in real purchasing decisions. Therefore, the aim of the study is to compare consumer preferences measured by a quasi-experiment to those quantified by direct questions. Another objective is to quantify the part-worth utilities of product characteristics such as origin, price and food labels. Part-worth utilities are estimated on an interval scale with an arbitrary origin and are a measure for preferences. The real purchasing situation was simulated in a quasi-experiment using a choice-based conjoint analysis. The part-worth utilities were then compared with the results of a conventional preference assessment (Likert scale). For this purpose, 645 consumers from all over Germany were surveyed in 2014. The participants were on average 44 years old and 63% were women. The results of the conjoint analysis report the highest part-worth utility (2.853) for the lowest price (1.49€), followed by the characteristic "grown locally" (2.157). For the labels, the German organic label shows the highest part-worth utility (0.785) followed by Fairtrade/"A heart for the producer" (0.200). It is noticeable that the carbon footprint labels have negative part-worth utilities compared to tomatoes without a label (-0.130 with CO2 indication, -0.186 without CO2 indication). The price is ranked 12th in the importance of the characteristics of purchasing tomatoes in the survey with a Likert scale, whereas it is first in the evaluation of the quasi-experiment (conjoint analysis), which supports the assumption of a social desirability bias. Copyright © 2016 Elsevier Ltd. All rights reserved.

Farmers' preferences for automatic lameness-detection systems in dairy cattle.

PubMed

Van De Gucht, T; Saeys, W; Van Nuffel, A; Pluym, L; Piccart, K; Lauwers, L; Vangeyte, J; Van Weyenberg, S

2017-07-01

As lameness is a major health problem in dairy herds, a lot of attention goes to the development of automated lameness-detection systems. Few systems have made it to the market, as most are currently still in development. To get these systems ready for practice, developers need to define which system characteristics are important for the farmers as end users. In this study, farmers' preferences for the different characteristics of proposed lameness-detection systems were investigated. In addition, the influence of sociodemographic and farm characteristics on farmers' preferences was assessed. The third aim was to find out if preferences change after the farmer receives extra information on lameness and its consequences. Therefore, a discrete choice experiment was designed with 3 alternative lameness-detection systems: a system attached to the cow, a walkover system, and a camera system. Each system was defined by 4 characteristics: the percentage missed lame cows, the percentage false alarms, the system cost, and the ability to indicate which leg is lame. The choice experiment was embedded in an online survey. After answering general questions and choosing their preferred option in 4 choice sets, extra information on lameness was provided. Consecutively, farmers were shown a second block of 4 choice sets. Results from 135 responses showed that farmers' preferences were influenced by the 4 system characteristics. The importance a farmer attaches to lameness, the interval between calving and first insemination, and the presence of an estrus-detection system contributed significantly to the value a farmer attaches to lameness-detection systems. Farmers who already use an estrus detection system were more willing to use automatic detection systems instead of visual lameness detection. Similarly, farmers who achieve shorter intervals between calving and first insemination and farmers who find lameness highly important had a higher tendency to choose for automatic lameness detection. A sensor attached to the cow was preferred, followed by a walkover system and a camera system. In general, visual lameness detection was preferred over automatic detection systems, but this preference changed after informing farmers about the consequences of lameness. To conclude, the system cost and performance were important features, but dairy farmers should be sensitized on the consequences of lameness and its effect on farm profitability. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

An anthology: Rationale for a US ballistic missile defense (1969 - 1984)

NASA Astrophysics Data System (ADS)

Tircuit, E. C.

1985-04-01

This anthology is a selection and short synopsis of representative articles on the rationale for a US ballistic missile defense (BMD). Unclassified articles and documents were reviewed and analyzed to identify and include nine representative articles in the anthology. The anthology reduces the search for quality material on the subject and documents the fundamental rationale for a BMD. The author concluded that the fundamental rationale for a US BMD is to deter nuclear war. In addition, specific rationale for a US BMD is provided in the anthology. Finally, an extensive bibliography is included in the anthology to enhance further research on the subject.

An Objective Rationale for the Choice of Regularisation Parameter with Application to Global Multiple-Frequency S-Wave Tomography

NASA Astrophysics Data System (ADS)

Zaroli, C.; Sambridge, M.; Leveque, J. J.; Debayle, E.; Nolet, G.

2014-12-01

In a linear ill-posed inverse problem, the regularisation parameter (damping) controls the balance between minimising both the residual data misfit and the model norm. Poor knowledge of data uncertainties often makes the selection of damping rather arbitrary. To go beyond that subjectivity, an objective rationale for the choice of damping is presented, which is based on the coherency of delay-time estimates in different frequency bands. Our method is tailored to the problem of global Multiple-Frequency Tomography, using a data set of 287078 S-wave delay-times measured in five frequency bands (10, 15, 22, 34, 51 s central periods). Whereas for each ray path the delay-time estimates should vary coherently from one period to the other, the noise most likely is not coherent. Thus, the lack of coherency of the information in different frequency bands is exploited, using an analogy with the cross-validation method, to identify models dominated by noise.In addition, a sharp change of behaviour of the model infinity-norm, as the damping becomes lower than a threshold value, is interpreted as the signature of data noise starting to significantly pollute at least one model component. Models with damping larger than this threshold are diagnosed as being constructed with poor data exploitation.Finally, a preferred model is selected from the remaining range of permitted model solutions. This choice is quasi-objective in terms of model interpretation, as the selected model shows a high degree of similarity with almost all other permitted models. The obtained tomographic model is displayed in mid lower-mantle (660-1910 km depth), and is shown to be mostly compatible with three other recent global shear-velocity models, while significant differences can be noticed. A wider application of the presented rationale should permit us to converge towards more objective seismic imaging of the Earth's mantle, using as much as possible of the relevant structural information in the data. This work was recently published: Zaroli, C., Sambridge, M., Lévêque, J.-J., Debayle, E., and Nolet, G. (2013) - Solid Earth, 4, 357-371, doi:10.5194/se-4-357-2013

Making sense of sexual orientation measures: findings from a cognitive processing study with adolescents on health survey questions.

PubMed

Austin, S Bryn; Conron, Kerith; Patel, Aarti; Freedner, Naomi

2007-01-01

To carry out a study using cognitive processing interview methods to explore ways in which adolescents understand sexual orientation questions currently used on epidemiologic surveys. In-depth, individual interviews were conducted to probe cognitive processes involved in answering four self-report survey questions assessing sexual identity, sexual attraction, and sex of sexual partners.A semi-structured interview guide was used to explore variation in question interpretation, information retrieval patterns and problems, item clarity, valence of reactions to items (positive, negative, neutral), respondent burden, and perceived threat associated with the measures. Thirty adolescents aged 15 to 21 of diverse sexual orientations and race/ethnicities participated in the study, including female, male, and transgender youth. A question on sexual attraction was the most consistently understood and thus was easy for nearly all youth to answer. In contrast, a measure of sexual identity with options heterosexual, bisexual, gay/lesbian, and unsure was the most difficult to answer. Most preferred a sexual identity item that also provided the intermediate options mostly heterosexual and mostly homosexual, which many said reflected their experience of feeling between categories. Participants had varying and inconsistent interpretations of sexual behavior terms, such as sex and sexual intercourse, used in assessing the sex of sexual partners. Differences in understanding could affect interpretation of survey data in important ways. Development of valid measures of sexual orientation will be essential to better monitor health disparities.

Medical Students' Understanding of Directed Questioning by Their Clinical Preceptors.

PubMed

Lo, Lawrence; Regehr, Glenn

2017-01-01

Phenomenon: Throughout clerkship, preceptors ask medical students questions for both assessment and teaching purposes. However, the cognitive and strategic aspects of students' approaches to managing this situation have not been explored. Without an understanding of how students approach the question and answer activity, medical educators are unable to appreciate how effectively this activity fulfills their purposes of assessment or determine the activity's associated educational effects. A convenience sample of nine 4th-year medical students participated in semistructured one-on-one interviews exploring their approaches to managing situations in which they have been challenged with questions from preceptors to which they do not know the answer. Through an iterative and recursive analytic reading of the interview transcripts, data were coded and organized to identify themes relevant to the students' considerations in answering such questions. Students articulated deliberate strategies for managing the directed questioning activity, which at times focused on the optimization of their learning but always included considerations of image management. Managing image involved projecting not only being knowledgeable but also being teachable. The students indicated that their considerations in selecting an appropriate strategy in a given situation involved their perceptions of their preceptors' intentions and preferences as well as several contextual factors. Insights: The medical students we interviewed were quite sophisticated in their understanding of the social nuances of the directed questioning process and described a variety of contextually invoked strategies to manage the situation and maintain a positive image.

Optimism bias leads to inconclusive results - an empirical study

PubMed Central

Djulbegovic, Benjamin; Kumar, Ambuj; Magazin, Anja; Schroen, Anneke T.; Soares, Heloisa; Hozo, Iztok; Clarke, Mike; Sargent, Daniel; Schell, Michael J.

2010-01-01

Objective Optimism bias refers to unwarranted belief in the efficacy of new therapies. We assessed the impact of optimism bias on a proportion of trials that did not answer their research question successfully, and explored whether poor accrual or optimism bias is responsible for inconclusive results. Study Design Systematic review Setting Retrospective analysis of a consecutive series phase III randomized controlled trials (RCTs) performed under the aegis of National Cancer Institute Cooperative groups. Results 359 trials (374 comparisons) enrolling 150,232 patients were analyzed. 70% (262/374) of the trials generated conclusive results according to the statistical criteria. Investigators made definitive statements related to the treatment preference in 73% (273/374) of studies. Investigators’ judgments and statistical inferences were concordant in 75% (279/374) of trials. Investigators consistently overestimated their expected treatment effects, but to a significantly larger extent for inconclusive trials. The median ratio of expected over observed hazard ratio or odds ratio was 1.34 (range 0.19 – 15.40) in conclusive trials compared to 1.86 (range 1.09 – 12.00) in inconclusive studies (p<0.0001). Only 17% of the trials had treatment effects that matched original researchers’ expectations. Conclusion Formal statistical inference is sufficient to answer the research question in 75% of RCTs. The answers to the other 25% depend mostly on subjective judgments, which at times are in conflict with statistical inference. Optimism bias significantly contributes to inconclusive results. PMID:21163620

Optimism bias leads to inconclusive results-an empirical study.

PubMed

Djulbegovic, Benjamin; Kumar, Ambuj; Magazin, Anja; Schroen, Anneke T; Soares, Heloisa; Hozo, Iztok; Clarke, Mike; Sargent, Daniel; Schell, Michael J

2011-06-01

Optimism bias refers to unwarranted belief in the efficacy of new therapies. We assessed the impact of optimism bias on a proportion of trials that did not answer their research question successfully and explored whether poor accrual or optimism bias is responsible for inconclusive results. Systematic review. Retrospective analysis of a consecutive-series phase III randomized controlled trials (RCTs) performed under the aegis of National Cancer Institute Cooperative groups. Three hundred fifty-nine trials (374 comparisons) enrolling 150,232 patients were analyzed. Seventy percent (262 of 374) of the trials generated conclusive results according to the statistical criteria. Investigators made definitive statements related to the treatment preference in 73% (273 of 374) of studies. Investigators' judgments and statistical inferences were concordant in 75% (279 of 374) of trials. Investigators consistently overestimated their expected treatment effects but to a significantly larger extent for inconclusive trials. The median ratio of expected and observed hazard ratio or odds ratio was 1.34 (range: 0.19-15.40) in conclusive trials compared with 1.86 (range: 1.09-12.00) in inconclusive studies (P<0.0001). Only 17% of the trials had treatment effects that matched original researchers' expectations. Formal statistical inference is sufficient to answer the research question in 75% of RCTs. The answers to the other 25% depend mostly on subjective judgments, which at times are in conflict with statistical inference. Optimism bias significantly contributes to inconclusive results. Copyright © 2011 Elsevier Inc. All rights reserved.

Comparison of Brief Summary Formats Through a Health Literacy Lens.

PubMed

Sharp, Michele L; Hall, Lori; Eleftherion, Anthony; Simpson, Katherine; Neuhauser, Linda

2018-01-01

Print pharmaceutical advertisements in the United States require inclusion of a brief summary of side effects, warnings, precautions, and contraindications from the labeling. The full package insert, which sponsors have traditionally used to fulfill the brief summary requirement, does not adhere to health literacy best practices, limiting its value to consumers. This study compared the understandability and usability of brief summaries in 3 formats designed to be more consumer friendly. Three brief summary formats were tested: (1) 2-column "Question and Answer"; (2) "Prescription Drug Facts Box," similar to current US over-the-counter drug facts labeling; and (3) "Health Literacy," based on clear communication principles. Researchers evaluated the formats using the Suitability Assessment of Materials (SAM) tool and conducted structured, scripted, one-on-one interviews (usability tests) with participants with estimated low to average education levels. This research was replicated across 2 therapeutic areas (type 2 diabetes and plaque psoriasis). SAM scores showed that the Health Literacy format outperformed the Question and Answer format and the Prescription Drug Facts Box format in both therapeutic areas, with both Health Literacy brief summaries rated on the SAM as "superior." Qualitative usability tests supported the SAM findings, with the Health Literacy format preferred consistently over the Question and Answer format, and more often than not over the Prescription Drug Facts Box format. Sponsors can employ a user-tested Health Literacy format to improve the understandability and usability of brief summaries with patients.

Adhesives: Test Method, Group Assignment, and Categorization Guide for High-Loading Rate Applications - History and Rationale

DTIC Science & Technology

2017-04-20

Categorization Guide for High -Loading- Rate Applications – History and Rationale by Robert Jensen, David Flanagan, Daniel DeSchepper, and Charles...Adhesives: Test Method, Group Assignment, and Categorization Guide for High -Loading- Rate Applications – History and Rationale by Robert Jensen...Categorization Guide for High - Loading-Rate Applications – History and Rationale 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

Chemoselection: A Paradigm for Optimization of Organ Preservation in Locally Advanced Larynx Cancer

PubMed Central

Vainshtein, Jeffrey M.; Wu, Vivian F.; Spector, Matthew E.; Bradford, Carol R.; Wolf, Gregory T.; Worden, Francis P.

2014-01-01

Summary Definitive chemoradiation (CRT) and laryngectomy followed by postoperative radiotherapy (RT) are both considered standard of care options for the management of advanced laryngeal cancer. While organ preservation with chemoradiotherapy is often the preferred up-front approach for appropriately selected candidates, the functional benefits of organ preservation must be carefully balanced against the considerable morbidity of salvage laryngectomy in patients who fail primary chemoradiation. Up-front identification of patients who are likely to require surgical salvage, therefore, is an important aim of any organ preserving approach in order to minimize morbidity while maximizing organ preservation. To this end, a strategy of “chemoselection”, using the primary tumor's response after one cycle of induction chemotherapy as an in vivo method of selecting responders for definitive chemoradiation while reserving primary surgical management for non-responders, has been employed extensively at our institution. The rationale, treatment results, and future directions of this approach are discussed. PMID:24053204

The ethics of policy writing: how should hospitals deal with moral disagreement about controversial medical practices?

PubMed Central

Winkler, E

2005-01-01

Every healthcare organisation (HCO) enacts a multitude of policies, but there has been no discussion as to what procedural and substantive requirements a policy writing process should meet in order to achieve good outcomes and to possess sufficient authority for those who are asked to follow it. Using, as an example, the controversy about patient's refusal of blood transfusions, I argue that a hospital wide policy is preferable to individual decision making, because it ensures autonomy, quality, fairness, and efficiency. Policy writing for morally controversial medical practices needs additional justification compared to policies on standard medical practices and secures legitimate authority for HCO members by meeting five requirements: all parties directed by the policy are represented; the deliberative process encompasses all of the HCO's obligations; the rationales for the policy are made available; there is a mechanism for criticising, and for evaluating the policy. PMID:16199594

Avoiding Complications with MPFL Reconstruction.

PubMed

Smith, Marvin K; Werner, Brian C; Diduch, David R

2018-05-12

To discuss the potentially significant complications associated with medial patellofemoral ligament (MPFL) reconstruction. Additionally, to review the most current and relevant literature with an emphasis on avoiding these potential complications. Multiple cadaveric studies have characterized the anatomy of the MPFL and the related morphologic abnormalities that contribute to recurrent lateral patellar instability. Such abnormalities include patella alta, excessive tibial tubercle to trochlear grove (TT-TG) distance, trochlear dysplasia, and malalignment. Recent studies have evaluated the clinical outcomes associated with the treatment of concomitant pathology in combination with MPFL reconstruction, which is critical in avoiding recurrent instability and complications. Although there remains a lack of consensus regarding various critical aspects of MPFL reconstruction, certain concepts remain imperative. Our preferred methods and rationales for surgical techniques are described. These include appropriate work up, a combination of procedures to address abnormal morphology, anatomical femoral insertion, safe and secure patellar fixation, appropriate graft length fixation, and thoughtful knee flexion during fixation.

Validating the Multidimensional Measure of Cultural Identity Scales for Latinos Among Latina Mothers and Daughters

PubMed Central

Dillon, Frank R.; Félix-Ortiz, Maria; Rice, Christopher; De La Rosa, Mario; Rojas, Patria; Duan, Rui

2009-01-01

The psychometric properties of the Multidimensional Measure of Cultural Identity Scales for Latinos (MMCISL; Félix-Ortiz, Newcomb, & Myers, 1994) have never been examined in an adult Latina sample representing various levels of nativity and nationality. The rationale for the study was to confirm the factor structure and psychometric properties of the MMCISL with a predominantly immigrant sample of Latina mothers and daughters (n = 316). Adequate reliability estimates were found for 6 of the original 10 scales. Confirmatory factor analyses provided evidence of construct validity for the reliable scales. The Preferred Latino Affiliation scale was the only scale to meet strict measurement invariance criteria across mothers and daughters. Criterion validity was evidenced by relations between the Familiarity with Latino Culture scale and all criterion variables. Implications for acculturation and cultural identity research involving the MMCISL are discussed. PMID:19364206

Developmental toxicity testing of monoclonal antibodies: an enhanced pre- and postnatal study design option.

PubMed

Stewart, Jane

2009-09-01

For many monoclonal antibodies (mAb), the preferred species for general and reproductive safety testing is often the cynomolgus monkey. This article describes the rationale for combining the traditional "segmented" embryofetal development study with the pre- and postnatal development (PPND) study into a single "enhanced" PPND study design in the cynomolgus monkey where a single cohort of animals is exposed throughout gestation and allowed to give birth naturally. The proposed "enhanced" PPND study design evaluates all the stages of the traditional two study design using fewer animals. It also assesses the functional consequences of mid to late gestational exposure. This is of particular relevance to the risk assessment of monoclonal antibodies where fetal exposure to maternal IgG increases as pregnancy progresses and where morphologic examination of a pre-term fetus may not be adequate to reveal the presence of adverse effects on functional development of key target organs.

Haploidentical Hematopoietic Stem Cell Transplantation as Platform for Post-transplant Cellular Therapy

PubMed Central

Kongtim, Piyanuch; Lee, Dean A.; Cooper, Laurence J. N.; Kebriaei, Partow; Champlin, Richard E.; Ciurea, Stefan O.

2016-01-01

Haploidentical transplantation can extend the opportunity for transplantation to almost all patients who lack an HLA-matched donor. Advances in the field of haploidentical transplantation have led to a marked decrease in treatment-related mortality, allowing investigators to focus on developing rationale pre- and peri-remission therapies aimed at preventing disease relapse post-transplant. Due to widespread availability, low treatment-related mortality and cost, haploidentical donors may become the preferred “alternative” donors for allogeneic hematopoietic stem cell transplantation. One of the major advantages of using a related donor is the possibility to collect or generate additional cellular products from the same immediate available donor, which will not be rejected. Infusion of these cells in the peri-transplant period, derived from the same immune system, is opening the possibility to markedly enhance the anti-tumor effects of the graft and hasten immunologic reconstitution post-transplant. PMID:26172479

Fostering multiple repertoires in undergraduate behavior analysis students

PubMed Central

Polson, David A. D.

1995-01-01

Eight techniques used by the author in teaching an introductory applied behavior analysis course are described: (a) a detailed study guide, (b) frequent tests, (c) composition of practice test questions, (d) in-class study groups, (e) fluency building with a computerized flash-card program, (f) bonus marks for participation during question-and-answer sessions, (g) student presentations that summarize and analyze recently published research, and (h) in-class behavior analysis of comic strips. Together, these techniques require an extensive amount of work by students. Nevertheless, students overwhelmingly prefer this approach to the traditional lecture-midterm-final format, and most earn an A as their final course grade. PMID:22478226

Looking Closer at the Effects of Framing on Risky Choice: An Item Response Theory Analysis.

PubMed

Sickar; Highhouse

1998-07-01

Item response theory (IRT) methodology allowed an in-depth examination of several issues that would be difficult to explore using traditional methodology. IRT models were estimated for 4 risky-choice items, answered by students under either a gain or loss frame. Results supported the typical framing finding of risk-aversion for gains and risk-seeking for losses but also suggested that a latent construct we label preference for risk was influential in predicting risky choice. Also, the Asian Disease item, most often used in framing research, was found to have anomalous statistical properties when compared to other framing items. Copyright 1998 Academic Press.

Individual responsibility and health-risk behaviour: a contingent valuation study from the ex ante societal perspective.

PubMed

van der Star, Sanne M; van den Berg, Bernard

2011-08-01

This study analyzes peoples' social preferences for individual responsibility to health-risk behaviour in health care using the contingent valuation method adopting a societal perspective. We measure peoples' willingness to pay for inclusion of a treatment in basic health insurance of a hypothetical lifestyle dependent (smoking) and lifestyle independent (chronic) health problem. Our hypothesis is that peoples' willingness to pay for the independent and the dependent health problems are similar. As a methodological challenge, this study also analyzes the extent to which people consider their personal situation when answering contingent valuation questions adopting a societal perspective. 513 Dutch inhabitants responded to the questionnaire. They were asked to state their maximum willingness to pay for inclusion of treatments in basic health insurance package for two health problems. We asked them to assume that one hypothetical health problem was totally independent of behaviour (for simplicity called chronic disease). Alternatively, we asked them to assume that the other hypothetical health problem was totally caused by health-risk behaviour (for simplicity called smoking disease). We applied the payment card method to guide respondents to answer the contingent valuation method questions. Mean willingness to pay was 42.39 Euros (CI=37.24-47.55) for inclusion of treatment for health problem that was unrelated to behaviour, with '5-10' and '10-20 Euros' as most frequently stated answers. In contrast, mean willingness to pay for inclusion treatment for health-risk related problem was 11.29 Euros (CI=8.83-14.55), with '0' and '0-5 Euros' as most frequently provided answers. Difference in mean willingness to pay was substantial (over 30 Euros) and statistically significant (p-value=0.000). Smokers were statistically significantly more (p-value<0.01) willing to pay for the health-risk related (smoking) problem compared with non-smokers, while people with chronic condition were not willing to pay more for the health-risk unrelated (chronic) problem than people without chronic condition. This suggests that sub groups of people might differ in terms of abstracting from their personal situation when answering valuation questions from a societal perspective. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

[A guide to successful public relations for hospitals and emergency medical services].

PubMed

Ausserer, J; Schwamberger, J; Preloznik, R; Klimek, M; Paal, P; Wenzel, V

2014-04-01

Tragic accidents, e.g. involving celebrity patients or severe incidents in hospital occur suddenly without any advance warning, often produce substantial interest by the media and quickly overburden management personnel involved in both hospitals and emergency medical services. While doctors, hospitals and emergency medical services desire objective media reports, the media promote emotionalized and dramatized reports to ensure maximum attention and circulation. When briefing the media, the scales may quickly tilt from professional, well-deliberated information to unfortunate, often unintended disinformation. Such phenomena may result in continuing exaggerated reports in the tabloid press, which in the presence of aggressive lawyers and a competitive hospital environment can turn into image and legal problems. In this article, several aspects are discussed in order to achieve successful public relations.Interviews should be given only after consultation with the responsible press officer and the director of the respective department or hospital director. Requests for information by the media should always be answered as otherwise one-sided, unintentional publications can result that are extremely difficult to correct later. One should be available to be contacted easily by journalists, regular press conferences should be held and critics should be taken seriously and not be brushed off. Questions by journalists should be answered in a timely manner as journalists are continuously under time pressure and do not understand unnecessary delays. Information for the media should always be provided at the same time, no publication should be given preference and an absolutely current list of E-mail contacts is required. When facing big events a press conference is preferred as many questions can be answered at once. Always be well prepared for an interview or even for just a statement. Each interview should be regarded as an opportunity to put a story forward which you wanted to do for a long time and your message should not contain more than three main points.Each hospital or emergency medical service should have a professional department for public relations, an exact knowledge of the regional and national media and strategies how to handle an incident that is of interest for the media. The media should be provided with information not only when a negative incident has happened but should be provided with regular positive messages as well. An interview must be carefully prepared to achieve a good image.

Corrective Action Decision Document for Corrective Action Unit 568. Area 3 Plutonium Dispersion Sites, Nevada National Security Site, Nevada Revision 0

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

Matthews, Patrick

The purpose of this Corrective Action Decision Document is to identify and provide the rationale for the recommendation of corrective action alternatives (CAAs) for the 14 CASs within CAU 568. Corrective action investigation (CAI) activities were performed from April 2014 through May 2015, as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 568: Area 3 Plutonium Dispersion Sites, Nevada National Security Site, Nevada; and in accordance with the Soils Activity Quality Assurance Plan, which establishes requirements, technical planning, and general quality practices. The purpose of the CAI was to fulfill data needs as defined during themore » DQO process. The CAU 568 dataset of investigation results was evaluated based on a data quality assessment. This assessment demonstrated that the dataset is complete and acceptable for use in fulfilling the DQO data needs. Based on the evaluation of analytical data from the CAI, review of future and current operations at the 14 CASs, and the detailed and comparative analysis of the potential CAAs, the following corrective actions are recommended for CAU 568: • No further action is the preferred corrective action for CASs 03-23-17, 03-23-22, 03-23-26. • Closure in place is the preferred corrective action for CAS 03-23-19; 03-45-01; the SE DCBs at CASs 03-23-20, 03-23-23, 03-23-31, 03-23-32, 03-23-33, and 03-23-34; and the Pascal-BHCA at CAS 03-23-31. • Clean closure is the preferred corrective action for CASs 03-08-04, 03-23-30, and 03-26-04; and the four well head covers at CASs 03-23-20, 03-23-23, 03-23-31, and 03-23-33.« less

Tolerance and sensitization to chronic escalating-dose heroin following extended withdrawal in Fischer rats: possible role of mu-opioid receptors

PubMed Central

Seip-Cammack, Katharine M.; Reed, Brian; Zhang, Yong; Ho, Ann; Kreek, Mary Jeanne

2012-01-01

Rationale/objectives Heroin addiction is characterized by recurrent cycles of drug use, abstinence and relapse. It is likely that neurobiological changes during chronic heroin exposure persist across withdrawal and impact behavioral responses to re-exposure. We hypothesized that, after extended withdrawal, heroin-withdrawn rats would express behavioral tolerance and/or sensitization in response to heroin re-exposure and that these responses might be associated with altered mu-opioid receptor (MOPr) activity. Methods Male Fischer rats were exposed chronically to escalating doses of heroin (7.5–75mg/kg/day), experienced acute spontaneous withdrawal and extended (10-day) abstinence, and were re-exposed chronically to heroin. Homecage behaviors and locomotor activity in response to heroin, as well as somatic withdrawal signs, were recorded. Separate groups of rats were sacrificed after extended abstinence and MOPr expression and G-protein coupling were analyzed using [3H]DAMGO and [35S]GTPγS assays. Results The depth of behavioral stupor was lower during the initial days of heroin re-exposure compared to the initial days of the first exposure period. Behavioral responses (e.g., stereotypy) and locomotion were elevated in response to heroin re-exposure at low doses. Rats conditioned for heroin place preference during the chronic re-exposure period expressed heroin preference during acute withdrawal; this preference was stronger than rats conditioned during chronic heroin exposure that followed chronic saline and injection-free periods. Extended withdrawal was associated with increased MOPr expression in the caudate-putamen and frontal and cingulate cortices. No changes in G-protein coupling were identified. Conclusions Aspects of tolerance/sensitization to heroin are present even after extended abstinence and may be associated with altered MOPr density. PMID:22829433

Effect of fendiline on the maintenance and expression of methamphetamine-induced conditioned place preference in Sprague-Dawley rats

PubMed Central

Voigt, Robin M.; Riddle, Jennifer L.; Napier, T. Celeste

2014-01-01

Rationale Fendiline is a GABAB receptor positive allosteric modulator and L-type Ca2+ channel blocker that is safe for human use. Based on these pharmacological properties, fendiline may be useful to disrupt associative memories that can drive relapse to drug use in drug-addicted individuals. Objective The current study evaluated the potential of fendiline to inhibit the maintenance and expression of learned associations between methamphetamine (meth) and an environmental context using conditioned place preference (CPP) in rats, to model for the associative learning that occurs during drug abuse by humans. Methods Following meth conditioning (1mg/kg), fendiline (5mg/kg) was administered at various post-conditioning times to ascertain if there was a temporal window during which fendiline would be effective. Results Two once-daily injections of fendiline did not influence the maintenance of CPP regardless of the post-conditioning treatment time while 10 once-daily fendiline treatments inhibited CPP maintenance (p<0.05). Fendiline administered immediately prior to the CPP test inhibited expression of meth-induced CPP in rats with a fendiline treatment history of 10 once-daily injections (p<0.05) or those that received two injections that corresponded to the last two days of the 10 day treatment (p<0.05). Fendiline did not produce preference or aversion on its own, nor did it alter motivated motor behavior. Conclusion Maintenance and expression of meth CPP is mitigated by repeated fendiline treatments when administered during the days that precede CPP testing. Reduction in the significance of meth-associated cues can reduce relapse; therefore, fendiline may be of value for addiction therapy in abstinent, meth-addicted humans. PMID:24264565

Breaking bad news–what patients want and what they get: evaluating the SPIKES protocol in Germany

PubMed Central

Seifart, C.; Hofmann, M.; Bär, T.; Riera Knorrenschild, J.; Seifart, U.; Rief, W.

2014-01-01

Background Evaluation of the SPIKES protocol, a recommended guideline for breaking bad news, is sparse, and information about patients' preferences for bad-news delivery in Germany is lacking. Being the first actual–theoretical comparison of a ‘breaking bad news’ guideline, the present study evaluates the recommended steps of the SPIKES protocol. Moreover, emotional consequences and quality of bad-news delivery are investigated. Patients and methods A total of 350 cancer patients answered the MABBAN (Marburg Breaking Bad News Scale), a questionnaire representing the six SPIKES subscales, asking for the procedure, perception and satisfaction of the first cancer disclosure and patient’s assign to these items. Results Only 46.2% of the asked cancer patients are completely satisfied with how bad news had been broken to them. The overall quality is significantly related to the emotional state after receiving bad news (r = −0.261, P < 0.001). Patients’ preferences differ highly significantly from the way bad news were delivered, and the resulting rang list of patients’ preferences indicates that the SPIKES protocol do not fully meet the priorities of cancer patients in Germany. Conclusions It could be postulated that the low satisfaction of patients observed in this study reflects the highly significant difference between patients’ preferences and bad-news delivery. Therefore, some adjunctions to the SPIKES protocol should be considered, including a frequent reassurance of listeners’ understanding, the perpetual possibility to ask question, respect for prearrangement needs and the conception of bad-news delivery in a two-step procedure. PMID:24504443

Texting preferences in a Paediatric residency.

PubMed

Draper, Lauren; Kuklinski, Cadence; Ladley, Amy; Adamson, Greg; Broom, Matthew

2017-12-01

Text messaging is ubiquitous among residents, but remains an underused educational tool. Though feasibility has been demonstrated, evidence of its ability to improve standardised test scores and provide insight on resident texting preferences is lacking. The authors set out to evaluate: (1) satisfaction with a hybrid question-and-answer (Q&A) texting format; and (2) pre-/post-paediatric in-training exam (ITE) performance. A prospective study with paediatrics and internal medicine-paediatrics residents. Residents were divided into subgroups: adolescent medicine (AM) and developmental medicine (DM). Messages were derived from ITE questions and sent Monday-Friday with a 20 per cent variance in messages specific to the sub-group. Residents completed surveys gauging perceptions of the programme, and pre- and post-programme ITE scores were analysed. Forty-one residents enrolled and 32 (78%) completed a post-programme survey. Of those, 21 (66%) preferred a Q&A format with an immediate text response versus information-only texts. The percentage change in ITE scores between 2013 and 2014 was significant. Comparing subgroups, there was no significant difference between the percentage change in ITE scores. Neither group performed significantly better on either the adolescent or developmental sections of the ITE. Text messaging… remains an underused educational tool CONCLUSIONS: Overall, participants improved their ITE scores, but no improvement was seen in the targeted subgroups on the exam. Although Q&A texts are preferred by residents, further assessment is required to assess the effect on educational outcomes. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

A comparative analysis of homosexual behaviors, sex role preferences, and anal sex proclivities in Latino and non-Latino men.

PubMed

Jeffries, William L

2009-10-01

Machismo prescribes that homosexual encounters among Latino men are conducted along highly gendered lines: men tend to be anally insertive or receptive over the lifecourse, but not both. Some have argued that Latino men have more lifecourse homosexual behaviors in comparison to other racial/ethnic groups. This is often due to the perception that Latin America has quasi-institutionalized homosexuality, which sharply contrasts it with the United States. Although scholars suggest that sex role preferences and greater likelihoods for homosexual behaviors exist among Latino men in the United States, limited empirical data validate these claims. Latino/non-Latino differences in male homosexual behaviors and sex role preferences were analyzed by using the 2002 cycle of the National Survey of Family Growth, a nationally representative, probability sample of 4,928 men. Findings revealed that non-Mexican Latino, but not Mexican, men had increased likelihoods of ever having anal sex than non-Latino Whites and oral sex than non-Latino Blacks. These relationships remained after controlling for age, education, and foreign birth. Latino men preferred insertive or receptive sex in comparison to non-Latino Blacks and Whites, but this difference disappeared after education was controlled. In full and reduced models, Mexican men tended to be orifice-specific (oral or anal), while non-Mexican Latinos were more oriented to both oral and anal sex. Controlling for other factors, all Latinos were more likely than non-Latino Blacks and Whites to refuse to answer male homosexual behavior questions. The implications of race/ethnicity are discussed for homosexual behavior patterns among U.S. men.

Does estrogen play a role in response to adjuvant bone-targeted therapies?

PubMed Central

Russell, Kent; Amir, Eitan; Paterson, Alexander; Josse, Robert; Addison, Christina; Kuchuk, Iryna; Clemons, Mark

2013-01-01

Bone remains the most common site of breast cancer recurrence. The results of population studies, pre-clinical research and clinical studies in patients with metastatic disease provided a rationale for testing bone-targeted agents in the adjuvant setting. Despite the initial optimism, results from eight prospectively designed, randomized control studies powered to assess the value of adjuvant bone-targeted therapy in early breast cancer are conflicting. Data have shown that, where benefit exists, it tends to be in women with a “low estrogen environment”, either through menopause or suppression of ovarian function. In this manuscript, we review clinical data supporting the hypothesis that estrogen levels may play a part in explaining the response of patients to bone-targeted agents in the adjuvant setting. The results presented to date suggest that there may be data supporting a unifying role for estrogen in adjuvant trials. However, in the absence of any prospective randomized trials in which estrogen data has been systematically collected we cannot specifically answer this question. We await the results of the Oxford overview analysis of individual patient data with interest. PMID:26909288

Mixed-methods research in pharmacy practice: recommendations for quality reporting. Part 2.

PubMed

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

2014-02-01

This is the second of two papers that explore the use of mixed-methods research in pharmacy practice. This paper discusses the rationale, applications, limitations and challenges of conducting mixed-methods research. As with other research methods, the choice of mixed-methods should always be justified because not all research questions require a mixed-methods approach. Mixed-methods research is particularly suitable when one dataset may be inadequate in answering the research question, an explanation of initial results is required, generalizability of qualitative findings is desired or broader and deeper understanding of a research problem is necessary. Mixed-methods research has its own challenges and limitations, which should be considered carefully while designing the study. There is a need to improve the quality of reporting of mixed-methods research. A framework for reporting mixed-methods research is proposed, for researchers and reviewers, with the intention of improving its quality. Pharmacy practice research can benefit from research that uses both 'numbers' (quantitative) and 'words' (qualitative) to develop a strong evidence base to support pharmacy-led services. © 2013 Royal Pharmaceutical Society.

Is traditional financial aid too little, too late to help youth succeed in college? An introduction to The Degree Project promise scholarship experiment.

PubMed

Harris, Douglas N

2013-01-01

One of the key barriers in accessing postsecondary opportunities for many students is financial aid. This chapter begins by providing a review of prior evidence on the relationship between financial aid and postsecondary outcomes. One type of financial aid intervention that challenges traditional aid and scholarship options are "promise programs." These programs make commitments to low-income students when they are much younger than when students typically apply for aid and have the potential to encourage students to better prepare during high school, develop the social capital they need to navigate the path to college, and pay for growing college costs. In this chapter, the author describes the design and rationale for The Degree Project (TDP), which is the first randomized trial of a promise scholarship in the United States. In addition to the important new evidence the demonstration program will generate, TDP also shows how educators and researchers can work together to provide the insight and answers policy makers need to address very real education gaps. © WILEY PERIODICALS, INC.

The NASA probe-class mission concept, CETUS (Cosmic Evolution Through Ultraviolet Spectroscopy)

NASA Astrophysics Data System (ADS)

Heap, Sara; Danchi, William; Burge, James; Dodson, Kelly; Hull, Anthony; Kendrick, Steven; McCandliss, Stephan; Mehle, Gregory; Purves, Lloyd; Sheikh, David; Valente, Martin; Woodruff, Robert A.

2017-09-01

We report on the early phases of a NASA-sponsored study of CETUS (Cosmic Evolution Through Ultraviolet Spectroscopy), a Probe-class mission concept. By definition, the full lifecycle cost of a Probe mission is greater than 400M (i.e. Explorer missions) and less than 1.00B ("Flagship" missions). The animating idea behind our study is that CETUS can help answer fundamental questions about galaxy evolution by carrying out a massive UV imaging and spectroscopic survey of galaxies and combining its findings with data obtained by other survey telescopes of the 2020's. The CETUS mission concept comprises a 1.5-m wide-field telescope and three scientific instruments: a near-UV multi-object slit spectrograph with a micro-shutter array as the slit device; a near-UV and far-UV camera with angular resolution of 0.42" (near-UV) or 0.55" (far-UV); and a near-UV or far-UV single-object spectrograph aimed at providing access to the UV after Hubble is gone. We describe the scientific rationale for CETUS and the telescope and instruments in their early design phase.

Brain Tissue Oxygen Monitoring and the Intersection of Brain and Lung: A Comprehensive Review.

PubMed

Ngwenya, Laura B; Burke, John F; Manley, Geoffrey T

2016-09-01

Traumatic brain injury is a problem that affects millions of Americans yearly and for which there is no definitive treatment that improves outcome. Continuous brain tissue oxygen (PbtO2 ) monitoring is a complement to traditional brain monitoring techniques, such as intracranial pressure and cerebral perfusion pressure. PbtO2 monitoring has not yet become a clinical standard of care, due to several unresolved questions. In this review, we discuss the rationale and technology of PbtO2 monitoring. We review the literature, both historic and current, and show that continuous PbtO2 monitoring is feasible and useful in patient management. PbtO2 numbers reflect cerebral blood flow and oxygen diffusion. Thus, continuous monitoring of PbtO2 yields important information about both the brain and the lung. The preclinical and clinical studies demonstrating these findings are discussed. In this review, we demonstrate that patient management in a PbtO2 -directed fashion is not the sole answer to the problem of treating traumatic brain injury but is an important adjunct to the armamentarium of multimodal neuromonitoring. Copyright © 2016 by Daedalus Enterprises.

33 CFR 279.9 - Objective rationale.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Section 279.9 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.9 Objective rationale. (a) Statement of objectives... objective(s) and providing the rationale, impact, and basic management measures for their accomplishment...

33 CFR 279.9 - Objective rationale.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Section 279.9 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.9 Objective rationale. (a) Statement of objectives... objective(s) and providing the rationale, impact, and basic management measures for their accomplishment...

33 CFR 279.9 - Objective rationale.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Section 279.9 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.9 Objective rationale. (a) Statement of objectives... objective(s) and providing the rationale, impact, and basic management measures for their accomplishment...

33 CFR 279.9 - Objective rationale.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Section 279.9 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.9 Objective rationale. (a) Statement of objectives... objective(s) and providing the rationale, impact, and basic management measures for their accomplishment...

33 CFR 279.9 - Objective rationale.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 279.9 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE RESOURCE USE: ESTABLISHMENT OF OBJECTIVES § 279.9 Objective rationale. (a) Statement of objectives... objective(s) and providing the rationale, impact, and basic management measures for their accomplishment...

Internal Medicine Physicians’ Perceptions Regarding Rate versus Rhythm Control for Atrial Fibrillation

PubMed Central

McCabe, James M.; Johnson, Colleen J; Marcus, Gregory M

2011-01-01

Atrial fibrillation (AF) is often managed by general internal medicine physicians. Available data suggest that guidelines regarding AF management are often not followed, but the reasons for this remain unknown. We sought to assess the knowledge and beliefs of internists regarding strategies to treat AF. We conducted a national electronic survey of internal medicine physicians regarding their perceptions of optimal AF management, with an emphasis on the rationale for choosing a rhythm or rate control strategy. One hundred and forty-eight physicians from 36 different states responded (representing at least 19% of unique e-mails opened). Half of the respondents reported managing their AF patients independently without referral to a cardiologist. Seventy-three percent of participants believe a rhythm control strategy conveys a decreased stroke risk, 64% believe there is a mortality benefit to rhythm control, and 55% think that it would help avoid long term anticoagulation. Comparing those who prefer a rhythm control strategy to everyone else, those who favor rhythm control statistically significantly more often believe that rhythm control reduces the risk for stroke (96% versus 67%, p=0.009) and that rhythm control allows for the discontinuation of anticoagulation therapy (76% versus 49%, p=0.045). In conclusion, contrary to available data in clinical trials and recent guidelines regarding the rationale for choosing a rhythm control strategy in treating AF, the majority of study participants believe that rhythm control decreases stroke risk, decreases mortality, and allows for discontinuation of anticoagulation therapy. These prevalent misconceptions may substantially contribute to guideline non-adherence. PMID:19195516

"Selling smarter, not harder": Life course effects on drug sellers' risk perceptions and management.

PubMed

Fader, Jamie J

2016-10-01

Policies undergirding the American War on Drugs assume that drug offenders respond rationally to adjustments in sanction certainty and severity. Previous studies find that instead of absolute deterrence, or the termination of criminal activity, drug offenders employ restrictive deterrence, or a variety of risk management strategies. Extant research and current drug policy both fail to examine the interaction of risk perception, management techniques, and life course events or circumstances. This dynamic examination of apprehension avoidance strategies relies on in-depth interviews mapping out the careers of 20 drug sellers in Philadelphia, Pennsylvania. It examines their risk perceptions and risk management strategies and techniques, exploring rationales for shifts in offending behavior. Respondents were highly risk-averse but used a narrow definition of sanctions relevant to shaping future offending behavior, typically making small adjustments in sales techniques. Rationales for these shifts included sanctions, personal preference, and life course events or circumstances. Only one attributed lasting desistance from offending to a sanction, although life course events such as parenthood and employment were associated with short-term and planned desistance. The limited relevance of sanctions to offenders' thinking about risk avoidance contextualizes the widespread failure of policies designed to deter drug sales. Findings support a growing conclusion that severity of punishment is a less powerful deterrent than certainty and that adjustments in certainty after arrest are offense-specific. The relationship of life course events - especially employment - to desistance and resumed offending suggest that social policies may be more effective than criminal justice sanctions in reducing drug offending. Copyright © 2016 Elsevier B.V. All rights reserved.

The recruitment of patients to trials in head and neck cancer: a qualitative study of the EaStER trial of treatments for early laryngeal cancer.

PubMed

Hamilton, D W; de Salis, I; Donovan, J L; Birchall, M

2013-08-01

We aimed to investigate the factors contributing to poor recruitment to the EaStER trial "Early Stage glottic cancer: Endoscopic excision or Radiotherapy" feasibility study. We performed a prospective qualitative assessment of the EaStER trial at three centres to investigate barriers to recruitment and implement changes. Methods used included semi-structured interviews, focus groups and audio-recordings of recruitment encounters. First, surgeons and recruiters did not all accept the primary outcome as the rationale for the trial. Surgeons did not always adhere to the trial eligibility criteria leading to variations between centres in the numbers of "eligible" patients. Second, as both treatments were considered equally successful, recruiters and patients focused on the pragmatics of the different trial arms, favouring surgery over radiotherapy. The lack of equipoise was reflected in the way recruiters presented trial information. Third, patient views, beliefs and preferences were not fully elicited or addressed by recruiters. Fourth, in some centres, logistical issues made trial participation difficult. This qualitative research identified several major issues that explained recruitment difficulties. While there was insufficient time to address these in the EaStER trial, several factors would need to be addressed to launch further RCTs in head and neck cancer. These include the need for clear ongoing agreement among recruiting clinicians regarding details in the study protocol; an understanding of the logistical issues hindering recruitment at individual centres; and training recruiters to enable them to explain the need for randomisation and the rationale for the RCT to patients.

A demonstration of mixed-methods research in the health sciences.

PubMed

Katz, Janet; Vandermause, Roxanne; McPherson, Sterling; Barbosa-Leiker, Celestina

2016-11-18

Background The growth of patient, community and population-centred nursing research is a rationale for the use of research methods that can examine complex healthcare issues, not only from a biophysical perspective, but also from cultural, psychosocial and political viewpoints. This need for multiple perspectives requires mixed-methods research. Philosophy and practicality are needed to plan, conduct, and make mixed-methods research more broadly accessible to the health sciences research community. The traditions and dichotomy between qualitative and quantitative research makes the application of mixed methods a challenge. Aim To propose an integrated model for a research project containing steps from start to finish, and to use the unique strengths brought by each approach to meet the health needs of patients and communities. Discussion Mixed-methods research is a practical approach to inquiry, that focuses on asking questions and how best to answer them to improve the health of individuals, communities and populations. An integrated model of research begins with the research question(s) and moves in a continuum. The lines dividing methods do not dissolve, but become permeable boundaries where two or more methods can be used to answer research questions more completely. Rigorous and expert methodologists work together to solve common problems. Conclusion Mixed-methods research enables discussion among researchers from varied traditions. There is a plethora of methodological approaches available. Combining expertise by communicating across disciplines and professions is one way to tackle large and complex healthcare issues. Implications for practice The model presented in this paper exemplifies the integration of multiple approaches in a unified focus on identified phenomena. The dynamic nature of the model signals a need to be open to the data generated and the methodological directions implied by findings.

Questionnaire about psychology/disease correlation–I

PubMed Central

Ojog, DG; Pănescu, OM; Rusu, EC; Tănăsescu, MD

2011-01-01

Rationale: The existing personality inventories are exploring too general psychological features so that the possible psychology/disease associations might be leveled out. Objective: We attempt to build a tool to explore the possible correlation between certain psychological features and the most common internal disorders. Method: We have used two questionnaires containing many pairs of synonymous items (necessary for assessing the consistency of the answers). The items are divided into four main domains: preoccupation for the basal conditions of existence (health/ disease/ death, fear, money, lodging); interaction with other people; action, will/ volition, self-assertion; and preoccupation with the exterior. In this first article we are presenting the correlations between items of the first domain, based on the answers from our first 3138 respondents. Results and discussion: The concern about health is best reflected by general formulations. The desire for security is best expressed by items combining the worry about money and dwelling, and worst by items reflecting the eagerness to gain, keep or judiciously spend money. Among the various fears, those of future, darkness, and loneliness are better indicators of security concern. In assessing the anxiety about safety/ security, specific worries are more revelatory than the general ones. Precaution and inclination for order are the best indicators for the aspiration to stability. Poorer ones are the desire for cleanliness and the tendency to attachment. Health and security concerns seem to be consistently linked. The consistency evaluating system will be based upon pairs of synonymous items correlated with a10–200 or less error probability Abbreviations: PP = psychological profile; PF = personality feature; Q1/ Q2/ Q3 = first/ second/ third questionnaire; HeSD = health subdomain; SeSD = security subdomain; StSD = stability subdomain; ChiSq = chi square; ErrProb = error probability (probability of error). PMID:21505574

Rationale, design, and baseline characteristics of the Acetylcystein for Contrast-Induced nephropaThy (ACT) Trial: a pragmatic randomized controlled trial to evaluate the efficacy of acetylcysteine for the prevention of contrast-induced nephropathy

PubMed Central

2009-01-01

Background Aceltylcysteine has been evaluated in several small trials as a means of reducing the risk of contrast-induced nephropathy (CIN), however systematic reviews of these studies do not provide conclusive answers. Therefore, a large randomized controlled trial (RCT) is needed to provide a reliable answer as to whether acetylcysteine is effective in decreasing the risk of CIN in high-risk patients undergoing angiographic procedures. Methods ACT is a RCT of acetylcysteine versus placebo in 2,300 patients at-risk for CIN undergoing an intravascular angiographic procedure. The randomization list will be concealed. Participants, health care staff, investigators and outcome assessors will be blinded to whether patients receive acetylcysteine or placebo. All analysis will follow the intention-to-treat principle. The study drugs (acetylcysteine 1200 mg or placebo) will be administered orally twice daily for two doses before and two doses after the procedure. The primary outcome is the occurrence of CIN, defined as a 25% elevation of serum creatinine above baseline between 48 and 96 hours after angiography. Discussion The first patient entered the trial on September, 2008. Up to April 7, 2009, 810 patients had been included in 35 centers. The mean age was 69 (Standard deviation: 10), 18% had a baseline serum creatinine >1.5 mg/dL, 57% were diabetics and 13% had a history of heart failure. The ongoing ACT Trial is the largest multicentre RCT that will determine whether acetylcysteine is effective in decreasing the risk of CIN in patients at risk undergoing angiography. Trial registration Clinicaltrials.gov NCT00736866 PMID:19497091

Mechanisms of Communicating Health Information Through Facebook: Implications for Consumer Health Information Technology Design

PubMed Central

Menefee, Hannah K; Thompson, Morgan J; Guterbock, Thomas M; Williams, Ishan C

2016-01-01

Background Consumer health information technology (IT) solutions are designed to support patient health management and have the ability to facilitate patients’ health information communication with their social networks. However, there is a need for consumer health IT solutions to align with patients’ health management preferences for increased adoption of the technology. It may be possible to gain an understanding of patients’ needs for consumer health IT supporting their health information communication with social networks by explicating how they have adopted and adapted social networking sites, such as Facebook, for this purpose. Objective Our aim was to characterize patients’ use of all communication mechanisms within Facebook for health information communication to provide insight into how consumer health IT solutions may be better designed to meet patients’ communication needs and preferences. Methods This study analyzed data about Facebook communication mechanisms use from a larger, three-phase, sequential, mixed-methods study. We report here on the results of the study’s first phase: qualitative interviews (N=25). Participants were over 18, used Facebook, were residents or citizens of the United States, spoke English, and had a diagnosis consistent with type 2 diabetes. Participants were recruited through Facebook groups and pages. Participant interviews were conducted via Skype or telephone between July and September 2014. Data analysis was grounded in qualitative content analysis and the initial coding framework was informed by the findings of a previous study. Results Participants’ rationales for the use or disuse of a particular Facebook mechanism to communicate health information reflected six broad themes: (1) characteristics and circumstances of the person, (2) characteristics and circumstances of the relationship, (3) structure and composition of the social network, (4) content of the information, (5) communication purpose, and (6) attributes of the technology. Conclusions The results of this study showed that participants consider multiple factors when choosing a Facebook mechanism for health information communication. Factors included what information they intended to share, what they were trying to accomplish, attributes of technology, and attributes and communication practices of their social networks. There is a need for consumer health IT that allows for a range of choices to suit the intersectionality of participants’ rationales. Technology that better meets patients’ needs may lead to better self-management of health conditions, and therefore, improve overall health outcomes. PMID:27515151

Mechanisms of Communicating Health Information Through Facebook: Implications for Consumer Health Information Technology Design.

PubMed

Menefee, Hannah K; Thompson, Morgan J; Guterbock, Thomas M; Williams, Ishan C; Valdez, Rupa S

2016-08-11

Consumer health information technology (IT) solutions are designed to support patient health management and have the ability to facilitate patients' health information communication with their social networks. However, there is a need for consumer health IT solutions to align with patients' health management preferences for increased adoption of the technology. It may be possible to gain an understanding of patients' needs for consumer health IT supporting their health information communication with social networks by explicating how they have adopted and adapted social networking sites, such as Facebook, for this purpose. Our aim was to characterize patients' use of all communication mechanisms within Facebook for health information communication to provide insight into how consumer health IT solutions may be better designed to meet patients' communication needs and preferences. This study analyzed data about Facebook communication mechanisms use from a larger, three-phase, sequential, mixed-methods study. We report here on the results of the study's first phase: qualitative interviews (N=25). Participants were over 18, used Facebook, were residents or citizens of the United States, spoke English, and had a diagnosis consistent with type 2 diabetes. Participants were recruited through Facebook groups and pages. Participant interviews were conducted via Skype or telephone between July and September 2014. Data analysis was grounded in qualitative content analysis and the initial coding framework was informed by the findings of a previous study. Participants' rationales for the use or disuse of a particular Facebook mechanism to communicate health information reflected six broad themes: (1) characteristics and circumstances of the person, (2) characteristics and circumstances of the relationship, (3) structure and composition of the social network, (4) content of the information, (5) communication purpose, and (6) attributes of the technology. The results of this study showed that participants consider multiple factors when choosing a Facebook mechanism for health information communication. Factors included what information they intended to share, what they were trying to accomplish, attributes of technology, and attributes and communication practices of their social networks. There is a need for consumer health IT that allows for a range of choices to suit the intersectionality of participants' rationales. Technology that better meets patients' needs may lead to better self-management of health conditions, and therefore, improve overall health outcomes.

Medial prefrontal serotonin in the rat is involved in goal-directed behaviour when affect guides decision making

PubMed Central

La Fors, Sabrina S. B. M.; Meerkerk, Dorie T. J.; Joosten, Ruud N. J. M. A.; Uylings, Harry B. M.; Feenstra, Matthijs G. P.

2007-01-01

Rationale Across species, serotonin (5-HT) depletion in the prefrontal cortex (PFC) has been shown to cause impaired performance on tests of cognitive flexibility and the processing of affective information (e.g. information with an ‘emotional’ content). While recent work has explored the specific role of the orbital PFC herein, the role of the medial PFC remains unclear. Objectives The aim of our current experiments was to study the role of medial PFC 5-HT in both the processing of affective information and reversal learning across stimulus modalities. Materials and methods To this end, we selectively destroyed 5-HT terminals in the medial PFC of male Wistar rats by means of local infusion of the toxin 5,7-dihydroxytryptamine. Both control and lesioned animals were tested in two reversal learning paradigms with either spatial or odour cues and an affective switch from non-preferred to preferred food rewards. Results Our results indicate that a pellet switch during reversal learning impaired performance in control animals but not in lesioned animals, independent of the stimulus modality. Conclusion These results indicate that lesioned animals are not guided in their behaviour by the affective value of the reward like intact animals and thus that medial prefrontal 5-HT is needed for affective processing in goal-directed behaviour. PMID:17874235

DECIDE: a Decision Support Tool to Facilitate Parents' Choices Regarding Genome-Wide Sequencing.

PubMed

Birch, Patricia; Adam, S; Bansback, N; Coe, R R; Hicklin, J; Lehman, A; Li, K C; Friedman, J M

2016-12-01

We describe the rationale, development, and usability testing for an integrated e-learning tool and decision aid for parents facing decisions about genome-wide sequencing (GWS) for their children with a suspected genetic condition. The online tool, DECIDE, is designed to provide decision-support and to promote high quality decisions about undergoing GWS with or without return of optional incidental finding results. DECIDE works by integrating educational material with decision aids. Users may tailor their learning by controlling both the amount of information and its format - text and diagrams and/or short videos. The decision aid guides users to weigh the importance of various relevant factors in their own lives and circumstances. After considering the pros and cons of GWS and return of incidental findings, DECIDE summarizes the user's responses and apparent preferred choices. In a usability study of 16 parents who had already chosen GWS after conventional genetic counselling, all participants found DECIDE to be helpful. Many would have been satisfied to use it alone to guide their GWS decisions, but most would prefer to have the option of consulting a health care professional as well to aid their decision. Further testing is necessary to establish the effectiveness of using DECIDE as an adjunct to or instead of conventional pre-test genetic counselling for clinical genome-wide sequencing.

Avoiding the "brick wall of awkward": Perspectives of youth with autism spectrum disorder on social-focused intervention practices.

PubMed

Bottema-Beutel, Kristen; Mullins, Teagan S; Harvey, Michelle N; Gustafson, Jenny R; Carter, Erik W

2016-02-01

Many youth with autism spectrum disorder participate in school-based, peer-mediated intervention programs designed to improve their social experiences. However, there is little research discerning how these youth view intervention practices currently represented in the literature, information which could improve the social validity of intervention programming. In this mixed-methods study, we interviewed 33 youth with autism spectrum disorder about seven social-focused, peer-mediated intervention components. We asked participants to rate the favorability of each component to determine their degree of liking. Subsequently, we asked participants to give a rationale for their rating, in order to explore influencing factors. Chi-square tests indicated that high ratings were most prevalent for recruiting peers and family involvement and medium ratings were most prevalent for meeting with peers. Analyses of variance also indicated that preferences in the specific format intervention components were delivered. Several themes emerged from our qualitative analysis of open-ended responses, including the ramifications of adults in adolescent social life, the advantages of learning through shared activities with peers, and the effects of disclosing disability status. Our findings will offer guidance for researchers and practitioners interested in individualizing interventions to reflect student preferences. Furthermore, we document areas of concern for youth with autism spectrum disorder as they access school-based interventions. © The Author(s) 2015.

Acceptability of prolonged exposure therapy among U.S. Iraq war veterans with PTSD symptomology.

PubMed

Kehle-Forbes, Shannon M; Polusny, Melissa A; Erbes, Christopher R; Gerould, Heather

2014-08-01

Despite efforts to increase the availability of prolonged exposure therapy (PE) within the Department of Veterans Affairs, little is known about the acceptability of PE among veteran populations. We queried a sample of 58 U.S. National Guard Iraq War veterans previously deployed to combat who screened positive for posttraumatic stress disorder (PTSD) as to whether they would prefer PE, treatment with an antidepressant, or no treatment. We also gathered open-ended responses regarding the veterans' reasons for their choice and potential barriers to engaging in that treatment. A majority (53.4%) of veterans who completed the interview said they would choose to participate in PE, 36.2% preferred antidepressant treatment, 8.6% chose no treatment, and 1.8% were unable to choose among the options. Credibility of the treatment rationale and beliefs about the treatment's efficacy were the most frequently given reasons for choosing PE (45.2%); past treatment experience was the most common reason for choosing antidepressant treatment (47.6%). The most commonly cited barrier for those who chose both antidepressant treatment and PE was time to participate (52.4% and 77.4%, respectively). The findings suggest that PE is a credible and acceptable treatment option for veterans with PTSD symptomology. Published 2014. This article is a US Government work and is in the public domain in the USA.

Attitudes and preferences for the clinical management of patients with hypertension and hypertension with chronic obstructive pulmonary disease in Italy: main results of a survey questionnaire.

PubMed

Tocci, Giuliano; Cicero, Arrigo F; Salvetti, Massimo; Passerini, Jasmine; Musumeci, Maria Beatrice; Ferrucci, Andrea; Borghi, Claudio; Volpe, Massimo

2015-12-01

Hypertension treatment and control represent a clinical challenge, particularly in case of concomitant risk factors and comorbidities, including chronic obstructive pulmonary disease (COPD). To evaluate attitudes and preferences for the clinical management of hypertension and hypertension associated with COPD by a large community sample of physicians in Italy. A predefined 18-item survey questionnaire was anonymously administered to both specialised physicians (SPs) and general practitioners (GPs), who have been included in an educational programme, performed between January and June 2014. A total of 1181 physicians (767 males, mean age 55.8 ± 7.3 years, average age of medical activity 27.6 ± 8.3 years), among whom 64 (5.4 %) SPs and 1117 (94.6 %) GPs, provided 21,809 valid answers to the survey questionnaire. Concomitant presence of hypertension and COPD was frequently associated (21-40 %) with hypertension-related organ damage and comorbidities. Concomitant presence of hypertension and COPD was able to affect physicians' ability to achieve the recommended therapeutic targets. To achieve the recommended BP goals, ACE inhibitors or ARBs were considered the most effective antihypertensive strategies, both in monotherapies and in combination therapies with either diuretics or calcium-channel blockers. This observational, cross-sectional survey provides useful information on physicians' attitudes and preferences for the clinical management of patients with hypertension and hypertension associated with COPD.

Improving GRADE evidence tables part 1: a randomized trial shows improved understanding of content in summary of findings tables with a new format.

PubMed

Carrasco-Labra, Alonso; Brignardello-Petersen, Romina; Santesso, Nancy; Neumann, Ignacio; Mustafa, Reem A; Mbuagbaw, Lawrence; Etxeandia Ikobaltzeta, Itziar; De Stio, Catherine; McCullagh, Lauren J; Alonso-Coello, Pablo; Meerpohl, Joerg J; Vandvik, Per Olav; Brozek, Jan L; Akl, Elie A; Bossuyt, Patrick; Churchill, Rachel; Glenton, Claire; Rosenbaum, Sarah; Tugwell, Peter; Welch, Vivian; Garner, Paul; Guyatt, Gordon; Schünemann, Holger J

2016-06-01

The current format of summary of findings (SoFs) tables for presenting effect estimates and associated quality of evidence improve understanding and assist users finding key information in systematic reviews. Users of SoF tables have demanded alternative formats to express findings from systematic reviews. We conducted a randomized controlled trial among systematic review users to compare the relative merits of a new format with the current formats of SoF tables regarding understanding, accessibility of information, satisfaction, and preference. Our primary goal was to show that the new format is not inferior to the current format. Of 390 potentially eligible subjects, 290 were randomized. Of seven items testing understanding, three showed similar results, two showed small differences favoring the new format, and two (understanding risk difference and quality of the evidence associated with a treatment effect) showed large differences favoring the new format [63% (95% confidence interval {CI}: 55, 71) and 62% (95% CI: 52, 71) more correct answers, respectively]. Respondents rated information in the alternative format as more accessible overall and preferred the new format over the current format. While providing at least similar levels of understanding for some items and increased understanding for others, users prefer the new format of SoF tables. Copyright © 2016 Elsevier Inc. All rights reserved.

Sleeping position and reported quality of sleep. A comparison between subjects demanding treatment for temporomandibular disorders and controls.

PubMed

Mundt, Anna-Kerstin Göthe; Helkimo, Martti; Magnusson, Tomas

2011-01-01

The aims of the present study were to investigate if there are differences concerning preferred body posture during sleep between 100 patients, 66 women and 34 men, mean age: 49 years (range: 20-85 years) referred to a specialist clinic because of TMD and 100 matched controls from a public dental clinic. The participants were asked to answer a questionnaire with questions about TMD symptoms and neck or shoulder pain. They were also asked about preferred sleeping position as well as about perceived sleep quality. No differences could be found between the two groups in respect of sleeping position. However, significantly more individuals in the TMD group compared to the controls had changed their preferred sleeping position due to their face and/or jaw and/ or neck-shoulder symptoms. Subjects in the TMD group also more frequently stated that they often felt insufficiently rested at awakening and/or felt tired or sleepy in the daytime because of symptoms from face/jaws. A significant number in the control group reported TMD symptoms indicating a latent need for TMD treatment. It is concluded that sleep position seems to have little or no significance for the development or maintenance of TMD symptoms. However, the study indicates that TMD symptoms and associated neck- and shoulder pain affect the quality of sleep.

Those who hesitate lose: the relationship between assertiveness and response latency.

PubMed

Collins, L H; Powell, J L; Oliver, P V

2000-06-01

Individuals who are low in assertiveness may take longer to sort out, process, and state their own perceptions, attitudes and priorities, which puts them at a disadvantage in getting their needs met. The reason for this may not be inhibition in social situations or cognitive ability, but a lack of clarity regarding their own attitudes, opinions, preferences, goals, and priorities. 101 undergraduate students (57% women and 43% men) completed a demographics questionnaire, the Wonderlic Personnel Test, a self-monitoring scale, the Marlowe-Crowne Social Desirability Scale, the Rosenberg Self-esteem Scale, the College Self-expression Scale, and a test of the false-consensus effect. Response latencies to questions were measured. Individuals with higher scores on the Wonderlic Personnel Test answered items more quickly but, even when cognitive ability was controlled, individuals low in assertiveness still took significantly longer to respond to questions about themselves, their opinions, and their preferences. If individuals fall behind at this early step in the process of asserting themselves, then they may be more likely to miss opportunities to be assertive.

Negatively-Marked MCQ Assessments That Reward Partial Knowledge Do Not Introduce Gender Bias Yet Increase Student Performance and Satisfaction and Reduce Anxiety

PubMed Central

Bond, A. Elizabeth; Bodger, Owen; Skibinski, David O. F.; Jones, D. Hugh; Restall, Colin J.; Dudley, Edward; van Keulen, Geertje

2013-01-01

Multiple-choice question (MCQ) examinations are increasingly used as the assessment method of theoretical knowledge in large class-size modules in many life science degrees. MCQ-tests can be used to objectively measure factual knowledge, ability and high-level learning outcomes, but may also introduce gender bias in performance dependent on topic, instruction, scoring and difficulty. The ‘Single Answer’ (SA) test is often used in which students choose one correct answer, in which they are unable to demonstrate partial knowledge. Negatively marking eliminates the chance element of guessing but may be considered unfair. Elimination testing (ET) is an alternative form of MCQ, which discriminates between all levels of knowledge, while rewarding demonstration of partial knowledge. Comparisons of performance and gender bias in negatively marked SA and ET tests have not yet been performed in the life sciences. Our results show that life science students were significantly advantaged by answering the MCQ test in elimination format compared to single answer format under negative marking conditions by rewarding partial knowledge of topics. Importantly, we found no significant difference in performance between genders in either cohort for either MCQ test under negative marking conditions. Surveys showed that students generally preferred ET-style MCQ testing over SA-style testing. Students reported feeling more relaxed taking ET MCQ and more stressed when sitting SA tests, while disagreeing with being distracted by thinking about best tactics for scoring high. Students agreed ET testing improved their critical thinking skills. We conclude that appropriately-designed MCQ tests do not systematically discriminate between genders. We recommend careful consideration in choosing the type of MCQ test, and propose to apply negative scoring conditions to each test type to avoid the introduction of gender bias. The student experience could be improved through the incorporation of the elimination answering methods in MCQ tests via rewarding partial and full knowledge. PMID:23437081

Forum: The Rise of International Large-Scale Assessments and Rationales for Participation

ERIC Educational Resources Information Center

Addey, Camilla; Sellar, Sam; Steiner-Khamsi, Gita; Lingard, Bob; Verger, Antoni

2017-01-01

This Forum discusses the significant growth of international large-scale assessments (ILSAs) since the mid-1990s. Addey and Sellar's contribution ("A Framework for Analysing the Multiple Rationales for Participating in International Large-Scale Assessments") outlines a framework of rationales for participating in ILSAs and examines the…

The Social Benefits of Higher Education: Implications for Regional Finance.

ERIC Educational Resources Information Center

Winkler, Donald R.

This paper evaluates the nature, size, and distribution of public benefits generated by institutions of higher education and assesses the rationale for regional subsidies. Following introductory material, part two discusses the rationale for general public support of higher education and assesses the legitimacy of extending this rationale to…

"Socialized Music": Historical Formations of Community Music through Social Rationales

ERIC Educational Resources Information Center

Yerichuk, Deanna

2014-01-01

This article traces the formation of community music through professional and scholarly articles over the last century in North America, and argues that community music has been discursively formed through social rationales, although the specific rationales have shifted. The author employs an archaeological framework inspired by Michel Foucault to…

Rationale for Student Dress Codes: A Review of School Handbooks

ERIC Educational Resources Information Center

Freeburg, Elizabeth W.; Workman, Jane E.; Lentz-Hees, Elizabeth S.

2004-01-01

Through dress codes, schools establish rules governing student appearance. This study examined stated rationales for dress and appearance codes in secondary school handbooks; 182 handbooks were received. Of 150 handbooks containing a rationale, 117 related dress and appearance regulations to students' right to a non-disruptive educational…

Measuring mental illness stigma with diminished social desirability effects.

PubMed

Michaels, Patrick J; Corrigan, Patrick W

2013-06-01

For persons with mental illness, stigma diminishes employment and independent living opportunities as well as participation in psychiatric care. Public stigma interventions have sought to ameliorate these consequences. Evaluation of anti-stigma programs' impact is typically accomplished with self-report questionnaires. However, cultural mores encourage endorsement of answers that are socially preferred rather than one's true belief. This problem, social desirability, has been circumvented through development of faux knowledge tests (KTs) (i.e., Error-Choice Tests); written to assess prejudice. Our KT uses error-choice test methodology to assess stigmatizing attitudes. Test content was derived from review of typical KTs for façade reinforcement. Answer endorsement suggests bias or stigma; such determinations were based on the empirical literature. KT psychometrics were examined in samples of college students, community members and mental health providers and consumers. Test-retest reliability ranged from fair (0.50) to good (0.70). Construct validity analyses of public stigma indicated a positive relationship with the Attribution Questionnaire and inverse relationships with Self-Determination and Empowerment Scales. No significant relationships were observed with self-stigma measures (recovery, empowerment). This psychometric evaluation study suggests that a self-administered questionnaire may circumvent social desirability and have merit as a stigma measurement tool.

Cost-effectiveness analysis: problems and promise for evaluating medical technology

NASA Astrophysics Data System (ADS)

Juday, Timothy R.

1994-12-01

Although using limited financial resources in the most beneficial way, in principle, a laudable goal, actually developing standards for measuring the cost-effectiveness of medical technologies and incorporating them into the coverage process is a much more difficult proposition. Important methodological difficulties include determining how to compare a technology to its leading alternative, defining costs, incorporating patient preferences, and defining health outcomes. In addition, more practical questions must be addressed. These questions include: who does the analysis? who makes the decisions? which technologies to evaluate? what resources are required? what is the political and legal environment? how much is a health outcome worth? The ultimate question that must be answered is what is a health outcome worth? Cost-effectiveness analysis cannot answer this question; it only enables comparison of cost-effectiveness ratios across technologies. In order to determine whether a technology should be covered, society or individual insurers must determine how much they are willing to pay for the health benefits. Conducting cost-effectiveness analysis will not remove the need to make difficult resource allocation decisions; however, explicitly examining the tradeoffs involved in these decisions should help to improve the process.

Effect of rural practice observation on the anxiety of medical students.

PubMed

Aydin, Se; Yaris, F; Dikici, M F; Artiran Igde, F

2015-01-01

The aim of this study is to identify the level and causes of anxiety of sixth year medical students related to working in a rural area and the effect of a 1-day mobile rural health service observation on their anxiety. In the Ondokuz Mayis University Medical School in Samsun, Turkey, 212 students participated in a 1-day mobile rural health service led by a family physician. Between June 2011 and June 2013, during their family medicine internship, each student completed a structured questionnaire and a State-Trait Anxiety Inventory (STAI) before and after the observation. A total of 85.8% of the students preferred to work in an urban area compared to 14.2%, who preferred a rural area. Currently, 89.6% of the students live in an urban area while 84.4% had lived in an urban area during most of their childhood. A total of 18.5% had no opinion about living conditions in a rural area, 71.7% thought they would be able to deal with the challenges, and 52.4% said the idea of working in a rural area made them anxious. Those students who had lived in a rural area as a child were found to be less anxious about working in a rural area. The association between the preferred work area and the student's anxiety about working in a rural area was statistically significant (p<0.001). Of the students, 76.8% thought that rural areas are more difficult places to work; a major reason for this as stated by 76.4% was the desire to have access to easy transportation. Difficult living conditions was noted by the students as their main reason for not wanting to work in a rural areas. Of the students, 77.8% answered that the 1-day rural health service observation positively affected their perspective on working in a rural area. There were 102 (48.1%) anxious students before the observation and the total decreased to 87 (41%) after the observation. Difficult living conditions were the main reason for students' anxiety about working in a rural area. Most of the students answered that the curriculum positively affected their perspective. Medical schools should provide students with the rural primary care environment experience, which would decrease their anxiety.

[Medical students and psychiatry. A survey of students' opinion].

PubMed

Giberti, F; Corsini, G; Rovida, S

1994-06-01

In the last years research on the didactics of Psychiatry and opinions of medical students on Psychiatry has gained great interest. The authors think that this research could be useful for the improvement of didactics, for better understanding the meanings of professional choice, the identity of psychiatrist and their relationship with colleagues in other medical field. The goal of this research work was a preliminary survey of Genoese University Medical Student's opinions about psychiatry didactics, and choice of specialization. A questionnaire was submitted to all the students who passed Clinical Psychiatry examination in the period from November 1987 to December 1988. The students were divided in two randomized groups: the first group of students (224) was submitted to the questionnaire immediately after Clinical Psychiatry examination; while to the second group of students (66) the questionnaire was mailed. The aim of the questions was to assess the student's opinions on psychiatry, psychoanalysis, psychotherapy, the career they wanted to take up, and the difficulties of studying psychiatry: 69% of the students of the first group and 42% of the students of the second group answered the questionnaire. Female students answered that they preferred psychiatric specialization more than their male colleagues did, but the difference has no statistical importance. In most cases, the students who answered that they have taken into account psychiatry as a choice of specialisation, are more interested in medical specialties (primary care, etc.) than in surgical specialties. Most of the medical students declare some emotional troubles (anxiety, sleeplessness, problem in social relations).(ABSTRACT TRUNCATED AT 250 WORDS)

IMPLEMENTING LAPAROSCOPY IN BRAZIL'S NATIONAL PUBLIC HEALTH SYSTEM: THE BARIATRIC SURGEONS' POINT OF VIEW

PubMed Central

SUSSENBACH, Samanta; SILVA, Everton N; PUFAL, Milene Amarante; ROSSONI, Carina; CASAGRANDE, Daniela Schaan; PADOIN, Alexandre Vontobel; MOTTIN, Cláudio Corá

2014-01-01

Background Although Brazilian National Public Health System (BNPHS) has presented advances regarding the treatment for obesity in the last years, there is a repressed demand for bariatric surgeries in the country. Despite favorable evidences to laparoscopy, the BNPHS only performs this procedure via laparotomy. Aim 1) Estimate whether bariatric surgeons would support the idea of incorporating laparoscopic surgery in the BNPHS; 2) If there would be an increase in the total number of surgeries performed; 3) As well as how BNPHS would redistribute both procedures. Methods A panel of bariatric surgeons was built. Two rounds to answer the structured Delphi questionnaire were performed. Results From the 45 bariatric surgeons recruited, 30 (66.7%) participated in the first round. For the second (the last) round, from the 30 surgeons who answered the first round, 22 (48.9%) answered the questionnaire. Considering the possibility that BNPHS incorporated laparoscopic surgery, 95% of surgeons were interested in performing it. Therefore, in case laparoscopic surgery was incorporated by the BNPHS there would be an average increase of 25% in the number of surgeries and they would be distributed as follows: 62.5% via laparoscopy and 37.5% via laparotomy. Conclusion 1) There was a preference by laparoscopy; 2) would increase the number of operations compared to the current model in which only the laparotomy is available to users of the public system; and 3) the distribution in relation to the type of procedure would be 62.5% and 37.5% for laparoscopy laparotomy. PMID:25409964

A community survey on knowledge of the impact of environmental and epigenetic factors on health and disease.

PubMed

Miller, Marian; Bailey, Banita; Govindarajah, Vinothini; Levin, Linda; Metzger, Traci; Pinney, Susan M; Leung, Yuet-Kin; Ho, Shuk-Mei

2016-11-01

An outreach effort was designed to survey breast cancer survivors, supporters and their families and friends with respect to their interest in, and knowledge of, the potential impact of the environment and epigenetics on health. Two nearly identical questionnaires (one for adolescents and one for adults) were designed to gauge the perception of this community as to whether the environment impacts health and cancer risk through processes other than genetics. The questionnaires were filled out at casual social gatherings, fundraisers and wellness campaigns as well as in schools (730 participants). The differences among correct (scientific consensus) versus other responses (incorrect and not known) were evaluated. Each answer was first analysed individually and then grouped into one of three categories (diet, inheritance and environment) with age, race and gender. Differences for each response, question or group were compared by repeated measures analysis of variance. Respondents generally acknowledged that many factors could be associated with breast cancer although answers to key questions related to epigenetics based on diet, inheritance and environment were often incorrect or not known. The adult participants tended to answer more questions correctly than adolescents did. The majority of participants preferred the Internet as a major source for obtaining further information. The growing awareness and educational needs for adolescents may bring new paradigm-related environmental risk factors, which may minimise negative epigenetic outcome in subsequent generations. There is an educational opportunity, especially using electronic media, for public education concerning the impact of the environment on human health. © Royal Society for Public Health 2016.

Attitudes towards Affirmative Action: Effects of Procedural Rationale and Candidates' Qualifications.

ERIC Educational Resources Information Center

Mann, Jeffrey A.; Fasolo, Peter M.

This study examined whether individuals in higher education who are exposed to a hiring rationale based on a diversity value (minority group differences are valuable and should be relevant criteria for employment decisions in higher education) will rate affirmative action as fairer than those exposed to a compensation rationale (minority status is…

Moral and Instrumental Rationales for Affirmative Action in Five National Contexts

ERIC Educational Resources Information Center

Moses, Michele S.

2010-01-01

The author's primary aims are to clarify the differing rationales for affirmative action that have emerged in five nations--France, India, South Africa, the United States, and Brazil--and to make the case for the most compelling rationales, whether instrumentally or morally based. She examines the different social contexts surrounding the…

Structure, Citizenship, and Professionalism: Exploring Rationale Development as Part of Graduate Education in Social Studies

ERIC Educational Resources Information Center

Hawley, Todd S.; Pifel, A. Robert; Jordan, Adam W.

2012-01-01

This article details an interpretive, qualitative interview study that explored rationales developed by seven social studies graduate students, all experienced teachers, at a large Midwestern university. Interviews revealed three common themes regarding the influence of the rationale development process. The three themes were: providing structure,…

Rationales for Challenged Books. [CD-ROM].

ERIC Educational Resources Information Center

National Council of Teachers of English, Urbana, IL.

This CD-ROM presents a collection of over 200 rationales for over 170 works (mainly novels but a few films) for use by teachers combating censorship. Some rationales on the disc are from published sources; others are student papers. Although the materials in the collection range from kindergarten through grade 12, the emphasis is on the middle…

Scientific management and implementation of the geophysical fluid flow cell for Spacelab missions

NASA Technical Reports Server (NTRS)

Hart, J.; Toomre, J.

1980-01-01

Scientific support for the spherical convection experiment to be flown on Spacelab 3 was developed. This experiment takes advantage of the zero gravity environment of the orbiting space laboratory to conduct fundamental fluid flow studies concerned with thermally driven motions inside a rotating spherical shell with radial gravity. Such a system is a laboratory analog of large scale atmospheric and solar circulations. The radial body force necessary to model gravity correctly is obtained by using dielectric polarization forces in a radially varying electric field to produce radial accelerations proportional to temperature. This experiment will answer fundamental questions concerned with establishing the preferred modes of large scale motion in planetary and stellar atmospheres.

Supplement use in sport: is there a potentially dangerous incongruence between rationale and practice?

PubMed Central

Petróczi, Andrea; Naughton, Declan P

2007-01-01

Background Supplement use by athletes is complex and research supports the alarming notion of misinformed decisions regarding supplements. Hypothesis A frequent divergence between the type of supplements chosen by athletes and the rationale dictating the supplement use is hypothesized. Thus, a potentially dangerous incongruence may exist between rationale and practice. Testing the hypothesis In the continued absence of reliable data on supplement use, an alternative approach of studying the reasons underlying supplement use in athletes is proposed to determine whether there is an incongruence between rationale and practice. Existing data from large scale national surveys can be used to investigate this incongruence. Implications of the hypothesis In this report, analyses of distinctive patterns between the use and rationale for use of supplements among athletes are recommended to explore this potentially dangerous phenomenon. PMID:17535442

Fairness expectations and altruistic sharing in 15-month-old human infants.

PubMed

Schmidt, Marco F H; Sommerville, Jessica A

2011-01-01

Human cooperation is a key driving force behind the evolutionary success of our hominin lineage. At the proximate level, biologists and social scientists have identified other-regarding preferences--such as fairness based on egalitarian motives, and altruism--as likely candidates for fostering large-scale cooperation. A critical question concerns the ontogenetic origins of these constituents of cooperative behavior, as well as whether they emerge independently or in an interrelated fashion. The answer to this question will shed light on the interdisciplinary debate regarding the significance of such preferences for explaining how humans become such cooperative beings. We investigated 15-month-old infants' sensitivity to fairness, and their altruistic behavior, assessed via infants' reactions to a third-party resource distribution task, and via a sharing task. Our results challenge current models of the development of fairness and altruism in two ways. First, in contrast to past work suggesting that fairness and altruism may not emerge until early to mid-childhood, 15-month-old infants are sensitive to fairness and can engage in altruistic sharing. Second, infants' degree of sensitivity to fairness as a third-party observer was related to whether they shared toys altruistically or selfishly, indicating that moral evaluations and prosocial behavior are heavily interconnected from early in development. Our results present the first evidence that the roots of a basic sense of fairness and altruism can be found in infancy, and that these other-regarding preferences develop in a parallel and interwoven fashion. These findings support arguments for an evolutionary basis--most likely in dialectical manner including both biological and cultural mechanisms--of human egalitarianism given the rapidly developing nature of other-regarding preferences and their role in the evolution of human-specific forms of cooperation. Future work of this kind will help determine to what extent uniquely human sociality and morality depend on other-regarding preferences emerging early in life.

Prey preference follows phylogeny: evolutionary dietary patterns within the marine gastropod group Cladobranchia (Gastropoda: Heterobranchia: Nudibranchia).

PubMed

Goodheart, Jessica A; Bazinet, Adam L; Valdés, Ángel; Collins, Allen G; Cummings, Michael P

2017-10-26

The impact of predator-prey interactions on the evolution of many marine invertebrates is poorly understood. Since barriers to genetic exchange are less obvious in the marine realm than in terrestrial or freshwater systems, non-allopatric divergence may play a fundamental role in the generation of biodiversity. In this context, shifts between major prey types could constitute important factors explaining the biodiversity of marine taxa, particularly in groups with highly specialized diets. However, the scarcity of marine specialized consumers for which reliable phylogenies exist hampers attempts to test the role of trophic specialization in evolution. In this study, RNA-Seq data is used to produce a phylogeny of Cladobranchia, a group of marine invertebrates that feed on a diverse array of prey taxa but mostly specialize on cnidarians. The broad range of prey type preferences allegedly present in two major groups within Cladobranchia suggest that prey type shifts are relatively common over evolutionary timescales. In the present study, we generated a well-supported phylogeny of the major lineages within Cladobranchia using RNA-Seq data, and used ancestral state reconstruction analyses to better understand the evolution of prey preference. These analyses answered several fundamental questions regarding the evolutionary relationships within Cladobranchia, including support for a clade of species from Arminidae as sister to Tritoniidae (which both preferentially prey on Octocorallia). Ancestral state reconstruction analyses supported a cladobranchian ancestor with a preference for Hydrozoa and show that the few transitions identified only occur from lineages that prey on Hydrozoa to those that feed on other types of prey. There is strong phylogenetic correlation with prey preference within Cladobranchia, suggesting that prey type specialization within this group has inertia. Shifts between different types of prey have occurred rarely throughout the evolution of Cladobranchia, indicating that this may not have been an important driver of the diversity within this group.

Consumer views on safety of over-the-counter drugs, preferred retailers and information sources in Sweden: after re-regulation of the pharmacy market.

PubMed

Westerlund, Tommy; Barzi, Sahra; Bernsten, Cecilia

2017-01-01

The availability of over-the-counter drugs (OTCs) has increased in Sweden since a re-regulation of the pharmacy market in 2009, through which non-pharmacy retailers became permitted to provide certain OTCs. To examine the adult general public's views on safety, purchasing and information channels, storage and disposal of OTCs in Sweden, three years after the re-regulation of the pharmacy market. A questionnaire study in 2012-13 in a stratified, random sample of all inhabitants in Sweden ≥ 18 years old. Totally 8,302 people (42%) answered the questionnaire. Seven percent found OTCs completely harmless regardless of how they are being used, 18% felt they should be used only on health professionals' recommendation. Differences in how OTCs are perceived were however found with regards to respondents' country of birth, family type, educational level and income. The pharmacy was still the preferred OTC drug retailer by 83% of the respondents and preferred information source by 80% Reasons for preferred retailers were primarily due to out of habit (45%), counseling provided (35%), the product range (34%) and the confidence in staff (27%). Analgesics are the most common OTCs to have at home (90%). The bathroom cabinet is the primary site for storage (42%) and 16% throw their OTC leftovers in the trash. The study population does not consider OTCs as harmless regardless of how they are used, but on the other hand feels they should not be taken on health professionals' recommendation only. The pharmacy is still the preferred retailer and information source, and there is room for further improvement in the storage and disposal of OTCs. A return of OTC drug leftovers to the pharmacy should be further encouraged. Due to several limitations, great caution should however be observed when generalizing the results to the adult population of Sweden.

Consumer views on safety of over-the-counter drugs, preferred retailers and information sources in Sweden: after re-regulation of the pharmacy market

PubMed Central

2016-01-01

Background: The availability of over-the-counter drugs (OTCs) has increased in Sweden since a re-regulation of the pharmacy market in 2009, through which non-pharmacy retailers became permitted to provide certain OTCs. Objective: To examine the adult general public’s views on safety, purchasing and information channels, storage and disposal of OTCs in Sweden, three years after the re-regulation of the pharmacy market. Methods: A questionnaire study in 2012-13 in a stratified, random sample of all inhabitants in Sweden ≥ 18 years old. Results: Totally 8,302 people (42%) answered the questionnaire. Seven percent found OTCs completely harmless regardless of how they are being used, 18% felt they should be used only on health professionals’ recommendation. Differences in how OTCs are perceived were however found with regards to respondents’ country of birth, family type, educational level and income. The pharmacy was still the preferred OTC drug retailer by 83% of the respondents and preferred information source by 80% Reasons for preferred retailers were primarily due to out of habit (45%), counseling provided (35%), the product range (34%) and the confidence in staff (27%). Analgesics are the most common OTCs to have at home (90%). The bathroom cabinet is the primary site for storage (42%) and 16% throw their OTC leftovers in the trash. Conclusions: The study population does not consider OTCs as harmless regardless of how they are used, but on the other hand feels they should not be taken on health professionals’ recommendation only. The pharmacy is still the preferred retailer and information source, and there is room for further improvement in the storage and disposal of OTCs. A return of OTC drug leftovers to the pharmacy should be further encouraged. Due to several limitations, great caution should however be observed when generalizing the results to the adult population of Sweden. PMID:28503226

[Reading behavior and preferences regarding subscriptions to scientific journals : Results of a survey of members of the German Society for General and Visceral Surgery].

PubMed

Ronellenfitsch, U; Klinger, C; Buhr, H J; Post, S

2015-11-01

The purpose of surgical literature is to publish the latest study results and to provide continuing medical education to readers. For optimal allocation of resources, institutional subscribers, professional societies and scientific publishers require structured data on reading and subscription preferences of potential readers of surgical literature. To obtain representative data on the preferences of German general and visceral surgeons regarding reading of and subscription to scientific journals. All members of the German Society for General and Visceral Surgery (DGAV) were invited to participate in a web-based survey. Questions were asked on the affiliation and position of the member, individual journal subscriptions, institutional access to scientific journals, preferences regarding electronic or print articles and special subscriptions for society members. Answers were descriptively analyzed. A total of 630 out of 4091 (15 %) members participated in the survey and 73 % of the respondents had at least 1 individual subscription to a scientific journal. The most frequently subscribed journal was Der Chirurg (47 % of respondents). The institutional access to journals was deemed insufficient by 48 % of respondents, predominantly in primary care hospitals and outpatient clinics. Almost half of the respondents gave sufficient importance to reading printed versions of articles for which they would pay extra fees. A group subscription for society members was perceived as advantageous as long as no relevant extra costs were incurred. This structured survey among members of the DGAV provides data on preferences regarding reading of and subscription to scientific journals. Individual subscriptions to journals are still common, possibly due to suboptimal institutional access particularly at smaller non-academic institutions. In an age of online publications it seems surprising that many respondents place a high value on printed versions. The results are relevant for potential institutional subscribers, professional societies and scientific publishers.

Writing and reading in the electronic health record: an entirely new world.

PubMed

Han, Heeyoung; Lopp, Lauri

2013-02-05

Electronic health records (EHRs) are structured, distributed documentation systems that differ from paper charts. These systems require skills not traditionally used to navigate a paper chart and to produce a written clinic note. Despite these differences, little attention has been given to physicians' electronic health record (EHR)-writing and -reading competence. This study aims to investigate physicians' self-assessed competence to document and to read EHR notes; writing and reading preferences in an EHR; and demographic characteristics associated with their perceived EHR ability and preference. Fourteen 5-point Likert scale items, based on EHR system characteristics and a literature review, were developed to measure EHR-writing and -reading competence and preference. Physicians in the midwest region of the United States were invited via e-mail to complete the survey online from February to April 2011. Factor analysis and reliability testing were conducted to provide validity and reliability of the instrument. Correlation and regression analysis were conducted to pursue answers to the research questions. Ninety-one physicians (12.5%), from general and specialty fields, working in inpatient and outpatient settings, participated in the survey. Despite over 3 years of EHR experience, respondents perceived themselves to be incompetent in EHR writing and reading (Mean = 2.74, SD = 0.76). They preferred to read succinct, narrative notes in EHR systems. However, physicians with higher perceived EHR-writing and -reading competence had less preference toward reading succinct (r= - 0.33, p<0.001) and narrative (r= - 0.36, p<0.001) EHR notes than physicians with lower perceived EHR competence. Physicians' perceived EHR-writing and -reading competence was strongly related to their EHR navigation skills (r=0.55, p<0.0001). Writing and reading EHR documentation is different for physicians. Maximizing navigation skills can optimize non-linear EHR writing and reading. Pedagogical questions remain related to how physicians and medical students are able to retrieve correct information effectively and to understand thought patterns in collectively lengthier and sometimes fragmented EHR chart notes.

Assessment of older adults' knowledge of and preferences for medication management tools and support systems.

PubMed

Lakey, Susan L; Gray, Shelly L; Borson, Soo

2009-06-01

A variety of strategies are available to assist older adults who have difficulties managing medications. Little is known about older adults' knowledge of or willingness to use these strategies. To assess older adults' current use of, knowledge of, and preferences for medication management tools and supports. A cross-sectional study was conducted at a continuing care retirement community. All 152 independent-living residents were approached for participation. We developed a 6-page survey to gather information about knowledge of and preferences for medication management tools (eg, medi-sets, bubblepacks) and supports (eg, family, caregivers, regimen simplification). Information on demographic variables, medication management capacity, cognition, self-reported difficulty taking medications, and medication use were collected along with survey answers during an in-home interview. chi(2) and t-tests were used to compare knowledge and preferences by complexity and organizer use. Our sample consisted of 109 participants ranging in age from 73 to 98 years (average 85.9). Most of the subjects were well educated (average 15.5 y of education), 98% were white, and 80% were female. The majority (82%) were using a medication tool, mainly simple, self-filled medi-sets (62%) and easy-open vials (55%). Knowledge about, use of, and preferences for other devices, including pharmacist-filled tools and programmable devices, were low. Participants who used medication organizers rated self-filled medi-sets higher than did non-users (4.7 vs 1.6; p < 0.01). Only 18% of participants had asked a provider to simplify their medications, while 40% did not realize that they could do so. Of those who did ask a provider, 80% asked a physician. Educational strategies are needed to increase awareness of the pharmacist's role in facilitating medication management and the option of simplifying complex regimens. It is within the scope of pharmacy to provide this type of medication education.

Young adults' responses to alternative messages describing a sugar-sweetened beverage price increase.

PubMed

Gollust, Sarah E; Tang, Xuyang; White, James M; French, Simone A; Runge, Carlisle Ford; Rothman, Alexander J

2017-01-01

Many jurisdictions in the USA and globally are considering raising the prices of sugar-sweetened beverages (SSB) through taxes as a strategy to reduce their consumption. The objective of the present study was to identify whether the rationale provided for an SSB price increase affects young adults' behavioural intentions and attitudes towards SSB. Participants were randomly assigned to receive one of eight SSB price increase rationales. Intentions to purchase SSB and attitudes about the product and policy were measured. A forty-six-item cross-sectional Internet survey. Undergraduate students (n 494) at a large US Midwestern university. Rationale type was significantly associated with differences in participants' purchasing intentions for the full sample (F 7,485=2·53, P=0·014). Presenting the rationale for an SSB price increase as a user fee, an effort to reduce obesity, a strategy to offset health-care costs or to protect children led to lower SSB purchasing intentions compared with a message with no rationale. Rationale type was also significantly associated with differences in perceptions of soda companies (F 7,485=2·10, P=0·043); among low consumers of SSB, messages describing the price increase as a user fee or tax led to more negative perceptions of soda companies. The rationale attached to an SSB price increase could influence consumers. However, these message effects may depend on individuals' level of SSB consumption.

Comparison of Rating Scales in the Development of Patient-Reported Outcome Measures for Children with Eye Disorders.

PubMed

Hatt, Sarah R; Leske, David A; Wernimont, Suzanne M; Birch, Eileen E; Holmes, Jonathan M

2017-03-01

A rating scale is a critical component of patient-reported outcome instrument design, but the optimal rating scale format for pediatric use has not been investigated. We compared rating scale performance when administering potential questionnaire items to children with eye disorders and their parents. Three commonly used rating scales were evaluated: frequency (never, sometimes, often, always), severity (not at all, a little, some, a lot), and difficulty (not difficult, a little difficult, difficult, very difficult). Ten patient-derived items were formatted for each rating scale, and rating scale testing order was randomized. Both child and parent were asked to comment on any problems with, or a preference for, a particular scale. Any confusion about options or inability to answer was recorded. Twenty-one children, aged 5-17 years, with strabismus, amblyopia, or refractive error were recruited, each with one of their parents. Of the first 10 children, 4 (40%) had problems using the difficulty scale, compared with 1 (10%) using frequency, and none using severity. The difficulty scale was modified, replacing the word "difficult" with "hard." Eleven additional children (plus parents) then completed all 3 questionnaires. No children had problems using any scale. Four (36%) parents had problems using the difficulty ("hard") scale and 1 (9%) with frequency. Regarding preference, 6 (55%) of 11 children and 5 (50%) of 10 parents preferred using the frequency scale. Children and parents found the frequency scale and question format to be the most easily understood. Children and parents also expressed preference for the frequency scale, compared with the difficulty and severity scales. We recommend frequency rating scales for patient-reported outcome measures in pediatric populations.

Intensive procedure preferences at the end of life (EOL) in older Latino adults with end stage renal disease (ESRD) on dialysis.

PubMed

Gonzalez, Karla; Ulloa, Jesus G; Moreno, Gerardo; Echeverría, Oscar; Norris, Keith; Talamantes, Efrain

2017-10-23

Latinos in the U.S. are almost twice as likely to progress to End Stage Renal disease (ESRD) compared to non-Latino whites. Patients with ESRD on dialysis experience high morbidity, pre-mature mortality and receive intensive procedures at the end of life (EOL). This study explores intensive procedure preferences at the EOL in older Latino adults. Seventy-three community-dwelling Spanish- and English-Speaking Latinos over the age of 60 with and without ESRD participated in this study. Those without ESRD (n = 47) participated in one of five focus group sessions, and those with ESRD on dialysis (n = 26) participated in one-on-one semi-structured interviews. Focus group and individual participants answered questions regarding intensive procedures at the EOL. Recurring themes were identified using standard qualitative content-analysis methods. Participants also completed a brief survey that included demographics, language preference, health insurance coverage, co-morbidities, Emergency Department visits and functional limitations. The majority of participants were of Mexican origin with mean age of 70, and there were more female participants in the non-ESRD group, compared to the ESRD dialysis dependent group. The dialysis group reported a higher number of co-morbidities and functional limitations. Nearly 69% of those in the dialysis group reported one or more emergency department visits in the past year, compared to 38% in the non-ESRD group. Primary themes centered on 1) The acceptability of a "natural" versus "invasive" procedure 2) Cultural traditions and family involvement 3) Level of trust in physicians and autonomy in decision-making. Our results highlight the need for improved patient- and family-centered approaches to better understand intensive procedure preferences at the EOL in this underserved population of older adults.

Coping Strategies, Psychological Impact, and Support Preferences of Men With Rheumatoid Arthritis: A Multicenter Survey.

PubMed

Flurey, Caroline A; Hewlett, Sarah; Rodham, Karen; White, Alan; Noddings, Robert; Kirwan, John R

2018-06-01

To investigate the existence and distribution of 2 typologies (termed "factors") of men with rheumatoid arthritis (RA) identified through our previous Q-methodology study (n = 30) in a larger sample of men with RA, and whether differences in psychosocial impact or support preferences exist between the 2 factors, and between men and women with RA. A postal survey was sent to 620 men with RA from 6 rheumatology units across England, and the support preferences section of the survey was given to 232 women with RA. A total of 295 male patients (47.6%) and 103 female patients (44.4%) responded; 15 male participants had missing data, and thus 280 were included in the analysis. Of these, 61 (22%) were assigned to factor A ("accept and adapt"), 120 (35%) were assigned to factor B ("struggling to match up"), and 99 (35%) were unassigned. The two factors differed significantly, with factor B reporting more severe disease, less effective coping strategies, and poorer psychological status. For support, men favored a question and answer session with a consultant (54%) or specialist nurse (50%), a website for information (69%), a talk by researchers (54%), or a symptom management session (54%). Overall, women reported more interest in support sessions than men, with ≥50% of women reporting interest in nearly every option provided. Some men accept and adapt to their RA, but others (43%) report severe disease, less effective coping, and poor psychological status. Men's preferences for support are practical, with a focus on expanding their knowledge. © 2017 The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.

Health utility scores of colorectal cancer based on societal preference in Japan.

PubMed

Shiroiwa, Takeru; Fukuda, Takashi; Tsutani, Kiichiro

2009-10-01

We measured health utility scores of colorectal cancer (CRC) patients from a societal perspective in Japan. Twenty-five states of health were described: four metastatic states without severe adverse events (AEs), 16 metastatic states with Grade 3/4 AEs, four adjuvant states, and one terminal state. A total of 1,500 respondents stratified by age and gender were recruited randomly from the largest Web-panel in Japan. Respondents were allocated randomly to three of the 25 health states and answered questionnaires by standard gamble (SG) and time trade-off (TTO) methods. Although utility scores of metastatic CRC receiving XELOX (capecitabine plus oxaliplatin) chemotherapy were 0.48(SG and TTO) (with stoma) and 0.57(SG) or 0.59(TTO) (without stoma), utility scores of those receiving FOLFOX4 (5-fluorouracil/folinic acid and oxaliplatin) chemotherapy were 0.42(SG) or 0.43(TTO) (with stoma) and 0.52(SG) or 0.53(TTO) (without stoma). These differences between XELOX and FOLFOX4 were statistically significant (P = 0.0198 in SG and P = 0.0059 in TTO). Stage 3/4 AEs decreased utility scores to 0.35-0.4 and 0.4-0.45 in the presence and absence of stoma, respectively. XELOX was generally considered a significantly preferable chemotherapy regimen compared to FOLFOX4 for CRC in Japan. Almost all Grade 3/4 AEs and stoma significantly decreased utility scores. These differences are dependent on the accuracy of the health state description and to confirm these results. In future research, it would be preferable that preference-based HRQoL measures are used directly in patients if utility scores are practically measurable by such method.

How does ocean seasonality drive habitat preferences of highly mobile top predators? Part II: The eastern North-Atlantic

NASA Astrophysics Data System (ADS)

Lambert, C.; Pettex, E.; Dorémus, G.; Laran, S.; Stéphan, E.; Canneyt, O. Van; Ridoux, V.

2017-07-01

Marine ecosystems are characterised by strong heterogeneity and variability, both spatially and temporally. In particular, seasonal variations may lead to severe constraints for predators which have to cope with these variations, for example through migration to avoid unfavourable seasons, or adaptation to local modification of the ecosystem. In the Bay of Biscay and English Channel, ecosystem seasonality is well marked, especially over the shelf. Cetacean and seabird communities within the Bay of Biscay, Celtic Sea and English Channel were studied during aerial surveys conducted in winter 2011-2012 and summer 2012, following a strip-transect methodology deployed from the coast to oceanic waters. We explored seasonal variations of habitat preferences of four cetacean and six seabird groups through Generalised Additive Models, using physiographic variables and weekly- and monthly-averaged oceanographic predictors for both seasons. Our results provided the first overview at such a large scale of the variation of habitat preferences in response to the seasonality of the ocean by seabirds in that region, at such a large scale. Habitat models resulted in explained deviances from 13 to 55%. Predators answered the seasonality of their environment in different ways. Long-finned pilot whales and Risso's dolphins were the only studied group exhibiting no habitat variations between seasons, targeting the shelf break throughout the year. The other groups modulated their habitat preferences between seasons to optimise the compromise between the ocean seasonal variations and their own constraints: common and striped dolphins, bottlenose dolphins and harbour porpoises for cetaceans; northern gannets, auks, northern fulmars and kittiwakes for seabirds. For shearwaters, the seasonality had an extreme impact, inducing a complete absence from the region during the unfavourable season.

“What we want”: chronically ill adolescents’ preferences and priorities for improving health care

PubMed Central

van Staa, AnneLoes; Jedeloo, Susan; van der Stege, Heleen

2011-01-01

Background: As important users of health care, adolescents with chronic conditions deserve to be consulted about their experiences and expectations. This study aimed to explore chronically ill adolescents’ preferences regarding providers’ qualities, and outpatient and inpatient care. Furthermore, suggestions for improvement of service delivery were collected. Methods: This research was a sequential mixed methods study in adolescents aged 12–19 years with various chronic conditions treated in a university children’s hospital. Methods comprised 31 face-to-face interviews at home, a hospital-based peer research project in which nine adolescents interviewed 34 fellow patients, and a web-based questionnaire (n = 990). Emerging qualitative themes were transformed into questionnaire items. Results: Having “a feeling of trust” and “voice and choice” in the hospital were central to these adolescents. Regarding providers’ qualities, “being an expert” and “being trustworthy and honest” were ranked highest, followed by “being caring and understanding”, “listening and showing respect”, and “being focused on me”. Regarding outpatient consultations, preferences were ranked as follows: “answering all questions”; “attending to my and my parents’ needs”; and “clear communication”, while “limited waiting times” and “attractive outpatient surroundings” scored lowest. Regarding hospitalization, adolescents most preferred to “avoid pain and discomfort”, “keep in touch with home”, and “be entertained”, while “being hospitalized with peers” and “being heard” were least important. Regarding priorities for improvement, 52% of the respondents felt that more attention should be paid to older children, followed by enabling more contact with family and friends (45%), shorter waiting times (43%), and more activities to meet fellow patients (35%). Conclusion: Adolescents prefer technically competent providers, who are honest and trustworthy, and attend to their needs. As they gradually grow out of the pediatric environment, they desire staff attitudes to become less childish and more age-appropriate, and welcome being treated as an equal partner in care. Health care professionals should inquire into preferences and adjust their communication style accordingly. PMID:21792301

Shared Decision Making, Fast and Slow: Implications for Informed Consent, Resource Utilization, and Patient Satisfaction in Orthopaedic Surgery.

PubMed

Bernstein, Joseph; Kupperman, Eli; Kandel, Leonid Ari; Ahn, Jaimo

2016-07-01

Through shared decision making, the physician and patient exchange information to arrive at an agreement about the patient's preferred treatment. This process is predicated on the assumption that there is a single preferred treatment, and the goal of the dialog is to discover it. In contrast, psychology theory (ie, prospect theory) suggests that people can make decisions both analytically and intuitively through parallel decision-making processes, and depending on how the choice is framed, the two processes may not agree. Thus, patients may not have a single preferred treatment, but rather separate intuitive and analytic preferences. The research question addressed here is whether subjects might reveal different therapeutic preferences based on how a decision is framed. Five clinical scenarios on the management of tibial plateau fractures were constructed. Healthy volunteers were asked to select among treatments offered. Four weeks later, the scenarios were presented again; the facts of the scenario were unchanged, but the description was altered to test the null hypothesis that minor changes in wording would not lead the subjects to change their decision about treatment. For example, incomplete improvement after surgery was described first as a gain from the preoperative state and then as a loss from the preinjury state. In all five cases, the variation predicted by psychology theory was detected. Respondents were affected by whether choices were framed as avoided losses versus potential gains; by emotional cues; by choices reported by others (ie, bandwagon effect); by the answers proposed to them in the question (ie, anchors); and by seemingly irrelevant options (ie, decoys). The influence of presentation on preferences can be highly significant in orthopaedic surgery. The presence of parallel decision-making processes implies that the standard methods of obtaining informed consent may require further refinement. Furthermore, if the way that information is portrayed makes surgery more or less appealing, the use of services may be subject to unwanted influence. If surgery were accepted preoperatively by the patient's intuitive process but evaluated after the fact by the analytic process (or vice versa), well-indicated and well-performed surgery may still fail to provide patient satisfaction.

Physician and Patient and Caregiver Health Attitudes and Their Effect on Medicare Resource Allocation for Patients With Advanced Cancer.

PubMed

Rocke, Daniel J; Beumer, Halton W; Taylor, Donald H; Thomas, Steven; Puscas, Liana; Lee, Walter T

2014-06-01

Physicians must participate in end-of-life discussions, but they understand poorly their patients' end-of-life values and preferences. A better understanding of these preferences and the effect of baseline attitudes will improve end-of-life discussions. To determine how baseline attitudes toward quality vs quantity of life affect end-of-life resource allocation. Otolaryngology-head and neck surgery (OHNS) physicians were recruited to use a validated online tool to create a Medicare health plan for advanced cancer patients. During the exercise, participants allocated a limited pool of resources among 15 benefit categories. These data were compared with preliminary data from patients with cancer and their caregivers obtained from a separate study using the same tool. Attitudes toward quality vs quantity of life were assessed for both physicians and patients and caregivers. Participation in online assessment exercise. Medicare resource allocation. Of 9120 OHNS physicians e-mailed, 767 participated. Data collected from this group were compared with data collected from 146 patients and 114 caregivers. Compared with patients and caregivers, OHNS physician allocations differed significantly in all 15 benefit categories except home care. When stratified by answers to 3 questions about baseline attitudes toward quality vs quantity of life, there were 3 categories in which allocations of patients and caregivers differed significantly from the group with the opposite attitude for at least 2 questions: other medical care (question 1, P < .001; question 2, P = .005), palliative care (question 1, P = .008; question 2, P = .006; question 3, P = .009), and treatment for cancer (questions 1 and 2, P < .001). In contrast, physician preferences showed significant differences in only 1, nonmatching category for each attitude question: cash (question 1, P = .02), drugs (question 2, P = .03), and home care (question 3, P = .048). Patients with cancer and their caregivers have different preferences from physicians. These preferences are, for these patients and their caregivers, affected by their baseline health attitudes, but physician preferences are not. Understanding the effect of baseline attitudes is important for effective end-of-life discussions.

A Rationale for Building a Comprehensive Science Program for Inner-City Education.

ERIC Educational Resources Information Center

Martin, Charles Arthur

The intent of this dissertation was to develop a science curriculum from an inner-city perspective. Five units and a rationale for inner-city education are included. The units include both physical and biological science topics. The units are as follows: (1) Rationale for Building a Comprehensive Science Program for Inner-City Education; (2) With…

Soft Power as a Policy Rationale for International Education in the UK: A Critical Analysis

ERIC Educational Resources Information Center

Lomer, Sylvie

2017-01-01

This article presents the results of a textual analysis conducted on policy discourses on international students in the UK between 1999 and 2013. A number of rationales for and against increasing their numbers have been made, which have largely remained consistent over changing political administrations. One key rationale is that international…

Rationales Shaping International Linkages in Higher Education: A Qualitative Case Study of the ASU-ITESM Strategic Alliance

ERIC Educational Resources Information Center

Camacho Lizarraga, Monica Irene

2011-01-01

This qualitative case study examines the rationales of the relationship between Arizona State University (ASU)--an American public research university--and Tecnologico de Monterrey (ITESM), a Mexican private not for profit research university. The focus of the study is to document the different meanings participants attached to the rationales of…

The Effects of Rationales, Differential Reinforcement, and a Guided Compliance Procedure to Increase Compliance among Preschool Children

ERIC Educational Resources Information Center

Wilder, David A.; Myers, Kristin; Nicholson, Katie; Allison, Janelle; Fischetti, Anthony T.

2012-01-01

Previous research suggests that rationales, or statements describing why a child should comply with a caregiver-delivered instruction, are ineffective at increasing compliance. In the current study, we compared the effects of rationales to a differential reinforcement procedure and a guided compliance procedure. The results indicated that…

Theoretical evaluation of two plausible routes for bioactivation of S-(1,1-difluoro-2,2-dihaloethyl)-L-cysteine conjugates: thiirane vs thionoacyl fluoride pathway.

PubMed

Shim, J Y; Richard, A M

1997-01-01

The selective nephrotoxicity of halogenated alkenes has been attributed to a glutathione (GSH) S-conjugate pathway involving enzymatic hydrolysis to the cysteine S-conjugate and beta-lyase bioactivation to thiolates, which are presumed to give rise to the ultimate mutagenic or cytotoxic reactive species. Studies have shown that the brominated S-(2,2-dihalo-1,1-difluoroethyl)-L-cysteine conjugates are mutagenic in the Ames test, whereas the nonbrominated analogues are nonmutagenic. While careful experimentation has contributed much to current understanding, the ultimate reactive species responsible for the differing mutagenic effects remain unknown. Computational methods were applied to the investigation of two proposed metabolic pathways leading from the thiolate to either a thiirane or thionoacyl fluoride intermediate, both electrophilic species presumed capable of binding to proteins or DNA. Studied were six F-, Cl-, and Br-substituted 2,2-dihalo-1,1-difluoroethane-1-thiolates (2,2-dihalo-DFETs). Pathway preference was determined for each thiolate by comparison of reaction energy profiles and activation energies. At all but the lowest level of ab initio theory, a thionoacyl fluoride pathway was predicted for 2,2-difluoro-DFET, while a thiirane pathway was energetically preferred for the brominated 2,2-dihalo-DFETs. These results offer a clear mechanism-based rationale for distinguishing 2,2-difluoro-DFET from the brominated 2,2-dihalo-DFETs, while the results are less clear for the 2,2-dichloro and 2-chloro-2-fluoro-DFETs, which at the highest level of ab initio treatment had a relatively small energy preference (2.4 kcal/mol) for the thiirane pathway. The predicted clear preference for a thiirane pathway for the brominated 2,2-dihalo-DFETs is not consistent with a recently proposed pathway involving alpha-thiolactone formation through a thionoacyl fluoride intermediate [Finkelstein, M. B., et al. (1995) J. Am. Chem. Soc. 117, 9590-9591], but is supported by results of a recent study providing experimental evidence for thiirane formation from the brominated 2,2-dihalo-DFETs [Finkelstein, M. B., et al. (1996) Chem. Res. Toxicol. 9, 227-231].

Rationale, design, and baseline findings from HIPP: A randomized controlled trial testing a home-based, individually-tailored physical activity print intervention for African American women in the Deep South.

PubMed

Pekmezi, Dori; Ainsworth, Cole; Joseph, Rodney; Bray, Molly S; Kvale, Elizabeth; Isaac, Shiney; Desmond, Renee; Meneses, Karen; Marcus, Bess; Demark-Wahnefried, Wendy

2016-03-01

African American women report high rates of physical inactivity and related health disparities. In our previous formative research, we conducted a series of qualitative assessments to examine physical activity barriers and intervention preferences among African American women in the Deep South. These data were used to inform a 12-month Home-based, Individually-tailored Physical activity Print (HIPP) intervention, which is currently being evaluated against a wellness contact control condition among 84 post-menopausal African American women residing in the metropolitan area of Birmingham, Alabama. This paper reports the rationale, design and baseline findings of the HIPP trial. The accrued participants had an average age of 57 (SD=4.7), a BMI of 32.1 kg/m(2) (SD=5.16) with more than half (55%) having a college education and an annual household income under $50,000 (53.6%). At baseline, participants reported an average of 41.5 min/week (SD=49.7) of moderate intensity physical activity, and 94.1% were in the contemplation or preparation stages of readiness for physical activity. While social support for exercise from friends and family was low, baseline levels of self-efficacy, cognitive and behavioral processes of change, decisional balance, outcome expectations, and enjoyment appeared promising. Baseline data indicated high rates of obesity and low levels of physical activity, providing strong evidence of need for intervention. Moreover, scores on psychosocial measures suggested that such efforts may be well received. This line of research in technology-based approaches for promoting physical activity in African American women in the Deep South has great potential to address health disparities and impact public health. Copyright © 2016 Elsevier Inc. All rights reserved.

Rationale, design, and baseline findings from HIPP: A randomized controlled trial testing a Home-based, Individually-tailored Physical activity Print intervention for African American women in the Deep South

PubMed Central

Pekmezi, Dori; Ainsworth, Cole; Joseph, Rodney; Bray, Molly S.; Kvale, Elizabeth; Isaac, Shiney; Desmond, Renee; Meneses, Karen; Marcus, Bess; Demark-Wahnefried, Wendy

2016-01-01

African American women report high rates of physical inactivity and related health disparities. In our previous formative research, we conducted a series of qualitative assessments to examine physical activity barriers and intervention preferences among African American women in the Deep South. These data were used to inform a 12-month Home-based, Individually-tailored Physical activity Print (HIPP) intervention, which is currently being evaluated against a wellness contact control condition among 84 post-menopausal African American women residing in the metropolitan area of Birmingham, Alabama. This paper reports the rationale, design and baseline findings of the HIPP trial. The accrued participants had an average age of 57 (SD= 4.7), a BMI of 32.1 kg/m2 (SD=5.16) with more than half (55%) having a college education and an annual household income under $50,000 (53.6%). At baseline, participants reported an average of 41.5 minutes/week (SD=49.7) of moderate intensity physical activity, and 94.1% were in the contemplation or preparation stages of readiness for physical activity. While social support for exercise from friends and family was low, baseline levels of self-efficacy, cognitive and behavioral processes of change, decisional balance, outcome expectations, and enjoyment appeared promising. Baseline data indicated high rates of obesity and low levels of physical activity, providing strong evidence of need for intervention. Moreover, scores on psychosocial measures suggested that such efforts may be well received. This line of research in technology-based approaches for promoting physical activity in African American women in the Deep South has great potential to address health disparities and impact public health. PMID:26944022

Rationale and study protocol for the Nursing Home Compare Plus (NHCPlus) randomized controlled trial: A personalized decision aid for patients transitioning from the hospital to a skilled-nursing facility.

PubMed

Sorkin, Dara H; Amin, Alpesh; Weimer, David L; Sharit, Joseph; Ladd, Heather; Mukamel, Dana B

2016-03-01

Annually more than 3 million people are admitted to one of the 15,965 skilled nursing facilities (SNFs) in the United States, with 90% of admissions occurring from a hospital. Although the Centers for Medicare and Medicaid Services (CMS) publishes several internet-based report cards, including one for nursing homes (Nursing Home Compare, NHC), they are not widely used. This is due, in part, to the complexity of the information available and the fact that the choice of nursing homes is typically made while in the hospital without access to the web-based NHC. We developed Nursing Home Compare Plus (NHCPlus) to address these limitations and to improve the decision-making process. This paper describes the design and rationale of a two-arm randomized controlled trial designed to test the effectiveness of NHCPlus compared to usual care only, in a sample of patients being discharged from the hospital to an SNF (N=229). Assessments were conducted within 24h prior to patient discharge and 30-days post discharge. Primary outcomes to be examined included the use of NHC, increased choice of nursing homes with better reported outcomes, and increased distance between patient/family residence and nursing home. Secondary outcomes included satisfaction with the decision to go to a nursing home, confidence in the choice of nursing home, and reduced hospital length of stay. NHCPlus is an innovative mobile application designed to allow patients to personalize their choice of nursing homes to meet their medical needs and preferences. The application to other quality report cards is discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Rationale and study protocol for the Nursing Home Compare Plus (NHCPlus) randomized controlled trial: A personalized decision aid for patients transitioning from the hospital to a skilled-nursing facility

PubMed Central

Sorkin, Dara H.; Amin, Alpesh; Weimer, David L.; Sharit, Joseph; Ladd, Heather

2016-01-01

Background Annually more than 3 million people are admitted to one of the 15,965 skilled nursing facilities (SNFs) in the United States with 90% of admissions occurring from a hospital. Although the Centers for Medicare and Medicaid Services (CMS) publishes several web-based report cards, including one for nursing homes (Nursing Home Compare, NHC), they are not widely used. This is due, in part, to the complexity of the information available and the fact that the choice of nursing homes is typically made while in the hospital without access to the web-based NHC. We developed Nursing Home Compare Plus (NHCPlus) to address these limitations and to improve the decision-making process. Methods/Design This paper describes the design and rationale of a two-arm randomized controlled trial designed to test the effectiveness of NHCPlus compared to usual care only, in a sample of patients being discharged from the hospital to an SNF (N=229). Assessments were conducted within 24-hours prior to patient discharge and 30-days post discharge. Primary outcomes to be examined included use of NHC, increased choice of nursing homes with better reported outcomes, and increased distance between patient/family residence and nursing home. Secondary outcomes included satisfaction with the decision to go to a nursing home, confidence in the choice of nursing home, and reduced hospital length of stay. Discussion NHCPlus is an innovative mobile application designed to allow patients to personalize their choice of nursing homes to meet their medical needs and preferences. The application to other quality report cards is discussed. PMID:26772624

Barriers and benefits associated with nurses information seeking related to patient education needs on clinical nursing units.

PubMed

Jones, Josette; Schilling, Katherine; Pesut, Daniel

2011-01-01

The purpose of this study was to answer the following two questions: What are clinical nurses' rationales for their approaches to finding patient educational materials on the web? What are perceived barriers and benefits associated with the use of web-based information resources for patient education in the context of nursing clinical practice?Over 179 individual data units were analyzed to understand clinical nurses' rationales for their approaches to find patient educational materials on the web. Rationales were defined as those underlying catalysts or activators leading to an information need. Analyses found that the primary reasons why clinical nurses conducted web-based information searches included direct patient requests ( 9 requests), colleague requests (6 requests), building patient materials collections (4), patients' family requests (3), routine teaching (1), personal development (1), or staff development (1). From these data, four broad themes emerged: professional reasons, personal reasons, technology reasons, and organization reasons for selecting information resources. Content analysis identified 306 individual data units representing either 'benefits' (178 units) or 'barriers' (128) to the nurses' use of web resources for on-unit patient care. Inter-rater reliability was assessed and found to be excellent (r = 0.943 to 0.961). The primary themes that emerged as barriers to the used of web-based resources included: 1) time requirements to perform a search, 2) nurses' experience and knowledge about the resources or required technology, 3) specific characteristics of individuals electronic information resources, and 4) organizational procedures and policies. Three primary themes that represented the benefits of using web-based resources were also identified: 1) past experiences and knowledge of a specific resource or the required technologies, 2) availability and accessibility on the unit, and 3) specific characteristics of individual information tool. In many cases, nurses commented on specific characteristics or features of favorite information resources. Favorite sites included a variety or reputable health care organizations that displayed context in text, audio, and/or video. In addition such sites were described as easy-to read and provided content related to patient-focused information or specific content such as toll free telephone contact numbers.Information searching is the interaction between and among information users and computer-based information systems. Information seeking is becoming an important part of the knowledge work of nurses. Information seeking and searching intersects with the field of human computer interaction (HCI), which focuses on all aspects of human, and computer interactions. Users of an information system are understood as "actors" in situations, with a set of skills and shared practices based on work experiences with others. Designing better tools and developing information searching strategies that support, extend, and transform practices, begins by asking: Who are the users? What are the tasks? What is the interplay between the technology and the organization of the task? This study contributes fundamental data and information about the rationales nurses use in information seeking tasks. In addition it provides empirical evidences regarding barriers and benefits of information seeking in the context of patient education needs in inpatient clinical settings.

Effect of framing as gain versus loss on understanding and hypothetical treatment choices: survival and mortality curves.

PubMed

Armstrong, Katrina; Schwartz, J Sanford; Fitzgerald, Genevieve; Putt, Mary; Ubel, Peter A

2002-01-01

Presentation of information using survival or mortality (i.e., incidence) curves offers a potentially powerful method of communication because such curves provide information about risk over time in a relatively simple graphic format. However, the effect of framing as survival versus mortality on understanding and treatment choice is not known. In this study, 451 individuals awaiting jury duty at the Philadelphia City Courthouse were randomized to receive 1 of 3 questionnaires: (1) survival curves, (2) mortality curves, or (3) both survival and mortality curves. Each questionnaire included a brief description of a hypothetical treatment decision, survival curve graphs and/or mortality curve graphs presenting the outcome of the treatment, and questions measuring understanding of the information contained in the graphs and preference for undergoing treatment. After completing a brief practice exercise, participants were asked to answer questions assessing their ability to interpret single points on a curve and the difference between curves, and then to decide whether they would choose to undergo preventive surgery for 3 different scenarios in which the benefit of surgery varied. Participants who received only survival curves or who received both survival and mortality curves were significantly more accurate in answering questions about the information than participants who received only mortality curves (P < 0.05). For 2 of the 3 treatment presentations, participants who received only mortality curves were significantly less likely to prefer preventive surgery than participants who received survival curves only or both survival and mortality curves (P < 0.05). The effect of framing on understanding was greatest among participants with less than a college education and among non-Caucasian participants. Framing graphic risk information as chance of death over time results in lower levels of understanding and less interest in preventive surgery than framing as chance of survival over time.

Quality of life differences in patients with right- versus left-sided facial paralysis: Universal preference of right-sided human face recognition.

PubMed

Ryu, Nam Gyu; Lim, Byung Woo; Cho, Jae Keun; Kim, Jin

2016-09-01

We investigated whether experiencing right- or left-sided facial paralysis would affect an individual's ability to recognize one side of the human face using hybrid hemi-facial photos by preliminary study. Further investigation looked at the relationship between facial recognition ability, stress, and quality of life. To investigate predominance of one side of the human face for face recognition, 100 normal participants (right-handed: n = 97, left-handed: n = 3, right brain dominance: n = 56, left brain dominance: n = 44) answered a questionnaire that included hybrid hemi-facial photos developed to determine decide superiority of one side for human face recognition. To determine differences of stress level and quality of life between individuals experiencing right- and left-sided facial paralysis, 100 patients (right side:50, left side:50, not including traumatic facial nerve paralysis) answered a questionnaire about facial disability index test and quality of life (SF-36 Korean version). Regardless of handedness or hemispheric dominance, the proportion of predominance of the right side in human face recognition was larger than the left side (71% versus 12%, neutral: 17%). Facial distress index of the patients with right-sided facial paralysis was lower than that of left-sided patients (68.8 ± 9.42 versus 76.4 ± 8.28), and the SF-36 scores of right-sided patients were lower than left-sided patients (119.07 ± 15.24 versus 123.25 ± 16.48, total score: 166). Universal preference for the right side in human face recognition showed worse psychological mood and social interaction in patients with right-side facial paralysis than left-sided paralysis. This information is helpful to clinicians in that psychological and social factors should be considered when treating patients with facial-paralysis. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Assessing the Rationales for Educational Reforms: A Test of the Professional Development, Comprehensive Reform, and Direct Instruction Hypotheses. Policy Research Report.

ERIC Educational Resources Information Center

St. John, Edward P.; Manset, Genevieve; Chung, Choong-Geun; Worthington, Kimberly

Educational reforms are advocated based on rationales that emerge from the research literature. However, evaluation studies seldom examine whether the rationales used to argue for a reform actually hold up when empirical evidence is examined after the reform has been implemented. This paper examines survey data from 3 years of analyses of early…

The Influence of Neighbor Effect and Urbanization Toward Organ Donation in Thailand.

PubMed

Wongboonsin, Kua; Jindahra, Pavitra; Teerakapibal, Surat

2018-03-01

Toward population wellness, an extreme scarcity of organ supply is proven to be an enormous hindrance. Preferences toward organ donation are vital to raise the organ donation rate. Notably, the area people live in can address the social influence on individual preference toward organ donation. This article studies the impact of the neighbor effect on organ donation decisions, addressing the social influence of urbanization on preferences. How neighborhood-specific variables, population density, and socioeconomic status drive the neighbor effect is investigated. The pursuit of organ donor traits is to be answered. The study uses organ donation interview survey data and neighborhood-specific data from Thailand to estimate a series of logistic regression models. Individuals residing in urban areas exhibit a greater likelihood to sign the donor card than those in rural areas. The neighborhood socioeconomic status is the key driver. An individual is more willing to be an organ donor when having neighbors with higher socioeconomic statuses. Results also reveal positive influences of males and education on the organ donation rate. This article documents the "neighbor effect" on the organ donation decision via living area type, offering an alternative exposition in raising the organ donation rate. In shifting the society norm toward organ donation consent, policy-makers should acknowledge the benefit of urbanization on organ donation decision derived from resourceful urban areas. Moreover, raising education levels does improve not only citizens' well-being but also their tendency to exhibit an altruistic act toward others.

The ideal subject distance for passport pictures.

PubMed

Verhoff, Marcel A; Witzel, Carsten; Kreutz, Kerstin; Ramsthaler, Frank

2008-07-04

In an age of global combat against terrorism, the recognition and identification of people on document images is of increasing significance. Experiments and calculations have shown that the camera-to-subject distance - not the focal length of the lens - can have a significant effect on facial proportions. Modern passport pictures should be able to function as a reference image for automatic and manual picture comparisons. This requires a defined subject distance. It is completely unclear which subject distance, in the taking of passport photographs, is ideal for the recognition of the actual person. We show here that the camera-to-subject distance that is perceived as ideal is dependent on the face being photographed, even if the distance of 2m was most frequently preferred. So far the problem of the ideal camera-to-subject distance for faces has only been approached through technical calculations. We have, for the first time, answered this question experimentally with a double-blind experiment. Even if there is apparently no ideal camera-to-subject distance valid for every face, 2m can be proposed as ideal for the taking of passport pictures. The first step would actually be the determination of a camera-to-subject distance for the taking of passport pictures within the standards. From an anthropological point of view it would be interesting to find out which facial features allow the preference of a shorter camera-to-subject distance and which allow the preference of a longer camera-to-subject distance.

A Survey of Hospice and Palliative Care Physicians Regarding Palliative Sedation Practices.

PubMed

Lux, Michael R; Protus, Bridget McCrate; Kimbrel, Jason; Grauer, Phyllis

2017-04-01

Patients nearing the end of life may experience symptoms that are refractory to standard therapeutic options. Physicians may consider palliative sedation to relieve intolerable suffering. There is limited clinical literature regarding preferred medications for palliative sedation. To determine the preferred medications physicians use when implementing palliative sedation. An Internet-based, cross-sectional survey of hospice and palliative care physicians in the United States. A link to the survey was e-mailed to 3130 physician members of the American Academy of Hospice and Palliative Medicine, of which 381 physicians completed the survey. Physicians were not required to answer all questions. Nearly all (n = 335, 99%) respondents indicated that palliative sedation may be used (acceptable by 73% [n = 248] for refractory symptoms and acceptable by 26% [n = 87] only for imminently dying patients). Seventy-nine percent (n = 252) believed that opioids should not be used to induce palliative sedation but should be continued to provide pain control. Midazolam was the most commonly selected first-line choice for palliative sedation (n = 155, 42%). The most commonly reported second-line agents for the induction of palliative sedation were lorazepam, midazolam (for those who did not select midazolam as first-line agent), and phenobarbital with a reported preference of 20% (n = 49), 19% (n = 46), and 17% (n = 40), respectively. Of the physicians surveyed, 99% (n = 335) felt that palliative sedation is a reasonable treatment modality. Midazolam was considered a drug of choice for inducing and maintaining sedation, and opioids were continued for pain control.

"It is not just about the alcohol": service users' views about individualised and standardised clinical assessment in a therapeutic community for alcohol dependence.

PubMed

Alves, Paula Cristina Gomes; Sales, Célia Maria Dias; Ashworth, Mark

2016-07-19

The involvement of service users in health care provision in general, and specifically in substance use disorder treatment, is of growing importance. This paper explores the views of patients in a therapeutic community for alcohol dependence about clinical assessment, including general aspects about the evaluation process, and the specific characteristics of four measures: two individualised and two standardised. A focus group was conducted and data were analysed using a framework synthesis approach. Service users welcomed the experience of clinical assessment, particularly when conducted by therapists. The duration of the evaluation process was seen as satisfactory and most of its contents were regarded as relevant for their population. Regarding the evaluation measures, patients diverged in their preferences for delivery formats (self-report vs. interview). Service users enjoyed the freedom given by individualised measures to discuss topics of their own choosing. However, they felt that part of the standardised questions were difficult to answer, inadequate (e.g. quantification of health status in 0-20 points) and sensitive (e.g. suicide-related issues), particularly for pre-treatment assessments. Patients perceived clinical assessment as helpful for their therapeutic journey, including the opportunity to reflect about their problems, either related or unrelated to alcohol use. Our study suggests that patients prefer to have evaluation protocols administered by therapists, and that measures should ideally be flexible in their formats to accommodate for patient preferences and needs during the evaluation.

Perception of dental illness among persons receiving public assistance in Montreal.

PubMed

Bedos, Christophe; Brodeur, Jean-Marc; Levine, Alissa; Richard, Lucie; Boucheron, Laurence; Mereus, Witnisse

2005-08-01

We examined rationales for behaviors related to dental care among persons receiving public assistance in Montreal, Quebec. Fifty-seven persons receiving public assistance participated in 8 focus groups conducted in 2002. Sessions were recorded on audiotape and transcribed; analyses included debriefing sessions and coding and interpreting transcribed data. In the absence of dental pain and any visible cavity, persons receiving public assistance believed they were free of dental illness. However, they knew that dental pain signals a pathological process that progressively leads to tooth decay and, therefore, should be treated by a dentist. However, when in pain, despite recognizing that they needed professional treatment, they preferred to wait and suffer because of a fear of painful dental treatments and a reluctance to undertake certain procedures. Persons receiving public assistance have perceptions about dental health and illness that prevent them from receiving early treatment for tooth decay, which may lead to disagreements with dentists when planning dental treatments.

A biological rationale for musical scales.

PubMed

Gill, Kamraan Z; Purves, Dale

2009-12-03

Scales are collections of tones that divide octaves into specific intervals used to create music. Since humans can distinguish about 240 different pitches over an octave in the mid-range of hearing, in principle a very large number of tone combinations could have been used for this purpose. Nonetheless, compositions in Western classical, folk and popular music as well as in many other musical traditions are based on a relatively small number of scales that typically comprise only five to seven tones. Why humans employ only a few of the enormous number of possible tone combinations to create music is not known. Here we show that the component intervals of the most widely used scales throughout history and across cultures are those with the greatest overall spectral similarity to a harmonic series. These findings suggest that humans prefer tone combinations that reflect the spectral characteristics of conspecific vocalizations. The analysis also highlights the spectral similarity among the scales used by different cultures.

Measuring the impact of a team model of nursing practice using work sampling.

PubMed

Walker, Kim; Donoghue, Judith; Mitten-Lewis, Suzanne

2007-02-01

The increasing number of inexperienced graduates, as well as other levels of nurse such as the enrolled nurse and assistant-in-nursing, requires health service and nursing managers in the acute care sector to rethink the long-preferred "patient allocation" model of care provision. As well, the escalating shortage of registered nurses and subsequent low morale among those remaining in the workforce require hospitals to re-examine skills mix and staffing ratios. This paper presents the results of two work-sampling studies conducted in a major metropolitan private hospital, the first of which was to provide a rationale for changing from the patient allocation model to a team model of care. The second study aimed to evaluate and provide data on the impact of the change. Staff were heavily involved in both studies as well as the change process. The findings highlight how effective the new model has been in redistributing certain aspects of care to make better use of each nurse level's knowledge and skills.

Selective adsorption of a supramolecular structure on flat and stepped gold surfaces

NASA Astrophysics Data System (ADS)

Peköz, Rengin; Donadio, Davide

2018-04-01

Halogenated aromatic molecules assemble on surfaces forming both hydrogen and halogen bonds. Even though these systems have been intensively studied on flat metal surfaces, high-index vicinal surfaces remain challenging, as they may induce complex adsorbate structures. The adsorption of 2,6-dibromoanthraquinone (2,6-DBAQ) on flat and stepped gold surfaces is studied by means of van der Waals corrected density functional theory. Equilibrium geometries and corresponding adsorption energies are systematically investigated for various different adsorption configurations. It is shown that bridge sites and step edges are the preferred adsorption sites for single molecules on flat and stepped surfaces, respectively. The role of van der Waals interactions, halogen bonds and hydrogen bonds are explored for a monolayer coverage of 2,6-DBAQ molecules, revealing that molecular flexibility and intermolecular interactions stabilize two-dimensional networks on both flat and stepped surfaces. Our results provide a rationale for experimental observation of molecular carpeting on high-index vicinal surfaces of transition metals.

Spatiotemporal control of opioid signaling and behavior

PubMed Central

Siuda, Edward R.; Copits, Bryan A.; Schmidt, Martin J.; Baird, Madison A.; Al-Hasani, Ream; Planer, William J.; Funderburk, Samuel C.; McCall, Jordan G.; Gereau, Robert W.; Bruchas, Michael R.

2015-01-01

Summary Optogenetics is now a widely accepted tool for spatiotemporal manipulation of neuronal activity. However, a majority of optogenetic approaches use binary on/off control schemes. Here we extend the optogenetic toolset by developing a neuromodulatory approach using a rationale-based design to generate a Gi-coupled, optically-sensitive, mu-opioid-like receptor, we term opto-MOR. We demonstrate that opto-MOR engages canonical mu-opioid signaling through inhibition of adenylyl cyclase, activation of MAPK and G protein-gated inward rectifying potassium (GIRK) channels, and internalizes with similar kinetics as the mu-opioid receptor. To assess in vivo utility we expressed a Cre-dependent viral opto-MOR in RMTg/VTA GABAergic neurons, which led to a real-time place preference. In contrast, expression of opto-MOR in GABAergic neurons of the ventral pallidum hedonic cold spot, led to real-time place aversion. This tool has generalizable application for spatiotemporal control of opioid signaling and, furthermore, can be used broadly for mimicking endogenous neuronal inhibition pathways. PMID:25937173

A Biological Rationale for Musical Scales

PubMed Central

Gill, Kamraan Z.; Purves, Dale

2009-01-01

Scales are collections of tones that divide octaves into specific intervals used to create music. Since humans can distinguish about 240 different pitches over an octave in the mid-range of hearing [1], in principle a very large number of tone combinations could have been used for this purpose. Nonetheless, compositions in Western classical, folk and popular music as well as in many other musical traditions are based on a relatively small number of scales that typically comprise only five to seven tones [2]–[6]. Why humans employ only a few of the enormous number of possible tone combinations to create music is not known. Here we show that the component intervals of the most widely used scales throughout history and across cultures are those with the greatest overall spectral similarity to a harmonic series. These findings suggest that humans prefer tone combinations that reflect the spectral characteristics of conspecific vocalizations. The analysis also highlights the spectral similarity among the scales used by different cultures. PMID:19997506

Continuing education for pathology laboratory technologists: a needs analysis in a Singapore teaching hospital.

PubMed

Tan, Kong-Bing; Thamboo, Thomas Paulraj; Lim, Yaw-Chyn

2007-11-01

Continuing education is important to laboratory technologists. It helps them keep pace with the advances in medicine and pathology and thus to provide quality service. A survey was conducted to assess the attitudes of pathology laboratory technologists towards different educational activities. Relevant continuing education activities include lectures, case discussions, journal clubs, short courses, scientific conferences and higher educational courses. Technologists were asked for their views on these various activities, scoring each item 1-5 out of 5. The response rate was 66% (19/29); respondents' work experience ranged from <3 years to >20 years. Short courses was rated the most highly; 89% of respondents considered them good/excellent. General medical knowledge and the methods and rationale of key histopathology procedures were the preferred lecture topics. Most respondents (58%) were interested (4-5/5) to have their own journal club. 84% of respondents were fairly keen/keen (4-5/5) to participate in conferences. 74% responded that they were fairly keen/keen to consider pursuing higher education. 84% were fairly keen/keen to upgrade themselves and to assume higher responsibilities. The results indicate a positive outlook of technologists towards continuing education. The planning of future lecture topics has taken into account their preferences, and talks on the pursuit of higher education have been organised. It is hoped that these measures and others, will help boost the usefulness of continuing education and enhance the work environment.