Protocols for Molecular Modeling with Rosetta3 and RosettaScripts

PubMed Central

2016-01-01

Previously, we published an article providing an overview of the Rosetta suite of biomacromolecular modeling software and a series of step-by-step tutorials [Kaufmann, K. W., et al. (2010) Biochemistry 49, 2987–2998]. The overwhelming positive response to this publication we received motivates us to here share the next iteration of these tutorials that feature de novo folding, comparative modeling, loop construction, protein docking, small molecule docking, and protein design. This updated and expanded set of tutorials is needed, as since 2010 Rosetta has been fully redesigned into an object-oriented protein modeling program Rosetta3. Notable improvements include a substantially improved energy function, an XML-like language termed “RosettaScripts” for flexibly specifying modeling task, new analysis tools, the addition of the TopologyBroker to control conformational sampling, and support for multiple templates in comparative modeling. Rosetta’s ability to model systems with symmetric proteins, membrane proteins, noncanonical amino acids, and RNA has also been greatly expanded and improved. PMID:27490953

Space lab system analysis: Advanced Solid Rocket Motor (ASRM) communications networks analysis

NASA Technical Reports Server (NTRS)

Ingels, Frank M.; Moorhead, Robert J., II; Moorhead, Jane N.; Shearin, C. Mark; Thompson, Dale R.

1990-01-01

A synopsis of research on computer viruses and computer security is presented. A review of seven technical meetings attended is compiled. A technical discussion on the communication plans for the ASRM facility is presented, with a brief tutorial on the potential local area network media and protocols.

Enhanced recovery from surgery in the UK: an audit of the enhanced recovery partnership programme 2009-2012.

PubMed

Simpson, J C; Moonesinghe, S R; Grocott, M P W; Kuper, M; McMeeking, A; Oliver, C M; Galsworthy, M J; Mythen, M G

2015-10-01

The UK Department of Health Enhanced Recovery Partnership Programme collected data on 24 513 surgical patients in the UK from 2009-2012. Enhanced Recovery is an approach to major elective surgery aimed at minimizing perioperative stress for the patient. Previous studies have shown Enhanced Recovery to be associated with reduced hospital length of stay and perioperative morbidity. In this national clinical audit, National Health Service hospitals in the UK were invited to submit patient-level data. The data regarding length of stay and compliance with each element of Enhanced Recovery protocols for colorectal, orthopaedic, urological and gynaecological surgery patients were analysed. The relationship between Enhanced Recovery protocol compliance and length of stay was measured. From 16 267 patients from 61 hospital trusts, three out of four surgical specialties showed Enhanced Recovery, compliance being weakly associated with shorter length of stay (correlation coefficients -0.18, -0.14, -0.25 in colorectal, orthopaedics and gynaecology respectively). At a cut-off of 80% compliance, good compliance was associated with two, one and three day reductions in median length of stay respectively in colorectal, orthopaedic and urological surgeries, with no saving in gynaecology. This study is the largest assessment of the relationship between Enhanced Recovery protocol compliance and outcome in four surgical specialties. The data suggest that higher compliance with an Enhanced Recovery protocol has a weak association with shorter length of stay. This suggests that changes in process, resulting from highly protocolised pathways, may be as important in reducing perioperative length of stay as any individual element of Enhanced Recovery protocols in isolation. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Chemical Functionalization of Plasmonic Surface Biosensors: A Tutorial Review on Issues, Strategies, and Costs

PubMed Central

2017-01-01

In an ideal plasmonic surface sensor, the bioactive area, where analytes are recognized by specific biomolecules, is surrounded by an area that is generally composed of a different material. The latter, often the surface of the supporting chip, is generally hard to be selectively functionalized, with respect to the active area. As a result, cross talks between the active area and the surrounding one may occur. In designing a plasmonic sensor, various issues must be addressed: the specificity of analyte recognition, the orientation of the immobilized biomolecule that acts as the analyte receptor, and the selectivity of surface coverage. The objective of this tutorial review is to introduce the main rational tools required for a correct and complete approach to chemically functionalize plasmonic surface biosensors. After a short introduction, the review discusses, in detail, the most common strategies for achieving effective surface functionalization. The most important issues, such as the orientation of active molecules and spatial and chemical selectivity, are considered. A list of well-defined protocols is suggested for the most common practical situations. Importantly, for the reported protocols, we also present direct comparisons in term of costs, labor demand, and risk vs benefit balance. In addition, a survey of the most used characterization techniques necessary to validate the chemical protocols is reported. PMID:28796479

Metabolomics Workbench: An international repository for metabolomics data and metadata, metabolite standards, protocols, tutorials and training, and analysis tools

PubMed Central

Sud, Manish; Fahy, Eoin; Cotter, Dawn; Azam, Kenan; Vadivelu, Ilango; Burant, Charles; Edison, Arthur; Fiehn, Oliver; Higashi, Richard; Nair, K. Sreekumaran; Sumner, Susan; Subramaniam, Shankar

2016-01-01

The Metabolomics Workbench, available at www.metabolomicsworkbench.org, is a public repository for metabolomics metadata and experimental data spanning various species and experimental platforms, metabolite standards, metabolite structures, protocols, tutorials, and training material and other educational resources. It provides a computational platform to integrate, analyze, track, deposit and disseminate large volumes of heterogeneous data from a wide variety of metabolomics studies including mass spectrometry (MS) and nuclear magnetic resonance spectrometry (NMR) data spanning over 20 different species covering all the major taxonomic categories including humans and other mammals, plants, insects, invertebrates and microorganisms. Additionally, a number of protocols are provided for a range of metabolite classes, sample types, and both MS and NMR-based studies, along with a metabolite structure database. The metabolites characterized in the studies available on the Metabolomics Workbench are linked to chemical structures in the metabolite structure database to facilitate comparative analysis across studies. The Metabolomics Workbench, part of the data coordinating effort of the National Institute of Health (NIH) Common Fund's Metabolomics Program, provides data from the Common Fund's Metabolomics Resource Cores, metabolite standards, and analysis tools to the wider metabolomics community and seeks data depositions from metabolomics researchers across the world. PMID:26467476

Stability and sensitivity of ABR flow control protocols

NASA Astrophysics Data System (ADS)

Tsai, Wie K.; Kim, Yuseok; Chiussi, Fabio; Toh, Chai-Keong

1998-10-01

This tutorial paper surveys the important issues in stability and sensitivity analysis of ABR flow control of ATM networks. THe stability and sensitivity issues are formulated in a systematic framework. Four main cause of instability in ABR flow control are identified: unstable control laws, temporal variations of available bandwidth with delayed feedback control, misbehaving components, and interactions between higher layer protocols and ABR flow control. Popular rate-based ABR flow control protocols are evaluated. Stability and sensitivity is shown to be the fundamental issues when the network has dynamically-varying bandwidth. Simulation result confirming the theoretical studies are provided. Open research problems are discussed.

The Xpress Transfer Protocol (XTP): A tutorial (expanded version)

NASA Technical Reports Server (NTRS)

Sanders, Robert M.; Weaver, Alfred C.

1990-01-01

The Xpress Transfer Protocol (XTP) is a reliable, real-time, light weight transfer layer protocol. Current transport layer protocols such as DoD's Transmission Control Protocol (TCP) and ISO's Transport Protocol (TP) were not designed for the next generation of high speed, interconnected reliable networks such as fiber distributed data interface (FDDI) and the gigabit/second wide area networks. Unlike all previous transport layer protocols, XTP is being designed to be implemented in hardware as a VLSI chip set. By streamlining the protocol, combining the transport and network layers and utilizing the increased speed and parallelization possible with a VLSI implementation, XTP will be able to provide the end-to-end data transmission rates demanded in high speed networks without compromising reliability and functionality. This paper describes the operation of the XTP protocol and in particular, its error, flow and rate control; inter-networking addressing mechanisms; and multicast support features, as defined in the XTP Protocol Definition Revision 3.4.

Evaluation of the relationship between compliance with the follow-up and treatment protocol and health literacy in bladder tumor patients.

PubMed

Turkoglu, Ali Riza; Demirci, Hakan; Coban, Soner; Guzelsoy, Muhammet; Toprak, Erdem; Aydos, Mustafa Murat; Ture, Deniz Azkan; Ustundag, Yasemin

2018-03-07

To investigate the relationship between the compliance of bladder cancer patients with cystoscopic follow-up and the treatment protocol, and their health literacy. Patients who underwent transurethral resection surgery for bladder tumor were found to have non-muscular invasive bladder carcinoma on pathology examination and then underwent cystoscopic follow-up for 1 year or more were included in the study. Cystoscopic follow-up was recommended to the low- and high-risk groups in terms of progression and recurrence. The patients were evaluated with the Health Literacy Survey-European Union scale. The mean age of the patients was 67.13 ± 10.77 years. The treatment continuity rate was 80.50% (n = 33) in the adequate health literacy group (n = 41) and significantly higher than the 56.50% (n = 48) rate in the inadequate health literacy group (n = 85) (p = .008). The health literacy results revealed that the health promotion and general index score was higher in the group of patients under the age of 65. Adequate health literacy in bladder cancer patients is associated with better compliance with the treatment protocol. Young patients show better compliance with the follow-up protocol recommended by the physician. Increasing the follow-up protocol compliance of elderly patients with inadequate health literacy is necessary.

Performance Support Technology to Assess Training Effectiveness: Functional and Test-Bed Requirements

DTIC Science & Technology

1992-10-01

Su22ort Technologv SN Conge ~t ------------------ ------------------------------ 1. Compliance with TRADOC policy 1.1 Job aid that lays out SOP. 1.2 Tutorial...Inverse area . .Mark area after matched I-Custom cursor w rong respons,,e ¶Try again (Change Response TUpe jane) Erase feedback: SOK" Edit dlsplag OK...MANAGER for GROUP rou Choose an option: U - USER NAMES *2* A - ACTIVITIES *2* F - FILE MANAGEMENr C - CODEWORD E - ERROP REPORT *PRESENT* S - SPECIAL

[Change of care model in natural childbirth: Implementation in La Ribera delivery room].

PubMed

Camacho-Morell, F; Romero-Martín, M J

To assess knowledge, wish for inclusion and implementation of normal childbirth care protocols at La Ribera University Hospital, the reason why they are not applied, and to assess the attendance at antepartum training activities. Cross-sectional descriptive study. They were carried out 186 surveys by convenience sampling to pregnant women attending fetal well-being control at hospital between 2014 and 2015. They were collected data about knowledge, wish for inclusion, compliance of protocols and reasons for non-compliance, and attendance at antepartum training activities. Percentages and confidence intervals were calculated. Chi-square test was used to compare categorical variables. They were collected percentages of knowledge (77%, CI95%: 75,5-78,5) and wish for inclusion (84,6%, CI 95% : 82,5-86,7). Protocol compliance ranged from 6% (nitrous oxide administration) to 91% (skin-to-skin contact). The main reasons for non-compliance were due to circumstances of childbirth process (56,3%, CI 95% : 51,1-61,5). Attendance at maternal education classes was 62%, mainly primiparous women (p=0,0001) with medium or high education level (p=0,001). Pregnant women have a high knowledge and wish for inclusion of normal childbirth care protocols. Attendance at antepartum training activities could by improved and the main reason for non-attendance is lack of information. Compliance is good enough in most protocols; when they are not applied is due to childbirth circumstances. Remaining tasks include the introduction of additional protocols and to involve pregnant women in decision-making. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Basics of mass spectrometry based metabolomics.

PubMed

Courant, Frédérique; Antignac, Jean-Philippe; Dervilly-Pinel, Gaud; Le Bizec, Bruno

2014-11-01

The emerging field of metabolomics, aiming to characterize small molecule metabolites present in biological systems, promises immense potential for different areas such as medicine, environmental sciences, agronomy, etc. The purpose of this article is to guide the reader through the history of the field, then through the main steps of the metabolomics workflow, from study design to structure elucidation, and help the reader to understand the key phases of a metabolomics investigation and the rationale underlying the protocols and techniques used. This article is not intended to give standard operating procedures as several papers related to this topic were already provided, but is designed as a tutorial aiming to help beginners understand the concept and challenges of MS-based metabolomics. A real case example is taken from the literature to illustrate the application of the metabolomics approach in the field of doping analysis. Challenges and limitations of the approach are then discussed along with future directions in research to cope with these limitations. This tutorial is part of the International Proteomics Tutorial Programme (IPTP18). © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Compliance With a Comprehensive Antibiotic Protocol Improves Infection Incidence in Pediatric Spine Surgery.

PubMed

Vandenberg, Curt; Niswander, Cameron; Carry, Patrick; Bloch, Nikki; Pan, Zhaoxing; Erickson, Mark; Garg, Sumeet

A multidisciplinary task force, designated Target Zero, has developed protocols for prevention of surgical site infection (SSI) for spine surgery at our institution. The purpose of this study was to evaluate how compliance with an antibiotic bundle impacts infection incidences in pediatric spine surgery. After institutional review board approval, a consecutive series of 511 patients (517 procedures) who underwent primary spine procedures from 2008 to 2012 were retrospectively reviewed to identify patients who developed SSI. Patients were followed for a minimum of 90 days postoperatively. Compliance data were collected prospectively in 511 consecutive patients and a total of 517 procedures. Three criteria were required for antibiotic bundle compliance: appropriate antibiotics completely administered within 1 hour before incision, antibiotics appropriately redosed intraoperatively for blood loss and time, and antibiotics discontinued within 24 hours postoperatively. A multivariable logistic regression analysis was used to test the association between compliance and the development of an infection. Overall antibiotic bundle compliance rate was 85%. After adjusting for risk category, estimated blood loss, and study year, the likelihood of an infection was increased in the noncompliant group compared with the compliant group (adjusted odds ratio: 3.0, 95% CI, 0.96-9.47, P=0.0587). When expressed as the number needed to treat, strict adherence to antibiotic bundle compliance prevented 1 SSI within 90 days of surgery for every 26 patients treated with the antibiotic bundle. Reasons for noncompliance included failure to infuse preoperative antibiotics 1 hour before incision (10.3%), failure to redose antibiotics intraoperatively based on time or blood loss (5.5%), and failure to discontinue antibiotics within 24 hours postoperatively (1.9%). Compliance with a comprehensive antibiotic protocol can lead to meaningful reductions in SSI incidences in pediatric spine surgery. Institutions should focus on improving compliance with prophylactic antibiotic protocols to decrease SSI in pediatric spine surgery. Level III-retrospective cohort study.

Metabolomics Workbench: An international repository for metabolomics data and metadata, metabolite standards, protocols, tutorials and training, and analysis tools.

PubMed

Sud, Manish; Fahy, Eoin; Cotter, Dawn; Azam, Kenan; Vadivelu, Ilango; Burant, Charles; Edison, Arthur; Fiehn, Oliver; Higashi, Richard; Nair, K Sreekumaran; Sumner, Susan; Subramaniam, Shankar

2016-01-04

The Metabolomics Workbench, available at www.metabolomicsworkbench.org, is a public repository for metabolomics metadata and experimental data spanning various species and experimental platforms, metabolite standards, metabolite structures, protocols, tutorials, and training material and other educational resources. It provides a computational platform to integrate, analyze, track, deposit and disseminate large volumes of heterogeneous data from a wide variety of metabolomics studies including mass spectrometry (MS) and nuclear magnetic resonance spectrometry (NMR) data spanning over 20 different species covering all the major taxonomic categories including humans and other mammals, plants, insects, invertebrates and microorganisms. Additionally, a number of protocols are provided for a range of metabolite classes, sample types, and both MS and NMR-based studies, along with a metabolite structure database. The metabolites characterized in the studies available on the Metabolomics Workbench are linked to chemical structures in the metabolite structure database to facilitate comparative analysis across studies. The Metabolomics Workbench, part of the data coordinating effort of the National Institute of Health (NIH) Common Fund's Metabolomics Program, provides data from the Common Fund's Metabolomics Resource Cores, metabolite standards, and analysis tools to the wider metabolomics community and seeks data depositions from metabolomics researchers across the world. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

Preventive Neuromuscular Training for Young Female Athletes: Comparison of Coach and Athlete Compliance Rates

PubMed Central

Sugimoto, Dai; Mattacola, Carl G.; Bush, Heather M.; Thomas, Staci M.; Foss, Kim D. Barber; Myer, Gregory D.; Hewett, Timothy E.

2017-01-01

Context: Fewer athletic injuries and lower anterior cruciate ligament injury incidence rates were noted in studies of neuromuscular-training (NMT) interventions that had high compliance rates. However, several groups have demonstrated that preventive NMT interventions were limited by low compliance rates. Objective: To descriptively analyze coach and athlete compliance with preventive NMT and compare the compliance between study arms as well as among school levels and sports. Design: Randomized, controlled clinical trial. Setting: Middle and high school athletic programs. Participants or Other Participants: A total of 52 teams, comprising 547 female athletes, were randomly assigned to the experimental or control group and followed for 1 athletic season. Intervention(s): The experimental group (n = 30 teams [301 athletes]: 12 basketball teams [125 athletes], 6 soccer teams [74 athletes], and 12 volleyball teams [102 athletes]) participated in an NMT program aimed at reducing traumatic knee injuries through a trunk-stabilization and hip-strengthening program. The control group (n = 22 teams [246 athletes]: 11 basketball teams [116 athletes], 5 soccer teams [68 athletes], and 6 volleyball teams [62 athletes]) performed a resistive rubber-band running program. Main Outcome Measure(s): Compliance with the assigned intervention protocols (3 times per week during the preseason [mean = 3.4 weeks] and 2 times per week in-season [mean = 11.9 weeks] of coaches [coach compliance] and athletes [athlete compliance]) was measured descriptively. Using an independent t test, we compared coach and athlete compliance between the study arms. A 2-way analysis of variance was calculated to compare differences between coach and athlete compliance by school level (middle and high schools) and sport (basketball, soccer, and volleyball). Results: The protocols were completed at a mean rate of 1.3 ± 1.1 times per week during the preseason and 1.2 ± 0.5 times per week in-season. A total of 88.4% of athletes completed 2/3 of the intervention sessions. Coach compliance was greater in the experimental group than in the control group (P = .014). Coach compliance did not differ by sport but was greater at the high school than the middle school (P = .001) level. Athlete compliance did not differ by study arm, sport, or school level. Conclusions: Athletes received instruction in about 50% of each protocol. Nearly 90% of athletes performed more than 2/3 of the assigned NMT interventions. The assigned intervention was performed more often in the experimental arm compared with the control arm. Coaches at the high school level complied with the given protocol more than middle school coaches did. Athletes complied well with the protocol, but coaches did not, especially at the middle school level. PMID:27977300

Preventive Neuromuscular Training for Young Female Athletes: Comparison of Coach and Athlete Compliance Rates.

PubMed

Sugimoto, Dai; Mattacola, Carl G; Bush, Heather M; Thomas, Staci M; Foss, Kim D Barber; Myer, Gregory D; Hewett, Timothy E

2017-01-01

 Fewer athletic injuries and lower anterior cruciate ligament injury incidence rates were noted in studies of neuromuscular-training (NMT) interventions that had high compliance rates. However, several groups have demonstrated that preventive NMT interventions were limited by low compliance rates.  To descriptively analyze coach and athlete compliance with preventive NMT and compare the compliance between study arms as well as among school levels and sports.  Randomized, controlled clinical trial.  Middle and high school athletic programs. Participants or Other Participants: A total of 52 teams, comprising 547 female athletes, were randomly assigned to the experimental or control group and followed for 1 athletic season.  The experimental group (n = 30 teams [301 athletes]: 12 basketball teams [125 athletes], 6 soccer teams [74 athletes], and 12 volleyball teams [102 athletes]) participated in an NMT program aimed at reducing traumatic knee injuries through a trunk-stabilization and hip-strengthening program. The control group (n = 22 teams [246 athletes]: 11 basketball teams [116 athletes], 5 soccer teams [68 athletes], and 6 volleyball teams [62 athletes]) performed a resistive rubber-band running program.  Compliance with the assigned intervention protocols (3 times per week during the preseason [mean = 3.4 weeks] and 2 times per week in-season [mean = 11.9 weeks] of coaches [coach compliance] and athletes [athlete compliance]) was measured descriptively. Using an independent t test, we compared coach and athlete compliance between the study arms. A 2-way analysis of variance was calculated to compare differences between coach and athlete compliance by school level (middle and high schools) and sport (basketball, soccer, and volleyball).  The protocols were completed at a mean rate of 1.3 ± 1.1 times per week during the preseason and 1.2 ± 0.5 times per week in-season. A total of 88.4% of athletes completed 2/3 of the intervention sessions. Coach compliance was greater in the experimental group than in the control group (P = .014). Coach compliance did not differ by sport but was greater at the high school than the middle school (P = .001) level. Athlete compliance did not differ by study arm, sport, or school level.  Athletes received instruction in about 50% of each protocol. Nearly 90% of athletes performed more than 2/3 of the assigned NMT interventions. The assigned intervention was performed more often in the experimental arm compared with the control arm. Coaches at the high school level complied with the given protocol more than middle school coaches did. Athletes complied well with the protocol, but coaches did not, especially at the middle school level.

Effect of an Incontinence Training Program on Nursing Home Staff's Knowledge, Attitudes, and Behavior.

ERIC Educational Resources Information Center

Campbell, Emily B; And Others

1991-01-01

Nursing staff (n=166) in four nursing homes participated in quasi-experimental study to measure knowledge and attitudes about urinary incontinence and compliance with toileting protocols. Intervention group (n=96) showed slight increase in knowledge; their attitudes remained positive over four testing times. Compliance with protocol was only 72…

Implementation of remote video auditing with feedback and compliance for manual-cleaning protocols of endoscopic retrograde cholangiopancreatography endoscopes.

PubMed

Armellino, Donna; Cifu, Kelly; Wallace, Maureen; Johnson, Sherly; DiCapua, John; Dowling, Oonagh; Jacobs, Mitchel; Browning, Susan

2018-05-01

A pilot initiative to assess the use of remote video auditing in monitoring compliance with manual-cleaning protocols for endoscopic retrograde cholangiopancreatography (ERCP) endoscopes was performed. Compliance with manual-cleaning steps following the initiation of feedback was measured. A video feed of the ERCP reprocessing room was provided to remote auditors who scored items of an ERCP endoscope manual-cleaning checklist. Compliance feedback was provided in the form of reports and reeducation. Outcomes were reported as checklist compliance. The use of remote video auditing to document manual processing is a feasible approach and feedback and reeducation increased manual-cleaning compliance from 53.1% (95% confidence interval, 34.7-71.6) to 98.9% (95.0% confidence interval, 98.1-99.6). Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Protocols and Hospital Mortality in Critically Ill Patients: The United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study.

PubMed

Sevransky, Jonathan E; Checkley, William; Herrera, Phabiola; Pickering, Brian W; Barr, Juliana; Brown, Samuel M; Chang, Steven Y; Chong, David; Kaufman, David; Fremont, Richard D; Girard, Timothy D; Hoag, Jeffrey; Johnson, Steven B; Kerlin, Mehta P; Liebler, Janice; O'Brien, James; O'Keefe, Terence; Park, Pauline K; Pastores, Stephen M; Patil, Namrata; Pietropaoli, Anthony P; Putman, Maryann; Rice, Todd W; Rotello, Leo; Siner, Jonathan; Sajid, Sahul; Murphy, David J; Martin, Greg S

2015-10-01

Clinical protocols may decrease unnecessary variation in care and improve compliance with desirable therapies. We evaluated whether highly protocolized ICUs have superior patient outcomes compared with less highly protocolized ICUs. Observational study in which participating ICUs completed a general assessment and enrolled new patients 1 day each week. A total of 6,179 critically ill patients. Fifty-nine ICUs in the United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study. None. The primary exposure was the number of ICU protocols; the primary outcome was hospital mortality. A total of 5,809 participants were followed prospectively, and 5,454 patients in 57 ICUs had complete outcome data. The median number of protocols per ICU was 19 (interquartile range, 15-21.5). In single-variable analyses, there were no differences in ICU and hospital mortality, length of stay, use of mechanical ventilation, vasopressors, or continuous sedation among individuals in ICUs with a high versus low number of protocols. The lack of association was confirmed in adjusted multivariable analysis (p = 0.70). Protocol compliance with two ventilator management protocols was moderate and did not differ between ICUs with high versus low numbers of protocols for lung protective ventilation in acute respiratory distress syndrome (47% vs 52%; p = 0.28) and for spontaneous breathing trials (55% vs 51%; p = 0.27). Clinical protocols are highly prevalent in U.S. ICUs. The presence of a greater number of protocols was not associated with protocol compliance or patient mortality.

Is the standard compliance check protocol a valid measure of the accessibility of tobacco to underage smokers?

PubMed Central

DiFranza, J.; Savageau, J.; Bouchard, J.

2001-01-01

OBJECTIVE—To determine if the standard compliance check protocol is a valid measure of the experience of underage smokers when purchasing tobacco in unfamiliar communities.
SETTING—160 tobacco outlets in eight Massachusetts communities where underage tobacco sales laws are vigorously enforced.
PROCEDURE—Completed purchase rates were compared between underage smokers who behaved normally and inexperienced non-smoking youths who were not allowed to lie or present proof of age (ID).
RESULTS—The "smoker protocol" increased the likelihood of a sale nearly sixfold over that for the non-smokers (odds ratio (OR) 5.7, 95% confidence interval (CI) 1.5 to 22). When the youths presented an ID with an underage birth date, the odds of a completed sale increased dramatically (OR 27, 95% CI 3.4 to 212). Clerks judged to be under 21 years of age were seven times more likely to make an illegal sale (OR 7.6, 95% CI 2.4 to 24.0).
CONCLUSIONS—Commonly used compliance check protocols are too artificial to reflect accurately the experience of underage smokers. The validity of compliance checks might be improved by having youths present ID, and by employing either tobacco users, or non-tobacco users who are sufficiently experienced to mimic the self confidence exhibited by tobacco users in this situation. Consideration should be given to prohibiting the sale of tobacco by individuals under 21 years of age.


Keywords: compliance check protocol; underage smokers PMID:11544386

Spreadsheet for designing valid least-squares calibrations: A tutorial.

PubMed

Bettencourt da Silva, Ricardo J N

2016-02-01

Instrumental methods of analysis are used to define the price of goods, the compliance of products with a regulation, or the outcome of fundamental or applied research. These methods can only play their role properly if reported information is objective and their quality is fit for the intended use. If measurement results are reported with an adequately small measurement uncertainty both of these goals are achieved. The evaluation of the measurement uncertainty can be performed by the bottom-up approach, that involves a detailed description of the measurement process, or using a pragmatic top-down approach that quantify major uncertainty components from global performance data. The bottom-up approach is not so frequently used due to the need to master the quantification of individual components responsible for random and systematic effects that affect measurement results. This work presents a tutorial that can be easily used by non-experts in the accurate evaluation of the measurement uncertainty of instrumental methods of analysis calibrated using least-squares regressions. The tutorial includes the definition of the calibration interval, the assessments of instrumental response homoscedasticity, the definition of calibrators preparation procedure required for least-squares regression model application, the assessment of instrumental response linearity and the evaluation of measurement uncertainty. The developed measurement model is only applicable in calibration ranges where signal precision is constant. A MS-Excel file is made available to allow the easy application of the tutorial. This tool can be useful for cases where top-down approaches cannot produce results with adequately low measurement uncertainty. An example of the application of this tool to the determination of nitrate in water by ion chromatography is presented. Copyright © 2015 Elsevier B.V. All rights reserved.

Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses' hand washing.

PubMed

Fox, Cherie; Wavra, Teresa; Drake, Diane Ash; Mulligan, Debbie; Bennett, Yvonne Pacheco; Nelson, Carla; Kirkwood, Peggy; Jones, Louise; Bader, Mary Kay

2015-05-01

Critically ill patients are at marked risk of hospital-acquired infections, which increase patients' morbidity and mortality. Registered nurses are the main health care providers of physical care, including hygiene to reduce and prevent hospital-acquired infections, for hospitalized critically ill patients. To investigate a new patient hand hygiene protocol designed to reduce hospital-acquired infection rates and improve nurses' hand-washing compliance in an intensive care unit. A preexperimental study design was used to compare 12-month rates of 2 common hospital-acquired infections, central catheter-associated bloodstream infection and catheter-associated urinary tract infection, and nurses' hand-washing compliance measured before and during use of the protocol. Reductions in 12-month infection rates were reported for both types of infections, but neither reduction was statistically significant. Mean 12-month nurse hand-washing compliance also improved, but not significantly. A hand hygiene protocol for patients in the intensive care unit was associated with reductions in hospital-acquired infections and improvements in nurses' hand-washing compliance. Prevention of such infections requires continuous quality improvement efforts to monitor lasting effectiveness as well as investigation of strategies to eliminate these infections. ©2015 American Association of Critical-Care Nurses.

How do gut feelings feature in tutorial dialogues on diagnostic reasoning in GP traineeship?

PubMed

Stolper, C F; Van de Wiel, M W J; Hendriks, R H M; Van Royen, P; Van Bokhoven, M A; Van der Weijden, T; Dinant, G J

2015-05-01

Diagnostic reasoning is considered to be based on the interaction between analytical and non-analytical cognitive processes. Gut feelings, a specific form of non-analytical reasoning, play a substantial role in diagnostic reasoning by general practitioners (GPs) and may activate analytical reasoning. In GP traineeships in the Netherlands, trainees mostly see patients alone but regularly consult with their supervisors to discuss patients and problems, receive feedback, and improve their competencies. In the present study, we examined the discussions of supervisors and their trainees about diagnostic reasoning in these so-called tutorial dialogues and how gut feelings feature in these discussions. 17 tutorial dialogues focussing on diagnostic reasoning were video-recorded and transcribed and the protocols were analysed using a detailed bottom-up and iterative content analysis and coding procedure. The dialogues were segmented into quotes. Each quote received a content code and a participant code. The number of words per code was used as a unit of analysis to quantitatively compare the contributions to the dialogues made by supervisors and trainees, and the attention given to different topics. The dialogues were usually analytical reflections on a trainee's diagnostic reasoning. A hypothetico-deductive strategy was often used, by listing differential diagnoses and discussing what information guided the reasoning process and might confirm or exclude provisional hypotheses. Gut feelings were discussed in seven dialogues. They were used as a tool in diagnostic reasoning, inducing analytical reflection, sometimes on the entire diagnostic reasoning process. The emphasis in these tutorial dialogues was on analytical components of diagnostic reasoning. Discussing gut feelings in tutorial dialogues seems to be a good educational method to familiarize trainees with non-analytical reasoning. Supervisors need specialised knowledge about these aspects of diagnostic reasoning and how to deal with them in medical education.

Administration of medicines by emergency nurse practitioners according to protocols in an accident and emergency department.

PubMed Central

Marshall, J; Edwards, C; Lambert, M

1997-01-01

OBJECTIVE: To present the legal and professional issues related to nurse administration of drugs according to protocols, and describe the implementation and initial audit findings of such a scheme. SETTING: Accident and emergency (A&E) department of a district general hospital. METHODS: Analysis of legal and professional opinion. Protocols acceptable to the medical, nursing, and pharmacy professions were developed across a wide range of drugs appropriate for administration by accident and emergency nurse practitioners (ENPs). The first six months of the scheme were audited. Audit initially addressed general compliance with protocols and later the specific areas of tetanus immunisation and emergency contraception. RESULTS: ENPs assessed 2925 patients in six months (10.9% of all new patients); 455 patients (15.5% of the ENP patients) were given drugs according to protocols. There were no breaches of the protocols. Subsequent audit of tetanus immunisation showed 94-100% compliance with protocol standards and 71-100% compliance for emergency contraception. CONCLUSIONS: There are no legal or professional obstacles to the development of protocols for the administration of drugs to patients by nurses without reference to a doctor, providing the protocols meet all the requirements of the UKCC and have the support of consultant medical staff. Such a system must be subject to regular audit to promote a dynamic approach to protocols and training. The system safely enhanced the quality of care of patients treated by ENPs in A&E. Images Figure 1 PMID:9248912

Protocols and Hospital Mortality in Critically ill Patients: The United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study

PubMed Central

Sevransky, Jonathan E.; Checkley, William; Herrera, Phabiola; Pickering, Brian W.; Barr, Juliana; Brown, Samuel M; Chang, Steven Y; Chong, David; Kaufman, David; Fremont, Richard D; Girard, Timothy D; Hoag, Jeffrey; Johnson, Steven B; Kerlin, Mehta P; Liebler, Janice; O'Brien, James; O'Keefe, Terence; Park, Pauline K; Pastores, Stephen M; Patil, Namrata; Pietropaoli, Anthony P; Putman, Maryann; Rice, Todd W.; Rotello, Leo; Siner, Jonathan; Sajid, Sahul; Murphy, David J; Martin, Greg S

2015-01-01

Objective Clinical protocols may decrease unnecessary variation in care and improve compliance with desirable therapies. We evaluated whether highly protocolized intensive care units have superior patient outcomes compared with less highly protocolized intensive care units. Design Observational study in which participating intensive care units completed a general assessment and enrolled new patients one day each week. Setting and Patients 6179 critically ill patients across 59 intensive care units in the United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study Interventions: None Measurements and Main Results The primary exposure was the number of intensive care unit protocols; the primary outcome was hospital mortality. 5809 participants were followed prospectively and 5454 patients in 57 intensive care units had complete outcome data. The median number of protocols per intensive care unit was 19 (IQR 15 to 21.5). In single variable analyses, there were no differences in intensive care unit and hospital mortality, length of stay, use of mechanical ventilation, vasopressors, or continuous sedation among individuals in intensive care units with a high vs. low number of protocols. The lack of association was confirmed in adjusted multivariable analysis (p=0.70). Protocol compliance with two ventilator management protocols was moderate and did not differ between intensive care units with high vs. low numbers of protocols for lung protective ventilation in ARDS (47% vs. 52%; p=0.28) and for spontaneous breathing trials (55% vs. 51%; p=0.27). Conclusions Clinical protocols are highly prevalent in United States intensive care units. The presence of a greater number of protocols was not associated with protocol compliance or patient mortality. PMID:26110488

A Primer on Architectural Level Fault Tolerance

NASA Technical Reports Server (NTRS)

Butler, Ricky W.

2008-01-01

This paper introduces the fundamental concepts of fault tolerant computing. Key topics covered are voting, fault detection, clock synchronization, Byzantine Agreement, diagnosis, and reliability analysis. Low level mechanisms such as Hamming codes or low level communications protocols are not covered. The paper is tutorial in nature and does not cover any topic in detail. The focus is on rationale and approach rather than detailed exposition.

Defense Data Network/TOPS-20 Tutorial. An Interative Computer Program.

DTIC Science & Technology

1985-12-01

33 XI. ELECTRONIC MAIL HOST ( EMH )-------------------------- 34 XII. EMACS...contents of text buffer to a file X EXCHANGE , used to search for and replace text Z ZAP, puts your entire file into the print buffer 23 - -° SWITCH...prompt USC-ISIE.ARPA> Sample foreign host command level prompt FTP COMMAND LEVEL COMMANDS COMMAND USE(S) FTP Invokes the FTP protocol CONNECT Connects

300 area TEDF NPDES Permit Compliance Monitoring Plan

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

Loll, C.M.

1995-09-05

This document presents the 300 Area Treated Effluent Disposal Facility (TEDF) National Pollutant Discharge Elimination System (NPDES) Permit Compliance Monitoring Plan (MP). The MP describes how ongoing monitoring of the TEDF effluent stream for compliance with the NPDES permit will occur. The MP also includes Quality Assurance protocols to be followed.

Development of a method to assess compliance with ergonomic posture in dental students

PubMed Central

Garcia, Patrícia Petromilli Nordi Sasso; Wajngarten, Danielle; Campos, Juliana Alvares Duarte Bonini

2018-01-01

CONTEXT: The ergonomic posture protocol is extremely important for the maintenance of occupational health in dentistry. The lack of compliance with this protocol results in a high risk of developing musculoskeletal disorders. AIMS: This study developed a direct observation method for the evaluation of dental student compliance with ergonomic posture protocol. SUBJECTS AND METHODS: The method is named compliance assessment of dental ergonomic posture requirements (CADEP). During the development of the method, 14 items were elaborated considering the theory of dental ergonomics. Each item should be classified as appropriate, partially appropriate, or inappropriate. After evaluation, all item values should be added, and the final score expressed as the percent of compliance with correct postures, with a score range of 0%–100%. STATISTICAL ANALYSIS USED: The reliability of CADEP was assessed through intra- and interobserver reproducibility. For the CADEP application, 73 senior year students from the undergraduate course in dentistry were evaluated. The intra- and interexaminer concordance was estimated using the intraclass correlation coefficient (ρ). A descriptive statistical analysis was performed. RESULTS: The reproducibility of evaluator 1 (ρ =0.90; confidence interval [CI] 95%: 0.83–0.94), evaluator 2 (ρ = 0.83; CI 95%: 0.70–0.90), the interexaminer in the first evaluation (ρ = 0.81; CI 95%:0.67–0.89), and in the second one (ρ = 0.76; CI 95%: 0.59–0.87) was classified as good. In the analysis of the compliance, it was verified that moderate compliance was the most prevalent among the evaluated students (65.6%, CI 95%: 60.3%–70.7%). CONCLUSIONS: CADEP was valid and reliable for the assessment of dentistry students’ compliance regarding ergonomic posture requirements. PMID:29693025

Mars Sample Quarantine Protocol Workshop

NASA Technical Reports Server (NTRS)

DeVincenzi, Donald L. (Editor); Bagby, John (Editor); Race, Margaret (Editor); Rummel, John (Editor)

1999-01-01

The Mars Sample Quarantine Protocol (QP) Workshop was convened to deal with three specific aspects of the initial handling of a returned Mars sample: 1) biocontainment, to prevent uncontrolled release of sample material into the terrestrial environment; 2) life detection, to examine the sample for evidence of live organisms; and 3) biohazard testing, to determine if the sample poses any threat to terrestrial life forms and the Earth's biosphere. During the first part of the Workshop, several tutorials were presented on topics related to the workshop in order to give all participants a common basis in the technical areas necessary to achieve the objectives of the Workshop.

76 FR 11447 - Agency Information Collection Activities; Proposed Collection; Comment Request; Protection of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-02

... Protection regulations, the science of ozone layer depletion, and related topics. SUPPLEMENTARY INFORMATION... compliance with the Montreal Protocol on Substances that Deplete the Ozone Layer (Protocol) and the CAA.... obligations under Article 2H of the Montreal Protocol on Substances that Deplete the Ozone Layer (Protocol...

Compliance with the national palestinian infection prevention and control protocol at governmental paediatric hospitals in gaza governorates.

PubMed

Eljedi, Ashraf; Dalo, Shareef

2014-08-01

Nosocomial infections are a significant burden for both patients and the healthcare system. For this reason, infection prevention and control (IPC) practices are extremely important. The Palestinian Ministry of Health adopted the national IPC Protocol in 2004. This study aimed to assess the compliance of healthcare providers (HCPs) with the Protocol in three governmental paediatric hospitals in Gaza governorates. This descriptive cross-sectional study was conducted from February to November 2010. Data were collected from a sample of doctors, nurses and physiotherapists (N = 334) using a self-administered questionnaire and observation checklists to record HCP practices and assess the hospital environment. The response rate was 92%. The most important reasons for non-compliance with the IPC Protocol were the absence of an education programme (61.5%), lack of knowledge (52.4%) and the scarcity of required supplies (46.9%). Only 2.3% of respondents had a copy of the IPC Protocol, while 65.8% did not know of its existence. Only 16.9% had participated in training sessions regarding general IPC practices. The observation checklist regarding HCP practices revealed low levels of compliance in hand washing (45.9%), wearing gloves (40.7%) and using antiseptics/disinfectants (49.16%). The health facilities checklist indicated that there was a lack of certain essential equipment and materials, such as covered waste containers and heavy-duty gloves. Due to the lack of HPC knowledge, the authors recommend that the IPC Protocol be made available in all hospitals. In addition, a qualified team should implement intensive IPC education and training programmes and facilities should provide the required equipment and materials.

Best practices in specialty pharmacy management.

PubMed

Patterson, Courtney J

2013-01-01

Specialty pharmacy is a growing area of research, utilization, and cost. Because of the unique nature of the diseases treated by specialty pharmaceuticals, such as cancer and rheumatoid arthritis, novel management approaches are needed. Advocate Physician Partners (APP) is an entity within the Advocate Health Care Health System in the Chicago and the central Illinois area. It coordinates the care management and managed care contracting between the Advocate Health Care System and more than 4,000 physicians on the medical staffs of Advocate hospitals. APP has experienced a per-member-per-month (PMPM) increase of less than  3% in oncology intravenous medications spend in 2012. This spend refers to the intravenous medications covered under the medical benefits for APP's health maintenance organization (HMO) population. The spend has consistently been less than national projections, and we believe this is tied to the adoption of several key best practices. Prior to instituting the best practices, the yearly percentage increases for oncology spending were 5.52% (2007 to 2008), 9.39% (2008 to 2009), and 5.29% (2009 to 2010). After instituting best practices during the first quarter of 2011, the increases in PMPM were 3.11% (2010 to 2011) and 2.11% (2011 to 2012), which were below previous years. To describe the best practices of specialty pharmacy management adopted by APP, specifically (a) establishing a content expert and governing bodies, (b) ensuring compliance with policies, and (c) providing educational resources. APP has several key result areas (KRAs). One KRA was compliance with appropriate utilization of intravenous oncology protocols for its HMO population. The protocols for each medication outline the appropriate indication and patient population. These protocols were developed and reviewed by the APP Pharmacy and Technology (PT) committee. The PT-approved indications reflect FDA indications and indications found in national guidelines. The APP KRA target for the utilization of protocols was 80%. The compliance for completing the protocols that correspond to these medications was calculated by tabulating the number of paid claims over the number of completed protocols, resulting in a compliance percentage. APP defined noncompliance as any utilization not outlined in the protocol. Another KRA was physician feedback. APP requires that physicians complete a certain number of continuing medical education (CME) programs provided by APP each year. Feedback from physicians, provided at the end of the CME, were tabulated and utilized for further programs. Additionally, APP strived to increase physician engagement by placing them in key roles that oversaw clinical and business aspects of the organization. In order to meet the KRAs, investigate inappropriate utilization, and become better involved in engaging oncology specialists, APP invested in an oncology clinical pharmacist position. The primary responsibility of the oncology clinical pharmacist was to be a specialty drug resource for the organization with a focus on provider education. The oncology clinical pharmacist was deemed the content expert who developed clinical protocols, educated providers, and encouraged compliance with organizational policies and procedures as it pertained to the KRAs. Since establishing the oncology clinical pharmacist position, APP has seen an increase in protocol compliance. Prior to the institution of this position, the protocol compliance was 62%. In less than 1 year after hiring the oncology clinical pharmacist, the compliance percentage spiked to over 80%. APP has several committees and boards that oversee the clinical and business aspects of the organization. By placing physicians in chairmanship positions of the committees, APP has seen the benefit of handling difficult patient decisions and increased compliance with policies. Lastly, extensive provider education has led to an improved physician satisfaction in the educational initiatives of APP. Greater than 80% of the physicians felt the CME content was relevant to their practices; the content would likely have a positive impact on their practices; and the clinical content was evidence based and accepted by the medical community. By hiring an oncology clinical pharmacist, engaging physicians by placing them in key roles, and providing more specialist-specific education, APP has improved its KRAs and compliance percentages. APP achieved success in containing expenditures for oncology intravenous medications by implementing key best practices combined with traditional management strategies.

Minimizing variance in pediatric gastrostomy: does standardized perioperative feeding plan decrease cost and improve outcomes?

PubMed

Sunstrom, Rachel; Hamilton, Nicholas; Fialkowski, Elizabeth; Lofberg, Katrine; McKee, Julie; Sims, Thomas; Krishnaswami, Sanjay; Azarow, Kenneth

2016-05-01

A protocol for laparoscopic gastrostomy placement was implemented which specified perioperative antibiotics, feeding regimens, and discharge criteria. Our hypothesis was that hospital cost could be decreased, whereas at the same time improving or maintaining patient outcomes. Data were collected on consecutive patients beginning 6 months after implementation of our protocol. We recorded surgeon compliance, patient outcomes (as defined by 30-day NSQIP complication rates), and cost of initial hospitalization, which was then compare to a 6-month historical control period. Our control group n = 26 and protocol group n = 39. Length of stay was shorter in the protocol group (P ≤ .05 by nonparametric analysis). The complication rate was similar in both groups (23% control vs 15% protocol, P = .43). Initial hospital costs were not different. Surgeon compliance to protocol was 82%. A standard protocol is achievable for gastrostomy tube management. After implementation of our protocol, we were able to show a significant decrease in length of stay, whereas maintaining quality. Copyright © 2016 Elsevier Inc. All rights reserved.

Digital retinal imaging in a residency-based patient-centered medical home.

PubMed

Newman, Robert; Cummings, Doyle M; Doherty, Lisa; Patel, Nick R

2012-03-01

Diabetic retinopathy is the leading cause of blindness in adults in the United States, and early screening/treatment may preserve vision. This study examined the feasibility of using non-mydriatic digital retinal imaging (DRI) for retinopathy screening in a busy family medicine residency program at the point of care using a nurse-driven protocol. We compared the number of diabetics screened during a 1-year period before and after DRI protocol implementation. We also determined the prevalence of retinopathy, assessed patient satisfaction with the alternative screening process, and tracked ophthalmologic appointment compliance for patients referred because of abnormal screening results. Screening approximately doubled from 161 patients/year before the protocol to 330 patients/year after protocol implementation. However, DRI screening had no impact on ophthalmologic appointment compliance; only 58% of 153 patients referred for ophthalmologic evaluation because of positive screening findings completed their referral appointment. Seven cases needing urgent ophthalmologic treatment were identified. Satisfaction with primary care retinopathy screening was high. Use of a nurse-driven protocol for digital retinal imaging at the point of care dramatically improves rates of annual retinopathy screening in academic family medicine practice and can identify patients who require subspecialty referral. However, DRI screening does not improve visit compliance rates with ophthalmologists for evaluation and management.

Lead Sampling Protocols: Why So Many and What Do They Tell You?

EPA Science Inventory

Sampling protocols can be broadly categorized based on their intended purpose of 1) Pb regulatory compliance/corrosion control efficacy, 2) Pb plumbing source determination or Pb type identification, and 3) Pb exposure assessment. Choosing the appropriate protocol is crucial to p...

CTC Sentinel. Volume 2, Issue 8, August 2009

DTIC Science & Technology

2009-08-01

Ul-Islami As-Sahih Tutorial Protocol for Prisoners,” NEFA Foundation, December 14, 2007. 9 Shaykh Jamaal al-Din Zarabozo’s “He Came to Teach You...Prison,” U.S. Department of Justice, Central District of California, March 6, 2009. 17 See Kevin James, “Blue Print 2005,” available at nefa ...International Airport, the Israeli 22 Kevin James, “Notoriety Moves,” available at nefa - foundation.org/miscellaneous/FeaturedDocs/U.S._v_

Financial aspects of sentinel lymph node biopsy in early breast cancer.

PubMed

Severi, S; Gazzoni, E; Pellegrini, A; Sansovini, M; Raulli, G; Corbelli, C; Altini, M; Paganelli, G

2012-02-01

At present, early breast cancer is treated with conservative surgery of the primary lesion (BCS) along with axillary staging by sentinel lymph node biopsy (SLNB). Although the scintigraphic method is standardized, its surgical application is different for patient compliance, work organization, costs, and diagnosis related group (DRG) reimbursements. We compared four surgical protocols presently used in our region: (A) traditional BCS with axillary lymph node dissection (ALND); (B) BCS with SLNB and concomitant ALND for positive sentinel nodes (SN); (C) BCS and SLNB under local anaesthesia with subsequent ALND under general anaesthesia according to the SN result; (D) SLNB under local anaesthesia with subsequent BCS under local anaesthesia for negative SN, or ALND under general anaesthesia for positive SN. For each protocol, patient compliance, use of consumables, resources and time spent by various dedicated professionals, were analyzed. Furthermore, a detailed breakdown of 1-/2-day hospitalization costs was calculated using specific DRGs. We reported a mean costs variation that ranged from 1,634 to 2,221 Euros (protocols C and D). The number of procedures performed and the pathologists' results are the most significant variables affecting the rate of DRG reimbursements, that were the highest for protocol D and the lowest for protocol B. In our experience protocol C is the most suitable in terms of patient compliance, impact of surgical procedures, and work organization, and is granted by an appropriate DRG. We observed that a multidisciplinary approach enhances overall patient care and that a revaluation of DRG reimbursements is opportune.

Speech transport for packet telephony and voice over IP

NASA Astrophysics Data System (ADS)

Baker, Maurice R.

1999-11-01

Recent advances in packet switching, internetworking, and digital signal processing technologies have converged to allow realizable practical implementations of packet telephony systems. This paper provides a tutorial on transmission engineering for packet telephony covering the topics of speech coding/decoding, speech packetization, packet data network transport, and impairments which may negatively impact end-to-end system quality. Particular emphasis is placed upon Voice over Internet Protocol given the current popularity and ubiquity of IP transport.

The Pathway for Oxygen: Tutorial Modelling on Oxygen Transport from Air to Mitochondrion: The Pathway for Oxygen.

PubMed

Bassingthwaighte, James B; Raymond, Gary M; Dash, Ranjan K; Beard, Daniel A; Nolan, Margaret

2016-01-01

The 'Pathway for Oxygen' is captured in a set of models describing quantitative relationships between fluxes and driving forces for the flux of oxygen from the external air source to the mitochondrial sink at cytochrome oxidase. The intervening processes involve convection, membrane permeation, diffusion of free and heme-bound O2 and enzymatic reactions. While this system's basic elements are simple: ventilation, alveolar gas exchange with blood, circulation of the blood, perfusion of an organ, uptake by tissue, and consumption by chemical reaction, integration of these pieces quickly becomes complex. This complexity led us to construct a tutorial on the ideas and principles; these first PathwayO2 models are simple but quantitative and cover: (1) a 'one-alveolus lung' with airway resistance, lung volume compliance, (2) bidirectional transport of solute gasses like O2 and CO2, (3) gas exchange between alveolar air and lung capillary blood, (4) gas solubility in blood, and circulation of blood through the capillary syncytium and back to the lung, and (5) blood-tissue gas exchange in capillaries. These open-source models are at Physiome.org and provide background for the many respiratory models there.

The Pathway for Oxygen: Tutorial Modelling on Oxygen Transport from Air to Mitochondrion

PubMed Central

Bassingthwaighte, James B.; Raymond, Gary M.; Dash, Ranjan K.; Beard, Daniel A.; Nolan, Margaret

2016-01-01

The ‘Pathway for Oxygen’ is captured in a set of models describing quantitative relationships between fluxes and driving forces for the flux of oxygen from the external air source to the mitochondrial sink at cytochrome oxidase. The intervening processes involve convection, membrane permeation, diffusion of free and heme-bound O2 and enzymatic reactions. While this system’s basic elements are simple: ventilation, alveolar gas exchange with blood, circulation of the blood, perfusion of an organ, uptake by tissue, and consumption by chemical reaction, integration of these pieces quickly becomes complex. This complexity led us to construct a tutorial on the ideas and principles; these first PathwayO2 models are simple but quantitative and cover: 1) a ‘one-alveolus lung’ with airway resistance, lung volume compliance, 2) bidirectional transport of solute gasses like O2 and CO2, 3) gas exchange between alveolar air and lung capillary blood, 4) gas solubility in blood, and circulation of blood through the capillary syncytium and back to the lung, and 5) blood-tissue gas exchange in capillaries. These open-source models are at Physiome.org and provide background for the many respiratory models there. PMID:26782201

[Professor Xu Fu-song's traditional Chinese medicine protocols for male diseases: A descriptive analysis].

PubMed

Liu, Cheng-yong; Xu, Fu-song

2015-04-01

To analyze the efficacy and medication principles of Professor Xu Fu-songs traditional Chinese medicine (TCM) protocols for male diseases. We reviewed and descriptively analyzed the unpublished complete medical records of 100 male cases treated by Professor Xu Fu-song with his TCM protocols from 1978 to 1992. The 100 cases involved 32 male diseases, most of which were difficult and complicated cases. The drug compliance was 95%. Each prescription was made up of 14 traditional Chinese drugs on average. The cure rate was 32% , and the effective rate was 85%. Professor Xu Fu-song advanced and proved some new theories and therapeutic methods. Professor Xu Fu-song's TCM protocols can be applied to a wide range of male diseases, mostly complicated, and are characterized by accurate differentiation of symptoms and signs, high drug compliance, and excellent therapeutic efficacy.

Monitoring universal protocol compliance through real-time clandestine observation by medical students results in performance improvement.

PubMed

Logan, Catherine A; Cressey, Brienne D; Wu, Roger Y; Janicki, Adam J; Chen, Cyril X; Bolourchi, Meena L; Hodnett, Jessica L; Stratigis, John D; Mackey, William C; Fairchild, David G

2012-01-01

To measure universal protocol compliance through real-time, clandestine observation by medical students compared with chart audit reviews, and to enable medical students the opportunity to become conscious of the importance of medical errors and safety initiatives. With endorsement from Tufts Medical Center's (TMC's) Chief Medical Officer and Surgeon-in-Chief, 8 medical students performed clandestine observation audits of 98 cases from April to August 2009. A compliance checklist was based on TMC's presurgical checklist. Our initial results led to interventions to improve our universal protocol procedures, including modifications to the operating room white board and presurgical checklist, and specific feedback to surgical departments. One year later, 6 medical students performed observations of 100 cases from June to August 2010. Tufts Medical Center, Boston, Massachusetts, which is an academic medical center and the principal teaching hospital for Tufts University School of Medicine. An operating room coordinator placed the medical students into 1 of our 25 operating rooms with students entering under the premise of observing the anesthesiologist for clinical education. The observations were performed Monday to Friday between 7 am and 4 pm. Although observations were not randomized, no single service or type of surgery was targeted for observation. A broad range of departments was observed. In 8.2% of cases, the surgical site was unmarked. A Time Out occurred in 89.7% of cases. The entire surgical team was attentive during the time out in 82% of cases. The presurgical checklist was incomplete before incision in 13 cases. Images were displayed in 82% of cases. The operating room "white board" was filled out completely in 49% of cases. Team introductions occurred in 13 cases. One year later, compliance increased in all Universal Protocol dimensions. Direct, real-time observation by medical students provides an accurate and granular assessment of compliance with specific components of the universal protocol and engages medical students in the quality improvement process, raises their awareness of the gravity of medical errors, and ensures appreciation of the importance of quality and safety initiatives. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Next Generation Sequence Assembly with AMOS

PubMed Central

Treangen, Todd J; Sommer, Dan D; Angly, Florent E; Koren, Sergey; Pop, Mihai

2011-01-01

A Modular Open-Source Assembler (AMOS) was designed to offer a modular approach to genome assembly. AMOS includes a wide range of tools for assembly, including lightweight de novo assemblers Minimus and Minimo, and Bambus 2, a robust scaffolder able to handle metagenomic and polymorphic data. This protocol describes how to configure and use AMOS for the assembly of Next Generation sequence data. Additionally, we provide three tutorial examples that include bacterial, viral, and metagenomic datasets with specific tips for improving assembly quality. PMID:21400694

Guided Tour of Pythonian Museum

NASA Technical Reports Server (NTRS)

Lee, H. Joe

2017-01-01

At http:hdfeos.orgzoo, we have a large collection of Python examples of dealing with NASA HDF (Hierarchical Data Format) products. During this hands-on Python tutorial session, we'll present a few common hacks to access and visualize local NASA HDF data. We'll also cover how to access remote data served by OPeNDAP (Open-source Project for a Network Data Access Protocol). As a glue language, we will demonstrate how you can use Python for your data workflow - from searching data to analyzing data with machine learning.

The Impact of Anesthesia-Influenced Process Measure Compliance on Length of Stay: Results From an Enhanced Recovery After Surgery for Colorectal Surgery Cohort.

PubMed

Grant, Michael C; Pio Roda, Claro M; Canner, Joseph K; Sommer, Philip; Galante, Daniel; Hobson, Deborah; Gearhart, Susan; Wu, Christopher L; Wick, Elizabeth

2018-05-17

Process measure compliance has been associated with improved outcomes in enhanced recovery after surgery (ERAS) programs. Herein, we sought to assess the impact of compliance with measures directly influenced by anesthesiology in an ERAS for colorectal surgery cohort. From January 2013 to April 2015, data from 1140 consecutive patients were collected for all patients before (pre-ERAS) and after (ERAS) implementation of an ERAS program. Compliance with 9 specific process measures directly influenced by the anesthesiologist or acute pain service was analyzed to determine the impact on hospital length of stay (LOS). Process measure compliance was associated with a stepwise reduction in LOS. Patients who received >4 process measures (high compliance) had a significantly shorter LOS (incident rate ratio [IRR], 0.77; 95% CI, 0.70-0.85); P < .001) compared to low compliance (0-2 process measures) counterparts. Multivariable regression suggests that utilization of multimodal nausea and vomiting prophylaxis (IRR, 0.78; 95% CI, 0.68-0.89; P < .001), scheduled postoperative nonsteroidal pain medication use (IRR, 0.76; 95% CI, 0.67-0.85; P < .001), and strict adherence to a postoperative opioid administration (IRR, 0.58; 95% CI, 0.51-0.67; P < .001) protocol for breakthrough pain were independently associated with reduced LOS. Our findings suggest that increased compliance with process measures directly influenced by the anesthesiologists and in concert with a formal anesthesia protocol is associated with reduced LOS. Engaging anesthesiology colleagues throughout the surgical encounter increases the overall value of perioperative care.

Molecules for security measures: from keypad locks to advanced communication protocols.

PubMed

Andréasson, J; Pischel, U

2018-04-03

The idea of using molecules in the context of information security has sparked the interest of researchers from many scientific disciplines. This is clearly manifested in the diversity of the molecular platforms and the analytical techniques used for this purpose, some of which we highlight in this Tutorial Review. Moreover, those molecular systems can be used to emulate a broad spectrum of security measures. For a long time, molecular keypad locks enjoyed a clear preference and the review starts off with a description of how these devices developed. In the last few years, however, the field has evolved into something larger. Examples include more complex authentication protocols (multi-factor authentication and one-time passwords), the recognition of erroneous procedures in data transmission (parity devices), as well as steganographic and cryptographic protection.

Teacher Compliance and Accuracy in State Assessment of Student Motor Skill Performance

ERIC Educational Resources Information Center

Hall, Tina J.; Hicklin, Lori K.; French, Karen E.

2015-01-01

Purpose: The purpose of this study was to investigate teacher compliance with state mandated assessment protocols and teacher accuracy in assessing student motor skill performance. Method: Middle school teachers (N = 116) submitted eighth grade student motor skill performance data from 318 physical education classes to a trained monitoring…

VoIP for Telerehabilitation: A Pilot Usability Study for HIPAA Compliance

PubMed Central

Watzlaf, Valerie R.; Ondich, Briana

2012-01-01

Consumer-based, free Voice and video over the Internet Protocol (VoIP) software systems such as Skype and others are used by health care providers to deliver telerehabilitation and other health-related services to clients. Privacy and security applications as well as HIPAA compliance within these protocols have been questioned by practitioners, health information managers, and other healthcare entities. This pilot usability study examined whether four respondents who used the top three, free consumer-based, VoIP software systems perceived these VoIP technologies to be private, secure, and HIPAA compliant; most did not. While the pilot study limitations include the number of respondents and systems assessed, the protocol can be applied to future research and replicated for instructional purposes. Recommendations are provided for VoIP companies, providers, and clients/consumers. PMID:25945194

Exercise Countermeasures Demonstration Project During the Lunar-Mars Life Support Test Project Phase 2A

NASA Technical Reports Server (NTRS)

Lee, Stuart M. C.; Guilliams, Mark E.; Moore, Alan D., Jr.; Williams, W. Jon; Greenisen, M. C.; Fortney, S. M.

1998-01-01

This demonstration project assessed the crew members' compliance to a portion of the exercise countermeasures planned for use onboard the International Space Station (ISS) and the outcomes of their performing these countermeasures. Although these countermeasures have been used separately in other projects and investigations, this was the first time they'd been used together for an extended period (60 days) in an investigation of this nature. Crew members exercised every day for six days, alternating every other day between aerobic and resistive exercise, and rested on the seventh day. On the aerobic exercise days, subjects exercised on an electronically braked cycle ergometer using a protocol that has been previously shown to maintain aerobic capacity in subjects exposed to a space flight analogue. On the resistive exercise days, crew members performed five major multijoint resistive exercises in a concentric mode, targeting those muscle groups and bones we believe are most severely affected by space flight. The subjects favorably tolerated both exercise protocols, with a 98% compliance to aerobic exercise prescription and a 91% adherence to the resistive exercise protocol. After 60 days, the crew members improved their peak aerobic capacity by an average 7%, and strength gains were noted in all subjects. These results suggest that these exercise protocols can be performed during ISS, lunar, and Mars missions, although we anticipate more frequent bouts with both protocols for long-duration spaceflight. Future projects should investigate the impact of increased exercise duration and frequency on subject compliance, and the efficacy of such exercise prescriptions.

Hand disinfection in a neonatal intensive care unit: continuous electronic monitoring over a one-year period.

PubMed

Helder, Onno K; van Goudoever, Johannes B; Hop, Wim C J; Brug, Johannes; Kornelisse, René F

2012-10-08

Good hand hygiene compliance is essential to prevent nosocomial infections in healthcare settings. Direct observation of hand hygiene compliance is the gold standard but is time consuming. An electronic dispenser with built-in wireless recording equipment allows continuous monitoring of its usage. The purpose of this study was to monitor the use of alcohol-based hand rub dispensers with a built-in electronic counter in a neonatal intensive care unit (NICU) setting and to determine compliance with hand hygiene protocols by direct observation. A one-year observational study was conducted at a 27 bed level III NICU at a university hospital. All healthcare workers employed at the NICU participated in the study. The use of bedside dispensers was continuously monitored and compliance with hand hygiene was determined by random direct observations. A total of 258,436 hand disinfection events were recorded; i.e. a median (interquartile range) of 697 (559-840) per day. The median (interquartile range) number of hand disinfection events performed per healthcare worker during the day, evening, and night shifts was 13.5 (10.8 - 16.7), 19.8 (16.3 - 24.1), and 16.6 (14.2 - 19.3), respectively. In 65.8% of the 1,168 observations of patient contacts requiring hand hygiene, healthcare workers fully complied with the protocol. We conclude that the electronic devices provide useful information on frequency, time, and location of its use, and also reveal trends in hand disinfection events over time. Direct observations offer essential data on compliance with the hand hygiene protocol. In future research, data generated by the electronic devices can be supplementary used to evaluate the effectiveness of hand hygiene promotion campaigns.

Creating library tutorials for nursing students.

PubMed

Schroeder, Heidi

2010-04-01

This article describes one librarian's experiences with creating, promoting, and assessing online library tutorials. Tutorials were designed to provide on-demand and accessible library instruction to nursing students at Michigan State University. Topics for tutorials were chosen based on the librarian's liaison experiences and suggestions from nursing faculty. The tutorials were created using Camtasia and required the application of several tools and techniques. Tutorials were promoted through Web pages, the ANGEL course management system, blog posts, librarian interactions, e-mails, and more. In order to assess the tutorials' perceived effectiveness, feedback was gathered using a short survey. Future plans for the nursing tutorials project are also discussed.

Remote Sensing and the Kyoto Protocol: A Review of Available and Future Technology for Monitoring Treaty Compliance

NASA Technical Reports Server (NTRS)

Imhoff, Marc L.; Rosenquist, A.; Milne, A. K.; Dobson, M. C.; Qi, J.

2000-01-01

An International workshop was held to address how remote sensing technology could be used to support the environmental monitoring requirements of the Kyoto Protocol. An overview of the issues addressed and the findings of the workshop are discussed.

Embedding medical student computer tutorials into a busy emergency department.

PubMed

Pusic, Martin V; Pachev, George S; MacDonald, Wendy A

2007-02-01

To explore medical students' use of computer tutorials embedded in a busy clinical setting; to demonstrate that such tutorials can increase knowledge gain over and above that attributable to the clinical rotation itself. Six tutorials were installed on a computer placed in a central area in an emergency department. Each tutorial was made up of between 33 and 85 screens of information that include text, graphics, animations, and questions. They were designed to be brief (10 minutes), focused, interactive, and immediately relevant. The authors evaluated the intervention using quantitative research methods, including usage tracking, surveys of faculty and students, and a randomized pretest-posttest study. Over 46 weeks, 95 medical students used the tutorials 544 times, for an overall average of 1.7 times a day. The median time spent on completed tutorials was 11 minutes (average [SD], 14 [+/-12] minutes). Seventy-four students completed the randomized study. They completed 65% of the assigned tutorials, resulting in improved examination scores compared with the control (effect size, 0.39; 95% confidence interval = 0.15 to 0.62). Students were positively disposed to the tutorials, ranking them as "valuable." Fifty-four percent preferred the tutorials to small group teaching sessions with a preceptor. The faculty was also positive about the tutorials, although they did not appear to integrate the tutorials directly into their teaching. Medical students on rotation in a busy clinical setting can and will use appropriately presented computer tutorials. The tutorials are effective in raising examination scores.

Next generation sequence assembly with AMOS.

PubMed

Treangen, Todd J; Sommer, Dan D; Angly, Florent E; Koren, Sergey; Pop, Mihai

2011-03-01

A Modular Open-Source Assembler (AMOS) was designed to offer a modular approach to genome assembly. AMOS includes a wide range of tools for assembly, including the lightweight de novo assemblers Minimus and Minimo, and Bambus 2, a robust scaffolder able to handle metagenomic and polymorphic data. This protocol describes how to configure and use AMOS for the assembly of Next Generation sequence data. Additionally, we provide three tutorial examples that include bacterial, viral, and metagenomic datasets with specific tips for improving assembly quality. © 2011 by John Wiley & Sons, Inc.

Video analysis for insight and coding: Examples from tutorials in introductory physics

NASA Astrophysics Data System (ADS)

Scherr, Rachel E.

2009-12-01

The increasing ease of video recording offers new opportunities to create richly detailed records of classroom activities. These recordings, in turn, call for research methodologies that balance generalizability with interpretive validity. This paper shares methodology for two practices of video analysis: (1) gaining insight into specific brief classroom episodes and (2) developing and applying a systematic observational protocol for a relatively large corpus of video data. These two aspects of analytic practice are illustrated in the context of a particular research interest but are intended to serve as general suggestions.

Speaking the right language: the scientific method as a framework for a continuous quality improvement program within academic medical research compliance units.

PubMed

Nolte, Kurt B; Stewart, Douglas M; O'Hair, Kevin C; Gannon, William L; Briggs, Michael S; Barron, A Marie; Pointer, Judy; Larson, Richard S

2008-10-01

The authors developed a novel continuous quality improvement (CQI) process for academic biomedical research compliance administration. A challenge in developing a quality improvement program in a nonbusiness environment is that the terminology and processes are often foreign. Rather than training staff in an existing quality improvement process, the authors opted to develop a novel process based on the scientific method--a paradigm familiar to all team members. The CQI process included our research compliance units. Unit leaders identified problems in compliance administration where a resolution would have a positive impact and which could be resolved or improved with current resources. They then generated testable hypotheses about a change to standard practice expected to improve the problem, and they developed methods and metrics to assess the impact of the change. The CQI process was managed in a "peer review" environment. The program included processes to reduce the incidence of infections in animal colonies, decrease research protocol-approval times, improve compliance and protection of animal and human research subjects, and improve research protocol quality. This novel CQI approach is well suited to the needs and the unique processes of research compliance administration. Using the scientific method as the improvement paradigm fostered acceptance of the project by unit leaders and facilitated the development of specific improvement projects. These quality initiatives will allow us to improve support for investigators while ensuring that compliance standards continue to be met. We believe that our CQI process can readily be used in other academically based offices of research.

40 CFR 59.208 - Charcoal lighter material testing protocol.

Code of Federal Regulations, 2011 CFR

2011-07-01

... grams per start. The manufacturer or importer shall maintain the report of findings. (c) When a charcoal... protocol, or are unclear (subject to different interpretations) and inadequate, the Administrator must be... to this subpart shall demonstrate compliance with the applicable requirements of § 59.203(d) using...

40 CFR 59.208 - Charcoal lighter material testing protocol.

Code of Federal Regulations, 2010 CFR

2010-07-01

... grams per start. The manufacturer or importer shall maintain the report of findings. (c) When a charcoal... protocol, or are unclear (subject to different interpretations) and inadequate, the Administrator must be... to this subpart shall demonstrate compliance with the applicable requirements of § 59.203(d) using...

Making generic tutorials content specific: recycling evidence-based practice (EBP) tutorials for two disciplines.

PubMed

Jeffery, Keven M; Maggio, Lauren; Blanchard, Mary

2009-01-01

Librarians at the Boston University Medical Center constructed two interactive online tutorials, "Introduction to EBM" and "Formulating a Clinical Question (PICO)," for a Family Medicine Clerkship and then quickly repurposed the existing tutorials to support an Evidence-based Dentistry course. Adobe's ColdFusion software was used to populate the tutorials with course-specific content based on the URL used to enter each tutorial, and a MySQL database was used to collect student input. Student responses were viewable immediately by course faculty on a password-protected Web site. The tutorials ensured that all students received the same baseline training and allowed librarians to tailor a subsequent library skills workshop to student tutorial answers. The tutorials were well-received by the medical and dental schools and have been added to mandatory first-year Evidence-based Medicine (EBM) and Evidence-based Dentistry (EBD) courses, meaning that every medical and dental student at BUMC will be expected to complete these tutorials.

Teaching People and Machines to Enhance Images

NASA Astrophysics Data System (ADS)

Berthouzoz, Floraine Sara Martianne

Procedural tasks such as following a recipe or editing an image are very common. They require a person to execute a sequence of operations (e.g. chop onions, or sharpen the image) in order to achieve the goal of the task. People commonly use step-by-step tutorials to learn these tasks. We focus on software tutorials, more specifically photo manipulation tutorials, and present a set of tools and techniques to help people learn, compare and automate photo manipulation procedures. We describe three different systems that are each designed to help with a different stage in acquiring procedural knowledge. Today, people primarily rely on hand-crafted tutorials in books and on websites to learn photo manipulation procedures. However, putting together a high quality step-by-step tutorial is a time-consuming process. As a consequence, many online tutorials are poorly designed which can lead to confusion and slow down the learning process. We present a demonstration-based system for automatically generating succinct step-by-step visual tutorials of photo manipulations. An author first demonstrates the manipulation using an instrumented version of GIMP (GNU Image Manipulation Program) that records all changes in interface and application state. From the example recording, our system automatically generates tutorials that illustrate the manipulation using images, text, and annotations. It leverages automated image labeling (recognition of facial features and outdoor scene structures in our implementation) to generate more precise text descriptions of many of the steps in the tutorials. A user study finds that our tutorials are effective for learning the steps of a procedure; users are 20-44% faster and make 60-95% fewer errors when using our tutorials than when using screencapture video tutorials or hand-designed tutorials. We also demonstrate a new interface that allows learners to navigate, explore and compare large collections (i.e. thousands) of photo manipulation tutorials based on their command-level structure. Sites such as tutorialized.com or good-tutorials.com collect tens of thousands of photo manipulation tutorials. These collections typically contain many different tutorials for the same task. For example, there are many different tutorials that describe how to recolor the hair of a person in an image. Learners often want to compare these tutorials to understand the different ways a task can be done. They may also want to identify common strategies that are used across tutorials for a variety of tasks. However, the large number of tutorials in these collections and their inconsistent formats can make it difficult for users to systematically explore and compare them. Current tutorial collections do not exploit the underlying command-level structure of tutorials, and to explore the collection users have to either page through long lists of tutorial titles or perform keyword searches on the natural language tutorial text. We present a new browsing interface to help learners navigate, explore and compare collections of photo manipulation tutorials based on their command-level structure. Our browser indexes tutorials by their commands, identifies common strategies within the tutorial collection, and highlights the similarities and differences between sets of tutorials that execute the same task. User feedback suggests that our interface is easy to understand and use, and that users find command-level browsing to be useful for exploring large tutorial collections. They strongly preferred to explore tutorial collections with our browser over keyword search. Finally, we present a framework for generating content-adaptive macros (programs) that can transfer complex photo manipulation procedures to new target images. After learners master a photo manipulation procedure, they often repeatedly apply it to multiple images. For example, they might routinely apply the same vignetting effect to all their photographs. This process can be very tedious especially for procedures that involve many steps. While image manipulation programs provide basic macro authoring tools that allow users to record and then replay a sequence of operations, these macros are very brittle and cannot adapt to new images. We present a more comprehensive approach for generating content-adaptive macros that can automatically transfer operations to new target images. To create these macro, we make use of multiple training demonstrations. Specifically, we use automated image labeling and machine learning techniques to to adapt the parameters of each operation to the new image content. We show that our framework is able to learn a large class of the most commonly-used manipulations using as few as 20 training demonstrations. Our content-adaptive macros allow users to transfer photo manipulation procedures with a single button click and thereby significantly simplify repetitive procedures.

NOAA Freedom of Information Act (FOIA) Training and Tutorials

Science.gov Websites

Commerce FOIA Program Sample Letters FOIA Training and Tutorials FOIA Training and Tutorials Welcome to the National Oceanic and Atmospheric Administration's (NOAA) Freedom of Information Act (FOIA)Training Tutorial Training Tutorial is listed alphabetically by subject, so that individuals will not have to read the entire

PubMed

Aléx, Jonas; Gyllencreutz, Lina

2018-02-05

Trauma care at an accident site is of great importance for patient survival. The purpose of the study was to observe the compliance of ambulance nurses with the Prehospital Trauma Life Support (PHTLS) concept of trauma care in a simulation situation. The material consisted of video recordings in trauma simulation and an observation protocol was designed to analyze the video material. The result showed weaknesses in systematic exam and an ineffective use of time at the scene of injury. Development of observation protocols in trauma simulation can ensure the quality of ambulance nurses' compliance with established concepts. Our pilot study shows that insufficiencies in systematic care lead to an ineffective treatment for trauma patients which in turn may increase the risk of complications and mortality.

Surgeon Training, Protocol Compliance, and Technical Outcomes From Breast Cancer Sentinel Lymph Node Randomized Trial

PubMed Central

Ashikaga, Takamaru; Harlow, Seth P.; Skelly, Joan M.; Julian, Thomas B.; Brown, Ann M.; Weaver, Donald L.; Wolmark, Norman

2009-01-01

Background The National Surgical Adjuvant Breast and Bowel Project B-32 trial was designed to determine whether sentinel lymph node resection can achieve the same therapeutic outcomes as axillary lymph node resection but with fewer side effects and is one of the most carefully controlled and monitored randomized trials in the field of surgical oncology. We evaluated the relationship of surgeon trial preparation, protocol compliance audit, and technical outcomes. Methods Preparation for this trial included a protocol manual, a site visit with key participants, an intraoperative session with the surgeon, and prerandomization documentation of protocol compliance. Training categories included surgeons who submitted material on five prerandomization surgeries and were trained by a core trainer (category 1) or by a site trainer (category 2). An expedited group (category 3) included surgeons with extensive experience who submitted material on one prerandomization surgery. At completion of training, surgeons could accrue patients. Two hundred twenty-four surgeons enrolled 4994 patients with breast cancer and were audited for 94 specific items in the following four categories: procedural, operative note, pathology report, and data entry. The relationship of training method; protocol compliance performance audit; and the technical outcomes of the sentinel lymph node resection rate, false-negative rate, and number of sentinel lymph nodes removed was determined. All statistical tests were two-sided. Results The overall sentinel lymph node resection success rate was 96.9% (95% confidence interval [CI] = 96.4% to 97.4%), and the overall false-negative rate was 9.5% (95% CI = 7.4% to 12.0%), with no statistical differences between training methods. Overall audit outcomes were excellent in all four categories. For all three training groups combined, a statistically significant positive association was observed between surgeons’ average number of procedural errors and their false-negative rate (ρ = +0.188, P = .021). Conclusions All three training methods resulted in uniform and high overall sentinel lymph node resection rates. Subgroup analyses identified some variation in false-negative rates that were related to audited outcome performance measures. PMID:19704072

Analysis of the Impacts of an Early Start for Compliance with the Kyoto Protocol

EIA Publications

1999-01-01

This report describes the Energy Information Administration's analysis of the impacts of an early start, using the same methodology as in Impacts of the Kyoto Protocol on U.S. Energy Markets and Economic Activity, with only those changes in assumptions caused by the early start date.

Revitalizing problem based learning: student and tutor attitudes towards a structured tutorial.

PubMed

Espey, Eve; Ogburn, Tony; Kalishman, Summers; Zsemlye, Meggan; Cosgrove, Ellen

2007-03-01

The pre-clinical curriculum at the University of New Mexico School of Medicine is a hybrid model that includes small group, problem-based learning (PBL) tutorials and didactic lectures. A structured tutorial format was piloted for the human sexuality/reproduction organ system block for the PBL component. The objective of this study was to compare the acceptability of the structured format and its effectiveness with that of a traditional PBL tutorial. Students were surveyed after the renal/endocrinology block of 2004 (traditional tutorial format) and after the human sexuality/reproduction block of 2004 (structured tutorial format) (n = 70). Survey questions covered the quality of learning and of tutorial. Students (n = 132) and tutors (n = 24) who participated in human sexuality/reproduction in 2004 and 2005 were surveyed for attitudes about the structured tutorial overall and specific components. Means of responses were compared using t-tests. Students indicated that the structured tutorial format supported a greater improvement in their basic science and clinical knowledge and their ability to evaluate information (p < 0.05). The majority of students and tutors recommended the structured format for tutorials in other blocks. We demonstrated the acceptability of a structured tutorial format to students and faculty. Faculty members perceived greater depth of learning and participation by the students.

A Pediatric Intensive Care Unit Bedside Computer Clinical Decision Support Protocol for Hyperglycemia Is Feasible, Safe and Offers Advantages

PubMed Central

Lanspa, Michael J.; Wilson, Emily L.; Sward, Katherine A.; Jephson, Al; Larsen, Gitte Y.; Morris, Alan H.

2017-01-01

Abstract Background: Computer clinical decision support (CDS) systems are uncommon in the pediatric intensive care unit (PICU), despite evidence suggesting they improve outcomes in adult ICUs. We reasoned that a bedside CDS protocol for intravenous insulin titration, eProtocol-insulin, would be feasible and safe in critically ill children. Methods: We retrospectively reviewed data from non-diabetic children admitted to the PICU with blood glucose (BG) ≥140 mg/dL who were managed with intravenous insulin by either unaided clinician titration or eProtocol-insulin. Primary outcomes were BG measurements in target range (80–110 mg/dL) and severe hypoglycemia (BG ≤40 mg/dL); secondary outcomes were 60-day mortality and PICU length of stay. We assessed bedside nurse satisfaction with the eProtocol-insulin protocol by using a 5-point Likert scale and measured clinician compliance with eProtocol-insulin recommendations. Results: Over 5 years, 69 children were titrated with eProtocol-insulin versus 104 by unaided clinicians. eProtocol-insulin achieved target range more frequently than clinician titration (41% vs. 32%, P < 0.001). Severe hypoglycemia was uncommon in both groups (4.3% of patients in eProtocol-insulin, 8.7% in clinician titration, P = 0.37). There were no differences in mean time to BG target or median BG between the groups. Mortality was 23% in both groups. Clinician compliance with eProtocol-insulin recommendations was 89%. Nurses believed that eProtocol-insulin was easy to understand and safer than clinician titration. Conclusions: eProtocol-insulin is safe for titration of intravenous insulin in critically ill children. Clinical research protocols and quality improvement initiatives aimed at optimizing BG control should utilize detailed computer protocols that enable replicable clinician decisions. PMID:28248127

Tutorials for Africa: MedlinePlus

MedlinePlus

... NLM created the first MedlinePlus African Tutorial on malaria in collaboration with the Faculty of Medicine and ... meaningful text and illustrations for the tutorials. The malaria tutorial was then field tested in villages by ...

Dedicated Operating Room Teams and Clinical Outcomes in an Enhanced Recovery after Surgery Pathway for Colorectal Surgery.

PubMed

Grant, Michael C; Hanna, Andrew; Benson, Andrew; Hobson, Deborah; Wu, Christopher L; Yuan, Christina T; Rosen, Michael; Wick, Elizabeth C

2018-03-01

Our aim was to determine whether the establishment of a dedicated operating room team leads to improved process measure compliance and clinical outcomes in an Enhanced Recovery after Surgery (ERAS) program. Enhanced Recovery after Surgery programs involve the application of bundled best practices to improve the value of perioperative care. Successful implementation and sustainment of ERAS programs has been linked to compliance with protocol elements. Development of dedicated teams of anesthesia providers was a component of ERAS implementation. Intraoperative provider team networks (surgeons, anesthesiologists, and certified registered nurse anesthetists) were developed for all cases before and after implementation of colorectal ERAS. Four measures of centrality were analyzed in each network based on case assignments, and these measures were correlated with both rates of process measure compliance and clinical outcomes. Enhanced Recovery after Surgery provider teams led to a decrease in the closeness of anesthesiologists (p = 0.04) and significant increase in the clustering coefficient of certified registered nurse anesthetists (p = 0.005) compared with the pre-ERAS network. There was no significant change in centrality among surgeons (p = NS for all measures). Enhanced Recovery after Surgery designation among anesthesiologists and nurse anesthetists-whereby individual providers received an in-service on protocol elements and received compliance data was strongly associated with high compliance (>0.6 of measures; p < 0.001 for each group). In addition, high compliance was associated with a significant reduction in length of stay (p < 0.01), surgical site infection (p < 0.002), and morbidity (p < 0.009). Dedicated operating room teams led to increased centrality among anesthesia providers, which in turn not only increased compliance, but also improved several clinical outcomes. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Autonomous Diagnostic Imaging Performed by Untrained Operators using Augmented Reality as a Form of "Just-in-Time" Training

NASA Technical Reports Server (NTRS)

Martin, D. S.; Wang, L.; Laurie, S. S.; Lee, S. M. C.; Fleischer, A. C.; Gibson, C. R.; Stenger, M. B.

2017-01-01

We will address the Human Factors and Performance Team, "Risk of performance errors due to training deficiencies" by improving the JIT training materials for ultrasound and OCT imaging by providing advanced guidance in a detailed, timely, and user-friendly manner. Specifically, we will (1) develop an audio-visual tutorial using AR that guides non-experts through an abdominal trauma ultrasound protocol; (2) develop an audio-visual tutorial using AR to guide an untrained operator through the acquisition of OCT images; (3) evaluate the quality of abdominal ultrasound and OCT images acquired by untrained operators using AR guidance compared to images acquired using traditional JIT techniques (laptop-based training conducted before image acquisition); and (4) compare the time required to complete imaging studies using AR tutorials with images acquired using current JIT practices to identify areas for time efficiency improvements. Two groups of subjects will be recruited to participate in this study. Operator-subjects, without previous experience in ultrasound or OCT, will be asked to perform both procedures using either the JIT training with AR technology or the traditional JIT training via laptop. Images acquired by inexperienced operator-subjects will be scored by experts in that imaging modality for diagnostic and research quality; experts will be blinded to the form of JIT used to acquire the images. Operator-subjects also will be asked to submit feedback to improve the training modules used during the scans to improve future training modules. Scanned-subjects will be a small group individuals from whom all images will be acquired.

Autonomous Diagnostic Imaging Performed by Untrained Operator Using Augmented Reality as a Form of "Just-in-Time" Training

NASA Technical Reports Server (NTRS)

Martin, David S.; Wang, Lui; Laurie, Steven S.; Lee, Stuart M. C.; Stenger, Michael B.

2017-01-01

We will address the Human Factors and Performance Team, "Risk of performance errors due to training deficiencies" by improving the JIT training materials for ultrasound and OCT imaging by providing advanced guidance in a detailed, timely, and user-friendly manner. Specifically, we will (1) develop an audio-visual tutorial using AR that guides non-experts through an abdominal trauma ultrasound protocol; (2) develop an audio-visual tutorial using AR to guide an untrained operator through the acquisition of OCT images; (3) evaluate the quality of abdominal ultrasound and OCT images acquired by untrained operators using AR guidance compared to images acquired using traditional JIT techniques (laptop-based training conducted before image acquisition); and (4) compare the time required to complete imaging studies using AR tutorials with images acquired using current JIT practices to identify areas for time efficiency improvements. Two groups of subjects will be recruited to participate in this study. Operator-subjects, without previous experience in ultrasound or OCT, will be asked to perform both procedures using either the JIT training with AR technology or the traditional JIT training via laptop. Images acquired by inexperienced operator-subjects will be scored by experts in that imaging modality for diagnostic and research quality; experts will be blinded to the form of JIT used to acquire the images. Operator-subjects also will be asked to submit feedback to improve the training modules used during the scans to improve future training modules. Scanned-subjects will be a small group individuals from whom all images will be acquired.

Penile rehabilitation protocol after robot-assisted radical prostatectomy: assessment of compliance with phosphodiesterase type 5 inhibitor therapy and effect on early potency.

PubMed

Lee, Daniel J; Cheetham, Philippa; Badani, Ketan K

2010-02-01

Therapy (case series). 4. To evaluate factors that affect compliance in men who enroll in a phosphodiesterase type 5 inhibitor (PDE5I) protocol after nerve-sparing robot-assisted prostatectomy (RAP), and report on short-term outcomes, as PDE5Is may help restore erectile function after RAP and patient adherence to the regimen is a factor that potentially can affect outcome. We prospectively followed 77 men who had nerve-sparing RAP and enrolled in a postoperative penile rehabilitation protocol. The men received either sildenafil citrate or tadalafil three times weekly. The minimum follow-up was 8 weeks. Potency was defined as erection adequate for penetration and complete intercourse. Compliance was defined as men adhering to the regimen for > or =2 months. The mean age of the cohort was 57.8 years and the median follow-up was 8 months. In all, 32% of the men discontinued the therapy <2 months after RAP and were deemed noncompliant with an additional 39% discontinuing therapy by 6 months, with the high cost of medication being the primary reason (65%). Long-term compliance and preoperative erectile dysfunction were independent predictors of potency return after adjusting for age and nerve sparing. The high cost of medication remains a significant barrier to maintaining therapy. Noncompliance to PDE5I therapy in a tertiary care centre was much higher than reported in clinical trial settings. With longer-term follow-up, we need to further define the factors that improve overall recovery of sexual function after RAP.

Instructor-Designed Tutorials--Meeting the Needs of Our Students

ERIC Educational Resources Information Center

Brichta, J. P.; Bizheva, K.; Sanderson, J. H.; Holbrook, J.

2009-01-01

We have developed an easy-to-use online tutorial generator designed to allow instructors to make tutorials quickly and with a minimal learning curve. The motivation was to create a generator that would allow instructors to create tutorials as needed and possibly build up a bank of tutorials over a number of years. A key design feature of the…

Is Your Tutorial Pretty or Pretty Useless? Creating Effective Tutorials with the Principles of Multimedia Learning

ERIC Educational Resources Information Center

Rapchak, Marcia E.

2017-01-01

With the proliferation of free and easy-to-use tools to make online tutorials, many libraries have been creating online tutorials for their users. These cover everything from showing users how to navigate the databases to covering issues like copyright and evaluation. While the tutorials range from entertaining to rather dry, many of them,…

The "magic" of tutorial centres in Hong Kong: An analysis of media marketing and pedagogy in a tutorial centre

NASA Astrophysics Data System (ADS)

Koh, Aaron

2014-12-01

Why do more than three-quarters of Hong Kong's senior secondary students flock to tutorial centres like moths to light? What is the "magic" that is driving the popularity of the tutorial centre enterprise? Indeed, looking at the ongoing boom of tutorial centres in Hong Kong (there are almost 1,000 of them), it is difficult not to ask these questions. This paper examines the phenomenon of tutorial centres in Hong Kong and seeks to understand what draws students to these centres. Combining theories of marketing semiotics and emotion studies, the author investigates the pivotal role of media marketing in generating the "magic" of tutorial centres, whose advertising strategy includes, for example, a display of billboard posters featuring stylishly-dressed "celebrity teachers". The author reviews some of the literature available on the subject of tutorial centres. In a case study approach, he then maps out the pedagogy he observed in an English tutorial class, seeking heuristic insights into the kind of teaching students in the study were looking for. He argues that part of the "magical" attraction of what are essentially "cram schools" is their formulaic pedagogy of teaching and reinforcing exam skills. Finally, the paper considers the social implications of the tutorial centre industry in terms of media marketing of education and unequal access to tutorial services.

Assessment methods and schedules for collecting daily process data on substance use related health behaviors: A randomized control study.

PubMed

Buu, Anne; Massey, Lynn S; Walton, Maureen A; Cranford, James A; Zimmerman, Marc A; Cunningham, Rebecca M

2017-09-01

Interactive voice response (IVR) and short message service (SMS) systems have been used to collect daily process data on substance use. Yet, their relative compliance, use patterns, and user experiences are unknown. Furthermore, recent studies presented the potential of a hybrid weekly protocol requiring recall of behaviors in past week right after the weekend, in order to reduce the concerns about low compliance and measurement reactivity associated with daily data collection and also provide high quality data on the peak of use. This study randomized substance users to four (2×2) assessment groups with different combinations of assessment methods (IVR or SMS) and schedules (daily or weekly). The compliance rates and use patterns during the experimental period of 90days and user experiences reported after the period were compared across the groups. When IVR was assigned, the weekly schedule generated a higher compliance rate than the daily schedule. When SMS was used, however, the assessment schedule did not have an effect on compliance. While both the daily and weekly surveys via IVR can be completed within a short time, the weekly survey administered via SMS took much longer than its daily counterpart. Such an increased time consumption may offset the benefit of a less frequent assessment schedule. IVR is a better choice for delivering the hybrid protocol of weekly collection of daily process data because of its higher compliance rate, shorter duration, and lower likelihood of interruption during data collection. Copyright © 2017 Elsevier B.V. All rights reserved.

"May I Buy a Pack of Marlboros, Please?" A Systematic Review of Evidence to Improve the Validity and Impact of Youth Undercover Buy Inspections.

PubMed

Lee, Joseph G L; Gregory, Kyle R; Baker, Hannah M; Ranney, Leah M; Goldstein, Adam O

2016-01-01

Most smokers become addicted to tobacco products before they are legally able to purchase these products. We systematically reviewed the literature on protocols to assess underage purchase and their ecological validity. We conducted a systematic search in May 2015 in PubMed and PsycINFO. We independently screened records for inclusion. We conducted a narrative review and examined implications of two types of legal authority for protocols that govern underage buy enforcement in the United States: criminal (state-level laws prohibiting sales to youth) and administrative (federal regulations prohibiting sales to youth). Ten studies experimentally assessed underage buy protocols and 44 studies assessed the association between youth characteristics and tobacco sales. Protocols that mimicked real-world youth behaviors were consistently associated with substantially greater likelihood of a sale to a youth. Many of the tested protocols appear to be designed for compliance with criminal law rather than administrative enforcement in ways that limited ecological validity. This may be due to concerns about entrapment. For administrative enforcement in particular, entrapment may be less of an issue than commonly thought. Commonly used underage buy protocols poorly represent the reality of youths' access to tobacco from retailers. Compliance check programs should allow youth to present themselves naturally and attempt to match the community's demographic makeup.

"May I Buy a Pack of Marlboros, Please?" A Systematic Review of Evidence to Improve the Validity and Impact of Youth Undercover Buy Inspections

PubMed Central

Lee, Joseph G. L.; Gregory, Kyle R.; Baker, Hannah M.; Ranney, Leah M.; Goldstein, Adam O.

2016-01-01

Most smokers become addicted to tobacco products before they are legally able to purchase these products. We systematically reviewed the literature on protocols to assess underage purchase and their ecological validity. We conducted a systematic search in May 2015 in PubMed and PsycINFO. We independently screened records for inclusion. We conducted a narrative review and examined implications of two types of legal authority for protocols that govern underage buy enforcement in the United States: criminal (state-level laws prohibiting sales to youth) and administrative (federal regulations prohibiting sales to youth). Ten studies experimentally assessed underage buy protocols and 44 studies assessed the association between youth characteristics and tobacco sales. Protocols that mimicked real-world youth behaviors were consistently associated with substantially greater likelihood of a sale to a youth. Many of the tested protocols appear to be designed for compliance with criminal law rather than administrative enforcement in ways that limited ecological validity. This may be due to concerns about entrapment. For administrative enforcement in particular, entrapment may be less of an issue than commonly thought. Commonly used underage buy protocols poorly represent the reality of youths' access to tobacco from retailers. Compliance check programs should allow youth to present themselves naturally and attempt to match the community’s demographic makeup. PMID:27050671

Minimizing variance in Care of Pediatric Blunt Solid Organ Injury through Utilization of a hemodynamic-driven protocol: a multi-institution study.

PubMed

Cunningham, Aaron J; Lofberg, Katrine M; Krishnaswami, Sanjay; Butler, Marilyn W; Azarow, Kenneth S; Hamilton, Nicholas A; Fialkowski, Elizabeth A; Bilyeu, Pamela; Ohm, Erika; Burns, Erin C; Hendrickson, Margo; Krishnan, Preetha; Gingalewski, Cynthia; Jafri, Mubeen A

2017-12-01

An expedited recovery protocol for management of pediatric blunt solid organ injury (spleen, liver, and kidney) was instituted across two Level 1 Trauma Centers, managed by nine pediatric surgeons within three hospital systems. Data were collected for 18months on consecutive patients after protocol implementation. Patient demographics (including grade of injury), surgeon compliance, National Surgical Quality Improvement Program (NSQIP) complications, direct hospital cost, length of stay, time in the ICU, phlebotomy, and re-admission were compared to an 18-month control period immediately preceding study initiation. A total of 106 patients were treated (control=55, protocol=51). Demographics were similar among groups, and compliance was 78%. Hospital stay (4.6 vs. 3.5days, p=0.04), ICU stay (1.9 vs. 1.0days, p=0.02), and total phlebotomy (7.7 vs. 5.3 draws, p=0.007) were significantly less in the protocol group. A decrease in direct hospital costs was also observed ($11,965 vs. $8795, p=0.09). Complication rates (1.8% vs. 3.9%, p=0.86, no deaths) were similar. An expedited, hemodynamic-driven, pediatric solid organ injury protocol is achievable across hospital systems and surgeons. Through implementation we maintained quality while impacting length of stay, ICU utilization, phlebotomy, and cost. Future protocols should work to further limit resource utilization. Retrospective cohort study. Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

Forecast analysis of optical waveguide bus performance

NASA Technical Reports Server (NTRS)

Ledesma, R.; Rourke, M. D.

1979-01-01

Elements to be considered in the design of a data bus include: architecture; data rate; modulation, encoding, detection; power distribution requirements; protocol, work structure; bus reliability, maintainability; interterminal transmission medium; cost; and others specific to application. Fiber- optic data bus considerations for a 32 port transmissive star architecture, are discussed in a tutorial format. General optical-waveguide bus concepts, are reviewed. The electrical and optical performance of a 32 port transmissive star bus, and the effects of temperature on the performance of optical-waveguide buses are examined. A bibliography of pertinent references and the bus receiver test results are included.

The "Magic" of Tutorial Centres in Hong Kong: An Analysis of Media Marketing and Pedagogy in a Tutorial Centre

ERIC Educational Resources Information Center

Koh, Aaron

2014-01-01

Why do more than three-quarters of Hong Kong's senior secondary students flock to tutorial centres like moths to light? What is the "magic" that is driving the popularity of the tutorial centre enterprise? Indeed, looking at the ongoing boom of tutorial centres in Hong Kong (there are almost 1,000 of them), it is difficult not to ask…

Implementation of the Spanish ERAS program in bariatric surgery.

PubMed

Ruiz-Tovar, Jaime; Muñoz, José Luis; Royo, Pablo; Duran, Manuel; Redondo, Elisabeth; Ramirez, Jose Manuel

2018-03-08

The essence of Enhanced Recovery After Surgery (ERAS) programs is the multimodal approach, and many authors have demonstrated safety and feasibility in fast track bariatric surgery. According to this concept, a multidisciplinary ERAS program for bariatric surgery has been developed by the Spanish Fast Track Group (ERAS Spain). The aim of this study was to analyze the initial implementation of this Spanish National ERAS protocol in bariatric surgery, comparing it with a historical cohort receiving standard care. A multi-centric prospective study was performed, including 233 consecutive patients undergoing bariatric surgery during 2015 and following ERAS protocol. It was compared with a historical cohort of 286 patients, who underwent bariatric surgery at the same institutions between 2013 and 2014 and following standard care. Compliance with the protocol, morbidity, mortality, hospital stay and readmission were evaluated. Bariatric techniques performed were Roux-en-Y gastric bypass and sleeve gastrectomy. There were no significant differences in complications, mortality and readmission. Postoperative pain and hospital stay were significantly lower in the ERAS group. The total compliance to protocol was 80%. The Spanish National ERAS protocol is a safe issue, obtaining similar results to standard care in terms of complications, reoperations, mortality and readmissions. It is associated with less postoperative pain and earlier hospital discharge.

Monthly progress report

NASA Technical Reports Server (NTRS)

Moorhead, Robert J., II; Smith, Wayne

1992-01-01

This report is the mid-year report intended for the design concepts for the communication network for the Advanced Solid Rocket Motor (ASRM) facility being built at Yellow Creek near Iuka, MS. The overall network is to include heterogeneous computers, to use various protocols, and to have different bandwidths. Performance consideration must be given to the potential network applications in the network environment. The performance evaluation of X window applications was given the major emphasis in this report. A simulation study using Bones will be included later. This mid-year report has three parts: Part 1 is an investigation of X window traffic using TCP/IP over Ethernet networks; part 2 is a survey study of performance concepts of X window applications with Macintosh computers; and the last part is a tutorial on DECnet protocols. The results of this report should be useful in the design and operation of the ASRM communication network.

Carbon Offsets in California: What Role for Earth Scientists in the Policy Process? (Invited)

NASA Astrophysics Data System (ADS)

Cullenward, D.; Strong, A. L.

2013-12-01

This talk addresses the policy structure in California for developing and approving carbon offset protocols, which rely on findings from the environmental and earth sciences communities. In addition to providing an overview of the legal requirements of carbon offsets, we describe a series of case studies of how scientists can engage with policymakers. Based on those experiences, we suggest ways for the earth sciences community to become more involved in climate policy development. California's climate law, known as AB 32, requires that major sectors of the state's economy reduce their emissions to 1990 levels by 2020. As part of AB 32, the California Air Resources Board created a cap-and-trade market to ensure compliance with the statutory target. Under this system, regulated companies have to acquire tradable emissions permits (called 'compliance instruments') for the greenhouse gas emissions they release. The State allocates a certain number of allowances to regulated entities through a mixture of auctions and free transfers, with the total number equal to the overall emissions target; these allowances, along with approved offsets credits, are the compliance instruments that regulated entities are required to obtain by law. One of the key policy design issues in California's cap-and-trade market concerns the use of carbon offsets. Under AB 32, the Air Resources Board can issue offset credits to project developers who reduce emissions outside of the capped sectors (electricity, industry, and transportation)--or even outside of California--pursuant to approved offset protocols. Project developers then sell the credits to regulated companies in California. Essentially, offsets allow regulated entities in California to earn credit for emissions reductions that take place outside the scope of AB 32. Many regulated entities and economists are in favor of offsets because they view them as a source of low-cost compliance instruments. On the other hand, critics argue that some offset protocols award credits for activities that would have occurred anyway; by replacing a company's need to acquire an allowance in the carbon market, critics believe that poorly designed offset protocols increase greenhouse gas emissions. Thus, the effectiveness of the policy approach depends on the scientific integrity of the offset protocols. To date, California has approved offset protocols for emissions reductions in four applications: (1) forestry, (2) urban forestry, (3) livestock, and (4) destruction of ozone-depleting substances. In addition, the State is currently considering protocols that would address (5) methane emissions from mining and (6) greenhouse gas reductions from improved rice cultivation practices. These protocols rely heavily on findings from the environmental and earth sciences communities, especially when the protocol subject involves land use or land use change. Yet, due to budget constraints, the Air Resources Board is relying primarily on third-party protocol developers to design and propose the detailed structures under which offset credits will be issued. Despite the fact that any member of the public may participate in the governance regime that leads to protocol approvals, few scientists or scientific organizations provide input into the policy process. We use case studies from several of the California protocols to illustrate ways scientists can apply their skills to a crucial stage of climate policy development.

28 CFR 92.10 - Providing tutorials and other academic assistance programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Providing tutorials and other academic... tutorials and other academic assistance programs. (a) The program designed by the community organization must include academic counseling, tutorials and other academic assistance programs to enable...

28 CFR 92.10 - Providing tutorials and other academic assistance programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Providing tutorials and other academic... tutorials and other academic assistance programs. (a) The program designed by the community organization must include academic counseling, tutorials and other academic assistance programs to enable...

28 CFR 92.10 - Providing tutorials and other academic assistance programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Providing tutorials and other academic... tutorials and other academic assistance programs. (a) The program designed by the community organization must include academic counseling, tutorials and other academic assistance programs to enable...

28 CFR 92.10 - Providing tutorials and other academic assistance programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Providing tutorials and other academic... tutorials and other academic assistance programs. (a) The program designed by the community organization must include academic counseling, tutorials and other academic assistance programs to enable...

Caregiver's satisfaction with a video tutorial for shoulder dystocia management algorithm.

PubMed

Youssef, A; Salsi, G; Ragusa, A; Ghi, T; Pacella, G; Rizzo, N; Pilu, G

2015-01-01

In our questionnaire, a video tutorial illustrating the management of shoulder dystocia was considered by health personnel as a useful complementary training tool. We prepared a 5-min video tutorial on the management of shoulder dystocia, using a simulator that includes maternal pelvic and baby models. We performed a survey among obstetric personnel in order to assess their opinion on the tutorial by inviting them to watch the video tutorial and answer an online questionnaire. Five multiple-choice questions were set, focusing on the video's main objectives: clarity, simplicity and usefulness. Following the collection of answers, global and category-weighted analyses were conducted for each question. Out of 956 invitations sent, 482 (50.4%) answered the survey. More than 90% of all categories found the video tutorial to be clinically relevant and clear. For revising the management of shoulder dystocia most obstetric personnel would use the video tutorial together with traditional textbooks. In conclusion, our video tutorial was considered by health personnel as a useful complementary training tool.

Student-led tutorials in problem-based learning: educational outcomes and students' perceptions.

PubMed

Kassab, Salah; Abu-Hijleh, Marwan F; Al-Shboul, Qasim; Hamdy, Hossam

2005-09-01

The aim of this study was to examine the effectiveness of using students as tutors in a problem-based learning (PBL) medical curriculum. Ninety-one third-year medical students were divided into ten tutorial groups. The groups were randomly allocated into student-led tutorials (SLT) (five groups, n = 44 students) and faculty-led tutorials (FLT) (five groups, n = 47 students). Outcome measurements included assessment of students' performance in tutorials individually and as a group, end-unit examinations scores, assessment of tutoring skills and identifying students' perceptions about peer tutoring. Student tutors were perceived better in providing feedback and in understanding the difficulties students face in tutorials. Tutorial atmosphere, decision-making and support for the group leader were better in SLT compared with FLT groups. Self-assessment of student performance in SLT was not different from FLT. Student scores in the written and practical examinations were comparable in both groups. However, SLT groups found difficulties in analysis of problems presented in the first tutorial session. We conclude that the impact of peer tutoring on student performance in tutorials, group dynamics, and student achievement in examinations is positive overall. However, student tutors require special training before adopting this approach in PBL programs.

Assessment of an application for touchscreen devices to record calving-related events in dairy herds and monitor personnel performance.

PubMed

Barragan, A A; Workman, J D; Bas, S; Proudfoot, K L; Schuenemann, G M

2016-07-01

The objectives of the present study were to assess (1) the effectiveness of a calving training workshop and an application (app) for touchscreen devices to capture calving-related events, and (2) personnel compliance with calving protocols (time from birth to feeding of first colostrum and time that cows spent in labor). Calving personnel (n=23) from 5 large dairy farms (range: 800-10,000 cows) participated in the study. Participants received training through an on-farm workshop regarding calving management practices and functioning of the app before recording calving-related events. Pre- and posttest evaluations were administered to each participant to measure their knowledge gain and satisfaction with the workshop. Calving personnel recorded calving-related events (n=323) using the app for 7 d following training. Furthermore, the records collected with the app were used to assess missing and incorrect data and calving personnel compliance with calving management protocols (recording time that cows spent in labor and timing of feeding first colostrum to calves). Calving personnel reported that the information provided during the training was relevant (agree=14.3% and strongly agree=85.7%) and of great immediate use (agree=33.3% and strongly agree=66.7%). The presented materials and hands-on demonstrations substantially increased the knowledge level of the attendees (by 23.7 percentage points from pre- to posttest scores). The follow-up assessment with participants revealed that the app was easy to use (91.3%) and that they would continue to use it (100%). Frequency of incorrect (r=0.77) or missing (r=0.76) data was positively correlated with calving:personnel ratio. Furthermore, calving personnel compliance with calving protocols was significantly different within and between herds. These results substantiated the great variation in compliance with calving management protocols within and between dairy farms. Furthermore, the app may serve as a tool to monitor personnel compliance with first feeding of colostrum to calves and their awareness and recognition of amount of time that each cow spent in labor. This would allow decision-makers to adjust, reassign tasks, or plan the management according to actual calving rate to improve the overall quality of data (frequency of incorrect and missing data) and calf welfare (survival and performance). Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

High sound pressure levels in Bavarian discotheques remain after introduction of voluntary agreements.

PubMed

Twardella, Dorothee; Wellhoefer, Andrea; Brix, Jutta; Fromme, Hermann

2008-01-01

While no legal rules or regulations exist in Germany, voluntary measures were introduced to achieve a reduction of sound pressure levels in discotheques to levels below 100 dB(A). To evaluate the current levels in Bavarian discotheques and to find out whether these voluntary measures ensured compliance with the recommended limits, sound pressure levels were measured in 20 Bavarian discotheques between 11 p.m. and 2 a.m. With respect to the equivalent continuous A-weighted sound pressure level for each 30-minute period (L Aeq,30min ), only 4/20 discotheques remained below the limit of 100 dB(A) in all time periods. Ten discotheques had sound pressure levels below 100 dB(A) for the total measurement period (L Aeq,180min ). None of the evaluated factors (weekday, size, estimated age of attendees, the use of voluntary measures such as participation of disc jockeys in a tutorial, or the availability of a sound level meter for the DJs) was significantly associated with the maximal L Aeq, 30min . Thus, the introduction of voluntary measures was not sufficient to ensure compliance with the recommended limits of sound pressure levels.

International Affairs Sector (NAICS 928120)

EPA Pesticide Factsheets

Find EPA laws and regulatory information for international agreements, including import and export, Montreal Protocol for Ozone depleting substances, ocean vessels, MARPOL, and port and border compliance assistance centers.

Environmental Compliance Assessment for Army Reserves (ECAAR)

DTIC Science & Technology

1991-11-01

The number of environmental laws and regulations has continued to grow in the United States and worldwide, making compliance with these regulations...they became notices of violation. The concept was to combine Code of Federal Regulations and Army environmental regulations, with good management...items or operations to review, and would list a point of contact for that item to help assessors review the questions, or protocols, quickly and easily

Tutorial on use of intraclass correlation coefficients for assessing intertest reliability and its application in functional near-infrared spectroscopy-based brain imaging

NASA Astrophysics Data System (ADS)

Li, Lin; Zeng, Li; Lin, Zi-Jing; Cazzell, Mary; Liu, Hanli

2015-05-01

Test-retest reliability of neuroimaging measurements is an important concern in the investigation of cognitive functions in the human brain. To date, intraclass correlation coefficients (ICCs), originally used in inter-rater reliability studies in behavioral sciences, have become commonly used metrics in reliability studies on neuroimaging and functional near-infrared spectroscopy (fNIRS). However, as there are six popular forms of ICC, the adequateness of the comprehensive understanding of ICCs will affect how one may appropriately select, use, and interpret ICCs toward a reliability study. We first offer a brief review and tutorial on the statistical rationale of ICCs, including their underlying analysis of variance models and technical definitions, in the context of assessment on intertest reliability. Second, we provide general guidelines on the selection and interpretation of ICCs. Third, we illustrate the proposed approach by using an actual research study to assess intertest reliability of fNIRS-based, volumetric diffuse optical tomography of brain activities stimulated by a risk decision-making protocol. Last, special issues that may arise in reliability assessment using ICCs are discussed and solutions are suggested.

Design and evaluation of a computer tutorial on electric fields

NASA Astrophysics Data System (ADS)

Morse, Jeanne Jackson

Research has shown that students do not fully understand electric fields and their interactions with charged particles after completing traditional classroom instruction. The purpose of this project was to develop a computer tutorial to remediate some of these difficulties. Research on the effectiveness of computer-delivered instructional materials showed that students would learn better from media incorporating user-controlled interactive graphics. Two versions of the tutorial were tested. One version used interactive graphics and the other used static graphics. The two versions of the tutorial were otherwise identical. This project was done in four phases. Phases I and II were used to refine the topics covered in the tutorial and to test the usability of the tutorial. The final version of the tutorial was tested in Phases III and IV. The tutorial was tested using a pretest-posttest design with a control group. Both tests were administered in an interview setting. The tutorial using interactive graphics was more effective at remediating students' difficulties than the tutorial using static graphics for students in Phase III (p = 0.001). In Phase IV students who viewed the tutorial with static graphics did better than those viewing interactive graphics. The sample size in Phase IV was too small for this to be a statistically meaningful result. Some student reasoning errors were noted during the interviews. These include difficulty with the vector representation of electric fields, treating electric charge as if it were mass, using faulty algebraic reasoning to answer questions involving ratios and proportions, and using Coulomb's law in situations in which it is not appropriate.

Progress Report--Microsoft Office 2003 Lynchburg College Tutorials

ERIC Educational Resources Information Center

Murray, Tom

2004-01-01

For the past several years Lynchburg College has developed Microsoft tutorials for use with academic classes and faculty, student and staff training. The tutorials are now used internationally. Last year Microsoft and Verizon sponsored a tutorial web site at http://www.officetutorials.com. This website recognizes ASCUE members for their wonderful…

Additionality and permanence standards in California's Forest Offset Protocol: A review of project and program level implications.

PubMed

Ruseva, T; Marland, E; Szymanski, C; Hoyle, J; Marland, G; Kowalczyk, T

2017-08-01

A key component of California's cap-and-trade program is the use of carbon offsets as compliance instruments for reducing statewide GHG emissions. Under this program, offsets are tradable credits representing real, verifiable, quantifiable, enforceable, permanent, and additional reductions or removals of GHG emissions. This paper focuses on the permanence and additionality standards for offset credits as defined and operationalized in California's Compliance Offset Protocol for U.S. Forest Projects. Drawing on a review of the protocol, interviews, current offset projects, and existing literature, we discuss how additionality and permanence standards relate to project participation and overall program effectiveness. Specifically, we provide an overview of offset credits as compliance instruments in California's cap-and-trade program, the timeline for a forest offset project, and the factors shaping participation in offset projects. We then discuss the implications of permanence and additionality at both the project and program levels. Largely consistent with previous work, we find that stringent standards for permanent and additional project activities can present barriers to participation, but also, that there may be a trade-off between project quality and quantity (i.e. levels of participation) when considering overall program effectiveness. We summarize what this implies for California's forest offset program and provide suggestions for improvements in light of potential program diffusion and policy learning. Copyright © 2017 Elsevier Ltd. All rights reserved.

A less intensive bracing protocol for pectus carinatum.

PubMed

Wahba, George; Nasr, Ahmed; Bettolli, Marcos

2017-11-01

Despite the widespread use of bracing to correct Pectus carinatum (PC) there is no consensus in the number of hours per day patients are instructed to wear the brace. In our practice, we use a less rigorous protocol of 8-12h/day. We sought to evaluate our results and those in the literature to determine whether more intensive usage is necessary. We reviewed the outcomes of patients with PC treated at our institution between 2012 and 2015. We searched MEDLINE, EMBASE and Web of Science for studies describing the use of bracing to correct PC. Seventy-five patients presented with PC at our institution. Among those who were offered bracing and had adequate follow-up (n=32), the success rate (full correction or improvement) was 90.6%. The compliance rate was 93.8%. Fifteen studies met our inclusion criteria. Our pooled data combining our results with those of other published data showed that less intensive brace usage (<12h/day), when compared to more intensive usage (≥12h/day), is associated with higher patient compliance (89.6% vs. 81.1%) with a similar time to correction (7.3 vs 7.1months) and success rate (85.3% vs. 83.5%). Implementing a less intensive bracing protocol for PC is successful, efficient and improves compliance. Clinical Research. Oxford Centre for Evidence-Based Medicine Level-of-Evidence rating: Level IV. Copyright © 2017 Elsevier Inc. All rights reserved.

Facilitating students' application of the integral and the area under the curve concepts in physics problems

NASA Astrophysics Data System (ADS)

Nguyen, Dong-Hai

This research project investigates the difficulties students encounter when solving physics problems involving the integral and the area under the curve concepts and the strategies to facilitate students learning to solve those types of problems. The research contexts of this project are calculus-based physics courses covering mechanics and electromagnetism. In phase I of the project, individual teaching/learning interviews were conducted with 20 students in mechanics and 15 students from the same cohort in electromagnetism. The students were asked to solve problems on several topics of mechanics and electromagnetism. These problems involved calculating physical quantities (e.g. velocity, acceleration, work, electric field, electric resistance, electric current) by integrating or finding the area under the curve of functions of related quantities (e.g. position, velocity, force, charge density, resistivity, current density). Verbal hints were provided when students made an error or were unable to proceed. A total number of 140 one-hour interviews were conducted in this phase, which provided insights into students' difficulties when solving the problems involving the integral and the area under the curve concepts and the hints to help students overcome those difficulties. In phase II of the project, tutorials were created to facilitate students' learning to solve physics problems involving the integral and the area under the curve concepts. Each tutorial consisted of a set of exercises and a protocol that incorporated the helpful hints to target the difficulties that students expressed in phase I of the project. Focus group learning interviews were conducted to test the effectiveness of the tutorials in comparison with standard learning materials (i.e. textbook problems and solutions). Overall results indicated that students learning with our tutorials outperformed students learning with standard materials in applying the integral and the area under the curve concepts to physics problems. The results of this project provide broader and deeper insights into students' problem solving with the integral and the area under the curve concepts and suggest strategies to facilitate students' learning to apply these concepts to physics problems. This study also has significant implications for further research, curriculum development and instruction.

Introducing an enhanced recovery after surgery program in colorectal surgery: A single center experience

PubMed Central

Bona, Stefano; Molteni, Mattia; Rosati, Riccardo; Elmore, Ugo; Bagnoli, Pietro; Monzani, Roberta; Caravaca, Monica; Montorsi, Marco

2014-01-01

AIM: To study the implementation of an enhanced recovery after surgery (ERAS) program at a large University Hospital from “pilot study” to “standard of care”. METHODS: The study was designed as a prospective single centre cohort study. A prospective evaluation of compliance to a protocol based on full application of all ERAS principles, through the progressive steps of its implementation, was performed. Results achieved in the initial pilot study conducted by a dedicated team (n = 47) were compared to those achieved in the shared protocol phase (n = 143) three years later. Outcomes were length of postoperative hospital stay, readmission rate, compliance to the protocol and morbidity. Primary endpoint was the description of the results and the identification of critical issues of large scale implementation of an ERAS program in colorectal surgery emerged in the experience of a single center. Secondary endpoint was the identification of interventions that have been proven to be effective for facilitating the transition from traditional care pathways to a multimodal management protocol according to ERAS principles in colorectal surgery at a single center. RESULTS: During the initial pilot study (March 2009 to December 2010; 47 patients) conducted by a dedicated multidisciplinary team, compliance to the items of ERAS protocol was 93%, with a median length of hospital stay (LOS) of 3 d. Early anastomotic fistulas were observed in 2 cases (4.2%), which required reoperation (Clavien-Dindo grade IIIb). None of the patients had been discharged before the onset of the complication, which could therefore receive prompt treatment. There were also four (8.5%) minor complications (Clavien-Dindo grade II). Thirty days readmission rate was 4%. Perioperative mortality was nil. After implementation of the protocol throughout the Hospital in unselected patients (May 2012 to December 2012; 147 patients) compliance was 74%, with a median LOS of 6 d. Early anastomotic fistulas were observed in 11 cases (7.7%), 5 (3.5%) of which required reoperation (Clavien-Dindo grade IIIb). Two early anastomotic fistulas were treated by radiologic/endoscopic manoeuvres and 4 were treated conservatively. There were also 36 (25.2%) minor complications, 21 (14.7%) of which were Clavien-Dindo grade II and 15 (10.5%) of which were Clavien-Dindo grade I. Only two patients whose course was adversely affected by the development of an anastomotic leak had been discharged before the onset of the complication itself, requiring readmission. Readmission rate within 30 d was 4%. Perioperative mortality was 1%. CONCLUSION: Our results confirm that introduction of an ERAS protocol for colorectal surgery allows quicker postoperative recovery and shortens the length of stay compared to historical series. PMID:25516673

Video and HTML: Testing Online Tutorial Formats with Biology Students

ERIC Educational Resources Information Center

Craig, Cindy L.; Friehs, Curt G.

2013-01-01

This study compared two common types of online information literacy tutorials: a streaming media tutorial using animation and narration and a text-based tutorial with static images. Nine sections of an undergraduate biology lab class (234 students total) were instructed by a librarian on how to use the BIOSIS Previews database. Three sections…

Using Structure-Based Organic Chemistry Online Tutorials with Automated Correction for Student Practice and Review

ERIC Educational Resources Information Center

O'Sullivan, Timothy P.; Hargaden, Gra´inne C.

2014-01-01

This article describes the development and implementation of an open-access organic chemistry question bank for online tutorials and assessments at University College Cork and Dublin Institute of Technology. SOCOT (structure-based organic chemistry online tutorials) may be used to supplement traditional small-group tutorials, thereby allowing…

Captivate MenuBuilder: Creating an Online Tutorial for Teaching Software

ERIC Educational Resources Information Center

Yelinek, Kathryn; Tarnowski, Lynn; Hannon, Patricia; Oliver, Susan

2008-01-01

In this article, the authors, students in an instructional technology graduate course, describe a process to create an online tutorial for teaching software. They created the tutorial for a cyber school's use. Five tutorial modules were linked together through one menu screen using the MenuBuilder feature in the Adobe Captivate program. The…

A Matter of Preference--Lecturers vs. Teaching--Assistants in Tutorials

ERIC Educational Resources Information Center

Davidovitch, Nitza; Soen, Dan

2005-01-01

In many universities and colleges around the world, it is an accepted practice to supplement frontal lectures of courses with separate practice classes or tutorials. For this purpose lecturers may sometimes use the services of teaching-assistants to conduct the tutorials. Teaching-assistants conduct tutorials in many courses in Israel's academic…

Satisfaction, Settlement and Exposition: Conversation and the University Tutorial

ERIC Educational Resources Information Center

Fulford, Amanda

2013-01-01

In this paper, I consider the tutorial conversation in Higher Education. To focus the discussion I use the scenario of a tutorial conversation between a lecturer and a student. I begin by suggesting that the increasing emphasis placed on student satisfaction in certain Higher Education Institutions tends to focus the tutorial conversation towards…

Audio-Tutorial Instruction: A Strategy For Teaching Introductory College Geology.

ERIC Educational Resources Information Center

Fenner, Peter; Andrews, Ted F.

The rationale of audio-tutorial instruction is discussed, and the history and development of the audio-tutorial botany program at Purdue University is described. Audio-tutorial programs in geology at eleven colleges and one school are described, illustrating several ways in which programs have been developed and integrated into courses. Programs…

Communication and protocol compliance and their relation to the quality of cardiopulmonary resuscitation (CPR): A mixed-methods study of simulated telephone-assisted CPR.

PubMed

Nord-Ljungquist, Helena; Brännström, Margareta; Bohm, Katarina

2015-07-01

In the event of a cardiac arrest, emergency medical dispatchers (EMDs) play a critical role by providing telephone-assisted cardiopulmonary resuscitation (T-CPR) to laypersons. The aim of our investigation was to describe compliance with the T-CPR protocol, the performance of the laypersons in a simulated T-CPR situation, and the communication between laypersons and EMDs during these actions. We conducted a retrospective observational study by analysing 20 recorded video and audio files. In a simulation, EMDs provided laypersons with instructions following T-CPR protocols. These were then analysed using a mixed method with convergent parallel design. If the EMDs complied with the T-CPR protocol, the laypersons performed the correct procedures in 71% of the actions. The single most challenging instruction of the T-CPR protocol, for both EMDs and laypersons, was airway control. Mean values for compression depth and frequency did not reach established guideline goals for CPR. Proper application of T-CPR protocols by EMDs resulted in better performance by laypersons in CPR. The most problematic task for EMDs as well for laypersons was airway management. The study results did not establish that the quality of communication between EMDs and laypersons performing CPR in a cardiac arrest situation led to statistically different outcomes, as measured by the quality and effectiveness of the CPR delivered. Copyright © 2014 Elsevier Ltd. All rights reserved.

Adaptive Tutorials Versus Web-Based Resources in Radiology: A Mixed Methods Comparison of Efficacy and Student Engagement.

PubMed

Wong, Vincent; Smith, Ariella J; Hawkins, Nicholas J; Kumar, Rakesh K; Young, Noel; Kyaw, Merribel; Velan, Gary M

2015-10-01

Diagnostic imaging is under-represented in medical curricula globally. Adaptive tutorials, online intelligent tutoring systems that provide a personalized learning experience, have the potential to bridge this gap. However, there is limited evidence of their effectiveness for learning about diagnostic imaging. We performed a randomized mixed methods crossover trial to determine the impact of adaptive tutorials on perceived engagement and understanding of the appropriate use and interpretation of common diagnostic imaging investigations. Although concurrently engaged in disparate blocks of study, 99 volunteer medical students (from years 1-4 of the 6-year program) were randomly allocated to one of two groups. In the first arm of the trial on chest X-rays, one group received access to an adaptive tutorial, whereas the other received links to an existing peer-reviewed Web resource. These two groups crossed over in the second arm of the trial, which focused on computed tomography scans of the head, chest, and abdomen. At the conclusion of each arm of the trial, both groups completed an examination-style assessment, comprising questions both related and unrelated to the topics covered by the relevant adaptive tutorial. Online questionnaires were used to evaluate student perceptions of both learning resources. In both arms of the trial, the group using adaptive tutorials obtained significantly higher assessment scores than controls. This was because of higher assessment scores by senior students in the adaptive tutorial group when answering questions related to topics covered in those tutorials. Furthermore, students indicated significantly better engagement with adaptive tutorials than the Web resource and rated the tutorials as a significantly more valuable tool for learning. Medical students overwhelmingly accept adaptive tutorials for diagnostic imaging. The tutorials significantly improve the understanding of diagnostic imaging by senior students. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Identifying and addressing specific student difficulties in advanced thermal physics

NASA Astrophysics Data System (ADS)

Smith, Trevor I.

As part of an ongoing multi-university research study on student understanding of concepts in thermal physics at the upper division, I identified several student difficulties with topics related to heat engines (especially the Carnot cycle), as well as difficulties related to the Boltzmann factor. In an effort to address these difficulties, I developed two guided-inquiry worksheet activities (a.k.a. tutorials) for use in advanced undergraduate thermal physics courses. Both tutorials seek to improve student understanding of the utility and physical background of a particular mathematical expression. One tutorial focuses on a derivation of Carnot's theorem regarding the limit on thermodynamic efficiency, starting from the Second Law of Thermodynamics. The other tutorial helps students gain an appreciation for the origin of the Boltzmann factor and when it is applicable; focusing on the physical justification of its mathematical derivation, with emphasis on the connections between probability, multiplicity, entropy, and energy. Student understanding of the use and physical implications of Carnot's theorem and the Boltzmann factor was assessed using written surveys both before and after tutorial instruction within the advanced thermal physics courses at the University of Maine and at other institutions. Classroom tutorial sessions at the University of Maine were videotaped to allow in-depth scrutiny of student successes and failures following tutorial prompts. I also interviewed students on various topics related to the Boltzmann factor to gain a more complete picture of their understanding and inform tutorial revisions. Results from several implementations of my tutorials at the University of Maine indicate that students did not have a robust understanding of these physical principles after lectures alone, and that they gain a better understanding of relevant topics after tutorial instruction; Fisher's exact tests yield statistically significant improvement at the alpha = 0.05 level. Results from other schools indicate that difficulties observed before tutorial instruction in our classes (for both tutorials) are not unique, and that the Boltzmann factor tutorial can be an effective replacement for lecture instruction. Additional research is suggested that would further examine these difficulties and inform instructional strategies to help students overcome them.

Small-molecule ligand docking into comparative models with Rosetta

PubMed Central

Combs, Steven A; DeLuca, Samuel L; DeLuca, Stephanie H; Lemmon, Gordon H; Nannemann, David P; Nguyen, Elizabeth D; Willis, Jordan R; Sheehan, Jonathan H; Meiler, Jens

2017-01-01

Structure-based drug design is frequently used to accelerate the development of small-molecule therapeutics. Although substantial progress has been made in X-ray crystallography and nuclear magnetic resonance (NMR) spectroscopy, the availability of high-resolution structures is limited owing to the frequent inability to crystallize or obtain sufficient NMR restraints for large or flexible proteins. Computational methods can be used to both predict unknown protein structures and model ligand interactions when experimental data are unavailable. This paper describes a comprehensive and detailed protocol using the Rosetta modeling suite to dock small-molecule ligands into comparative models. In the protocol presented here, we review the comparative modeling process, including sequence alignment, threading and loop building. Next, we cover docking a small-molecule ligand into the protein comparative model. In addition, we discuss criteria that can improve ligand docking into comparative models. Finally, and importantly, we present a strategy for assessing model quality. The entire protocol is presented on a single example selected solely for didactic purposes. The results are therefore not representative and do not replace benchmarks published elsewhere. We also provide an additional tutorial so that the user can gain hands-on experience in using Rosetta. The protocol should take 5–7 h, with additional time allocated for computer generation of models. PMID:23744289

Varying Tutorial Modality and Interface Restriction to Maximize Transfer in a Complex Simulation Environment

ERIC Educational Resources Information Center

Mayrath, Michael C.; Nihalani, Priya K.; Robinson, Daniel H.

2011-01-01

In 2 experiments, 241 undergraduates with low domain knowledge viewed a tutorial on how to use Packet Tracer (PT), a computer-networking training simulation developed by the Cisco Networking Academy. Participants were then tested on retention of tutorial content and transfer using PT. Tutorial modality (text, narration, or narration plus text) was…

Student See versus Student Do: A Comparative Study of Two Online Tutorials

ERIC Educational Resources Information Center

Stonebraker, Ilana; Robertshaw, M. Brooke; Moss, Jennifer D.

2016-01-01

This study examines the impact on student performance after interactive and non-interactive tutorials using a 2?×?2 treatment-control design. In an undergraduate management course, a control group watched a video tutorial while the treatment group received the same content using a dynamic tutorial. Both groups received the same quiz questions.…

Learning from Tutorials: A Qualitative Study of Approaches to Learning and Perceptions of Tutorial Interaction

ERIC Educational Resources Information Center

Herrmann, Kim Jesper

2014-01-01

This study examines differences in university students' approaches to learning when attending tutorials as well as variation in students' perceptions of tutorials as an educational arena. In-depth qualitative analysis of semi-structured interviews with undergraduates showed how surface and deep approaches to learning were revealed in the…

Gender-related differences in learning in student-led PBL tutorials.

PubMed

Kassab, Salah; Abu-Hijleh, Marwan; Al-Shboul, Qasim; Hamdy, Hossam

2005-07-01

Male and female students behave differently in problem-based learning (PBL) tutorials. However, these differences could be partly attributed to faculty tutor behavior in male and female tutorials. This study aims to examine the gender differences in learning outcomes between medical students when peer tutors facilitate PBL tutorials. A questionnaire-based study conducted in single-gender student-led (SLT) and faculty-led (FLT) tutorials. The study involved third year medical students (n = 91) divided into ten groups (five groups each). The SLT groups consisted of 16 male and 28 female students, while the FLT group consisted of 20 male and 27 female students. Students evaluated their individual and group performance in tutorials and also skills of tutors. Student performance in end-unit examinations and their perceptions about peer tutoring were also analyzed. A total of 290 questionnaires (response rate = 63.7%) were collected over the five-week period of the study. Although individual performance in tutorials and achievement in examinations were comparable in both groups, there was significantly higher group performance in female compared with male student-led tutorials (p < 0.01). This difference between male and female groups was not attributed to improvement in the performance of female groups, but rather to a decline in performance of the male SLT groups. In addition, both male and female students expressed facing difficulties in discussion and analysis of the problem in the first tutorial session. Understanding the gender differences in the group behavior in student-led tutorials is important for PBL programs adopting this approach.

Tutor versus computer: a prospective comparison of interactive tutorial and computer-assisted instruction in radiology education.

PubMed

Lieberman, Gillian; Abramson, Richard; Volkan, Kevin; McArdle, Patricia J

2002-01-01

This study compared the educational effectiveness of an interactive tutorial with that of interactive computer-assisted instruction (CAI) and determined the effects of personal preference, learning style, and level of training. Fifty-four medical students and four radiology residents were prospectively, randomly assigned to receive instruction from different sections of an interactive tutorial and an interactive CAI module. Participants took tests of factual knowledge at the beginning and end of the instruction and a test of visual diagnosis at the end. They completed questionnaires to evaluate their preferred learning styles objectively and to elicit their subjective attitudes toward the two formats. Mean test scores of the tutorial and CAI groups were compared by means of analysis of covariance and two-tailed repeated-measures F test. Both the tutorial and CAI groups demonstrated significant improvement in posttest scores (P < .01 and P < .01, respectively) with the tutorial group's mean posttest score marginally but significantly higher (32.84 vs 28.13, P < .001). There were no significant interaction effects with participants' year of training (P = .845), objectively evaluated preferred learning style (P = .312), subjectively elicited attitude toward learning with CAI (P = .703), or visual diagnosis score (tutorial, 7.61; CD-ROM, 7.75; P = .79). Interactive tutorial and optimal CAI are both effective instructional formats. The tutorial was marginally but significantly more effective at teaching factual knowledge, an effect unrelated to students' year of training, learning style, or stated enjoyment of CAI. The superiority of the tutorial is expected to increase when it is compared with commercially expedient CAI modules.

Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders Using Internet-Based Technologies.

PubMed

Kobak, Kenneth A; Wolitzky-Taylor, Kate; Craske, Michelle G; Rose, Raphael D

2017-04-01

This study investigated a technology-enhanced training protocol to facilitate dissemination of therapist training on cognitive behavior therapy (CBT) for anxiety disorders. Seventy community clinicians received an online tutorial followed by live remote observation of clinical skills via videoconference. Impact of training on patient outcomes was also assessed. Training resulted in a significant increase in both trainee knowledge of CBT concepts and techniques and therapist competence in applying these skills. Patients treated by trainees following training had significant reductions in anxiety and depression. Ratings of user satisfaction were high. Results provide support for the use of these technologies for therapist training in CBT.

Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders Using Internet-Based Technologies

PubMed Central

Kobak, Kenneth A.; Wolitzky-Taylor, Kate; Craske, Michelle G.; Rose, Raphael D.

2016-01-01

This study investigated a technology-enhanced training protocol to facilitate dissemination of therapist training on cognitive behavior therapy (CBT) for anxiety disorders. Seventy community clinicians received an online tutorial followed by live remote observation of clinical skills via videoconference. Impact of training on patient outcomes was also assessed. Training resulted in a significant increase in both trainee knowledge of CBT concepts and techniques and therapist competence in applying these skills. Patients treated by trainees following training had significant reductions in anxiety and depression. Ratings of user satisfaction were high. Results provide support for the use of these technologies for therapist training in CBT. PMID:28435174

A Test of the Design of a Video Tutorial for Software Training

ERIC Educational Resources Information Center

van der Meij, J.; van der Meij, H.

2015-01-01

The effectiveness of a video tutorial versus a paper-based tutorial for software training has yet to be established. Mixed outcomes from the empirical studies to date suggest that for a video tutorial to outperform its paper-based counterpart, the former should be crafted so that it addresses the strengths of both designs. This was attempted in…

The MAGIC of Web Tutorials: How One Library (Re)Focused Its Delivery of Online Learning Objects on Users

ERIC Educational Resources Information Center

Hess, Amanda Nichols

2013-01-01

Oakland University (OU) Libraries undertook an assessment of how to leverage its resources to make online tutorials more focused on users' needs. A multi-part assessment process reconsidered Web tutorials offerings through the lenses of faculty and staff feedback, literature review, and an analysis of other universities' online tutorial offerings.…

Comparing three methods for teaching Newton's third law

NASA Astrophysics Data System (ADS)

Smith, Trevor I.; Wittmann, Michael C.

2007-12-01

Although guided-inquiry methods for teaching introductory physics have been individually shown to be more effective at improving conceptual understanding than traditional lecture-style instruction, researchers in physics education have not studied differences among reform-based curricula in much detail. Several researchers have developed University of Washington style tutorial materials, but the different curricula have not been compared against each other. Our study examines three tutorials designed to improve student understanding of Newton’s third law: the University of Washington’s Tutorials in Introductory Physics (TIP), the University of Maryland’s Activity-Based Tutorials (ABT), and the Open Source Tutorials (OST) also developed at the University of Maryland. Each tutorial was designed with different goals and agendas, and each employs different methods to help students understand the physics. We analyzed pretest and post-test data, including course examinations and data from the Force and Motion Conceptual Evaluation (FMCE). Using both FMCE and course data, we find that students using the OST version of the tutorial perform better than students using either of the other two.

Preoperative fasting among burns patients in an acute care setting: a best practice implementation project.

PubMed

Giuliani, Sara; McArthur, Alexa; Greenwood, John

2015-11-01

Major burn injury patients commonly fast preoperatively before multiple surgical procedures. The Societies of Anesthesiology in Europe and the United States recommend fasting from clear fluids for two hours and solids for six to eight hours preoperatively. However, at the Royal Adelaide Hospital, patients often fast from midnight proceeding the day of surgery. This project aims to promote evidence-based practice to minimize extended preoperative fasting in major burn patients. A baseline audit was conducted measuring the percentage compliance with audit criteria, specifically on preoperative fasting documentation and appropriate instructions in line with evidence-based guidelines. Strategies were then implemented to address areas of non-compliance, which included staff education, development of documentation tools and completion of a perioperative feeding protocol for major burn patients. Following this, a post implementation audit assessed the extent of change compared with the baseline audit results. Education on evidence-based fasting guidelines was delivered to 54% of staff. This resulted in a 19% improvement in compliance with fasting documentation and a 52% increase in adherence to appropriate evidence-based instructions. There was a notable shift from the most common fasting instruction being "fast from midnight" to "fast from 03:00 hours", with an overall four-hour reduction in fasting per theater admission. These results demonstrate that education improves compliance with documentation and preoperative fasting that is more reflective of evidence-based practice. Collaboration with key stakeholders and a hospital wide fasting protocol is warranted to sustain change and further advance compliance with evidence-based practice at an organizational level.

EPA Grants 101 Tutorial

EPA Pesticide Factsheets

EPA Grants 101 Tutorial teaches you how to apply for , manage, and complete an EPA Grant with this easy-to-follow flowchart. This tutorial is extremely benefical for those seeking EPA Grant knowledge.

Tutorials for Africa - Malaria: MedlinePlus

MedlinePlus

Tutorials for Africa: Malaria In Uganda, the burden of malaria outranks that of all other diseases. This tutorial includes information about how malaria spreads, the importance of treatment and techniques for ...

300 Area TEDF NPDES Permit Compliance Monitoring Plan

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

Loll, C.M.

1994-10-13

This monitoring plan describes the activities and methods that will be employed at the 300 Area Treated Effluent Disposal Facility (TEDF) in order to ensure compliance with the National Discharge Elimination System (NPDES) permit. Included in this document are a brief description of the project, the specifics of the sampling effort, including the physical location and frequency of sampling, the support required for sampling, and the Quality Assurance (QA) protocols to be followed in the sampling procedures.

Enhancing compliance at Department of Defense facilities: comparison of three environmental audit tools.

PubMed

Hepler, Jeff A; Neumann, Cathy

2003-04-01

To enhance environmental compliance, the U.S. Department of Defense (DOD) recently developed and implemented a standardized environmental audit tool called The Environmental Assessment and Management (TEAM) Guide. Utilization of a common audit tool (TEAM Guide) throughout DOD agencies could be an effective agent of positive change. If, however, the audit tool is inappropriate, environmental compliance at DOD facilities could worsen. Furthermore, existing audit systems such as the U.S. Environmental Protection Agency's (U.S. EPA's) Generic Protocol for Conducting Environmental Audits of Federal Facilities and the International Organization for Standardization's (ISO's) Standard 14001, "Environmental Management System Audits," may be abandoned even if they offer significant advantages over TEAM Guide audit tool. Widespread use of TEAM Guide should not take place until thorough and independent evaluation has been performed. The purpose of this paper is to compare DOD's TEAM Guide audit tool with U.S. EPA's Generic Protocol for Conducting Environmental Audits of Federal Facilities and ISO 14001, in order to assess which is most appropriate and effective for DOD facilities, and in particular those operated by the U.S. Army Corps of Engineers (USACE). USACE was selected as a result of one author's recent experience as a district environmental compliance coordinator responsible for the audit mission at this agency. Specific recommendations for enhancing the quality of environmental audits at all DOD facilities also are given.

VOIP for Telerehabilitation: A Risk Analysis for Privacy, Security, and HIPAA Compliance

PubMed Central

Watzlaf, Valerie J.M.; Moeini, Sohrab; Firouzan, Patti

2010-01-01

Voice over the Internet Protocol (VoIP) systems such as Adobe ConnectNow, Skype, ooVoo, etc. may include the use of software applications for telerehabilitation (TR) therapy that can provide voice and video teleconferencing between patients and therapists. Privacy and security applications as well as HIPAA compliance within these protocols have been questioned by information technologists, providers of care and other health care entities. This paper develops a privacy and security checklist that can be used within a VoIP system to determine if it meets privacy and security procedures and whether it is HIPAA compliant. Based on this analysis, specific HIPAA criteria that therapists and health care facilities should follow are outlined and discussed, and therapists must weigh the risks and benefits when deciding to use VoIP software for TR. PMID:25945172

VOIP for Telerehabilitation: A Risk Analysis for Privacy, Security, and HIPAA Compliance.

PubMed

Watzlaf, Valerie J M; Moeini, Sohrab; Firouzan, Patti

2010-01-01

Voice over the Internet Protocol (VoIP) systems such as Adobe ConnectNow, Skype, ooVoo, etc. may include the use of software applications for telerehabilitation (TR) therapy that can provide voice and video teleconferencing between patients and therapists. Privacy and security applications as well as HIPAA compliance within these protocols have been questioned by information technologists, providers of care and other health care entities. This paper develops a privacy and security checklist that can be used within a VoIP system to determine if it meets privacy and security procedures and whether it is HIPAA compliant. Based on this analysis, specific HIPAA criteria that therapists and health care facilities should follow are outlined and discussed, and therapists must weigh the risks and benefits when deciding to use VoIP software for TR.

Quality indicators for eye bank.

PubMed

Acharya, Manisha; Biswas, Saurabh; Das, Animesh; Mathur, Umang; Dave, Abhishek; Singh, Ashok; Dubey, Suneeta

2018-03-01

The aim of this study is to identify quality indicators of the eye bank and validate their effectivity. Adverse reaction rate, discard rate, protocol deviation rate, and compliance rate were defined as Quality Indicators of the eye bank. These were identified based on definition of quality that captures two dimensions - "result quality" and "process quality." The indicators were measured and tracked as part of quality assurance (QA) program of the eye bank. Regular audits were performed to validate alignment of standard operating procedures (SOP) with regulatory and surgeon acceptance standards and alignment of activities performed in the eye bank with the SOP. Prospective study of the indicators was performed by comparing their observed values over the period 2011-2016. Adverse reaction rate decreased more than 8-fold (from 0.61% to 0.07%), discard rate decreased and stabilized at 30%, protocol deviation rate decreased from 1.05% to 0.08%, and compliance rate reported by annual quality audits improved from 59% to 96% at the same time. In effect, adverse reaction rate, discard rate, and protocol deviation rate were leading indicators, and compliance rate was the trailing indicator. These indicators fulfill an important gap in available literature on QA in eye banking. There are two ways in which these findings can be meaningful. First, eye banks which are new to quality measurement can adopt these indicators. Second, eye banks which are already deeply engaged in quality improvement can test these indicators in their eye bank, thereby incorporating them widely and improving them over time.

The Effectiveness of a 3D Computerized Tutorial to Enhance Learning of the Canine Larynx and Hyoid Apparatus.

PubMed

Nemanic, Sarah; Mills, Serena; Viehdorfer, Matt; Clark, Terri; Bailey, Mike

Teaching the anatomy of the canine larynx and hyoid apparatus is challenging because dissection disassembles and/or damages these structures, making it difficult to understand their three-dimensional (3D) anatomy and spatial interrelationships. This study assessed the effectiveness of an interactive, computerized 3D tutorial for teaching the anatomy of the canine larynx and hyoid apparatus using a randomized control design with students enrolled in the first-year professional program at Oregon State University College of Veterinary Medicine. All first-year students from 2 consecutive years were eligible. All students received the traditional methods of didactic teaching and dissection to learn the anatomy of the canine larynx and hyoid apparatus, after which they were divided into two statistically equal groups based on their cumulative anatomy test scores from the prior term. The tutorial group received an interactive, computerized tutorial developed by the investigators containing 3D images of the canine larynx and hyoid apparatus, while the control group received the same 3D images without the computerized tutorial. Both groups received the same post-learning assessment and survey. Sixty-three first-year students participated in the study, 28 in the tutorial group, and 35 in the control group. Post-learning assessment and survey scores were both significantly higher among students in the computerized tutorial group than those in the control group. This study demonstrates that a 3D computerized tutorial is more effective in teaching the anatomy of the canine hyoid apparatus and larynx than 3D images without a tutorial. Students likewise rated their learning experience higher when using the 3D computerized tutorial.

Investigating and improving introductory physics students’ understanding of the electric field and superposition principle

NASA Astrophysics Data System (ADS)

Li, Jing; Singh, Chandralekha

2017-09-01

We discuss an investigation of the difficulties that students in a university introductory physics course have with the electric field and superposition principle and how that research was used as a guide in the development and evaluation of a research-validated tutorial on these topics to help students learn these concepts better. The tutorial uses a guided enquiry-based approach to learning and involved an iterative process of development and evaluation. During its development, we obtained feedback both from physics instructors who regularly teach introductory physics in which these concepts are taught and from students for whom the tutorial is intended. The iterative process continued and the feedback was incorporated in the later versions of the tutorial until the researchers were satisfied with the performance of a diverse group of introductory physics students on the post-test after they worked on the tutorial in an individual one-on-one interview situation. Then the final version of the tutorial was administered in several sections of the university physics course after traditional instruction in relevant concepts. We discuss the performance of students in individual interviews and on the pre-test administered before the tutorial (but after traditional lecture-based instruction) and on the post-test administered after the tutorial. We also compare student performance in sections of the class in which students worked on the tutorial with other similar sections of the class in which students only learned via traditional instruction. We find that students performed significantly better in the sections of the class in which the tutorial was used compared to when students learned the material via only lecture-based instruction.

Interoperative fundus image and report sharing in compliance with integrating the healthcare enterprise conformance and web access to digital imaging and communication in medicine persistent object protocol.

PubMed

Wu, Hui-Qun; Lv, Zheng-Min; Geng, Xing-Yun; Jiang, Kui; Tang, Le-Min; Zhou, Guo-Min; Dong, Jian-Cheng

2013-01-01

To address issues in interoperability between different fundus image systems, we proposed a web eye-picture archiving and communication system (PACS) framework in conformance with digital imaging and communication in medicine (DICOM) and health level 7 (HL7) protocol to realize fundus images and reports sharing and communication through internet. Firstly, a telemedicine-based eye care work flow was established based on integrating the healthcare enterprise (IHE) Eye Care technical framework. Then, a browser/server architecture eye-PACS system was established in conformance with the web access to DICOM persistent object (WADO) protocol, which contains three tiers. In any client system installed with web browser, clinicians could log in the eye-PACS to observe fundus images and reports. Multipurpose internet mail extensions (MIME) type of a structured report is saved as pdf/html with reference link to relevant fundus image using the WADO syntax could provide enough information for clinicians. Some functions provided by open-source Oviyam could be used to query, zoom, move, measure, view DICOM fundus images. Such web eye-PACS in compliance to WADO protocol could be used to store and communicate fundus images and reports, therefore is of great significance for teleophthalmology.

SRA Grant Writing Tutorial

EPA Pesticide Factsheets

This tutorial will help give your organization a broad but succinct analysis of what the SRA grant program is about. This self-paced tutorial is organized under two segments: Overview of Grant Program and Program Details.

A quality improvement project to improve early sepsis care in the emergency department.

PubMed

Gatewood, Medley O'Keefe; Wemple, Matthew; Greco, Sheryl; Kritek, Patricia A; Durvasula, Raghu

2015-12-01

Sepsis causes substantial morbidity and mortality in hospitalised patients. Although many studies describe the use of protocols in the management of patients with severe sepsis and septic shock, few have addressed emergency department (ED) screening and management for patients initially presenting with uncomplicated sepsis (ie, patients without organ failure or hypotension). A quality improvement task force at a large, quaternary care referral hospital sought to develop a protocol focusing on early identification of patients with uncomplicated sepsis, in addition to severe sepsis and septic shock. The three-tiered intervention consisted of (1) a nurse-driven screening tool and management protocol to identify and initiate early treatment of patients with sepsis, (2) a computer-assisted screening algorithm that generated a 'Sepsis Alert' pop-up screen in the electronic medical record for treating clinical healthcare providers and (3) automated suggested sepsis-specific order sets for initial workup and resuscitation, antibiotic selection and goal-directed therapy. A before and after retrospective cohort study was undertaken to determine the intervention's impact on compliance with recommended sepsis management, including serum lactate measured in the ED, 2 L of intravenous fluid administered within 2 h of triage, antibiotics administered within 3 h of triage and blood cultures drawn before antibiotic administration. Mortality rates for patients in the ED with a sepsis-designated ICD-9 code present on admission were also analysed. Overall bundle compliance increased by 154%, from 28% at baseline to 71% in the last quarter of the study (p<0.001). Bundle, antibiotic and intravenous fluid compliance all increased significantly after launch of the sepsis initiative (eg, bundle and intravenous fluid compliance increased by 74% and 54%, respectively; p<0.001). Bundle and antibiotic compliance both showed further significant increases after implementation of suggested order sets (31% and 25% increases, respectively; p<0.001). The mortality rate for patients in the ED admitted with sepsis was 13.3% before implementation and fell to 11.1% after (p=0.230); mortality in the last two quarters of the study was 9.3% (p=0.107). The new protocol demonstrates that early screening interventions can lead to expedited delivery of care to patients with sepsis in the ED and could serve as a model for other facilities. Mortality was not significantly improved by our intervention, which included patients with uncomplicated sepsis. 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/

A 'learning-by-doing' treatment planning tutorial for medical physicists.

PubMed

Meyer, J; Hartmann, B; Kalet, I

2009-06-01

A framework for a tutorial for treatment planning in radiation oncology physics was developed, based on the University of Washington treatment planning system Prism. The tutorial is aimed at students in Medical Physics to accompany the lectures on treatment planning to enhance their theoretical knowledge. A web-based layout was chosen to allow independent work of the students. The tutorial guides the students through three different learning modules, designed mainly to enhance their understanding of the processes involved in treatment planning but also to learn the specific features of a modern treatment planning system. Each of the modules contains four units, with the aim to introduce the relevant Prism features, practice skills in different tasks and finally check the learning outcomes with a challenge and a self-scoring quiz. A survey for students' feedback completes the tutorial. Various tools and learning methods help to create an interactive, appealing learning environment, in which the emphasis is shifted from teacher-centred to student-centred learning paradigms. In summary, Prism lends itself well for educational purposes. The tutorial covers all main aspects of treatment planning. In its current form the tutorial is self-contained but still adjustable and expandable. The tutorial can be made available upon request to the authors.

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

Aurich, Maike K.; Fleming, Ronan M. T.; Thiele, Ines

Metabolomic data sets provide a direct read-out of cellular phenotypes and are increasingly generated to study biological questions. Previous work, by us and others, revealed the potential of analyzing extracellular metabolomic data in the context of the metabolic model using constraint-based modeling. With the MetaboTools, we make our methods available to the broader scientific community. The MetaboTools consist of a protocol, a toolbox, and tutorials of two use cases. The protocol describes, in a step-wise manner, the workflow of data integration, and computational analysis. The MetaboTools comprise the Matlab code required to complete the workflow described in the protocol. Tutorialsmore » explain the computational steps for integration of two different data sets and demonstrate a comprehensive set of methods for the computational analysis of metabolic models and stratification thereof into different phenotypes. The presented workflow supports integrative analysis of multiple omics data sets. Importantly, all analysis tools can be applied to metabolic models without performing the entire workflow. Taken together, the MetaboTools constitute a comprehensive guide to the intra-model analysis of extracellular metabolomic data from microbial, plant, or human cells. In conclusion, this computational modeling resource offers a broad set of computational analysis tools for a wide biomedical and non-biomedical research community.« less

Online Pedagogical Tutorial Tactics Optimization Using Genetic-Based Reinforcement Learning

PubMed Central

Lin, Hsuan-Ta; Lee, Po-Ming; Hsiao, Tzu-Chien

2015-01-01

Tutorial tactics are policies for an Intelligent Tutoring System (ITS) to decide the next action when there are multiple actions available. Recent research has demonstrated that when the learning contents were controlled so as to be the same, different tutorial tactics would make difference in students' learning gains. However, the Reinforcement Learning (RL) techniques that were used in previous studies to induce tutorial tactics are insufficient when encountering large problems and hence were used in offline manners. Therefore, we introduced a Genetic-Based Reinforcement Learning (GBML) approach to induce tutorial tactics in an online-learning manner without basing on any preexisting dataset. The introduced method can learn a set of rules from the environment in a manner similar to RL. It includes a genetic-based optimizer for rule discovery task by generating new rules from the old ones. This increases the scalability of a RL learner for larger problems. The results support our hypothesis about the capability of the GBML method to induce tutorial tactics. This suggests that the GBML method should be favorable in developing real-world ITS applications in the domain of tutorial tactics induction. PMID:26065018

Online Pedagogical Tutorial Tactics Optimization Using Genetic-Based Reinforcement Learning.

PubMed

Lin, Hsuan-Ta; Lee, Po-Ming; Hsiao, Tzu-Chien

2015-01-01

Tutorial tactics are policies for an Intelligent Tutoring System (ITS) to decide the next action when there are multiple actions available. Recent research has demonstrated that when the learning contents were controlled so as to be the same, different tutorial tactics would make difference in students' learning gains. However, the Reinforcement Learning (RL) techniques that were used in previous studies to induce tutorial tactics are insufficient when encountering large problems and hence were used in offline manners. Therefore, we introduced a Genetic-Based Reinforcement Learning (GBML) approach to induce tutorial tactics in an online-learning manner without basing on any preexisting dataset. The introduced method can learn a set of rules from the environment in a manner similar to RL. It includes a genetic-based optimizer for rule discovery task by generating new rules from the old ones. This increases the scalability of a RL learner for larger problems. The results support our hypothesis about the capability of the GBML method to induce tutorial tactics. This suggests that the GBML method should be favorable in developing real-world ITS applications in the domain of tutorial tactics induction.

SMARTE TUTORIAL CD

EPA Science Inventory

SMARTe is a web-based decision support tool intended to help revitalization practitioners find information, perform data analysis, communicate, and evaluate future reuse options for a site or area. A tutorial was developed to help users navigate SMARTe. This tutorial is approxima...

Quantitative Microbial Risk Assessment Tutorial - Primer

EPA Science Inventory

This document provides a Quantitative Microbial Risk Assessment (QMRA) primer that organizes QMRA tutorials. The tutorials describe functionality of a QMRA infrastructure, guide the user through software use and assessment options, provide step-by-step instructions for implementi...

Using a Systems Engineering Initiative for Patient Safety to Evaluate a Hospital-wide Daily Chlorhexidine Bathing Intervention.

PubMed

Caya, Teresa; Musuuza, Jackson; Yanke, Eric; Schmitz, Michelle; Anderson, Brooke; Carayon, Pascale; Safdar, Nasia

2015-01-01

We undertook a systems engineering approach to evaluate housewide implementation of daily chlorhexidine bathing. We performed direct observations of the bathing process and conducted provider and patient surveys. The main outcome was compliance with bathing using a checklist. Fifty-seven percent of baths had full compliance with the chlorhexidine bathing protocol. Additional time was the main barrier. Institutions undertaking daily chlorhexidine bathing should perform a rigorous assessment of implementation to optimize the benefits of this intervention.

Materials and Processes for the New Millennium

NASA Technical Reports Server (NTRS)

Hayes, Paul W.; Richardson, Rod W.

2004-01-01

The single greatest threat to material availability over the last decade has been Compliance to New Environmental Regulations. Federal Regulations: a) Clean Air Acts Amendments - 1990 - Titles I, III and VI; b) NASA Interim Policy- 1995 end date; c) Montreal Protocol - 2000 and 2005 end dates; d) Industrial Toxics Project - HAP emissions by 1995; e) Florida DER - VOC limits by 1995 (CA); f) OSHA Health Related Regulations 1) Carcinogens 2) Mutagens 3). Material availability is complicated by local and state regulations and their own compliance schedules.

A computer assisted tutorial for applications of computer spreadsheets in nursing financial management.

PubMed

Edwardson, S R; Pejsa, J

1993-01-01

A computer-based tutorial for teaching nursing financial management concepts was developed using the macro function of a commercially available spreadsheet program. The goals of the tutorial were to provide students with an experience with spreadsheets as a computer tool and to teach selected financial management concepts. Preliminary results show the tutorial was well received by students. Suggestions are made for overcoming the general lack of computer sophistication among students.

2013 Community Earth System Model (CESM) Tutorial-Proposal to DOE

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

Holland, Marika; Bates, Susan

2014-12-04

THE SAME REQUEST WILL BE SENT TO BOTH NSF AND DOE TO EACH SUPPORT $35K. The third annual Community Earth System Model (CESM) tutorial for students and early career scientists was held from 30 July to 3 August, 2012. This event was extremely successful and, as for the tutorials in previous years, there was a greater demand than could be met. This indicates a continuing need for a tutorial of this type and we anticipate that the 2013 tutorial will be well received. The tutorial will include lectures on simulating the climate system and practical sessions on running CESM, modifyingmore » components, and analyzing data. These will be targeted to the graduate student level. Attendance will be limited to a maximum of 80 students with financial support for up to 40 students. Attendees will be balanced across institutions.« less

A Web Resource for Standardized Benchmark Datasets, Metrics, and Rosetta Protocols for Macromolecular Modeling and Design.

PubMed

Ó Conchúir, Shane; Barlow, Kyle A; Pache, Roland A; Ollikainen, Noah; Kundert, Kale; O'Meara, Matthew J; Smith, Colin A; Kortemme, Tanja

2015-01-01

The development and validation of computational macromolecular modeling and design methods depend on suitable benchmark datasets and informative metrics for comparing protocols. In addition, if a method is intended to be adopted broadly in diverse biological applications, there needs to be information on appropriate parameters for each protocol, as well as metrics describing the expected accuracy compared to experimental data. In certain disciplines, there exist established benchmarks and public resources where experts in a particular methodology are encouraged to supply their most efficient implementation of each particular benchmark. We aim to provide such a resource for protocols in macromolecular modeling and design. We present a freely accessible web resource (https://kortemmelab.ucsf.edu/benchmarks) to guide the development of protocols for protein modeling and design. The site provides benchmark datasets and metrics to compare the performance of a variety of modeling protocols using different computational sampling methods and energy functions, providing a "best practice" set of parameters for each method. Each benchmark has an associated downloadable benchmark capture archive containing the input files, analysis scripts, and tutorials for running the benchmark. The captures may be run with any suitable modeling method; we supply command lines for running the benchmarks using the Rosetta software suite. We have compiled initial benchmarks for the resource spanning three key areas: prediction of energetic effects of mutations, protein design, and protein structure prediction, each with associated state-of-the-art modeling protocols. With the help of the wider macromolecular modeling community, we hope to expand the variety of benchmarks included on the website and continue to evaluate new iterations of current methods as they become available.

Teaching clinical management skills for genetic testing of hereditary nonpolyposis colorectal cancer using a Web-based tutorial.

PubMed

Barnes, Kathleen; Itzkowitz, Steven; Brown, Karen

2003-01-01

To pilot and evaluate an interactive Web-based continuing medical education tutorial on clinical management of hereditary nonpolyposis colon cancer (HNPCC) and genetic testing. Gastroenterology fellows and genetic counseling trainees were asked to read standard written materials before taking the tutorial. A pretest/post-test assessment was used to measure change in subjects' clinical management skills. Subjects made the correct management decision 63.9% of the time before the tutorial and 81.1% of the time after the tutorial (P < 0.001). Supplementing written materials with an interactive program may assist medical professionals in integrating their knowledge of HNPCC and genetic testing into clinical practice.

The Impact of Library Tutorials on the Information Literacy Skills of Occupational Therapy and Physical Therapy Students in an Evidence-Based Practice Course: A Rubric Assessment.

PubMed

Schweikhard, April J; Hoberecht, Toni; Peterson, Alyssa; Randall, Ken

2018-01-01

This study measures how online library instructional tutorials implemented into an evidence-based practice course have impacted the information literacy skills of occupational and physical therapy graduate students. Through a rubric assessment of final course papers, this study compares differences in students' search strategies and cited sources pre- and post-implementation of the tutorials. The population includes 180 randomly selected graduate students from before and after the library tutorials were introduced into the course curriculum. Results indicate a statistically significant increase in components of students' searching skills and ability to find higher levels of evidence after completing the library tutorials.

Differential response of peripheral arterial compliance-related indices to a vasoconstrictive stimulus.

PubMed

Guerrisi, Maria; Vannucci, Italo; Toschi, Nicola

2009-01-01

Peripheral arterial elastic properties are greatly affected by cardiovascular as well as other pathologies, and their assessment can provide useful diagnostic indicators. The photoplethysmographic technique can provide finger blood volume and pressure waveforms non-invasively, which can then be processed statically or beat-to-beat to characterize parameters of the vessel wall mechanics. We employ an occlusion-deflation protocol in 48 healthy volunteers to study peripheral artery compliance-related indices over positive and negative transmural pressure values as well as under the influence of a valid vasoconstrictor (cigarette smoking). We calculate beat-to-beat indices (compliance index CI, distensibility index DI, three viscoelastic model parameters (compliance C, viscosity R and inertia L), pressure-volume loop areas A and damping factor DF as well as symmetrical (C(max)) and asymmetrical (C(A)(max)) static compliance estimates, and their distributions over transmural pressure. All distributions are bell-shaped and centred on negative transmural pressure values. Distribution heights were significantly lower in the smoking group (w.r.t. the non-smoking group) for C, CI, DI and significantly higher in R and DF. The estimated volume signal time lag was also significantly lower in the smoking group. Left and right distribution widths were significantly different in all parameters/groups but DI (both groups), C(A)(max), A (smoking group) and L (non-smoking group), and positions of maxima/minima were significantly altered in C(A)(max), R and DF. C, DF and CI are seen to be most sensitive under this protocol, while C(max) and C(A)(max) are seen to be insensitive. These quantities provide complementary, time- and transmural pressure-dependent information about arterial wall mechanics, and the choice of index should depend on the physiological conditions at hand as well as relevant time resolution and transmural pressure range.

RCR audit of compliance with UK guidelines for the prevention and detection of acute kidney injury in adult patients undergoing iodinated contrast media injections for CT.

PubMed

Cope, L H; Drinkwater, K J; Howlett, D C

2017-12-01

To determine radiology departmental compliance with current UK guidance on contrast-induced acute kidney injury (CI-AKI) and to provide data on the incidence of clinically significant post-contrast AKI (PC-AKI) in computed tomography (CT) practice. A questionnaire was sent to all UK acute National Health Service (NHS) providers (NHS boards in Scotland, local health boards in Wales, NHS trusts in England and health and social care trusts in Northern Ireland) to assess compliance of provider protocols with current UK guidelines for the prevention, recognition, and management of CI-AKI. Audit data were collected for 40 consecutive fit outpatients and 40 consecutive acutely unwell patients/inpatients from hospitals within each participating provider to assess clinical compliance. Eighty-nine of 172 (52%) health service providers responded, and data on 7,159 contrast-enhanced CT examinations were provided. Compliance with guidelines was poor with wide variation in clinical practice. The observed incidence of clinically significant (requiring treatment or resulting in death) PC-AKI was zero in 3,590 outpatients, although two patients developed AKI due to other causes (sepsis and progressive malignancy). Fourteen out of 3,569 (0.4%) patients in the inpatient group developed clinically significant PC-AKI, and a further 17 patients were identified who met the Kidney Disease Improving Global Outcomes (KDIGO) definition of AKI (Electronic Supplementary Material Appendix S1), but did not require active treatment, giving an overall incidence of AKI of 0.9%. In patients at high risk due to impaired renal function prior to the scan, there was no difference in the median serum creatinine (SCr) before and after contrast medium administration in either group. Health service provider protocols and clinical practice demonstrate poor compliance with current UK guidance on CI-AKI. A very low incidence of PC- AKI was demonstrated. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

A Pilot Evaluation of a Tutorial to Teach Clients and Clinicians About Gambling Game Design.

PubMed

Turner, Nigel E; Robinson, Janine; Harrigan, Kevin; Ferentzy, Peter; Jindani, Farah

2018-01-01

This paper describes the pilot evaluation of an Internet-based intervention, designed to teach counselors and problem gamblers about how electronic gambling machines (EGMs) work. This study evaluated the tutorial using assessment tools, such as rating scales and test of knowledge about EGMs and random chance. The study results are based on a number of samples, including problem gambling counselors ( n  = 25) and problem gamblers ( n  = 26). The interactive tutorial was positively rated by both clients and counselors. In addition, we found a significant improvement in scores on a content test about EGM games for both clients and counselors. An analysis of the specific items suggests that the effects of the tutorial were mainly on those items that were most directly related to the content of the tutorial and did not always generalize to other items. This tutorial is available for use with clients and for education counselors. The data also suggest that the tutorial is equally effective in group settings and in individual settings. These results are promising and illustrate that the tool can be used to teach counselors and clients about game design. Furthermore, research is needed to evaluate its impact on gambling behavior.

Design and Assessment of Online, Interactive Tutorials That Teach Science Process Skills.

PubMed

Kramer, Maxwell; Olson, Dalay; Walker, J D

2018-06-01

Explicit emphasis on teaching science process skills leads to both gains in the skills themselves and, strikingly, deeper understanding of content. Here, we created and tested a series of online, interactive tutorials with the goal of helping undergraduate students develop science process skills. We designed the tutorials in accordance with evidence-based multimedia design principles and student feedback from usability testing. We then tested the efficacy of the tutorials in an introductory undergraduate biology class. On the basis of a multivariate ordinary least-squares regression model, students who received the tutorials are predicted to score 0.82 points higher on a 15-point science process skill assessment than their peers who received traditional textbook instruction on the same topic. This moderate but significant impact indicates that well-designed online tutorials can be more effective than traditional ways of teaching science process skills to undergraduate students. We also found trends that suggest the tutorials are especially effective for nonnative English-speaking students. However, due to a limited sample size, we were unable to confirm that these trends occurred due to more than just variation in the student group sampled.

The MueLu Tutorial

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

Hu, Jonathan Joseph; Wiesner, Tobias A.; Prokopenko, Andrey

2014-10-01

The MueLu tutorial is written as a hands-on tutorial for MueLu, the next generation multigrid framework in Trilinos. It covers the whole spectrum from absolute beginners’ topics to expert level. Since the focus of this tutorial is on practical and technical aspects of multigrid methods in general and MueLu in particular, the reader is expected to have a basic understanding of multigrid methods and its general underlying concepts. Please refer to multigrid textbooks (e.g. [1]) for the theoretical background.

Druggists and pharmacists as gatekeepers: sales routines and compliance with sales protocols for over-the-counter naproxen 275 mg medicines in the Netherlands.

PubMed

van Hoof, Joris J; Cents, Michel H G; Megens, Nicole M J; van der Tang, Sijbrand J

2014-09-01

Since for the sales of over-the-counter (OTC) medicines, prescribing physicians are not involved, and written instructions on/in the medicine boxes are inefficient, druggists and pharmacists are important gatekeepers in preventing customers' accidents. In this study we investigated the sales routines, and compliance with sales protocols, in order to evaluate that gatekeeper's function. By means of the mystery shopping method, 228 pharmacies and drugstores in The Netherlands were visited and a naproxen 275mg medium-risk medicine was requested for a (fictitious) patient who was suffering from severe back pains. According to the sales protocols the vendors should never sell the requested medicine, because the mystery shoppers only gave an answer to one of the four mandatory sales protocol questions. Furthermore, the requested medicine is not the right or best choice for back pains. Four different scenarios were used in a 2×2 design (8-year-old patient vs. 25-year-old patient, and 1 box with 12 pills vs. 3 boxes with 12 pills). Of the drugstores and pharmacies only 16.7% complied with the sales protocols and did not sell the specific (or comparable) medicine, after asking all four mandatory questions (or already after one, two or three questions). Most vendors (83.3%) did not comply and sold the requested medicine, a comparable medicine, or even a more risky medicine after no question at all (or after asking some or even all four questions). Although both score low, pharmacists show better compliance (23.9%) than druggists (10.1%). When it comes to OTC medicines, druggists and pharmacists largely commit sloppy sales. The expected gatekeeping function of pharmacists and druggists is very limited, and customers might be in danger of inappropriate medicine selection, quantity and usage. We call for thorough evaluation of the over-the-counter system, improvement of the educational programs for medicine providers, and national campaigns to inform the public. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Junior doctor-led ‘near-peer’ prescribing education for medical students

PubMed Central

Gibson, Kyle R; Qureshi, Zeshan U; Ross, Michael T; Maxwell, Simon R

2014-01-01

Aims Prescribing errors are common and inadequate preparation of prescribers appears to contribute. A junior doctor-led prescribing tutorial programme has been developed for Edinburgh final year medical students to increase exposure to common prescribing tasks. The aim of this study was to assess the impact of these tutorials on students and tutors. Methods One hundred and ninety-six tutorials were delivered to 183 students during 2010–2011. Each student completed a questionnaire after tutorial attendance which explored their previous prescribing experiences and the perceived benefits of tutorial attendance. Tutors completed a questionnaire which evaluated their teaching experiences and the impact on their prescribing practice. Student tutorial attendance was compared with end-of-year examination performance using linear regression analysis. Results The students reported increased confidence in their prescribing knowledge and skills after attending tutorials. Students who attended more tutorials also tended to perform better in end-of-year examinations (Drug prescribing: r = 0.16, P = 0.015; Fluid prescribing: r = 0.18, P = 0.007). Tutors considered that participation enhanced their own prescribing knowledge and skills. Although they were occasionally unable to address student uncertainties, 80% of tutors reported frequently correcting misconceptions and deficits in student knowledge. Ninety-five percent of students expressed a preference for prescribing training delivered by junior doctors over more senior doctors. Conclusions A ‘near-peer’ junior doctor-led approach to delivering prescribing training to medical students was highly valued by both students and tutors. Although junior doctors have relatively less clinical experience of prescribing, we believe that this can be addressed by training and academic supervision and is outweighed by the benefits of these tutorials. PMID:23617320

The impact of maths support tutorials on mathematics confidence and academic performance in a cohort of HE Animal Science students

PubMed Central

Amory, Jonathan

2014-01-01

Students embarking on a bioscience degree course, such as Animal Science, often do not have sufficient experience in mathematics. However, mathematics forms an essential and integral part of any bioscience degree and is essential to enhance employability. This paper presents the findings of a project looking at the effect of mathematics tutorials on a cohort of first year animal science and management students. The results of a questionnaire, focus group discussions and academic performance analysis indicate that small group tutorials enhance students’ confidence in maths and improve students’ academic performance. Furthermore, student feedback on the tutorial programme provides a deeper insight into student experiences and the value students assign to the tutorials. PMID:25024925

The impact of maths support tutorials on mathematics confidence and academic performance in a cohort of HE Animal Science students.

PubMed

van Veggel, Nieky; Amory, Jonathan

2014-01-01

Students embarking on a bioscience degree course, such as Animal Science, often do not have sufficient experience in mathematics. However, mathematics forms an essential and integral part of any bioscience degree and is essential to enhance employability. This paper presents the findings of a project looking at the effect of mathematics tutorials on a cohort of first year animal science and management students. The results of a questionnaire, focus group discussions and academic performance analysis indicate that small group tutorials enhance students' confidence in maths and improve students' academic performance. Furthermore, student feedback on the tutorial programme provides a deeper insight into student experiences and the value students assign to the tutorials.

Multicenter Quality Improvement Project to Prevent Sternal Wound Infections in Pediatric Cardiac Surgery Patients.

PubMed

Woodward, Cathy; Taylor, Richard; Son, Minnette; Taeed, Roozbeh; Jacobs, Marshall L; Kane, Lauren; Jacobs, Jeffrey P; Husain, S Adil

2017-07-01

Children undergoing cardiac surgery are at risk for sternal wound infections (SWIs) leading to increased morbidity and mortality. Single-center quality improvement (QI) initiatives have demonstrated decreased infection rates utilizing a bundled approach. This multicenter project was designed to assess the efficacy of a protocolized approach to decrease SWI. Pediatric cardiac programs joined a collaborative effort to prevent SWI. Programs implemented the protocol, collected compliance data, and provided data points from local clinical registries using Society of Thoracic Surgery Congenital Heart Surgery Database harvest-compliant software or from other registries. Nine programs prospectively collected compliance data on 4,198 children. Days between infections were extended from 68.2 days (range: 25-82) to 130 days (range: 43-412). Protocol compliance increased from 76.7% (first quarter) to 91.3% (final quarter). Ninety (1.9%) children developed an SWI preprotocol and 64 (1.5%) postprotocol, P = .18. The 657 (15%) delayed sternal closure patients had a 5% infection rate with 18 (5.7%) in year 1 and 14 (4.3%) in year 2 P = .43. Delayed sternal closure patients demonstrated a trend toward increased risk for SWI of 1.046 for each day the sternum remained open, P = .067. Children who received appropriately timed preop antibiotics developed less infections than those who did not, 1.9% versus 4.1%, P = .007. A multicenter QI project to reduce pediatric SWIs demonstrated an extension of days between infections and a decrease in SWIs. Patients who received preop antibiotics on time had lower SWI rates than those who did not.

Assessing the flexibility of research-based instructional strategies: Implementing tutorials in introductory physics in the lecture environment

NASA Astrophysics Data System (ADS)

Kryjevskaia, Mila; Boudreaux, Andrew; Heins, Dustin

2014-03-01

Materials from Tutorials in Introductory Physics, originally designed and implemented by the Physics Education Group at the University of Washington, were used in modified form as interactive lectures under conditions significantly different from those suggested by the curriculum developers. Student learning was assessed using tasks drawn from the physics education research literature. Use of tutorials in the interactive lecture format yielded gains in student understanding comparable to those obtained through the canonical tutorial implementation at the University of Washington, suggesting that student engagement with the intellectual steps laid out in the tutorials, rather than the specific strategies used in facilitating such engagement, plays the central role in promoting student learning. We describe the implementation details and assessment of student learning for two different tutorials: one focused on mechanical waves, used at North Dakota State University, and one on Galilean relativity, used at Western Washington University. Also discussed are factors that may limit the generalizability of the results.

Sampling for Lead in Drinking Water

EPA Science Inventory

Sampling protocols for lead in water can be broadly categorized based on their intended purpose of 1) Pb regulatory compliance/corrosion control efficacy, 2) Pb plumbing source determination or Pb type identification, and 3) Pb exposure assessment. Choosing the appropriate protoc...

Environmental Compliance Assessment Protocol-Centers for Disease Control and Prevention (ECAP-CDC)

DTIC Science & Technology

1993-10-01

propellers, or appliances. 2. Military weapons or equipment designed for combat use. 3. Rockets or equipment designed for research, or experimental or...should be reproduced and used during the assessment to take notes. It is designed to be inserted between each page of the protocols, allowing the...procedures are designed as an aid and should not be considered exhaus- tive. Use of the guide requires the evaluator’s judgement to play a role in

Poor compliance with postmolar surveillance and treatment protocols by indigent women.

PubMed

Massad, L S; Abu-Rustum, N R; Lee, S S; Renta, V

2000-12-01

To estimate compliance by indigent women with surveillance protocols after molar pregnancy. Women whose molar pregnancies were evacuated at an urban, public hospital were advised to return weekly either until hCG levels decreased below 5 mIU/mL, then monthly for 6 months, or until diagnosis and treatment of gestational trophoblastic disease, then monthly for 12 months. Hormone testing was by enzyme-linked immunosorbent assay. Statistical analysis was by chi(2) tests. Of 51 women identified, 11 (22%) developed trophoblastic disease. All achieved remission after chemotherapy. Five (45%) of these 11 missed at least one treatment, seven (64%) missed at least one postremission visit, and none was fully compliant with protocols. Five (13%) of the 40 remaining women were lost to follow-up before remission. Seven (18%) of the 40 women who did not receive chemotherapy complied fully with protocols, whereas five (13%) were lost to follow-up before remission, and 16 (40%) were lost before completing 6 months of follow-up. Only 15 (29%) of the 51 women completed surveillance without gestational trophoblastic disease or pregnancy. Six women conceived, and injectable medroxyprogesterone acetate was associated with a lower pregnancy rate (zero of 25 compared with six of 26 (23%), P <.01). Most indigent women failed to comply with postmolar surveillance, although most achieved remission. Injectable medroxyprogesterone acetate is recommended for postmolar contraception in this population.

Reporting of methods was better in the Clinical Trials Registry-India than in Indian journal publications.

PubMed

Tharyan, Prathap; George, Aneesh Thomas; Kirubakaran, Richard; Barnabas, Jabez Paul

2013-01-01

We sought to evaluate if editorial policies and the reporting quality of randomized controlled trials (RCTs) had improved since our 2004-05 survey of 151 RCTs in 65 Indian journals, and to compare reporting quality of protocols in the Clinical Trials Registry-India (CTRI). An observational study of endorsement of Consolidated Standards for the Reporting of Trials (CONSORT) and International Committee of Medical Journal Editors (ICMJE) requirements in the instructions to authors in Indian journals, and compliance with selected requirements in all RCTs published during 2007-08 vs. our previous survey and between all RCT protocols in the CTRI on August 31, 2010 and published RCTs from both surveys. Journal policies endorsing the CONSORT statement (22/67, 33%) and ICMJE requirements (35/67, 52%) remained suboptimal, and only 4 of 13 CONSORT items were reported in more than 50% of the 145 RCTs assessed. Reporting of ethical issues had improved significantly, and that of methods addressing internal validity had not improved. Adequate methods were reported significantly more frequently in 768 protocols in the CTRI, than in the 296 published trials. The CTRI template facilitates the reporting of valid methods in registered trial protocols. The suboptimal compliance with CONSORT and ICMJE requirements in RCTs published in Indian journals reduces credibility in the reliability of their results. Copyright © 2013 Elsevier Inc. All rights reserved.

Occupational health provision and health surveillance in the semiconductor industry.

PubMed

Kinoulty, Mary; Williams, Nerys

2006-03-01

To identify the nature of occupational health provision in UK semiconductor-manufacturing plants. To identify the level of industry compliance with legal health surveillance requirements. A national inspection programme was carried out by Health & Safety Executive inspectors using a developed protocol. A wide range of occupational health provision was identified from none to use of an accredited specialist. The majority of work was of a reactive nature even where there was specialist occupational health input. Seven companies were identified as not meeting legal compliance and one as having unacceptable compliance for health surveillance. The spectrum of occupational health provision was very wide. Where health surveillance was provided, it was poorly targeted with limited interpretation and feedback to management.

Beyond Special Education: A New Vision of Academic Support

ERIC Educational Resources Information Center

Mowschenson, Julie Joyal; Weintraub, Robert J.

2009-01-01

This article describes Brookline High School's new Tutorial Program, an alternative to the more traditional special education learning center. The Tutorial serves students with learning disabilities, replacing conventional special education support with academic guidance from regular classroom teachers. Tutorial students meet daily with a team of…

Assess and Invest: Faculty Feedback on Library Tutorials

ERIC Educational Resources Information Center

Appelt, Kristina M.; Pendell, Kimberly

2010-01-01

Communication and collaboration with faculty are increasingly important in the development of both curriculum-integrated and stand-alone "just in time" library tutorials. In the final developmental stages of the Evidence-Based Practice online tutorials, faculty members were asked to provide input during structured faculty feedback…

2014 CESM Tutorial

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

Holland, Marika

2014-08-11

The 2014 annual tutorial for the Community Earth System Model (CESM) was held on August 11-August 15, 2014 at the National Center for Atmospheric Research in Boulder, CO. It included lectures and practical sessions on numerous aspects of the CESM model. The proceedings submitted here include a description of the tutorial.

[Enhanced Recovery after Surgery from Theory to Practice
What do We Need to Do?

PubMed

Che, Guowei; Liu, Lunxu; Zhou, Qinghua

2017-04-20

Enhanced recovery after surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes, shorter length of hospital stay and cost savings. But the current ERAS either by application of breadth or depth is not enough, why? The main reason is the lack of "operability, evaluation, repetition" ERAS protocol and suitable for clinical extensive application protocol. How to form the clinical available protocol? Operational mainly refers to the clinical scheme is simple and feasible, and protocol compliance is good; Evaluate refers to the methods used before, during and after are the objective evaluation criteria and plan; Repeatable is clinical scheme repeatability in the process of single or multiple center.

The Feedback Intervention Trial (FIT) — Improving Hand-Hygiene Compliance in UK Healthcare Workers: A Stepped Wedge Cluster Randomised Controlled Trial

PubMed Central

Fuller, Christopher; Michie, Susan; Savage, Joanne; McAteer, John; Besser, Sarah; Charlett, Andre; Hayward, Andrew; Cookson, Barry D.; Cooper, Ben S.; Duckworth, Georgia; Jeanes, Annette; Roberts, Jenny; Teare, Louise; Stone, Sheldon

2012-01-01

Introduction Achieving a sustained improvement in hand-hygiene compliance is the WHO’s first global patient safety challenge. There is no RCT evidence showing how to do this. Systematic reviews suggest feedback is most effective and call for long term well designed RCTs, applying behavioural theory to intervention design to optimise effectiveness. Methods Three year stepped wedge cluster RCT of a feedback intervention testing hypothesis that the intervention was more effective than routine practice in 16 English/Welsh Hospitals (16 Intensive Therapy Units [ITU]; 44 Acute Care of the Elderly [ACE] wards) routinely implementing a national cleanyourhands campaign). Intervention-based on Goal & Control theories. Repeating 4 week cycle (20 mins/week) of observation, feedback and personalised action planning, recorded on forms. Computer-generated stepwise entry of all hospitals to intervention. Hospitals aware only of own allocation. Primary outcome: direct blinded hand hygiene compliance (%). Results All 16 trusts (60 wards) randomised, 33 wards implemented intervention (11 ITU, 22 ACE). Mixed effects regression analysis (all wards) accounting for confounders, temporal trends, ward type and fidelity to intervention (forms/month used). Intention to Treat Analysis Estimated odds ratio (OR) for hand hygiene compliance rose post randomisation (1.44; 95% CI 1.18, 1.76;p<0.001) in ITUs but not ACE wards, equivalent to 7–9% absolute increase in compliance. Per-Protocol Analysis for Implementing Wards OR for compliance rose for both ACE (1.67 [1.28–2.22]; p<0.001) & ITUs (2.09 [1.55–2.81];p<0.001) equating to absolute increases of 10–13% and 13–18% respectively. Fidelity to intervention closely related to compliance on ITUs (OR 1.12 [1.04, 1.20];p = 0.003 per completed form) but not ACE wards. Conclusion Despite difficulties in implementation, intention-to-treat, per-protocol and fidelity to intervention, analyses showed an intervention coupling feedback to personalised action planning produced moderate but significant sustained improvements in hand-hygiene compliance, in wards implementing a national hand-hygiene campaign. Further implementation studies are needed to maximise the intervention’s effect in different settings. Trial Registration Controlled-Trials.com ISRCTN65246961 PMID:23110040

38 CFR 21.9685 - Tutorial Assistance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Tutorial Assistance. 21.9685 Section 21.9685 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Payments-Educational Assistance § 21.9685 Tutorial Assistance. (a) An individual who is...

The Effects of Reviews in Video Tutorials

ERIC Educational Resources Information Center

van der Meij, H.; van der Meij, J.

2016-01-01

This study investigates how well a video tutorial for software training that is based on Demonstration-Based Teaching supports user motivation and performance. In addition, it is studied whether reviews significantly contribute to these measures. The Control condition employs a tutorial with instructional features added to a dynamic task…

A Gene Ontology Tutorial in Python.

PubMed

Vesztrocy, Alex Warwick; Dessimoz, Christophe

2017-01-01

This chapter is a tutorial on using Gene Ontology resources in the Python programming language. This entails querying the Gene Ontology graph, retrieving Gene Ontology annotations, performing gene enrichment analyses, and computing basic semantic similarity between GO terms. An interactive version of the tutorial, including solutions, is available at http://gohandbook.org .

Building Shared Understandings in Introductory Physics Tutorials through Risk, Repair, Conflict & Comedy

ERIC Educational Resources Information Center

Conlin, Luke D.

2012-01-01

Collaborative inquiry learning environments, such as "The Tutorials in Physics Sensemaking," are designed to provide students with opportunities to partake in the authentic disciplinary practices of argumentation and sensemaking. Through these practices, groups of students in tutorial can build shared conceptual understandings of the…

A Tutorial Design Process Applied to an Introductory Materials Engineering Course

ERIC Educational Resources Information Center

Rosenblatt, Rebecca; Heckler, Andrew F.; Flores, Katharine

2013-01-01

We apply a "tutorial design process", which has proven to be successful for a number of physics topics, to design curricular materials or "tutorials" aimed at improving student understanding of important concepts in a university-level introductory materials science and engineering course. The process involves the identification…

Technical Specifications of the Nihongo Tutorial System.

ERIC Educational Resources Information Center

Leung, Kei Wai; Maciejewski, Anthony A.

The Nihongo tutorial system is an intelligent tutorial system designed to use a computer to assist scientists and engineers in developing reading competence in technical Japanese. It consists of three applications: the Nihongo Tutor, which provides useful information about an article (translation, syntax, pronunciation) to help understand the text…

User's Guide for the Nihongo Tutorial System.

ERIC Educational Resources Information Center

Leung, Kei Wai; Maciejewski, Anthony A.

The Nihongo tutorial system is an intelligent tutorial system designed to use a computer to assist scientists and engineers in developing reading competence in technical Japanese. It consists of three applications: the Nihongo Tutor, which provides useful information about an article (translation, syntax, pronunciation) to help understand the text…

Interdisciplinary, Application-Oriented Tutorials: Design, Implementation, and Evaluation

ERIC Educational Resources Information Center

Herman, Carolyn; Casiday, Rachel E.; Deppe, Roberta K.; Gilbertson, Michelle; Spees, William M.; Holten, Dewey; Frey, Regina F.

2005-01-01

Fifteen application-oriented chemical tutorials were developed out of which thirteen are currently in use in the general chemistry lab rotary curriculum for chemistry students at Washington University from 1998 to 2000. The central philosophy of the tutorial that the students learn to combine information from variety of sources like science…

Effectiveness of "Tutorials for Introductory Physics" in Argentinean High Schools

ERIC Educational Resources Information Center

Benegas J.; Flores, J. Sirur

2014-01-01

This longitudinal study reports the results of a replication of "Tutorials in Introductory Physics" in high schools of a Latin-American country. The main objective of this study was to examine the suitability of "Tutorials" for local science education reform. Conceptual learning of simple resistive electric circuits was…

Historical Text Comprehension Reflective Tutorial Dialogue System

ERIC Educational Resources Information Center

Grigoriadou, Maria; Tsaganou, Grammatiki; Cavoura, Theodora

2005-01-01

The Reflective Tutorial Dialogue System (ReTuDiS) is a system for learner modelling historical text comprehension through reflective dialogue. The system infers learners' cognitive profiles and constructs their learner models. Based on the learner model the system plans the appropriate--personalized for learners--reflective tutorial dialogue in…

The Nature of Reflective Practice and Emotional Intelligence in Tutorial Settings

ERIC Educational Resources Information Center

Gill, Gobinder Singh

2014-01-01

The purpose of this paper was to assess the nature of reflective practice and emotional intelligence in tutorial settings. Following the completion of a self-report measure of emotional intelligence, practitioners incorporated a model of reflective practice into their tutorial sessions. Practitioners were instructed to utilise reflective practice…

Design and Development of Web-Based Information Literacy Tutorials

ERIC Educational Resources Information Center

Su, Shiao-Feng; Kuo, Jane

2010-01-01

The current study conducts a thorough content analysis of recently built or up-to-date high-quality web-based information literacy tutorials contributed by academic libraries in a peer-reviewed database, PRIMO. This research analyzes the topics/skills PRIMO tutorials consider essential and the teaching strategies they consider effective. The…

Assessing the Effectiveness of Online Library Instruction with Finance Students

ERIC Educational Resources Information Center

Friehs, Curt G.; Craig, Cindy L.

2008-01-01

Many academic librarians use online information literacy tutorials as an alternative or a supplement to in-class library instruction. Tutorials created with streaming media software such as Camtasia Studio have become increasingly popular. Librarians at a mid-sized Midwestern university have created several such tutorials demonstrating various…

Would You Watch It? Creating Effective and Engaging Video Tutorials

ERIC Educational Resources Information Center

Martin, Nichole A.; Martin, Ross

2015-01-01

Video tutorials are a common form of library instruction used with distance learners. This paper combines professional experience and literature reviews from multiple disciplines to provide a contextual overview of recommendations and findings for effective and engaging videos. The tools for tutorials appear in five main categories: screencasts,…

Analysis of the Use of Online Tutorial

ERIC Educational Resources Information Center

Fatimah, Fatia; Andriyansah; Wahyuni, Purwaningdyah Murti

2012-01-01

UT (Universitas Terbuka), the open university in Indonesia, is one of the large universities in Indonesia that has more than 300,000 students. UT, as a distance learning education, has conducted online tutorial since 2001. The implementation of an effective and efficient online tutorial depends on three components: students, tutors, and supporting…

Online Interactive Tutorials for Creating Graphs With Excel 2007 or 2010

PubMed Central

Vanselow, Nicholas R

2012-01-01

Graphic display of clinical data is a useful tool for the behavior-analytic clinician. However, graphs can sometimes be difficult to create. We describe how to access and use an online interactive tutorial that teaches the user to create a variety of graphs often used by behavior analysts. Three tutorials are provided that cover the basics of Microsoft Excel 2007 or 2010, creating graphs for clinical purposes, and creating graphs for research purposes. The uses for this interactive tutorial and other similar programs are discussed. PMID:23326629

Online interactive tutorials for creating graphs with excel 2007 or 2010.

PubMed

Vanselow, Nicholas R; Bourret, Jason C

2012-01-01

Graphic display of clinical data is a useful tool for the behavior-analytic clinician. However, graphs can sometimes be difficult to create. We describe how to access and use an online interactive tutorial that teaches the user to create a variety of graphs often used by behavior analysts. Three tutorials are provided that cover the basics of Microsoft Excel 2007 or 2010, creating graphs for clinical purposes, and creating graphs for research purposes. The uses for this interactive tutorial and other similar programs are discussed.

Video Tutorial of Continental Food

NASA Astrophysics Data System (ADS)

Nurani, A. S.; Juwaedah, A.; Mahmudatussa'adah, A.

2018-02-01

This research is motivated by the belief in the importance of media in a learning process. Media as an intermediary serves to focus on the attention of learners. Selection of appropriate learning media is very influential on the success of the delivery of information itself both in terms of cognitive, affective and skills. Continental food is a course that studies food that comes from Europe and is very complex. To reduce verbalism and provide more real learning, then the tutorial media is needed. Media tutorials that are audio visual can provide a more concrete learning experience. The purpose of this research is to develop tutorial media in the form of video. The method used is the development method with the stages of analyzing the learning objectives, creating a story board, validating the story board, revising the story board and making video tutorial media. The results show that the making of storyboards should be very thorough, and detailed in accordance with the learning objectives to reduce errors in video capture so as to save time, cost and effort. In video capturing, lighting, shooting angles, and soundproofing make an excellent contribution to the quality of tutorial video produced. In shooting should focus more on tools, materials, and processing. Video tutorials should be interactive and two-way.

Data transmission protocol for Pi-of-the-Sky cameras

NASA Astrophysics Data System (ADS)

Uzycki, J.; Kasprowicz, G.; Mankiewicz, M.; Nawrocki, K.; Sitek, P.; Sokolowski, M.; Sulej, R.; Tlaczala, W.

2006-10-01

The large amount of data collected by the automatic astronomical cameras has to be transferred to the fast computers in a reliable way. The method chosen should ensure data streaming in both directions but in nonsymmetrical way. The Ethernet interface is very good choice because of its popularity and proven performance. However it requires TCP/IP stack implementation in devices like cameras for full compliance with existing network and operating systems. This paper describes NUDP protocol, which was made as supplement to standard UDP protocol and can be used as a simple-network protocol. The NUDP does not need TCP protocol implementation and makes it possible to run the Ethernet network with simple devices based on microcontroller and/or FPGA chips. The data transmission idea was created especially for the "Pi of the Sky" project.

Minimization of Hypoglycemia as an Adverse Event During Insulin Infusion: Further Refinement of the Yale Protocol.

PubMed

Marvin, Michael R; Inzucchi, Silvio E; Besterman, Brian J

2016-08-01

The management of hyperglycemia in the intensive care unit has been a controversial topic for more than a decade, with target ranges varying from 80-110 mg/dL to <200 mg/dL. Multiple insulin infusion protocols exist, including several computerized protocols, which have attempted to achieve these targets. Importantly, compliance with these protocols has not been a focus of clinical studies. GlucoCare™, a Food and Drug Administration (FDA)-cleared insulin-dosing calculator, was originally designed based on the Yale Insulin Infusion Protocol to target 100-140 mg/dL and has undergone several modifications to reduce hypoglycemia. The original Yale protocol was modified from 100-140 mg/dL to a range of 120-140 mg/dL (GlucoCare 120-140) and then to 140 mg/dL (GlucoCare 140, not a range but a single blood glucose [BG] level target) in an iterative and evidence-based manner to eliminate hypoglycemia <70 mg/dL. The final modification [GlucoCare 140(B)] includes the addition of bolus insulin "midprotocol" during an insulin infusion to reduce peak insulin rates for insulin-resistant patients. This study examined the results of these protocol modifications and evaluated the role of compliance with the protocol in the incidence of hypoglycemia <70 mg/dL. Protocol modifications resulted in mean BG levels of 133.4, 136.4, 143.8, and 146.4 mg/dL and hypoglycemic BG readings <70 mg/dL of 0.998%, 0.367%, 0.256%, and 0.04% for the 100-140, 120-140, 140, and 140(B) protocols, respectively (P < 0.001). Adherence to the glucose check interval significantly reduced the incidence of hypoglycemia (P < 0.001). Protocol modifications led to a reduction in peak insulin infusion rates (P < 0.001) and the need for dextrose-containing boluses (P < 0.001). This study demonstrates that refinements in protocol design can improve glucose control in critically ill patients and that the use of GlucoCare 140(B) can eliminate all significant hypoglycemia while achieving mean glucose levels between 140 and 150 mg/dL. In addition, attention to the timely performance of glucose levels can also reduce hypoglycemic events.

Job Burnout Reduces Hand Hygiene Compliance Among Nursing Staff.

PubMed

Manomenidis, Georgios; Panagopoulou, Efharis; Montgomery, Anthony

2017-10-13

Health professional burnout has been associated with suboptimal care and reduced patient safety. However, the extent to which burnout influences hand hygiene compliance among health professionals has yet to be explored. The aim of the study was to examine whether job burnout reduces hand washing compliance among nursing staff. A diary study was conducted. Forty registered nurses working in a general city hospital in Thessaloniki, Greece, completed a questionnaire, while they were monitored for hand hygiene compliance following the World Health Organization protocol for hand hygiene assessment. Burnout was measured using validated items from the Maslach Burnout Inventory. Data were collected from September to October 2015. Multiple regression analysis showed that controlling for years in practice, burnout was negatively associated with hand hygiene compliance (R = 0.322, F(3,36) = 5.704, P < 0.01). Nurses reporting higher levels of burnout were less likely to comply with hand hygiene opportunities (b = - 3.72, 95% confidence interval = -5.94 to -1.51). This study showed that burnout contributes to suboptimal care by reducing compliance to hand hygiene among nurses. Given the crucial role of hand hygiene compliance for the prevention of in-hospital infections, this study highlights the need for interventions targeting the prevention of burnout among nursing staff.

Modification, validation and implementation of a protocol for post-thyroidectomy hypocalcaemia.

PubMed

Stedman, T; Chew, P; Truran, P; Lim, C B; Balasubramanian, S P

2018-02-01

Introduction The management of post-thyroidectomy hypocalcaemia should facilitate early discharge, and reduce risks of hypocalcaemia, readmission and treatment related hypercalcaemia. This paper describes the implementation, evaluation and revision a protocol for the optimal management of this condition. Methods Day 1 parathyroid hormone (PTH) measurements in addition to calcium measurements were commenced following review of the unit's outcomes and literature on post-thyroidectomy hypocalcaemia. Outcomes from a three-year cohort of patients undergoing thyroid surgery helped amend this protocol (revision 1) to reduce biochemical tests, stipulate the need, nature and dose of vitamin D/calcium supplements, and encourage early discharge. This was further validated over seven months to assess compliance, episodes of hyper and/or hypocalcaemia after discharge, readmissions and need for treatment changes. Further revisions were made (revision 2) and implemented. Results The temporary and long-term postoperative hypocalcaemia rates were 29.1% and 3.2% respectively. Repeat calcium measurements on the first day altered management in only 1.4% of cases. The revised protocol was adhered to in 90% of cases. One patient had hypocalcaemia (due to non-compliance) and one had hypercalcaemia. Revision 2 involved reducing the dose of calcium. Conclusions This is a good example of a unit protocol for post-thyroidectomy hypocalcaemia being developed and modified on the basis of the literature and local experience. Day 1 PTH and calcium levels determine the need for treatment and frequency of follow-up visits, facilitate early discharge, reduce risk of over and/or undertreatment, and are good indicators of permanent hypocalcaemia.

The duty of care 2: risk assessment and risk management.

PubMed

Fullbrook, Suzanne

In this second article in the series, the issue of risk assessment and management, in the context of a recent case, is revisited. The case in question is outlined in the previous article 'Compliance with directives and protocols'.

13C/12C AND D/H ISOTOPIC ANALYSIS OF ATMOSPHERIC METHANE

EPA Science Inventory

The magnitudes of the sources and sinks of greenhouse gases like methane need to be better understood to accurately measure changes in emissions and ensure international compliance with global environmental policies such as the Kyoto Protocol.

Development of active learning modules in pharmacology for small group teaching.

PubMed

Tripathi, Raakhi K; Sarkate, Pankaj V; Jalgaonkar, Sharmila V; Rege, Nirmala N

2015-01-01

Current teaching in pharmacology in undergraduate medical curriculum in India is primarily drug centered and stresses imparting factual knowledge rather than on pharmacotherapeutic skills. These skills would be better developed through active learning by the students. Hence modules that will encourage active learning were developed and compared with traditional methods within the Seth GS Medical College, Mumbai. After Institutional Review Board approval, 90 second year undergraduate medical students who consented were randomized into six sub-groups, each with 15 students. Pre-test was administered. The three sub-groups were taught a topic using active learning modules (active learning groups), which included problems on case scenarios, critical appraisal of prescriptions and drug identification. The remaining three sub-groups were taught the same topic in a conventional tutorial mode (tutorial learning groups). There was crossover for the second topic. Performance was assessed using post-test. Questionnaires with Likert-scaled items were used to assess feedback on teaching technique, student interaction and group dynamics. The active and tutorial learning groups differed significantly in their post-test scores (11.3 ± 1.9 and 15.9 ± 2.7, respectively, P < 0.05). In students' feedback, 69/90 students had perceived the active learning session as interactive (vs. 37/90 students in tutorial group) and enhanced their understanding vs. 56/90 in tutorial group), aroused intellectual curiosity (47/90 students of active learning group vs. 30/90 in tutorial group) and provoked self-learning (41/90 active learning group vs. 14/90 in tutorial group). Sixty-four students in the active learning group felt that questioning each other helped in understanding the topic, which was the experience of 25/90 students in tutorial group. Nevertheless, students (55/90) preferred tutorial mode of learning to help them score better in their examinations. In this study, students preferred an active learning environment, though to pass examinations, they preferred the tutorial mode of teaching. Further efforts are required to explore the effects on learning of introducing similar modules for other topics.

Clinical outcomes and mortality before and after implementation of a pediatric sepsis protocol in a limited resource setting: A retrospective cohort study in Bangladesh.

PubMed

Kortz, Teresa Bleakly; Axelrod, David M; Chisti, Mohammod J; Kache, Saraswati

2017-01-01

Pediatric sepsis has a high mortality rate in limited resource settings. Sepsis protocols have been shown to be a cost-effective strategy to improve morbidity and mortality in a variety of populations and settings. At Dhaka Hospital in Bangladesh, mortality from pediatric sepsis in high-risk children previously approached 60%, which prompted the implementation of an evidenced-based protocol in 2010. The clinical effectiveness of this protocol had not been measured. We hypothesized that implementation of a pediatric sepsis protocol improved clinical outcomes, including reducing mortality and length of hospital stay. This was a retrospective cohort study of children 1-59 months old with a diagnosis of sepsis, severe sepsis or septic shock admitted to Dhaka Hospital from 10/25/2009-10/25/2011. The primary outcome was inpatient mortality pre- and post-protocol implementation. Secondary outcomes included fluid overload, heart failure, respiratory insufficiency, length of hospital stay, and protocol compliance, as measured by antibiotic and fluid bolus administration within 60 minutes of hospital presentation. 404 patients were identified by a key-word search of the electronic medical record; 328 patients with a primary diagnosis of sepsis, severe sepsis, or septic shock were included (143 pre- and185 post-protocol) in the analysis. Pre- and post-protocol mortality were similar and not statistically significant (32.17% vs. 34.59%, p = 0.72). The adjusted odds ratio (AOR) for post-protocol mortality was 1.55 (95% CI, 0.88-2.71). The odds for developing fluid overload were significantly higher post-protocol (AOR 3.45, 95% CI, 2.04-5.85), as were the odds of developing heart failure (AOR 4.52, 95% CI, 1.43-14.29) and having a longer median length of stay (AOR 1.81, 95% CI 1.10-2.96). There was no statistically significant difference in respiratory insufficiency (pre- 65.7% vs. post- 70.3%, p = 0.4) or antibiotic administration between the cohorts (pre- 16.08% vs. post- 12.43%, p = 0.42). Implementation of a pediatric sepsis protocol did not improve all-cause mortality or length of stay and may have been associated with increased fluid overload and heart failure during the study period in a large, non-governmental hospital in Bangladesh. Similar rates of early antibiotic administration may indicate poor protocol compliance. Though evidenced-based protocols are a potential cost-effective strategy to improve outcomes, future studies should focus on optimal implementation of context-relevant sepsis protocols in limited resource settings.

Successful implementation of a neonatal pain and sedation protocol at 2 NICUs.

PubMed

Deindl, Philipp; Unterasinger, Lukas; Kappler, Gregor; Werther, Tobias; Czaba, Christine; Giordano, Vito; Frantal, Sophie; Berger, Angelika; Pollak, Arnold; Olischar, Monika

2013-07-01

To evaluate the implementation of a neonatal pain and sedation protocol at 2 ICUs. The intervention started with the evaluation of local practice, problems, and staff satisfaction. We then developed and implemented the Vienna Protocol for Neonatal Pain and Sedation. The protocol included well-defined strategies for both nonpharmacologic and pharmacologic interventions based on regular assessment of a translated version of the Neonatal Pain Agitation and Sedation Scale and titration of analgesic and sedative therapy according to aim scores. Health care staff was trained in the assessment by using a video-based tutorial and bedside teaching. In addition, we performed reevaluation, retraining, and random quality checks. Frequency and quality of assessments, pharmacologic therapy, duration of mechanical ventilation, and outcome were compared between baseline (12 months before implementation) and 12 months after implementation. Cumulative median (interquartile range) opiate dose (baseline dose of 1.4 [0.5-5.9] mg/kg versus intervention group dose of 2.7 [0.4-57] mg/kg morphine equivalents; P = .002), pharmacologic interventions per episode of continuous sedation/analgesia (4 [2-10] vs 6 [2-13]; P = .005), and overall staff satisfaction (physicians: 31% vs 89%; P < .001; nurses: 17% vs 55%; P < .001) increased after implementation. Time on mechanical ventilation, length of stay at the ICU, and adverse outcomes were similar before and after implementation. Implementation of a neonatal pain and sedation protocol at 2 ICUs resulted in an increase in opiate prescription, pharmacologic interventions, and staff satisfaction without affecting time on mechanical ventilation, length of intensive care stay, and adverse outcomes.

Evaluation of an interactive, case-based review session in teaching medical microbiology.

PubMed

Blewett, Earl L; Kisamore, Jennifer L

2009-08-27

Oklahoma State University-Center for Health Sciences (OSU-CHS) has replaced its microbiology wet laboratory with a variety of tutorials including a case-based interactive session called Microbial Jeopardy!. The question remains whether the time spent by students and faculty in the interactive case-based tutorial is worthwhile? This study was designed to address this question by analyzing both student performance data and assessing students' perceptions regarding the tutorial. Both quantitative and qualitative data were used in the current study. Part One of the study involved assessing student performance using archival records of seven case-based exam questions used in the 2004, 2005, 2006, and 2007 OSU-CHS Medical Microbiology course. Two sample t-tests for proportions were used to test for significant differences related to tutorial usage. Part Two used both quantitative and qualitative means to assess student's perceptions of the Microbial Jeopardy! session. First, a retrospective survey was administered to students who were enrolled in Medical Microbiology in 2006 or 2007. Second, responses to open-ended items from the 2008 course evaluations were reviewed for comments regarding the Microbial Jeopardy! session. Both student performance and student perception data support continued use of the tutorials. Quantitative and qualitative data converge to suggest that students like and learn from the interactive, case-based session. The case-based tutorial appears to improve student performance on case-based exam questions. Additionally, students perceived the tutorial as helpful in preparing for exam questions and reviewing the course material. The time commitment for use of the case-based tutorial appears to be justified.

Evaluation of an interactive, case-based review session in teaching medical microbiology

PubMed Central

Blewett, Earl L; Kisamore, Jennifer L

2009-01-01

Background Oklahoma State University-Center for Health Sciences (OSU-CHS) has replaced its microbiology wet laboratory with a variety of tutorials including a case-based interactive session called Microbial Jeopardy!. The question remains whether the time spent by students and faculty in the interactive case-based tutorial is worthwhile? This study was designed to address this question by analyzing both student performance data and assessing students' perceptions regarding the tutorial. Methods Both quantitative and qualitative data were used in the current study. Part One of the study involved assessing student performance using archival records of seven case-based exam questions used in the 2004, 2005, 2006, and 2007 OSU-CHS Medical Microbiology course. Two sample t-tests for proportions were used to test for significant differences related to tutorial usage. Part Two used both quantitative and qualitative means to assess student's perceptions of the Microbial Jeopardy! session. First, a retrospective survey was administered to students who were enrolled in Medical Microbiology in 2006 or 2007. Second, responses to open-ended items from the 2008 course evaluations were reviewed for comments regarding the Microbial Jeopardy! session. Results Both student performance and student perception data support continued use of the tutorials. Quantitative and qualitative data converge to suggest that students like and learn from the interactive, case-based session. Conclusion The case-based tutorial appears to improve student performance on case-based exam questions. Additionally, students perceived the tutorial as helpful in preparing for exam questions and reviewing the course material. The time commitment for use of the case-based tutorial appears to be justified. PMID:19712473

Functional Seating for School-Age Children with Cerebral Palsy: An Evidence-Based Tutorial

ERIC Educational Resources Information Center

Costigan, F. Aileen; Light, Janice

2011-01-01

Purpose: This tutorial is designed to teach speech-language pathologists (SLPs) best practices to support functional seating of children with cerebral palsy (CP) in the classroom and in school-based therapy sessions. This tutorial teaches SLPs to (a) recognize the positive effects of seating intervention, (b) identify the characteristics of…

Reflections on the Evolving Triad Tutorial in a Postgraduate Art Studio

ERIC Educational Resources Information Center

Tripp, Sarah

2016-01-01

This article traces the evolution of the "triad tutorial". The triad model, predominantly used in the training of counsellors and psychotherapists, was originally combined with the art school tutorial model in the context of the Edinburgh Sculpture Workshop to enhance critical discourse between studio holders. The resulting hybrid, the…

Psychosemiotics and Libraries: Identifying Signways in Library Informational Guides, Games, and Tutorials

ERIC Educational Resources Information Center

Laster, Barbara; Blummer, Barbara; Kenton, Jeffrey M.

2010-01-01

Tutorials and digital learning objects provide librarians a quick, concise mechanism for delivering information and training on a wide range of library topics. The semiotic theory promoted by Charles Sanders Peirce (Wiener, 1958) and Howard Smith (2005) contains implications for enhancing the effectiveness of library tutorials through the…

Developing a Language Learning Rationale for African Language Tutorials.

ERIC Educational Resources Information Center

Dwyer, David

1999-01-01

Presents a rationale for the supervised tutorial component of the African language program at Michigan State University. The supervised tutorial is one of two modes through which African languages are offered at Michigan State University. The other, which is teacher led, is offered for high enrollment languages such as Arabic, Swahili, and Hausa.…

Graduate Student Research Instruction: Testing an Interactive Web-Based Library Tutorial for a Health Sciences Database

ERIC Educational Resources Information Center

Lechner, David L.

2005-01-01

Interactive electronic tutorials offer flexibility in delivering library instruction; however, questions linger regarding their effectiveness compared to traditional librarian-led classroom lectures. This study examines a tutorial introducing health science students to the Cumulative Index to Nursing and Allied Health Literature database. Half the…

Rating the Accessibility of Library Tutorials from Leading Research Universities

ERIC Educational Resources Information Center

Clossen, Amanda; Proces, Paul

2017-01-01

Video and Web-based tutorials created by libraries from 71 public universities designated by the Carnegie Classification as having the Highest Research Activity (R1) were reviewed for accessibility and usability by disabled people. The results of this review indicate that a large portion of library tutorial content meets neither the minimum legal…

Entre Nous: A Tutorial Approach to the Teaching of Business French.

ERIC Educational Resources Information Center

Chaisson, Arthur P.

Suffolk University (Massachusetts) has developed a degree program in international marketing in French and Spanish that links curricula in the economics department and the department of humanities and modern languages. Language tutorials are mandatory for students in the international economics major. The tutorials are taught by native French- and…

Effects of Using a Web-Based Individualized Education Program Decision Making Tutorial

ERIC Educational Resources Information Center

Shriner, James G.; Carty, Susan J.; Rose, Chad A.; Shogren, Karrie A.; Kim, Myungjin; Trach, John S.

2013-01-01

This study explored the effects of a web-based decision support system ("Tutorial") for writing standards-based Individualized Education Programs (IEPs). A total of 35 teachers and 154 students participated across two academic years. Participants were assigned to one of three intervention groups based on level of "Tutorial"…

Effects of Using a Web-Based Individualized Education Program Decision-Making Tutorial

ERIC Educational Resources Information Center

Shriner, James G.; Carty, Susan J.; Rose, Chad A.; Shogren, Karrie A.; Kim, Myungjin; Trach, John S.

2013-01-01

This study explored the effects of a web-based decision support system ("Tutorial") for writing standards-based Individualized Education Programs (IEPs). A total of 35 teachers and 154 students participated across two academic years. Participants were assigned to one of three intervention groups based on level of "Tutorial"…

Using Web-based Tutorials To Enhance Library Instruction.

ERIC Educational Resources Information Center

Kocour, Bruce G.

2000-01-01

Describes the development of a Web site for library instruction at Carson-Newman College (TN) and its integration into English composition courses. Describes the use of a virtual tour, a tutorial on database searching, tutorials on specific databases, and library guides to specific disciplines to create an effective mechanism for active learning.…

Demonstration-Based Training (DBT) in the Design of a Video Tutorial for Software Training

ERIC Educational Resources Information Center

van der Meij, Hans; van der Meij, Jan

2016-01-01

This study investigates the design and effectiveness of a video tutorial for software training. In accordance with demonstration-based training, the tutorial consisted of a series of task demonstrations, with instructional features added to enhance learning. An experiment is reported in which a demonstration-only control condition was compared…

Using a Sampling Strategy to Address Psychometric Challenges in Tutorial-Based Assessments

ERIC Educational Resources Information Center

Eva, Kevin W.; Solomon, Patty; Neville, Alan J.; Ladouceur, Michael; Kaufman, Karyn; Walsh, Allyn; Norman, Geoffrey R.

2007-01-01

Introduction: Tutorial-based assessment, despite providing a good match with the philosophy adopted by educational programmes that emphasize small group learning, remains one of the greatest challenges for educators working in this context. The current study was performed in an attempt to assess the psychometric characteristics of tutorial-based…

Approximate Degrees of Similarity between a User's Knowledge and the Tutorial Systems' Knowledge Base

ERIC Educational Resources Information Center

Mogharreban, Namdar

2004-01-01

A typical tutorial system functions by means of interaction between four components: the expert knowledge base component, the inference engine component, the learner's knowledge component and the user interface component. In typical tutorial systems the interaction and the sequence of presentation as well as the mode of evaluation are…

Dealing with Conflicts on Knowledge in Tutorial Groups

ERIC Educational Resources Information Center

Aarnio, Matti; Lindblom-Ylanne, Sari; Nieminen, Juha; Pyorala, Eeva

2013-01-01

The aim of our study was to gain understanding of different types of conflicts on knowledge in the discussions of problem-based learning tutorial groups, and how such conflicts are dealt with. We examined first-year medical and dental students' (N = 33) conflicts on knowledge in four videotaped reporting phase tutorials. A coding scheme was…

An Easy Recipe for Video Tutorials

ERIC Educational Resources Information Center

Thompson, Douglas Earl

2013-01-01

This article presents a recipe for making attractive, informative tutorials that can be sent to students and parents via e-mail or posted on a school website. Although tutorials are often included with software, many are either too complex or too rudimentary to directly address music educators’ unique needs. The recipe focuses on the following…

Examining Factors that Affect Performance in Complex Simulation Environments

ERIC Educational Resources Information Center

Mayrath, Michael Charles

2009-01-01

This study examined the effects of manipulating the modality (text-only, voice-only, voice+text) of a tutorial and restriction (restricted vs. unrestricted) of a simulation's interface on retention and transfer of tutorial content. The tutorial prepared novice students to use Packet Tracer, a simulation developed by Cisco that teaches network…

Creating Electronic Tutorials: On Your Mark, Get Set, Go!

ERIC Educational Resources Information Center

Plumb, Tawnya K.

2010-01-01

As library patrons move online, librarians must move instructional content online to join them. One means of educating library users is to meet them on their computers with electronic tutorials. Electronic tutorials may be used for various instructional tasks such as teaching users about the basic elements of a library catalog, pointing out the…

Evaluating Best Practices for Video Tutorials: A Case Study

ERIC Educational Resources Information Center

Weeks, Thomas; Putnam Davis, Jennifer

2017-01-01

This article will explore one library's experience creating best practices for the creation of video tutorials. First, a literature review establishes the best practices other creators have used. Then, the authors apply these best practices to the creation of their first video tutorial. Finally, they evaluate the usefulness of each practice in…

Indigenous Tutorial Assistance Scheme. Tertiary Tuition and Beyond: Transitioning with Strengths and Promoting Opportunities

ERIC Educational Resources Information Center

Wilks, Judith; Fleeton, Ellen Radnidge; Wilson, Katie

2017-01-01

The Indigenous Tutorial Assistance Scheme-Tertiary Tuition (ITAS-TT) has provided Australian government funding for one-to-one and group tutorial study support for Aboriginal and Torres Strait Islander students attending Australian universities since 1989. It has been a central plank supporting Indigenous university students in their studies.…

An Online Tutorial vs. Pre-Recorded Lecture for Reducing Incidents of Plagiarism

ERIC Educational Resources Information Center

Henslee, Amber M.; Goldsmith, Jacob; Stone, Nancy J.; Krueger, Merilee

2015-01-01

The current study compared an online academic integrity tutorial modified from Belter & du Pre (2009) to a pre-recorded online academic integrity lecture in reducing incidents of plagiarism among undergraduate students at a science and technology university. Participants were randomized to complete either the tutorial or the pre-recorded…

Effects of implementation of problem-based learning tutorials on fifth-year pharmacy students and future issues.

PubMed

Sato, Atsuko; Morone, Mieko; Azuma, Yutaka

2011-01-01

At Tohoku Pharmaceutical University, problem-based learning (PBL) tutorials were incorporated into "prescription analysis" and "case analysis" for fifth-year students in 2010 with the following objectives: ① application and confirmation of acquired knowledge and skills, and acquisition of ② communication ability, ③ presentation ability, ④ cooperativeness through groupwork, and ⑤ information collecting ability. In the present study, we conducted a questionnaire survey on a total of 158 fifth-year students in order to investigate the educational benefits of PBL tutorials. The results showed that the above five objectives of PBL tutorials were being achieved, and confirmed the educational benefits expected of PBL tutorials. In contrast, it was found to be necessary to improve the contents of scenarios and lectures, time allocation regarding schedules, the learning environment, the role of tutors, and other matters. In order to maximize the educational benefits of PBL tutorials, it will be necessary in the future to continue to conduct surveys on students and make improvements to the curriculum based on survey results.

The effectiveness of web-based, multimedia tutorials for teaching methods of human body composition analysis.

PubMed

Buzzell, Paul R; Chamberlain, Valerie M; Pintauro, Stephen J

2002-12-01

This study examined the effectiveness of a series of Web-based, multimedia tutorials on methods of human body composition analysis. Tutorials were developed around four body composition topics: hydrodensitometry (underwater weighing), dual-energy X-ray absorptiometry, bioelectrical impedance analysis, and total body electrical conductivity. Thirty-two students enrolled in the course were randomly assigned to learn the material through either the Web-based tutorials only ("Computer"), a traditional lecture format ("Lecture"), or lectures supplemented with Web-based tutorials ("Both"). All students were administered a validated pretest before randomization and an identical posttest at the completion of the course. The reliability of the test was 0.84. The mean score changes from pretest to posttest were not significantly different among the groups (65.4 plus minus 17.31, 78.82 plus minus 21.50, and 76 plus minus 21.22 for the Computer, Both, and Lecture groups, respectively). Additionally, a Likert-type assessment found equally positive attitudes toward all three formats. The results indicate that Web-based tutorials are as effective as the traditional lecture format for teaching these topics.

The duty of care 1: compliance with directives and protocols.

PubMed

Fullbrook, Suzanne

The first three articles in this series will concentrate on the issue the legal 'duty of care'--the terms of which we as nurses have to understand. The first article examines a recent decision of the High Court of England and Wales that discusses and examines directives and protocols. I have begun with a discussion of the fact that a duty of care not only extends from healthcare providers to patients (clients) but also from employers to employees, and between healthcare providers themselves.

MetaboTools: A comprehensive toolbox for analysis of genome-scale metabolic models

DOE PAGES

Aurich, Maike K.; Fleming, Ronan M. T.; Thiele, Ines

2016-08-03

Metabolomic data sets provide a direct read-out of cellular phenotypes and are increasingly generated to study biological questions. Previous work, by us and others, revealed the potential of analyzing extracellular metabolomic data in the context of the metabolic model using constraint-based modeling. With the MetaboTools, we make our methods available to the broader scientific community. The MetaboTools consist of a protocol, a toolbox, and tutorials of two use cases. The protocol describes, in a step-wise manner, the workflow of data integration, and computational analysis. The MetaboTools comprise the Matlab code required to complete the workflow described in the protocol. Tutorialsmore » explain the computational steps for integration of two different data sets and demonstrate a comprehensive set of methods for the computational analysis of metabolic models and stratification thereof into different phenotypes. The presented workflow supports integrative analysis of multiple omics data sets. Importantly, all analysis tools can be applied to metabolic models without performing the entire workflow. Taken together, the MetaboTools constitute a comprehensive guide to the intra-model analysis of extracellular metabolomic data from microbial, plant, or human cells. In conclusion, this computational modeling resource offers a broad set of computational analysis tools for a wide biomedical and non-biomedical research community.« less

Investigating and improving introductory physics students’ understanding of electric flux

NASA Astrophysics Data System (ADS)

Li, Jing; Singh, Chandralekha

2018-07-01

A solid grasp of the concept of electric flux is an important pre-requisite for appropriate use of Gauss’s law in solving electrostatics problems. As part of a broader investigation focusing on improving understanding of electrostatics concepts, we investigated the conceptual difficulties of college students in a traditionally taught calculus-based introductory physics course with the concept of electric flux and then the research on student difficulties was used as a guide in the development and evaluation of a research-validated tutorial which strives to help students learn this concept better. During the investigation of difficulties and the design and validation of the guided inquiry-based tutorial, college students in a calculus-based introductory physics course were given written questions to probe the common conceptual difficulties with the electric flux related concepts, and we also interviewed a subset of those students to get an in-depth account of the reasons behind the conceptual difficulties. The guided inquiry-based learning sequences in the tutorial were also iterated several times with instructors who regularly teach these courses. Here we discuss the common student difficulties with the electric flux found in our investigations, and the development and validation of a tutorial that strives to improve student understanding. We analyse how students performed on the pre-test (administered before the electric flux tutorial but after traditional instruction in the electric flux concepts) and on the post-test (administered after students in the tutorial group had engaged with the electric flux related tutorial). The performance of students in all sections of the course was comparable on the pre-test regardless of who taught that section. However, on the post-test, the performance of those in the sections of the course in which students engaged with the tutorial is significantly better that the section in which the tutorial was not used.

A Practical Tutorial on Modified Condition/Decision Coverage

NASA Technical Reports Server (NTRS)

Hayhurst, Kelly J.; Veerhusen, Dan S.; Chilenski, John J.; Rierson, Leanna K.

2001-01-01

This tutorial provides a practical approach to assessing modified condition/decision coverage (MC/DC) for aviation software products that must comply with regulatory guidance for DO-178B level A software. The tutorial's approach to MC/DC is a 5-step process that allows a certification authority or verification analyst to evaluate MC/DC claims without the aid of a coverage tool. In addition to the MC/DC approach, the tutorial addresses factors to consider in selecting and qualifying a structural coverage analysis tool, tips for reviewing life cycle data related to MC/DC, and pitfalls common to structural coverage analysis.

78 FR 27408 - Revised OIG's Provider Self-Disclosure Protocol

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-10

... programs (as defined in section 1128B(f) of the Social Security Act (the Act), 42 U.S.C. 1320a-7b(f)). The... on its Web site: http://oig.hhs.gov/compliance/self-disclosure-info/index.asp . FOR FURTHER...

Personal Exposure Monitoring Wearing Protocol Compliance: An Initial Assessment of Quantitative Measurements

EPA Science Inventory

Personal exposure sampling provides the most accurate and representative assessment of exposure to a pollutant, but only if measures are implemented to minimize exposure misclassification and reduce confounders that may cause misinterpretation of the collected data. Poor complian...

Using the Internet to teach parents and children about constipation and encopresis.

PubMed

Borowitz, S M; Ritterband, L

2001-01-01

Since 1995, we have maintained a tutorial about chronic childhood constipation and encopresis on our web site. The tutorial is directed at parents and older children and includes a feedback form comprised of six multiple-choice questions and a free-text comment field. Between 1 January 1998 and 30 April 2000, we received 1,142 completed feedback forms. The vast majority of respondents identified themselves as parents or guardians of a child with constipation or encopresis. All respondents felt the tutorial was clear and easy to understand. 98% of respondents felt the tutorial helped them understand why children develop constipation and/or encopresis and 91% of respondents felt the tutorial made them better able to take care of a child suffering from constipation and/or encopresis. More than 99% of respondents felt this type of tutorial was a good way to teach people about health problems. 74% of respondents sent us comments about the tutorial. Most often, the comments expressed thanks for having this information available in clear and understandable language, however a significant number of people inquired about a particular child's difficulties or asked a general question not clearly pertaining to a particular child. The results of this study indicate that many people are searching the Internet for information concerning childhood encopresis and that the World Wide Web can provide families with useful information about this common paediatric problem.

Assessment of the treatment protocol described in the guidelines for Trichophyton tonsurans infection.

PubMed

Shiraki, Yumi; Hiruma, Masataro; Sugita, Takashi; Ikeda, Shigaku

2008-01-01

Infection with the anthropophilic fungus Trichophyton tonsurans has spread among members of combat sports clubs and has become a serious public health problem in Japan and other countries. Infection usually provokes only a weak inflammatory response, and treatment compliance tends to be poor. To evaluate the hairbrush method and the treatment protocol described in the guidelines for T. tonsurans infection. The study subjects were 69 individuals with positive hairbrush culture from among 327 members of 12 judo clubs participating in the survey. (a) Subjects with no more than 4 colonies by the hairbrush method were treated with miconazole nitrate shampoo. (b) Subjects with 5 or more colonies were treated with (1) itraconazole at a dose of 100 mg/day for 6 weeks or at a dose of 400 mg/day for 1 week, or (2) terbinafine at a dose of 125 mg/day for 6 weeks or at a dose of 500 mg/day for 1 week. Treatment efficacy was monitored by the hairbrush method at 1.5 and 3 months after treatment. Of the 46 subjects with 5 or more colonies isolated by the hairbrush method, 32 (69.6%) took itraconazole or terbinafine in compliance with their treatment schedules and were negative for T. tonsurans after treatment. Of the 23 subjects with 4 or fewer colonies, 15 (65.2%) were negative for T. tonsurans after treatment with miconazole nitrate shampoo. The treatment protocol seems promising, but poor compliance is a problem with the oral treatment regimens. The shampoo therapy is only partially effective, with 35% of subjects remaining positive for T. tonsurans after this therapy. In order to eradicate this disease, we have renewed the guidelines for T. tonsurans infection.

Radiotherapy quality assurance report from children's oncology group AHOD0031

PubMed Central

Dharmarajan, Kavita V.; Friedman, Debra L.; FitzGerald, T.J.; McCarten, Kathleen M.; Constine, Louis S.; Chen, Lu; Kessel, Sandy K.; Iandoli, Matt; Laurie, Fran; Schwartz, Cindy L.; Wolden, Suzanne L.

2016-01-01

Purpose A phase III trial assessing response-based therapy in intermediate-risk Hodgkin lymphoma, mandated real-time central review of involved field radiotherapy and imaging records by a centralized review center to maximize protocol compliance. We report the impact of centralized radiotherapy review upon protocol compliance. Methods Review of simulation films, port films, and dosimetry records was required pre-treatment and after treatment completion. Records were reviewed by study-affiliated or review center-affiliated radiation oncologists. A 6–10% deviation from protocol-specified dose was scored as “minor”; >10% was “major”. A volume deviation was scored as “minor” if margins were less than specified, or “major” if fields transected disease-bearing areas. Interventional review and final compliance review scores were assigned to each radiotherapy case and compared. Results Of 1712 patients enrolled, 1173 underwent IFRT at 256 institutions in 7 countries. An interventional review was performed in 88% and a final review in 98%. Overall, minor and major deviations were found in 12% and 6%, respectively. Among the cases for which ≥ 1 pre-IFRT modification was requested by QARC and subsequently made by the treating institution, 100% were made compliant on final review. In contrast, among the cases for which ≥ 1 modification was requested but not made by the treating institution, 10% were deemed compliant on final review. Conclusion In a large trial with complex treatment pathways and heterogeneous radiotherapy fields, central review was performed in a large percentage of cases pre-IFRT and identified frequent potential deviations in a timely manner. When suggested modifications were performed by the institutions, deviations were almost eliminated. PMID:25670539

The MaizeGDB Genome Browser Tutorial: One example of database outreach to biologists via video

USDA-ARS?s Scientific Manuscript database

Video tutorials are an effective way for researchers to quickly learn how to use online tools offered by biological databases. At the Maize Genetics and Genomics Database (MaizeGDB), we have developed a number of video tutorials that aim to demonstrate how to use various tools as well as to explici...

Using Active-Learning Pedagogy to Develop Essay-Writing Skills in Introductory Political Theory Tutorials

ERIC Educational Resources Information Center

Murphy, Michael P. A.

2017-01-01

Building on prior research into active learning pedagogy in political science, I discuss the development of a new active learning strategy called the "thesis-building carousel," designed for use in political theory tutorials. This use of active learning pedagogy in a graduate student-led political theory tutorial represents the overlap…

Assessing the Effectiveness of Web-Based Tutorials Using Pre-and Post-Test Measurements

ERIC Educational Resources Information Center

Guy, Retta Sweat; Lownes-Jackson, Millicent

2012-01-01

Computer technology in general and the Internet in particular have facilitated as well as motivated the development of Web-based tutorials (MacKinnon & Williams, 2006). The current research study describes a pedagogical approach that exploits the use of self-paced, Web-based tutorials for assisting students with reviewing grammar and mechanics…

The Effectiveness of Tutorials in Behavioural Sciences for Nurses: An Action Learning Project.

ERIC Educational Resources Information Center

French, Peter; Callaghan, Patrick; Dudley-Brown, Sharon; Holroyd, Eleanor; Sellick, Ken

1998-01-01

Nursing students in behavioral science were divided as follows: 40 in 4 groups with tutorials and 20 in control groups (13 of whom did not have tutorials). Two of the four experimental groups showed significant changes in learning approach. Recommendations included reducing the number of assignments, integrating theory and practice, and having an…

"How Did You Find the Argument?": Conflicting Discourses in a Master's Dissertation Tutorial

ERIC Educational Resources Information Center

Salter-Dvorak, Hania

2017-01-01

This paper discusses feedback for developing L2 writing. It presents data from a serendipitous audio-recording of one L2 master's student's tutorial with her dissertation supervisor at a UK university, which is extracted from a 13-month linguistic ethnography. Following "academic literacies" scholars, I view the tutorial as a…

Proposing a Web-Based Tutorial System to Teach Malay Language Braille Code to the Sighted

ERIC Educational Resources Information Center

Wah, Lee Lay; Keong, Foo Kok

2010-01-01

The "e-KodBrailleBM Tutorial System" is a web-based tutorial system which is specially designed to teach, facilitate and support the learning of Malay Language Braille Code to individuals who are sighted. The targeted group includes special education teachers, pre-service teachers, and parents. Learning Braille code involves memorisation…

Student Perceptions of Learning in a Web-Based Tutorial.

ERIC Educational Resources Information Center

Brescia, William; McAuley, Sean

This case study used both quantitative and qualitative methods to investigate students' perceptions of learning using a Web-based tutorial. Students participated in a Web-based tutorial to learn basic HTML as part of a graduate-level Web design course. Four of five students agreed to participate in the survey and interviews. After completing the…

Staying on Top of Your Game and Scoring Big with Adobe Presenter Multimedia Tutorials

ERIC Educational Resources Information Center

Koury, Regina; Francis, Marcia J.; Gray, Catherine J.; Jardine, Spencer J.; Guo, Ruiling

2010-01-01

In order to reach distance students in times of financial uncertainty, librarians must be creative. While much has been written about Camtasia, Captivate and Jing tutorial software, Adobe Presenter, a Microsoft PowerPoint plug-in, has not been discussed. This article describes how our library team created multimedia tutorial projects at Idaho…

Relationships between Language Background, Secondary School Scores, Tutorial Group Processes, and Students' Academic Achievement in PBL: Testing a Causal Model

ERIC Educational Resources Information Center

Singaram, Veena S.; van der Vleuten, Cees P. M; Muijtjens, Arno M. M.; Dolmans, Diana H. J. M

2012-01-01

Little is known about the influence of language background in problem-based learning (PBL) tutorial groups on group processes and students' academic achievement. This study investigated the relationship between language background, secondary school score, tutorial group processes, and students' academic achievement in PBL. A validated tutorial…

Exploring the Effectiveness of a Measurement Error Tutorial in Helping Teachers Understand Score Report Results

ERIC Educational Resources Information Center

Zapata-Rivera, Diego; Zwick, Rebecca; Vezzu, Margaret

2016-01-01

The goal of this study was to explore the effectiveness of a short web-based tutorial in helping teachers to better understand the portrayal of measurement error in test score reports. The short video tutorial included both verbal and graphical representations of measurement error. Results showed a significant difference in comprehension scores…

Optimization of protocol design: a path to efficient, lower cost clinical trial execution

PubMed Central

Malikova, Marina A

2016-01-01

Managing clinical trials requires strategic planning and efficient execution. In order to achieve a timely delivery of important clinical trials’ outcomes, it is useful to establish standardized trial management guidelines and develop robust scoring methodology for evaluation of study protocol complexity. This review will explore the challenges clinical teams face in developing protocols to ensure that the right patients are enrolled and the right data are collected to demonstrate that a drug is safe and efficacious, while managing study costs and study complexity based on proposed comprehensive scoring model. Key factors to consider when developing protocols and techniques to minimize complexity will be discussed. A methodology to identify processes at planning phase, approaches to increase fiscal return and mitigate fiscal compliance risk for clinical trials will be addressed. PMID:28031939

Myopia and international educational performance.

PubMed

Morgan, Ian G; Rose, Kathryn A

2013-05-01

To analyse the relationship between myopia, educational performance and engagement in after-school tutorial classes. Educational performance data and data on engagement in after-school tutorial classes were taken from the results of the Organisation for Economic Cooperation and Development (OECD) Program in Secondary Assessment (PISA) reports for 2009, which tested educational outcomes in representative samples of 15 year-old school children from 65 jurisdictions. High prevalence of myopia (>70%) and low prevalence of myopia (<40%) locations were identified by systematic literature search. Six locations with a high prevalence of myopia were identified from among the participants in PISA 2009 - Shanghai-China, Hong Kong-China, Taiwan, Singapore, Japan and South Korea. All were ranked in the top quartile on educational performance. Other participants in the top educational performance quartile were identified as locations with a low prevalence of myopia, including Australia and Finland. The locations with a high prevalence of myopia combined high educational performance and high engagement in after-school tutorials, whereas the locations with a low prevalence of myopia combined high educational performance with little engagement in tutorials. These results show that it is possible to achieve high educational outcomes without extensive engagement in after-school tutorials, and that the combination of high educational outcomes with extensive use of tutorials is associated with high prevalence rates of myopia. We suggest that extensive use of after-school tutorials may be a marker of educational environments which impose high educational loads. Further quantification of educational loads to include after- school educational activities, such as homework, tutorials and other after-school classes, as well as formal school classes, is desirable. Policy initiatives to decrease these loads may contribute to the prevention of myopia, perhaps, at least in part, by enabling children to spend more time outdoors. Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

The effects of a computer skill training programme adopting social comparison and self-efficacy enhancement strategies on self-concept and skill outcome in trainees with physical disabilities.

PubMed

Tam, S F

2000-10-15

The aim of this controlled, quasi-experimental study was to evaluate the effects of both self-efficacy enhancement and social comparison training strategy on computer skills learning and self-concept outcome of trainees with physical disabilities. The self-efficacy enhancement group comprised 16 trainees, the tutorial training group comprised 15 trainees, and there were 25 subjects in the control group. Both the self-efficacy enhancement group and the tutorial training group received a 15 week computer skills training course, including generic Chinese computer operation, Chinese word processing and Chinese desktop publishing skills. The self-efficacy enhancement group received training with tutorial instructions that incorporated self-efficacy enhancement strategies and experienced self-enhancing social comparisons. The tutorial training group received behavioural learning-based tutorials only, and the control group did not receive any training. The following measurements were employed to evaluate the outcomes: the Self-Concept Questionnaire for the Physically Disabled Hong Kong Chinese (SCQPD), the computer self-efficacy rating scale and the computer performance rating scale. The self-efficacy enhancement group showed significantly better computer skills learning outcome, total self-concept, and social self-concept than the tutorial training group. The self-efficacy enhancement group did not show significant changes in their computer self-efficacy: however, the tutorial training group showed a significant lowering of their computer self-efficacy. The training strategy that incorporated self-efficacy enhancement and positive social comparison experiences maintained the computer self-efficacy of trainees with physical disabilities. This strategy was more effective in improving the learning outcome (p = 0.01) and self-concept (p = 0.05) of the trainees than the conventional tutorial-based training strategy.

Guided Versus Unguided Learning: Which One To Choose?

NASA Astrophysics Data System (ADS)

Speck, Angela; Ruzhitskaya, L.

2011-01-01

We present the results of a study that measures the effectiveness of two types of computer-based tutorials for teaching the concept of stellar parallax to non-science major students in a college-level introductory astronomy course. A number of previous studies on the use of computer technology in education suggested that a method of inquiry-based learning rooted in a discovery method must prevail over direct instruction. At the same time, a number of researchers raised a concern that the discovery approach especially in combination with interactive computer-based environments may present students with additional distractions and thus hinder the educational value of such interactions. This study was set to test the both approaches and to identify the preferable method for engaging students in active and meaningful learning. The study consisted of guided and unguided computer-based tutorials and used a control group in which students were engaged in paper-based exercises. The guided tutorial was an adaptive tutorial that was designed to respond to students’ input and to provide them with the next step: an exercise, an animated visualization, or a set of additional questions. The unguided tutorial allowed students to explore any part of the tutorial in any order. Both tutorials consisted of four parts and reviewed simple geometry, trigonometric parallax, angular sizes in astronomy, resolution and conversion of units, and had a concluding chapter on finding distance to a star. The control group used Lecture-Tutorials (Prather, et al) to learn angular sizes and stellar parallax. The efficacy of each treatment was validated through a 14-question pretest and two posttests to evaluate and contrast students’ immediate recall and their long-term knowledge and corroborated by a number of interviews with selected students. We present our preliminary results based on analyzed work of over 200 participants.

The Implementation of Blended Learning Using Android-Based Tutorial Video in Computer Programming Course II

NASA Astrophysics Data System (ADS)

Huda, C.; Hudha, M. N.; Ain, N.; Nandiyanto, A. B. D.; Abdullah, A. G.; Widiaty, I.

2018-01-01

Computer programming course is theoretical. Sufficient practice is necessary to facilitate conceptual understanding and encouraging creativity in designing computer programs/animation. The development of tutorial video in an Android-based blended learning is needed for students’ guide. Using Android-based instructional material, students can independently learn anywhere and anytime. The tutorial video can facilitate students’ understanding about concepts, materials, and procedures of programming/animation making in detail. This study employed a Research and Development method adapting Thiagarajan’s 4D model. The developed Android-based instructional material and tutorial video were validated by experts in instructional media and experts in physics education. The expert validation results showed that the Android-based material was comprehensive and very feasible. The tutorial video was deemed feasible as it received average score of 92.9%. It was also revealed that students’ conceptual understanding, skills, and creativity in designing computer program/animation improved significantly.

Learning in the tutorial group: a balance between individual freedom and institutional control.

PubMed

McAllister, Anita; Aanstoot, Janna; Hammarström, Inger Lundeborg; Samuelsson, Christina; Johannesson, Eva; Sandström, Karin; Berglind, Ulrika

2014-01-01

The study investigates factors in problem-based learning tutorial groups which promote or inhibit learning. The informants were tutors and students from speech-language pathology and physiotherapy programmes. Semi-structured focus-group interviews and individual interviews were used. Results revealed three themes: Responsibility. Time and Support. Under responsibility, the delicate balance between individual and institutional responsibility and control was shown. Time included short and long-term perspectives on learning. Under support, supporting documents, activities and personnel resources were mentioned. In summary, an increased control by the program and tutors decreases student's motivation to assume responsibility for learning. Support in tutorial groups needs to adapt to student progression and to be well aligned to tutorial work to have the intended effect. A lifelong learning perspective may help students develop a meta-awareness regarding learning that could make tutorial work more meaningful.

An Innovative Multimedia Approach to Laboratory Safety

NASA Technical Reports Server (NTRS)

Anderson, M. B.; Constant, K. P.

1996-01-01

A new approach for teaching safe laboratory practices has been developed for materials science laboratories at Iowa State university. Students are required to complete a computerized safety tutorial and pass an exam before working in the laboratory. The safety tutorial includes sections on chemical, electrical, radiation, and high temperature safety. The tutorial makes use of a variety of interactions, including 'assembly' interactions where a student is asked to drag and drop items with the mouse (either labels or pictures) to an appropriate place on the screen (sometimes in a specific order). This is extremely useful for demonstrating safe lab practices and disaster scenarios. Built into the software is a record tracking scheme so that a professor can access a file that records which students have completed the tutorial and their scores on the exam. This paper will describe the development and assessment of the safety tutorials.

School-Based Methylphenidate Placebo Protocols: Methodological and Practical Issues.

ERIC Educational Resources Information Center

Hyman, Irwin A.; Wojtowicz, Alexandra; Lee, Kee Duk; Haffner, Mary Elizabeth; Fiorello, Catherine A.; And Others

1998-01-01

Focuses on methodological issues involved in choosing instruments to monitor behavior, once a comprehensive evaluation has suggested trials on Ritalin. Case examples illustrate problems of teacher compliance in filling out measures, supplying adequate placebos, and obtaining physical cooperation. Emerging school-based methodologies are discussed…

40 CFR 63.783 - Standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... handling and transfer of VOHAP-containing materials to and from containers, tanks, vats, drums, and piping systems is conducted in a manner that minimizes spills. (2) All containers, tanks, vats, drums, and piping... monitoring protocol that includes operating parameter values to be monitored for compliance and an...

40 CFR 63.783 - Standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... handling and transfer of VOHAP-containing materials to and from containers, tanks, vats, drums, and piping systems is conducted in a manner that minimizes spills. (2) All containers, tanks, vats, drums, and piping... monitoring protocol that includes operating parameter values to be monitored for compliance and an...

Impact of a monitored program of care on incidence of ventilator-associated pneumonia: results of a longterm performance-improvement project.

PubMed

Weireter, Leonard J; Collins, J N; Britt, Rebecca C; Reed, Scott F; Novosel, T J; Britt, L D

2009-05-01

Ventilator-associated pneumonia (VAP) remains a major source of morbidity, mortality, and expense in the ICU despite therapies directed against it. A retrospective review of a prospectively developed performance-improvement project monitoring the incidence of VAP in two adjacent ICUs was conducted. In response to an excessive VAP rate, weekly multidisciplinary team meetings were instituted to review data, develop care protocols, and modify care routines. Protocol compliance was monitored daily and feedback provided weekly to the care teams. VAP rates were determined by the institutional Infection Control Committee and reviewed monthly with the ICU multidisciplinary team. Duration of the investigational period was 10 years. A standardized ventilator-weaning protocol was instituted with confirmed 95% use. Additional modifications of care, such as patient positioning, use of specific endotracheal tubes to minimize aspiration of supraglottic secretions, an oral-care regimen, and aggressive antibiotic stewardship were standardized, with a compliance rate >90%. VAP rates dropped from 12.8 per 1,000 patient-days in 1998 to 1.1 in 2007 in the burn trauma ICU and from 21.2 to <1 in the neurotrauma ICU in the same time frame. Also, mean ventilator length of stay decreased from 6 days to 4.2 and from 5.8 days to 4.75 simultaneously in the respective ICUs. Such performance improvement has been sustained since implementation of the program. A systematic, monitored program of standardized care protocols can markedly reduce VAP rate in the ICU.

Performance factors of mobile rich media job aids for community health workers

PubMed Central

Florez-Arango, Jose F; Dunn, Kim; Zhang, Jiajie

2011-01-01

Objective To study and analyze the possible benefits on performance of community health workers using point-of-care clinical guidelines implemented as interactive rich media job aids on small-format mobile platforms. Design A crossover study with one intervention (rich media job aids) and one control (traditional job aids), two periods, with 50 community health workers, each subject solving a total 15 standardized cases per period per period (30 cases in total per subject). Measurements Error rate per case and task, protocol compliance. Results A total of 1394 cases were evaluated. Intervention reduces errors by an average of 33.15% (p=0.001) and increases protocol compliance 30.18% (p<0.001). Limitations Medical cases were presented on human patient simulators in a laboratory setting, not on real patients. Conclusion These results indicate encouraging prospects for mHealth technologies in general, and the use of rich media clinical guidelines on cell phones in particular, for the improvement of community health worker performance in developing countries. PMID:21292702

Mobile phone-based clinical guidance for rural health providers in India.

PubMed

Gautham, Meenakshi; Iyengar, M Sriram; Johnson, Craig W

2015-12-01

There are few tried and tested mobile technology applications to enhance and standardize the quality of health care by frontline rural health providers in low-resource settings. We developed a media-rich, mobile phone-based clinical guidance system for management of fevers, diarrhoeas and respiratory problems by rural health providers. Using a randomized control design, we field tested this application with 16 rural health providers and 128 patients at two rural/tribal sites in Tamil Nadu, Southern India. Protocol compliance for both groups, phone usability, acceptability and patient feedback for the experimental group were evaluated. Linear mixed-model analyses showed statistically significant improvements in protocol compliance in the experimental group. Usability and acceptability among patients and rural health providers were very high. Our results indicate that mobile phone-based, media-rich procedural guidance applications have significant potential for achieving consistently standardized quality of care by diverse frontline rural health providers, with patient acceptance. © The Author(s) 2014.

Performance factors of mobile rich media job aids for community health workers.

PubMed

Florez-Arango, Jose F; Iyengar, M Sriram; Dunn, Kim; Zhang, Jiajie

2011-01-01

To study and analyze the possible benefits on performance of community health workers using point-of-care clinical guidelines implemented as interactive rich media job aids on small-format mobile platforms. A crossover study with one intervention (rich media job aids) and one control (traditional job aids), two periods, with 50 community health workers, each subject solving a total 15 standardized cases per period per period (30 cases in total per subject). Error rate per case and task, protocol compliance. A total of 1394 cases were evaluated. Intervention reduces errors by an average of 33.15% (p = 0.001) and increases protocol compliance 30.18% (p < 0.001). Limitations Medical cases were presented on human patient simulators in a laboratory setting, not on real patients. These results indicate encouraging prospects for mHealth technologies in general, and the use of rich media clinical guidelines on cell phones in particular, for the improvement of community health worker performance in developing countries.

Implementation and Evaluation of the Debate-Style Tutorial Study in a Third-Year Dental Curriculum in Japan

ERIC Educational Resources Information Center

Shingaki, Ryuji; Kamioka, Hiroshi; Irie, Masao; Nishimura, Fusanori

2006-01-01

We introduced a debate-style tutorial exercise into the third-year tutorial classes with the purpose of developing the students' logic, broadening their vision and encouraging them to express their opinions in public, before an audience. The issues for debate included medical (dental) and non-medical topics. Two separate debate exercises were…

Learning with On-Line and Hardcopy Tutorials. A Final Report. CDC Technical Report No. 32.

ERIC Educational Resources Information Center

Duffy, T. M.; And Others

Intended to aid in the design of computer systems that promote efficient learning and performance, this study compared the effects of using hard copy and online format tutorials on the learning activities of 48 undergraduate students in either design or engineering. The tutorials, which provided instruction on the use of the equipment and basic…

Comparison of Fixed-Item and Response-Sensitive Versions of an Online Tutorial

ERIC Educational Resources Information Center

Grant, Lyle K.; Courtoreille, Marni

2007-01-01

This study is a comparison of 2 versions of an Internet-based tutorial that teaches the behavior-analysis concept of positive reinforcement. A fixed-item group of students studied a version of the tutorial that included 14 interactive examples and nonexamples of the concept. A response-sensitive group of students studied a different version of the…

A Design of Computer Aided Instructions (CAI) for Undirected Graphs in the Discrete Math Tutorial (DMT). Part 1.

DTIC Science & Technology

1990-06-01

The objective of this thesis research is to create a tutorial for teaching aspects of undirected graphs in discrete math . It is one of the submodules...of the Discrete Math Tutorial (DMT), which is a Computer Aided Instructional (CAI) tool for teaching discrete math to the Naval Academy and the

A Design of Computer Aided Instructions (CAI) for Undirected Graphs in the Discrete Math Tutorial (DMT). Part 2

DTIC Science & Technology

1990-06-01

The objective of this thesis research is to create a tutorial for teaching aspects of undirected graphs in discrete math . It is one of the submodules...of the Discrete Math Tutorial (DMT), which is a Computer Aided Instructional (CAI) tool for teaching discrete math to the Naval Academy and the

Using Visual Assessments and Tutorials to Teach Solar System Concepts in Introductory Astronomy

ERIC Educational Resources Information Center

LoPresto, Michael C.

2010-01-01

Visual assessments and tutorials are instruments that rely on student construction and/or examination of pictures and/or diagrams rather than multiple choice and/or short answer questions. Being a very visual subject, astronomy lends itself to assessments and tutorials of this type. What follows is a report on the results of the use of visual…

How Levels of Interactivity in Tutorials Affect Students' Learning of Modeling Transportation Problems in a Spreadsheet

ERIC Educational Resources Information Center

Seal, Kala Chand; Przasnyski, Zbigniew H.; Leon, Linda A.

2010-01-01

Do students learn to model OR/MS problems better by using computer-based interactive tutorials and, if so, does increased interactivity in the tutorials lead to better learning? In order to determine the effect of different levels of interactivity on student learning, we used screen capture technology to design interactive support materials for…

Approximating Literacy Practices in Tutorials: What Is Learned and What Matters for Teacher Preparation

ERIC Educational Resources Information Center

Hoffman, James V.; Wetzel, Melissa Mosley; Peterson, Katie

2016-01-01

In this study, we examined the learning of preservice teachers associated with the features of a literacy tutorial experience. Our qualitative study focused on the close inspection of the experiences of 7 focus cases out of the 19 preservice teachers enrolled in our program across a one-semester tutorial experience. Through our research we…

The Purpose of Tutorial Groups: Social Influence and the Group as Means and Objective

ERIC Educational Resources Information Center

Rosander, Michael; Chiriac, Eva Hammar

2016-01-01

The aim of this study was to investigate how first-year students view the purpose of tutorial groups in problem-based learning. In all, 147 students from 24 groups participated, providing 399 statements. Data were analysed using thematic analysis. The results showed a focus on both learning and social influence. Learning involved the tutorial as…

Comparing the Effectiveness of a Supplemental Online Tutorial to Traditional Instruction with Nutritional Science Students

ERIC Educational Resources Information Center

Zubas, Patrice; Heiss, Cindy; Pedersen, Mary

2006-01-01

The purpose of this study was to ascertain if an online computer tutorial on diabetes mellitus, supplemented to traditional classroom lecture, is an effective tool in the education of nutrition students. Students completing a web-based tutorial as a supplement to classroom lecture displayed greater improvement in pre- vs. post-test scores compared…

Emergency Telemedicine: Achieving and Maintaining Compliance with the Emergency Medical Treatment and Labor Act.

PubMed

Rockwell, Kimberly Lovett; Gilroy, Alexis

2018-03-12

Telemedicine is a growing and important platform for medical delivery in the emergency department. Emergency telemedicine outlays often confront and conflict with important federal healthcare regulations. Because of this, academic medical centers, critical access hospitals, and other providers interested in implementing emergency telemedicine have often delayed or forgone such services due to reasonable fears of falling out of compliance with regulatory restrictions imposed by the Emergency Medical Treatment and Labor Act ("EMTALA"). This article offers insights into methods for implementing emergency telemedicine services while maintaining EMTALA compliance. Critical analysis of EMTALA and its attendant regulations. The primary means of ensuring EMTALA compliance while implementing emergency telemedicine programs include incorporating critical clinical details into the services contracts and implementing robust written policies that anticipate division of labor issues, the need for backup coverage, triaging, patient transfer protocols, and credentialing issues. With adequate up-front due diligence and meaningful contracting, hospitals and telemedicine providers can avoid common EMTALA liability pitfalls.

Village doctor-assisted case management of rural patients with schizophrenia: protocol for a cluster randomized control trial.

PubMed

Gong, Wenjie; Xu, Dong; Zhou, Liang; Brown, Henry Shelton; Smith, Kirk L; Xiao, Shuiyuan

2014-01-16

Strict compliance with prescribed medication is the key to reducing relapses in schizophrenia. As villagers in China lack regular access to psychiatrists to supervise compliance, we propose to train village 'doctors' (i.e., villagers with basic medical training and currently operating in villages across China delivering basic clinical and preventive care) to manage rural patients with schizophrenia with respect to compliance and monitoring symptoms. We hypothesize that with the necessary training and proper oversight, village doctors can significantly improve drug compliance of villagers with schizophrenia. We will conduct a cluster randomized controlled trial in 40 villages in Liuyang, Hunan Province, China, home to approximately 400 patients with schizophrenia. Half of the villages will be randomized into the treatment group (village doctor, or VD model) wherein village doctors who have received training in a schizophrenia case management protocol will manage case records, supervise drug taking, educate patients and families on schizophrenia and its treatment, and monitor patients for signs of relapse in order to arrange prompt referral. The other 20 villages will be assigned to the control group (case as usual, or CAU model) wherein patients will be visited by psychiatrists every two months and receive free antipsychotic medications under an on-going government program, Project 686. These control patients will receive no other management or follow up from health workers. A baseline survey will be conducted before the intervention to gather data on patient's socio-economic status, drug compliance history, and clinical and health outcome measures. Data will be re-collected 6 and 12 months into the intervention. A difference-in-difference regression model will be used to detect the program effect on drug compliance and other outcome measures. A cost-effectiveness analysis will also be conducted to compare the value of the VD model to that of the CAU group. Lack of specialists is a common problem in resource-scarce areas in China and other developing countries. The results of this experiment will provide high level evidence on the role of health workers with relatively limited medical training in managing severe psychiatric disease and other chronic conditions in developing countries. ChiCTR-TRC-13003263.

A multifaceted approach to education, observation, and feedback in a successful hand hygiene campaign.

PubMed

Doron, Shira I; Kifuji, Kayoko; Hynes, Brooke Tyson; Dunlop, Dan; Lemon, Tricia; Hansjosten, Karen; Cheung, Teresa; Curley, Barbara; Snydman, David R; Fairchild, David G

2011-01-01

Prevention of health care-associated infections starts with scrupulous hand hygiene (HH). Improving HH compliance is a major target for the World Health Organization Patient Safety Challenge and is one of The Joint Commission's National Patient Safety Goals. Yet, adherence to HH protocols is generally poor for health care professionals, despite interventions designed to improve compliance. At Tufts Medical Center (Boston), HH compliance rates were consistently low despite the presence of a traditional HH campaign that used communication and education. A comprehensive program incorporated strong commitment by hospital leadership-who were actively involved in responsibilities previously only performed by infection preventionists and quality and patient safety staff-dedication of financial resources, including securing a grant; collaborating with a private advertising firm in a marketing campaign; and employing a multifaceted approach to education, observation, and feedback. This campaign resulted in a rapid and sustained improvement in HH compliance: Compared with the mean HH compliance rate for the six months before the campaign (72%), postcampaign HH compliance (mean = 94%) was significantly greater (p < .0001). Factors contributing to the success of the campaign included the development of the marketing campaign to fit this academic medical center's particular culture, strong support from the medical center leadership, a multifaceted educational approach, and monthly feedback on HH compliance. A comprehensive campaign resulted in rapid and sustained improvement in HH compliance at an academic medical center after traditional communication and education strategies failed to improve HH performance.

Same-day colonoscopy preparation with Senna alkaloids and bisacodyl tablets: A pilot study

PubMed Central

Yenidogan, Erdinc; Okan, Ismail; Kayaoglu, Huseyin Ayhan; Akgul, Gokhan Giray; Sansal, Mufit; Tali, Servet; Ozsoy, Zeki; Sahin, Mustafa

2014-01-01

AIM: To evaluate the efficacy of same-day bowel preparation with Senna alkaloids combined with bisacodyl tablets in routine colonoscopy procedures. METHODS: Between March and June 2013, a same-day bowel preparation was implemented in our endoscopy unit. The preparation consisted of a semi-liquid, fiber-free diet one day prior to the procedure, with two bisacodyl tablets after lunch and dinner, and 250 mL of Senna alkaloid with 1.5 L of drinking water at 6 am the day of the procedure. The quality control parameters of colonoscopy were evaluated and implemented according to the guidelines of the American Society for Gastrointestinal Endoscopy. The pre-procedure, during-procedure and post-procedure patient data were collected and analyzed: (1) pre-procedure (age, gender, comorbid diseases, colonoscopy indications, complete lack of compliance with the bowel preparation protocol); (2) during-procedure (sedation dose, duration of colonoscopy, withdrawal time, cecal intubation rate, polyp detection rate, Boston Bowel Preparation Scores and presence of foam and clear liquid); and (3) post-procedure (visual analogue scale score, pain during the procedure, patient satisfaction and premature withdrawal due to the insufficient bowel preparation). RESULTS: A total of 75 patients were included in this study with a mean age of 54.64 ± 13.29 years; 53.3% (40/75) were female and 46.7% (35/75) were male. A complete lack of compliance with the bowel preparation protocol was seen in 6.7% of patients (5/75). The mean total duration of colonoscopy was 16.12 ± 6.51 min, and the mean withdrawal time was 8.89 ± 4.07 min. The cecal intubation rate was 93.8% (61/64) and the polyp detection rate was 40% (30/75). The mean Boston Bowel Preparation Score was 7.38 ± 1.81, with the following distribution: right colon, 2.34 ± 0.89; transverse colon, 2.52 ± 0.67; left colon, 2.52 ± 0.63. The mean visual analogue scale score was 4.59 ± 1.57. Due to insufficient bowel preparation, seven patients (7/75; 9.3%) were asked to repeat the procedure. Of these, five patients had poor or modest compliance with the protocol, and two patients reported constipation. Premature withdrawal due to insufficient bowel preparation was 2.7% (2/75). The overall satisfaction with the protocol was 86.7% (65/75), with patients reporting they would prefer the same protocol in a repeat procedure. CONCLUSION: The same-day administration of Senna alkaloids appears to be a safe and effective bowel cleansing protocol for colonoscopy procedures. PMID:25386088

Same-day colonoscopy preparation with Senna alkaloids and bisacodyl tablets: a pilot study.

PubMed

Yenidogan, Erdinc; Okan, Ismail; Kayaoglu, Huseyin Ayhan; Akgul, Gokhan Giray; Sansal, Mufit; Tali, Servet; Ozsoy, Zeki; Sahin, Mustafa

2014-11-07

To evaluate the efficacy of same-day bowel preparation with Senna alkaloids combined with bisacodyl tablets in routine colonoscopy procedures. Between March and June 2013, a same-day bowel preparation was implemented in our endoscopy unit. The preparation consisted of a semi-liquid, fiber-free diet one day prior to the procedure, with two bisacodyl tablets after lunch and dinner, and 250 mL of Senna alkaloid with 1.5 L of drinking water at 6 am the day of the procedure. The quality control parameters of colonoscopy were evaluated and implemented according to the guidelines of the American Society for Gastrointestinal Endoscopy. The pre-procedure, during-procedure and post-procedure patient data were collected and analyzed: (1) pre-procedure (age, gender, comorbid diseases, colonoscopy indications, complete lack of compliance with the bowel preparation protocol); (2) during-procedure (sedation dose, duration of colonoscopy, withdrawal time, cecal intubation rate, polyp detection rate, Boston Bowel Preparation Scores and presence of foam and clear liquid); and (3) post-procedure (visual analogue scale score, pain during the procedure, patient satisfaction and premature withdrawal due to the insufficient bowel preparation). A total of 75 patients were included in this study with a mean age of 54.64 ± 13.29 years; 53.3% (40/75) were female and 46.7% (35/75) were male. A complete lack of compliance with the bowel preparation protocol was seen in 6.7% of patients (5/75). The mean total duration of colonoscopy was 16.12 ± 6.51 min, and the mean withdrawal time was 8.89 ± 4.07 min. The cecal intubation rate was 93.8% (61/64) and the polyp detection rate was 40% (30/75). The mean Boston Bowel Preparation Score was 7.38 ± 1.81, with the following distribution: right colon, 2.34 ± 0.89; transverse colon, 2.52 ± 0.67; left colon, 2.52 ± 0.63. The mean visual analogue scale score was 4.59 ± 1.57. Due to insufficient bowel preparation, seven patients (7/75; 9.3%) were asked to repeat the procedure. Of these, five patients had poor or modest compliance with the protocol, and two patients reported constipation. Premature withdrawal due to insufficient bowel preparation was 2.7% (2/75). The overall satisfaction with the protocol was 86.7% (65/75), with patients reporting they would prefer the same protocol in a repeat procedure. The same-day administration of Senna alkaloids appears to be a safe and effective bowel cleansing protocol for colonoscopy procedures.

Implementation of a written protocol for management of central venous access devices: a theoretical and practical education, including bedside examinations.

PubMed

Ahlin, Catharina; Klang-Söderkvist, Birgitta; Brundin, Seija; Hellström, Birgitta; Pettersson, Karin; Johansson, Eva

2006-01-01

The objectives of this study were to evaluate registered nurses' (RN) compliance with a local clinical central venous access device (CVAD) protocol after completing an educational program and to determine RNs' perception of the program. Seventy-five RNs working in hematology participated in the educational part of the program. Sixty-eight RNs were examined while changing CVAD dressings or placing a Huber needle into a port on actual patients. Sixty percent of the RNs passed the examination and reported that the program increased their knowledge. The results indicated that the educational program could be recommended for use when implementing a new clinical protocol.

Electroporation of mRNA as Universal Technology Platform to Transfect a Variety of Primary Cells with Antigens and Functional Proteins.

PubMed

Gerer, Kerstin F; Hoyer, Stefanie; Dörrie, Jan; Schaft, Niels

2017-01-01

Electroporation (EP) of mRNA into human cells is a broadly applicable method to transiently express proteins of choice in a variety of different cell types. We have spent more than a decade to optimize and adapt this method, first for antigen-loading of dendritic cells (DCs), and subsequently for T cells, B cells, bulk PBMCs, and several cell lines. In this regard, antigens were introduced, processed, and presented in context of MHC class I and II. Next to that, functional proteins like adhesion receptors, T-cell receptors (TCRs), chimeric antigen receptors (CARs), constitutively active signal transducers, and others were successfully expressed. We have also established this protocol under full GMP compliance as part of a manufacturing license to produce mRNA-electroporated DCs for therapeutic vaccination in clinical trials. Therefore, we here want to share our universal mRNA electroporation protocol and the experience we have gathered with this method. The advantages of the transfection method presented here are: (1) easy adaptation to different cell types, (2) scalability from 10 6 to approximately 10 8 cells per shot, (3) high transfection efficiency (80-99 %), (4) homogenous protein expression, (5) GMP compliance if the EP is performed in a class A clean room, and (6) no transgene integration into the genome. The provided protocol involves: Opti-MEM® as EP medium, a square-wave pulse with 500 V, and 4 mm cuvettes. To adapt the protocol to differently sized cells, simply the pulse time is altered. Next to the basic protocol, we also provide an extensive list of hints and tricks, which in our opinion are of great value for everyone who intends to use this transfection technique.

The medico-legal prerequisite for initiating quarantine and isolation practices in public health emergency management in hospitals in Ghana.

PubMed

Norman, I D; Aikins, M; Binka, F N

2011-12-01

Hospitals and other health facilities in Ghana do not appear to have standardized practices for quarantine and isolation in public health emergency management. This paper reviews the legislative framework governing the medico-legal prerequisites for initiating quarantine and isolation procedures as articulated in the Infectious Disease Act (Cap 78) 1908 amended, 1935, the Quarantine Act (Cap 77) 1915 amended, 1938, the Emergency Powers Act of 1994, (Act 472), and the National Disaster Management Act, 1996, (Act 517) in consonance with the 1992 Constitution of Ghana. The findings provide that (1) The legislative framework outlines systematic standards and protocols to be followed in the committal of person or persons in quarantine and isolation during public health emergencies. (2) These standards and protocols consider as imperative, the creation of standardized national templates for the initiation of quarantine and isolation measures. (3) The non-compliance of the standards and protocols renders vulnerable medical facilities and hospitals with their personnel to the threat of medical malpractice suits and breach of professional ethics. This paper provides suggestions to hospital administrators and medical personnel of how to develop administrative templates in compliance with the law in managing public health emergencies. It also provides examples of such templates for possible adoption by hospitals and other health administrators.

Toward the modelling of safety violations in healthcare systems.

PubMed

Catchpole, Ken

2013-09-01

When frontline staff do not adhere to policies, protocols, or checklists, managers often regard these violations as indicating poor practice or even negligence. More often than not, however, these policy and protocol violations reflect the efforts of well intentioned professionals to carry out their work efficiently in the face of systems poorly designed to meet the diverse demands of patient care. Thus, non-compliance with institutional policies and protocols often signals a systems problem, rather than a people problem, and can be influenced among other things by training, competing goals, context, process, location, case complexity, individual beliefs, the direct or indirect influence of others, job pressure, flexibility, rule definition, and clinician-centred design. Three candidates are considered for developing a model of safety behaviour and decision making. The dynamic safety model helps to understand the relationship between systems designs and human performance. The theory of planned behaviour suggests that intention is a function of attitudes, social norms and perceived behavioural control. The naturalistic decision making paradigm posits that decisions are based on a wider view of multiple patients, expertise, systems complexity, behavioural intention, individual beliefs and current understanding of the system. Understanding and predicting behavioural safety decisions could help us to encourage compliance to current processes and to design better interventions.

ALT-114 and ALT-118 Alternative Approaches to NIST ...

EPA Pesticide Factsheets

In 2016, US EPA approved two separate alternatives (ALT 114 and ALT 118) for the preparation and certification of Hydrogen Chloride (HCl) and Mercury (Hg) cylinder reference gas standards that can serve as EPA Protocol gases where EPA Protocol are required, but unavailable. The alternatives were necessary due to the unavailability of NIST reference materials (SRM, NTRM, CRM or RGM) or VSL reference materials (VSL PRM or VSL CRM), reference materials identified in EPA’s Green Book as necessary to establish the traceability of EPA protocol gases. ALT 114 and ALT 118 provides a pathway for gas vendors to prepare and certify traceable gas cylinder standards for use in certifying Hg and HCl CEMS. In this presentation, EPA will describe the mechanics and requirements of the performance-based approach, provide an update on the availability of these gas standards and also discuss the potential for producing and certifying gas standards for other compounds using this approach. This presentation discusses the importance of NIST-traceable reference gases relative to regulatory source compliance emissions monitoring. Specifically this presentation discusses 2 new approaches for making necessary reference gases available in the absence of NIST reference materials. Moreover, these approaches provide an alternative approach to rapidly make available new reference gases for additional HAPS regulatory compliance emissions measurement and monitoring.

Effectiveness of Tutorials for Introductory Physics in Argentinean high schools

NASA Astrophysics Data System (ADS)

Benegas, J.; Flores, J. Sirur

2014-06-01

This longitudinal study reports the results of a replication of Tutorials in Introductory Physics in high schools of a Latin-American country. The main objective of this study was to examine the suitability of Tutorials for local science education reform. Conceptual learning of simple resistive electric circuits was determined by the application of the single-response multiple-choice test "Determining and Interpreting Resistive Electric Circuits Concepts Test" (DIRECT) to high school classes taught with Tutorials and traditional instruction. The study included state and privately run schools of different socioeconomic profiles, without formal laboratory space and equipment, in classes of mixed-gender and female-only students, taught by novice and experienced instructors. Results systematically show that student learning is significantly higher in the Tutorials classes compared with traditional teaching for all of the studied conditions. The results also show that long-term learning (one year after instruction) in the Tutorials classes is highly satisfactory, very similar to the performance of the samples of college students used to develop the test DIRECT. On the contrary, students following traditional instruction returned one year after instruction to the poor performance (<20%) shown before instruction, a result compatible with the very low level of conceptual knowledge of basic physics recently determined by a systematic study of first-year students attending seven universities in Spain and four Latin-American countries. Some replication and adaptation problems and difficulties of this experience are noted, as well as recommendations for successful use of Tutorials in high schools of similar educational systems.

Investigating and improving introductory physics students’ understanding of symmetry and Gauss’s law

NASA Astrophysics Data System (ADS)

Li, Jing; Singh, Chandralekha

2018-01-01

We discuss an investigation of student difficulties with symmetry and Gauss’s law and how the research on students’ difficulties was used as a guide to develop a tutorial related to these topics to help students in the calculus-based introductory physics courses learn these concepts. During the development of the tutorial, we interviewed students individually at various stages of development and administered written tests in the free-response and multiple-choice formats on these concepts to learn about common student difficulties. We also obtained feedback from physics instructors who teach introductory physics courses regularly in which these concepts were covered. The students in several ‘equivalent’ sections worked on the tutorial after traditional lecture-based instruction. We discuss the performance of students on the written pre-test (administered after lecture-based instruction in relevant concepts) and post-test given after students worked on the tutorial. We find that on the pre-test, all sections of the course performed comparably regardless of the instructor. Also, on average, student performance on the post-test after working on the tutorial is significantly better than on the pre-test after lecture-based instruction. We also compare the post-test performance of introductory students in sections of the course in which the tutorial was used versus not used and find that sections in which students engaged with the tutorial outperformed those in which students did not engage with it.

Effect of Tutorial Giving on The Topic of Special Theory of Relativity in Modern Physics Course Towards Students’ Problem-Solving Ability

NASA Astrophysics Data System (ADS)

Hartatiek; Yudyanto; Haryoto, Dwi

2017-05-01

A Special Theory of Relativity handbook has been successfully arranged to guide students tutorial activity in the Modern Physics course. The low of students’ problem-solving ability was overcome by giving the tutorial in addition to the lecture class. It was done due to the limited time in the class during the course to have students do some exercises for their problem-solving ability. The explicit problem-solving based tutorial handbook was written by emphasizing to this 5 problem-solving strategies: (1) focus on the problem, (2) picture the physical facts, (3) plan the solution, (4) solve the problem, and (5) check the result. This research and development (R&D) consisted of 3 main steps: (1) preliminary study, (2) draft I. product development, and (3) product validation. The developed draft product was validated by experts to measure the feasibility of the material and predict the effect of the tutorial giving by means of questionnaires with scale 1 to 4. The students problem-solving ability in Special Theory of Relativity showed very good qualification. It implied that the tutorial giving with the help of tutorial handbook increased students problem-solving ability. The empirical test revealed that the developed handbook was significantly affected in improving students’ mastery concept and problem-solving ability. Both students’ mastery concept and problem-solving ability were in middle category with gain of 0.31 and 0.41, respectively.

The Topology Prediction of Membrane Proteins: A Web-Based Tutorial.

PubMed

Kandemir-Cavas, Cagin; Cavas, Levent; Alyuruk, Hakan

2018-06-01

There is a great need for development of educational materials on the transfer of current bioinformatics knowledge to undergraduate students in bioscience departments. In this study, it is aimed to prepare an example in silico laboratory tutorial on the topology prediction of membrane proteins by bioinformatics tools. This laboratory tutorial is prepared for biochemistry lessons at bioscience departments (biology, chemistry, biochemistry, molecular biology and genetics, and faculty of medicine). The tutorial is intended for students who have not taken a bioinformatics course yet or already have taken a course as an introduction to bioinformatics. The tutorial is based on step-by-step explanations with illustrations. It can be applied under supervision of an instructor in the lessons, or it can be used as a self-study guide by students. In the tutorial, membrane-spanning regions and α-helices of membrane proteins were predicted by internet-based bioinformatics tools. According to the results achieved from internet-based bioinformatics tools, the algorithms and parameters used were effective on the accuracy of prediction. The importance of this laboratory tutorial lies on the facts that it provides an introduction to the bioinformatics and that it also demonstrates an in silico laboratory application to the students at natural sciences. The presented example education material is applicable easily at all departments that have internet connection. This study presents an alternative education material to the students in biochemistry laboratories in addition to classical laboratory experiments.

Compliance with occlusion therapy for childhood amblyopia.

PubMed

Wallace, Michael P; Stewart, Catherine E; Moseley, Merrick J; Stephens, David A; Fielder, Alistair R

2013-09-17

Explore compliance with occlusion treatment of amblyopia in the Monitored and Randomized Occlusion Treatment of Amblyopia Studies (MOTAS and ROTAS), using objective monitoring. Both studies had a three-phase protocol: initial assessment, refractive adaptation, and occlusion. In the occlusion phase, participants were instructed to dose for 6 hours/day (MOTAS) or randomized to 6 or 12 hour/day (ROTAS). Dose was monitored continuously using an occlusion dose monitor (ODM). One hundred and fifty-two patients (71 male, 81 female; 122 Caucasian, 30 non-Caucasian) of mean ± SD age 68 ± 18 months participated. Amblyopia was defined as an interocular acuity difference of at least 0.1 logMAR and was associated with anisometropia in 50, strabismus in 44, and both (mixed) in 58. Median duration of occlusion was 99 days (interquartile range 72 days). Mean compliance was 44%, mean proportion of days with no patch worn was 42%. Compliance was lower (39%) on weekends compared with weekdays (46%, P = 0.04), as was the likelihood of dosing at all (52% vs. 60%, P = 0.028). Compliance was lower when attendance was less frequent (P < 0.001) and with prolonged treatment duration (P < 0.001). Age, sex, amblyopia type, and severity were not associated with compliance. Mixture modeling suggested three subpopulations of patch day doses: less than 30 minutes; doses that achieve 30% to 80% compliance; and doses that achieve around 100% compliance. This study shows that compliance with patching treatment averages less than 50% and is influenced by several factors. A greater understanding of these influences should improve treatment outcome. (ClinicalTrials.gov number, NCT00274664).

Do cigarette health warning labels comply with requirements: A 14-country study.

PubMed

Cohen, Joanna E; Brown, Jennifer; Washington, Carmen; Welding, Kevin; Ferguson, Jacqueline; Smith, Katherine C

2016-12-01

The Framework Convention on Tobacco Control, a global health treaty ratified by over 175 countries, calls on countries to ensure that tobacco packages carry health warning labels (HWLs) describing the harmful effects of tobacco use. We assessed the extent of compliance with 14 countries' HWL requirements. Unique cigarette packs were purchased in 2013 using a systematic protocol in 12 distinct neighborhoods within three of the ten most populous cities in the 14 low- and middle-income countries with the greatest number (count) of smokers. HWL compliance codebooks were developed for each country based on the details of country-specific HWL requirements, with up to four common compliance indicators assessed for each country (location, size, label elements, text size). Packs (n=1859) were double coded for compliance. Compliance was examined by country and pack characteristics, including parent company and brand family. Overall, 72% of coded cigarette packs were compliant with all relevant compliance indicators, ranging from 17% in the Philippines to 94% in Mexico. Compliance was highest for location of the warning (ranging from 75%-100%) and lowest for warning size (ranging from 46%-99%). Compliance was higher for packs bought in high SES neighborhoods, and varied by parent company and brand family. This multi-country study found at least one pack in every country - and many packs in some countries - that were not compliant with key requirements for health warning labels in the country of purchase. Non-compliance may be exacerbating health disparities. Tobacco companies should be held accountable for complying with country HWL requirements. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Improving Ambulatory Saliva-Sampling Compliance in Pregnant Women: A Randomized Controlled Study

PubMed Central

Moeller, Julian; Lieb, Roselind; Meyer, Andrea H.; Loetscher, Katharina Quack; Krastel, Bettina; Meinlschmidt, Gunther

2014-01-01

Objective Noncompliance with scheduled ambulatory saliva sampling is common and has been associated with biased cortisol estimates in nonpregnant subjects. This study is the first to investigate in pregnant women strategies to improve ambulatory saliva-sampling compliance, and the association between sampling noncompliance and saliva cortisol estimates. Methods We instructed 64 pregnant women to collect eight scheduled saliva samples on two consecutive days each. Objective compliance with scheduled sampling times was assessed with a Medication Event Monitoring System and self-reported compliance with a paper-and-pencil diary. In a randomized controlled study, we estimated whether a disclosure intervention (informing women about objective compliance monitoring) and a reminder intervention (use of acoustical reminders) improved compliance. A mixed model analysis was used to estimate associations between women's objective compliance and their diurnal cortisol profiles, and between deviation from scheduled sampling and the cortisol concentration measured in the related sample. Results Self-reported compliance with a saliva-sampling protocol was 91%, and objective compliance was 70%. The disclosure intervention was associated with improved objective compliance (informed: 81%, noninformed: 60%), F(1,60)  = 17.64, p<0.001, but not the reminder intervention (reminders: 68%, without reminders: 72%), F(1,60)  = 0.78, p = 0.379. Furthermore, a woman's increased objective compliance was associated with a higher diurnal cortisol profile, F(2,64) = 8.22, p<0.001. Altered cortisol levels were observed in less objective compliant samples, F(1,705) = 7.38, p = 0.007, with delayed sampling associated with lower cortisol levels. Conclusions The results suggest that in pregnant women, objective noncompliance with scheduled ambulatory saliva sampling is common and is associated with biased cortisol estimates. To improve sampling compliance, results suggest informing women about objective compliance monitoring but discourage use of acoustical reminders. PMID:24465958

Immunization with a recombinant subunit OspA vaccine markedly impacts the rate of newly acquired Borrelia burgdorferi infections in client-owned dogs living in a coastal community in Maine, USA.

PubMed

Eschner, Andrew K; Mugnai, Kristen

2015-02-10

In North America, Borrelia burgdorferi is the causative bacterial agent of canine Lyme borreliosis and is transmitted following prolonged attachment and feeding of vector ticks, Ixodes scapularis or Ixodes pacificus. Its prevention is predicated upon tick-avoidance, effective on-animal tick control and effective immunization strategies. The purpose of this study is to characterize dogs that are newly seropositive for Borrelia burgdorferi infection in relation to compliant use of a recombinant OspA canine Lyme borreliosis vaccine. Specifically, Preventive Fractions (PF) and Risk Ratios (RR) associated with the degree of vaccine compliancy (complete versus incomplete) are determined. 6,202 dogs were tested over a five year period in a single veterinary hospital utilizing a non-adjuvanted, recombinant OspA vaccine according to a 0, 1, 6 month (then yearly) protocol. Rates of newly acquired "Lyme-positive" antibody test results were compared between protocol compliant and poorly compliant (incompletely and/or non-vaccinated) dogs. Over the five-year span, one percent (range 0.39 - 1.3) of protocol compliant vaccinated, previously antibody negative dogs became seropositive for infection. Approximately twenty-one percent (range 16.8 - 33.3) of incompletely vaccinated dogs became positive for infection-specific antibodies. The Preventative Fraction for testing positive for antibodies specific for infection with Borrelia burgdorferi in any given year based on optimal vaccine compliance was, on average, 95.3% (range 93.29 - 98.08). The Risk Ratio for becoming infected with Borrelia burgdorferi antibodies in any given year if vaccine non-compliant was 21.41 (range 14.9 - 52.1). There was a high statistically significant relationship (p = <0.0001) in the observed data in terms of vaccination protocol compliance and the probability of Borrelia burgdorferi infection in each of the five years under study. The recombinant outer surface protein A (rOspA) vaccine for dogs is highly effective in preventing new seropositive cases of Borrelia burgdoferi infection over a five-year period in dogs living in an endemic area. Dogs that were vaccine protocol-compliant were significantly less likely to become infected (as indirectly assessed by antibody) with the agent of canine Lyme borreliosis as measured by Preventive Fraction and Risk Ratio calculations.

Minor access control of Hong Kong under the Framework Convention on Tobacco Control.

PubMed

Kan, Ming-yue; Lau, Maggie

2010-05-01

Asia's tobacco control movement was strengthened owing to the need to fulfill the Framework Convention on Tobacco Control (FCTC). The present study aims to assess the compliance rates of tobacco retailers to the law forbidding the sales of tobacco to minors in Hong Kong before and after the growth of the tobacco control movement brought by the enactment of the newly amended tobacco control law with effect from 2007. The legislation was enacted to fulfill the FCTC. Two waves of territory-wide compliance checks conducted in 2006 and 2008 were compared. The compliance check was conducted using Standard Protocol. The overall compliance rate was still low though it increased from 18.9% in 2006 to 27.0% in 2008. The compliance rate of convenience stores and newspaper stands improved whereas the rate for restaurants, grocery stores and petrol stations worsened. Less tobacco retailing outlets displayed a specified warning sign required in 2008 (33.7%) comparing to 2006 (41.4%). The indoor smoking ban of the FCTC unintentionally changed the cigarette retailing landscape and finally improved the compliance rate. The case study also demonstrated that the Asia region still has much room for improvement in fulfilling the FCTC in term of effective implementation and enforcement. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Effectiveness of a new health care organization model in primary care for chronic cardiovascular disease patients based on a multifactorial intervention: the PROPRESE randomized controlled trial

PubMed Central

2013-01-01

Background To evaluate the effectiveness of a new multifactorial intervention to improve health care for chronic ischemic heart disease patients in primary care. The strategy has two components: a) organizational for the patient/professional relationship and b) training for professionals. Methods/design Experimental study. Randomized clinical trial. Follow-up period: one year. Study setting: primary care, multicenter (15 health centers). For the intervention group 15 health centers are selected from those participating in ESCARVAL study. Once the center agreed to participate patients are randomly selected from the total amount of patients with ischemic heart disease registered in the electronic health records. For the control group a random sample of patients with ischemic heart disease is selected from all 72 health centers electronic records. Intervention components: a) Organizational intervention on the patient/professional relationship. Centered on the Chronic Care Model, the Stanford Expert Patient Program and the Kaiser Permanente model: Teamwork, informed and active patient, decision making shared with the patient, recommendations based on clinical guidelines, single electronic medical history per patient that allows the use of indicators for risk monitoring and stratification. b) Formative strategy for professionals: 4 face-to-face training workshops (one every 3 months), monthly update clinical sessions, online tutorial by a cardiologist, availability through the intranet of the action protocol and related documents. Measurements: Blood pressure, blood glucose, HbA1c, lipid profile and smoking. Frequent health care visits. Number of hospitalizations related to vascular disease. Therapeutic compliance. Drug use. Discussion This study aims to evaluate the efficacy of a multifactorial intervention strategy involving patients with ischemic heart disease for the improvement of the degree of control of the cardiovascular risk factors and of the quality of life, number of visits, and number of hospitalizations. Trial registration NCT01826929 PMID:23915267

40 CFR 59.208 - Charcoal lighter material testing protocol.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the performance, design, and operation specifications of the prescribed equipment. A demonstration... Administrator prior to compliance testing, based on an evaluation of comparative performance specifications and... stack barbecue charcoal that is designed to be lit without the packaging, the same as in paragraph (h)(1...

40 CFR 59.208 - Charcoal lighter material testing protocol.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the performance, design, and operation specifications of the prescribed equipment. A demonstration... Administrator prior to compliance testing, based on an evaluation of comparative performance specifications and... stack barbecue charcoal that is designed to be lit without the packaging, the same as in paragraph (h)(1...

40 CFR 59.208 - Charcoal lighter material testing protocol.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the performance, design, and operation specifications of the prescribed equipment. A demonstration... Administrator prior to compliance testing, based on an evaluation of comparative performance specifications and... stack barbecue charcoal that is designed to be lit without the packaging, the same as in paragraph (h)(1...

33 CFR 151.23 - Inspection for compliance and enforcement.

Code of Federal Regulations, 2013 CFR

2013-07-01

... SECURITY (CONTINUED) POLLUTION VESSELS CARRYING OIL, NOXIOUS LIQUID SUBSTANCES, GARBAGE, MUNICIPAL OR COMMERCIAL WASTE, AND BALLAST WATER Implementation of MARPOL 73/78 and the Protocol on Environmental Protection to the Antarctic Treaty as it Pertains to Pollution from Ships Oil Pollution § 151.23 Inspection...

45 CFR 156.715 - Compliance reviews of QHP issuers in Federally-facilitated Exchanges.

Code of Federal Regulations, 2014 CFR

2014-10-01

...'s enrollees; (2) The QHP issuer's policies and procedures, protocols, standard operating procedures... REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Oversight and Financial Integrity Standards for Issuers of...

33 CFR 151.23 - Inspection for compliance and enforcement.

Code of Federal Regulations, 2014 CFR

2014-07-01

... SECURITY (CONTINUED) POLLUTION VESSELS CARRYING OIL, NOXIOUS LIQUID SUBSTANCES, GARBAGE, MUNICIPAL OR COMMERCIAL WASTE, AND BALLAST WATER Implementation of MARPOL 73/78 and the Protocol on Environmental Protection to the Antarctic Treaty as it Pertains to Pollution from Ships Oil Pollution § 151.23 Inspection...

33 CFR 151.23 - Inspection for compliance and enforcement.

Code of Federal Regulations, 2012 CFR

2012-07-01

... SECURITY (CONTINUED) POLLUTION VESSELS CARRYING OIL, NOXIOUS LIQUID SUBSTANCES, GARBAGE, MUNICIPAL OR COMMERCIAL WASTE, AND BALLAST WATER Implementation of MARPOL 73/78 and the Protocol on Environmental Protection to the Antarctic Treaty as it Pertains to Pollution from Ships Oil Pollution § 151.23 Inspection...

33 CFR 151.23 - Inspection for compliance and enforcement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... SECURITY (CONTINUED) POLLUTION VESSELS CARRYING OIL, NOXIOUS LIQUID SUBSTANCES, GARBAGE, MUNICIPAL OR COMMERCIAL WASTE, AND BALLAST WATER Implementation of MARPOL 73/78 and the Protocol on Environmental Protection to the Antarctic Treaty as it Pertains to Pollution from Ships Oil Pollution § 151.23 Inspection...

33 CFR 151.23 - Inspection for compliance and enforcement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SECURITY (CONTINUED) POLLUTION VESSELS CARRYING OIL, NOXIOUS LIQUID SUBSTANCES, GARBAGE, MUNICIPAL OR COMMERCIAL WASTE, AND BALLAST WATER Implementation of MARPOL 73/78 and the Protocol on Environmental Protection to the Antarctic Treaty as it Pertains to Pollution from Ships Oil Pollution § 151.23 Inspection...

Interactive Intragroup Tutorials: A Need-Based Modification to Enhance Learning in Physiology

ERIC Educational Resources Information Center

Srivastava, Tripti K.; Waghmare, Lalitbhushan S.; Jagzape, Arunita; Mishra, Vedprakash

2015-01-01

A tutorial is a period of instruction given by a university or college tutor to an individual or a very small group. Essentially, it is a small class of a few students in which the tutor (a lecturer or other academic staff member) gives individual attention to every learner. The tutorial focuses on certain subject areas and generally proceeds with…

2005 8th Annual Systems Engineering Conference. Volume 2, Wednesday Presentations

DTIC Science & Technology

2005-10-27

Acquisition Programs: An OSD Perspective, Col Warren Anderson, OUSD (AT&L) Defense Systems Implementation of Policy Requiring Systems Engineering Plans...Technical Excellence, Col Warren Anderson, OUSD (AT&L) Defense Systems Applying CMMI to System Safety, Mr. Tom Pfitzer, APT Research, Inc. System...to following pages for Tutorials Schedule) Buffett Lunch Tutorial Tracks (Please refer to following pages for Tutorials Schedule) Reception in

Learning Marketing Accounting Skills in the Introductory Marketing Course: The Development, Use, and Acceptance of a Self-Study Tutorial

ERIC Educational Resources Information Center

Chen, Yi Ju; Greenberg, Barnett; Dickson, Peter; Goodrich, Jonathan

2012-01-01

A self-study tutorial designed to teach, through a learning-by-doing application, how important marketing accounting is to the whole firm, and why every business graduate should have a solid understanding of marketing accounting is tested using an exam and satisfaction survey. Performance on the exam and satisfaction with the tutorial depended…

Clinical outcomes and mortality before and after implementation of a pediatric sepsis protocol in a limited resource setting: A retrospective cohort study in Bangladesh

PubMed Central

Axelrod, David M.; Chisti, Mohammod J.; Kache, Saraswati

2017-01-01

Background Pediatric sepsis has a high mortality rate in limited resource settings. Sepsis protocols have been shown to be a cost-effective strategy to improve morbidity and mortality in a variety of populations and settings. At Dhaka Hospital in Bangladesh, mortality from pediatric sepsis in high-risk children previously approached 60%, which prompted the implementation of an evidenced-based protocol in 2010. The clinical effectiveness of this protocol had not been measured. We hypothesized that implementation of a pediatric sepsis protocol improved clinical outcomes, including reducing mortality and length of hospital stay. Materials and methods This was a retrospective cohort study of children 1–59 months old with a diagnosis of sepsis, severe sepsis or septic shock admitted to Dhaka Hospital from 10/25/2009-10/25/2011. The primary outcome was inpatient mortality pre- and post-protocol implementation. Secondary outcomes included fluid overload, heart failure, respiratory insufficiency, length of hospital stay, and protocol compliance, as measured by antibiotic and fluid bolus administration within 60 minutes of hospital presentation. Results 404 patients were identified by a key-word search of the electronic medical record; 328 patients with a primary diagnosis of sepsis, severe sepsis, or septic shock were included (143 pre- and185 post-protocol) in the analysis. Pre- and post-protocol mortality were similar and not statistically significant (32.17% vs. 34.59%, p = 0.72). The adjusted odds ratio (AOR) for post-protocol mortality was 1.55 (95% CI, 0.88–2.71). The odds for developing fluid overload were significantly higher post-protocol (AOR 3.45, 95% CI, 2.04–5.85), as were the odds of developing heart failure (AOR 4.52, 95% CI, 1.43–14.29) and having a longer median length of stay (AOR 1.81, 95% CI 1.10–2.96). There was no statistically significant difference in respiratory insufficiency (pre- 65.7% vs. post- 70.3%, p = 0.4) or antibiotic administration between the cohorts (pre- 16.08% vs. post- 12.43%, p = 0.42). Conclusions Implementation of a pediatric sepsis protocol did not improve all-cause mortality or length of stay and may have been associated with increased fluid overload and heart failure during the study period in a large, non-governmental hospital in Bangladesh. Similar rates of early antibiotic administration may indicate poor protocol compliance. Though evidenced-based protocols are a potential cost-effective strategy to improve outcomes, future studies should focus on optimal implementation of context-relevant sepsis protocols in limited resource settings. PMID:28753618

A large-scale peer teaching programme - acceptance and benefit.

PubMed

Schuetz, Elisabeth; Obirei, Barbara; Salat, Daniela; Scholz, Julia; Hann, Dagmar; Dethleffsen, Kathrin

2017-08-01

The involvement of students in the embodiment of university teaching through peer-assisted learning formats is commonly applied. Publications on this topic exclusively focus on strictly defined situations within the curriculum and selected target groups. This study, in contrast, presents and evaluates a large-scale structured and quality-assured peer teaching programme, which offers diverse and targeted courses throughout the preclinical part of the medical curriculum. The large-scale peer teaching programme consists of subject specific and interdisciplinary tutorials that address all scientific, physiological and anatomic subjects of the preclinical curriculum as well as tutorials with contents exceeding the formal curriculum. In the study year 2013/14 a total of 1,420 lessons were offered as part of the programme. Paper-based evaluations were conducted over the full range of courses. Acceptance and benefit of this peer teaching programme were evaluated in a retrospective study covering the period 2012 to 2014. Usage of tutorials by students who commenced their studies in 2012/13 (n=959) was analysed from 2012 till 2014. Based on the results of 13 first assessments in the preclinical subjects anatomy, biochemistry and physiology, the students were assigned to one of five groups. These groups were compared according to participation in the tutorials. To investigate the benefit of tutorials of the peer teaching programme, the results of biochemistry re-assessments of participants and non-participants of tutorials in the years 2012 till 2014 (n=188, 172 and 204, respectively) were compared using Kolmogorov-Smirnov- and Chi-square tests as well as the effect size Cohen's d. Almost 70 % of the students attended the voluntary additional programme during their preclinical studies. The students participating in the tutorials had achieved different levels of proficiency in first assessments. The acceptance of different kinds of tutorials appears to correlate with their performance in first assessments. 94% of the students participating in tutorials offered in the study year 2013/14 rated the tutorials as "excellent" or "good". An objective benefit has been shown by a significant increase in re-assessment scores with an effect size between the medium and large magnitudes for participants of tutorials compared to non-participants in the years 2012, 2013 and 2014. In addition, significantly higher pass rates of re-assessments could be observed. Acceptance, utilisation and benefit of the assessed peer teaching programme are high. Beyond the support of students, a contribution to the individualisation of studies and teaching is made. Further studies are necessary to investigate possible influences of large-scale peer teaching programmes, for example on the reduction of study length and drop-off rates, as well as additional effects on academic achievements. Copyright © 2017. Published by Elsevier GmbH.

Compliance with therapy for cervical dysplasia among women of low socioeconomic status.

PubMed

Laedtke, T W; Dignan, M

1992-01-01

This paper reports results of a project designed to examine factors related to compliance with referral for follow-up and treatment of cervical dysplasia. Women studied had cervical dysplasia diagnosed by Pap smear between May 1989 and April 1990. These women had regular follow-up at the gynecology clinic of the Reynolds Health Center in Winston-Salem or at one of 14 county health departments in northwestern North Carolina. Data were collected by chart review, and included age, race, place of residence, marital status, parity/gravidity, education, previous papillomavirus infections, method of payment, and previous Pap smear results. Patients were traced through the treatment protocol, and compliance was assessed at each appointment. In these women of low socioeconomic status, approximately one third of those referred for treatment of dysplasia were noncompliant with referral.

Effect of an administrative intervention on rates of screening for domestic violence in an urban emergency department.

PubMed

Larkin, G L; Rolniak, S; Hyman, K B; MacLeod, B A; Savage, R

2000-09-01

This study measured the effects of an administrative intervention on health care provider compliance with universal domestic violence screening protocols. We used a simple, interrupted-time-series design in a stratified random sample of female emergency department patients 18 years or older (n = 1638 preintervention, n = 1617 postintervention). The intervention was a 4-tiered hospital-approved disciplinary action, and the primary outcome was screening compliance. Preintervention and postintervention screening rates were 29.5% and 72.8%, respectively. Before the intervention, screening was worse on the night shift (odds ratio [OR] = 0.46, 95% confidence interval [CI] = 0.31, 0.68) and with psychiatric patients (OR = 0.34, 95% CI = 0.14, 0.85); after the intervention, no previous screening barriers remained significant. An administrative intervention significantly enhanced compliance with universal domestic violence screening.

[Nursing role in prevention of Ventilator Associated Pneumonia: Spanish project "Neumonìa Zero"].

PubMed

Pinto, Cristina; Reig Valero, Roberto; Iadeluca, Antonio; Lomuscio, Sonia; Caldarulo, Tiziana; Sponton, Anna

2015-01-01

The incidence of Ventilator Associated Pneumonia (VAP) varies between 8 and 28% on patients with invasive mechanical ventilation, and it is associated with high mortality rates. The international literature indicates that the VAP has some risk factors that cannot be changed and some other that are closely related to nursing care procedures. The aim of this study is to analyze compliance level to the protocol of nursing prevention of the VAP in the ICU of "General Hospital" in Castellon de la Plana (Spain) within the project "Neumonía Zero". The data were collected during the months of May and June 2012 through direct observation which lasted 33 days. 5 check lists based on international recommendations were used for the objective evaluation on the adoption of preventive treatments. 58 patients in invasive mechanical ventilation and 43 ICU nurses were enrolled. Compliance procedure showed no significant differences among each other with an average adhesion of 78% of the observations. The observations trend shows a tendency of improvement in accordance with the checklists of cuff pressure and of the inclination of the bed head. An incidence rate of VAP 13,37/1000 was observed. In conclusion, direct observation showed good compliance to the protocols used in the ward. The obtained data allows to re-direct educational choices and assume a systematic application of this methodology with an important contribution to nursing.

Preparing dental students to recognize and respond to domestic violence: the impact of a brief tutorial.

PubMed

Danley, Dale; Gansky, Stuart A; Chow, Denise; Gerbert, Barbara

2004-01-01

The purpose of this study was to evaluate the impact of a brief, interactive multimedia tutorial designed to prepare dentists to recognize and respond to domestic violence. The authors randomly assigned dentists and dental students to one of three groups: a control group or one of two experimental groups in a modified Solomon four-group design. One hundred sixty-one dental students and 13 dentists completed the multimedia tutorial. At the posttest, subjects in both experimental groups demonstrated significantly better scores than did subjects in the control group on most items. The two experimental groups (pretest and posttest, posttest only) did not differ significantly from each other. An engaging, interactive tutorial presenting a simplified model for ways in which dental professionals can recognize and respond to domestic violence significantly improved dental students' knowledge of, and attitudes toward, the topic. Clinicians may improve the care they provide to patients by accessing this brief tutorial and following the lessons contained in it.

Brief Interventions for Tobacco Users: Using the Internet to Train Healthcare Providers

PubMed Central

Carpenter, Kelly M.; Cohn, Leslie G.; Glynn, Lisa H.; Stoner, Susan A.

2011-01-01

One fifth of Americans smoke; many have no plans to quit. Motivational Interviewing (MI) is an effective approach to intervention with precontemplative smokers, yet a substantial number of healthcare practitioners lack training in this approach. Two interactive online tutorials were developed to teach practitioners to deliver brief tobacco cessation interventions grounded in the MI approach. The tutorials emphasized the unique aspects of working with precontemplative smokers, incorporating audio and video examples of best practices, interactive exercises, targeted feedback, and practice opportunities. One hundred and fifty-two healthcare providers-in-training were randomly assigned to use the online tutorials or to read training material that was matched for content. A virtual standardized patient evaluation was given before and after the training. Both groups improved their scores from pre- to posttest; however, the tutorial group scored significantly better than the reading group at posttest. The results of this study demonstrate the promise of interactive online tutorials as an efficient and effective way to deliver clinical education. PMID:22096413

The Virtual Astronomical Observatory: Re-engineering access to astronomical data

NASA Astrophysics Data System (ADS)

Hanisch, R. J.; Berriman, G. B.; Lazio, T. J. W.; Emery Bunn, S.; Evans, J.; McGlynn, T. A.; Plante, R.

2015-06-01

The US Virtual Astronomical Observatory was a software infrastructure and development project designed both to begin the establishment of an operational Virtual Observatory (VO) and to provide the US coordination with the international VO effort. The concept of the VO is to provide the means by which an astronomer is able to discover, access, and process data seamlessly, regardless of its physical location. This paper describes the origins of the VAO, including the predecessor efforts within the US National Virtual Observatory, and summarizes its main accomplishments. These accomplishments include the development of both scripting toolkits that allow scientists to incorporate VO data directly into their reduction and analysis environments and high-level science applications for data discovery, integration, analysis, and catalog cross-comparison. Working with the international community, and based on the experience from the software development, the VAO was a major contributor to international standards within the International Virtual Observatory Alliance. The VAO also demonstrated how an operational virtual observatory could be deployed, providing a robust operational environment in which VO services worldwide were routinely checked for aliveness and compliance with international standards. Finally, the VAO engaged in community outreach, developing a comprehensive web site with on-line tutorials, announcements, links to both US and internationally developed tools and services, and exhibits and hands-on training at annual meetings of the American Astronomical Society and through summer schools and community days. All digital products of the VAO Project, including software, documentation, and tutorials, are stored in a repository for community access. The enduring legacy of the VAO is an increasing expectation that new telescopes and facilities incorporate VO capabilities during the design of their data management systems.

Microprocessor controlled compliance monitor for eye drop medication.

PubMed

Hermann, M M; Diestelhorst, M

2006-07-01

The effectiveness of a self administered eye drop medication can only be assessed if the compliance is known. The authors studied the specificity and sensitivity of a new microprocessor controlled monitoring device. The monitoring system was conducted by an 8 bit microcontroller for data acquisition and storage with sensors measuring applied pressure to the bottle, temperature, and vertical position. 10 devices were mounted under commercial 10 ml eye drops. Test subjects had to note down each application manually. A total of 15 applications each within 3 days was intended. Manual reports confirmed 15 applications for each of the 10 bottles. The monitoring devices detected a total of 149 events; one was missed; comprising a sensitivity of 99%. Two devices registered three applications, which did not appear in the manual protocols, indicating a specificity of about 98%. Refrigerated bottles were correctly identified. The battery lifetime exceeded 60 days. The new monitoring device demonstrated a high reliability of the collected compliance data. The important, yet often unknown, influence of compliance in patient care and clinical trials shall be illuminated by the new device. This may lead to a better adapted patient care. Studies will profit from a higher credibility and results will be less influenced by non-compliance.

A study at Manchester Dental Hospital, of the compliance of IV sedation patients and their escorts.

PubMed

Lightfoot, Kate

2014-01-01

Oral surgery, under intravenous sedation, is carried out on a daily basis at Manchester Dental Hospital. This essay discusses the background of conscious sedation in the dental setting and looks at the compliance of patients (and escorts) when having intravenous sedation. The patient journey, from pre-operative assessment through to treatment is considered. Hospital instructions indicate an obligation for patients to attend with a responsible adult (eighteen or over) who remains with them throughout their treatment, escorts them home,and arranges their care for the next twenty-four hours. By following these instructions the patient should receive optimal care. Two questionnaires were devised and given to patients/escorts to assess their compliance with Manchester Dental Hospital postoperative protocols. 100% compliance was the set standard, with results presented as pie charts. This work began during the undergraduate summer vacation of 2012 and continued over a five-month period. Initial results suggested that compliance was generally good but certain improvements could be made. Suggestions for future development are presented. These aim to give clarity to all patients/escorts and their specific roles in the anticipated treatment.

[Evaluation of good manufacturing practices in the elaboration of enteral formulas in public hospitals of Santiago (Chile)].

PubMed

Lara González, Sandra; Domecq Jendres, C; Atalah Samur, Eduardo

2013-11-01

The development of enteral formulas (FE) is subject to various risks of contamination. The World Health Organization (WHO) and the Food and Agriculture Organization (FAO), have worried about alerting, recommendations and documents released to prevent contamination the FE, suggesting the standardization and protocols for all procedures involved. The study was aimed to evaluate compliance with the technical criteria contained in a Guideline for Good Practice of Manufacture in relation to the development, maintenance and administration of enteral nutrition in hospitals of Santiago, in the Metropolitan Area. The verification criteria considered Physical Plant, Equipment and Implementation, Hygienic and Sanitary Standards, Human Resources, Organization and Management, Safety and Warranty Quality Assurance. 639 criteria were defined, 309 risk Type 1, by mayor risk of producing pollution. The study was conducted by observing Central Units Enteral Formulas and interview with the caregiver. Medium of compliance for each group of criteria risk 1 and overall, was analyzed. A total of 14 public hospitals were studied. The degree of compliance with the 639 reached a median of 33.2% (p25-75 31.6%-40.4%), with the lowest value for physical plant with 27.9% (p25-75 23.9%-38.2%) and the highest for human resources with 52.4% (p25-75 44.1%-52.4%). Median compliance for risk criteria Type 1 was only 31.8% (p25-75 27.5%-41.2%). Most of the units tested, meets less than half of the internationals recommendations, or the Ministry of Health of Chile. It should develop protocols and train staff to ensure quality and safety in the development of enteral formulas and reduce risk of infection. Copyright AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Active and passive compliance in an enhanced recovery programme.

PubMed

Thorn, Christopher C; White, Ian; Burch, Jennie; Malietzis, George; Kennedy, Robin; Jenkins, John T

2016-07-01

Enhanced recovery after surgery (ERAS) is a well-established and accepted practice following colorectal surgery and has been demonstrated to reduce hospital length of stay (LOS) and 30-day morbidity. Despite evidence to support the individual elements on which the programme is based, there remains uncertainty as to how many and which of these are required to realise its benefits. Furthermore, elements of an ERAS programme might either precipitate or reflect recovery, in which case compliance could have a role in the improvement or prediction of outcome. A multidimensional prospective database of 799 consecutive patients undergoing colorectal surgery within an established ERAS programme at a single institution was interrogated. After application of exclusion criteria, 614 patients were studied. The novel concept of 'active compliance' is introduced. An ERAS element is classified as 'active' if the participation of the patient is required to achieve its compliance. This contrasts with 'passive' compliance, where an intervention is delivered to the patient without their direct contribution. The short-term surgical outcomes of this cohort are reported with reference to ERAS protocol compliance. Compliance with the passive elements of the programme was higher than with the active elements. Univariate and multivariate analyses demonstrate that poor compliance with active but not passive elements of the programme was significantly associated with major morbidity. Receiver operator characteristic curve analysis demonstrated active compliance to be a stronger predictor of both major morbidity (AUC 0.71 vs. AUC 0.56) and length of stay (AUC 0.83 vs. 0.57) when compared with passive compliance. The results suggest that poor active compliance may be a surrogate marker of morbidity which can be recognised in the early post-operative period. This implies the potential for timely diagnosis and intervention. This aspect of ERAS compliance is clinically relevant yet has achieved scant attention. Independent validation of our observations is required.

Increased medication compliance of liver transplant patients switched from a twice-daily to a once-daily tacrolimus-based immunosuppressive regimen.

PubMed

Eberlin, M; Otto, G; Krämer, I

2013-01-01

Compliance with immunosuppressive therapy plays a major role in the long-term success of liver transplantation. Thus, the development of strategies to promote compliance of liver transplant patients and its evaluation over time are of particular interest. The main objective of this study was to compare medication compliance rates among liver transplant patients over time after transplantation where switched from a twice- to once-daily tacrolimus-based regimen. Sixty-five liver transplant patients being administered tacrolimus-based therapy were classified into three subgroups with regard to time posttransplantation. Medication compliance with tacrolimus-based therapy was measured using an electronic medication event monitoring system over a 12-month period: for 6 months tacrolimus was administered twice-daily and for 6 months, once-daily. Dosing, taking, and timing compliance as well as drug holidays were compared intra-individually between twice- and once-daily intake and among the three subgroups. In addition, patient compliance and quality of life were evaluated using questionnaires. A per protocol analysis of electronically obtained data showed 63 patients to be eligible. The resulting dosing, taking, and timing compliance rates of the patients were higher during the once-daily dosing period. No significant differences in compliance rates with tacrolimus therapy were observed among three subgroups independent of the dosing regimen. More patients failed the correct timing of the evening compared to the morning dose. Missing doses occurred particularly during weekends. Compliance variables measured by questionnaires (Morisky score, self-report, Medication Experience Scale for Immunosuppressants (MESI) score) and the Hospital Anxiety and Depression Scale score were similar in the two dosing periods. The short-form health survey (SF-36) score was higher with once-daily intake. The high measured compliance rates did not vary significantly dependent upon the time after transplantation. Nevertheless, compliance rates were greater using once-daily tacrolimus dosing. Copyright © 2013 Elsevier Inc. All rights reserved.

Community Earth System Model (CESM) Tutorial 2016 Final Report

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

Lamarque, Jean-Francois

For the 2016 tutorial, NCAR/CGD requested a total budget of $70,000 split equally between DOE and NSF. The funds were used to support student participation (travel, lodging, per diem, etc.). Lectures and practical session support was primarily provided by local participants at no additional cost (see list below). The seventh annual Community Earth System Model (CESM) tutorial (2016) for students and early career scientists was held 8 – 12 August 2016. As has been the case over the last few years, this event was extremely successful and there was greater demand than could be met. There was continued interest inmore » support of the NSF’s EaSM Infrastructure awards, to train these awardees in the application of the CESM. Based on suggestions from previous tutorial participants, the 2016 tutorial experience again provided direct connection to Yellowstone for each individual participant (rather than pairs), and used the NCAR Mesa Library. The 2016 tutorial included lectures on simulating the climate system and practical sessions on running CESM, modifying components, and analyzing data. These were targeted to the graduate student level. In addition, specific talks (“Application” talks) were introduced this year to provide participants with some in-depth knowledge of some specific aspects of CESM.« less

Innovative Training of In-service Teachers for Active Learning: A Short Teacher Development Course Based on Physics Education Research

NASA Astrophysics Data System (ADS)

Zavala, Genaro; Alarcón, Hugo; Benegas, Julio

2007-08-01

In this contribution we describe a short development course for in-service physics teachers. The course structure and materials are based on the results of educational research, and its main objective is to provide in-service teachers with a first contact with the active learning strategy “Tutorials in Introductory Physics,” developed by the Physics Education Research Group at the University of Washington. The course was organized in a constructivist, active learning environment, so that teachers have first to experience, as regular students, the whole Tutorial sequence of activities: Tutorial pre-test, Tutorial, and Tutorial Homework. After each Tutorial, teachers reflect on, and recognize their own students’ learning difficulties, discussing their teaching experiences with their colleagues in small collaborative groups first and the whole class later. Finally they read and discuss specific Physics Education Research literature, where these learning difficulties have been extensively studied by researchers. At the beginning and at the end of the course the participants were given the conceptual multiple-choice test Force Concept Inventory (FCI). The pre-/post-instruction FCI data were presented as a practical example of the use of a research-based test widely used in educational research and in formative assessment processes designed to improve instruction.

SFO-Project: The New Generation of Sharable, Editable and Open-Access CFD Tutorials

NASA Astrophysics Data System (ADS)

Javaherchi, Teymour; Javaherchi, Ardeshir; Aliseda, Alberto

2016-11-01

One of the most common approaches to develop a Computational Fluid Dynamic (CFD) simulation for a new case study of interest is to search for the most similar, previously developed and validated CFD simulation among other works. A simple search would result into a pool of written/visual tutorials. However, users should spend significant amount of time and effort to find the most correct, compatible and valid tutorial in this pool and further modify it toward their simulation of interest. SFO is an open-source project with the core idea of saving the above-mentioned time and effort. This is done via documenting/sharing scientific and methodological approaches to develop CFD simulations for a wide spectrum of fundamental and industrial case studies in three different CFD solvers; STAR-CCM +, FLUENT and Open FOAM (SFO). All of the steps and required files of these tutorials are accessible and editable under the common roof of Github (a web-based Git repository hosting service). In this presentation we will present the current library of 20 + developed CFD tutorials, discuss the idea and benefit of using them, their educational values and explain how the next generation of open-access and live resource of CFD tutorials can be built further hand-in-hand within our community.

Educational support for specialist international medical graduates in anaesthesia.

PubMed

Higgins, Niall S; Taraporewalla, Kersi; Edirippulige, Sisira; Ware, Robert S; Steyn, Michael; Watson, Marcus O

2013-08-19

To measure specialist international medical graduates' (SIMGs) level of learning through participation in guided tutorials, face-to-face or through videoconferencing (VC), and the effect of tutorial attendance and quality of participation on success in specialist college examinations. Tutorials were conducted at the Royal Brisbane and Women's Hospital between 19 September 2007 and 23 August 2010, and delivered through VC to participants at other locations. Tutorials were recorded and transcribed, and speaker contributions were tagged and ranked using content analysis software. Summary examination results were obtained from the Australian and New Zealand College of Anaesthetists. Tutorial participation and attendance, and college examination pass and fail rates. Transcripts were obtained for 116 tutorials. The median participation percentage for those who subsequently failed the college examinations was 1% (interquartile range [IQR], 0%-1%), while for those who passed the exams it was 5% (IQR, 2%-8%; P < 0.001). There was also an association between attendance and exam success; the median (IQR) attendance of those who failed was 24% (IQR, 14%-39%), while for those who passed it was 59% (IQR, 39%-77%; P < 0.001). Use of VC technology was found to be a feasible method to assist SIMGs to become aware of the requirements of the exam and to prepare more effectively.

COMPARISON OF CFC-114 AND HFC-236EA PERFORMANCE IN SHIPBOARD VAPOR COMPRESSION SYSTEMS

EPA Science Inventory

The report gives results of a comparison of the performance of two refrigerants - 1,1,1,2,3,3-hexafluoropropane (HFC-236ea) and 1,2-dichloro-tetrafluoroethane (CFC-114) - in shipboard vapor compression refrigeration systems. (NOTE: In compliance with the Montreal Protocol and Dep...

15 CFR 782.5 - Where to obtain APR report forms.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL REGULATIONS GENERAL... forms required by the APR may be downloaded from the Internet at http://www.ap.gov. You also may obtain these forms by contacting: Treaty Compliance Division, Bureau of Industry and Security, U.S. Department...

15 CFR 782.5 - Where to obtain APR report forms.

Code of Federal Regulations, 2013 CFR

2013-01-01

... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL REGULATIONS GENERAL... forms required by the APR may be downloaded from the Internet at http://www.ap.gov. You also may obtain these forms by contacting: Treaty Compliance Division, Bureau of Industry and Security, U.S. Department...

15 CFR 782.5 - Where to obtain APR report forms.

Code of Federal Regulations, 2011 CFR

2011-01-01

... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL REGULATIONS GENERAL... forms required by the APR may be downloaded from the Internet at http://www.ap.gov. You also may obtain these forms by contacting: Treaty Compliance Division, Bureau of Industry and Security, U.S. Department...

15 CFR 782.5 - Where to obtain APR report forms.

Code of Federal Regulations, 2012 CFR

2012-01-01

... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL REGULATIONS GENERAL... forms required by the APR may be downloaded from the Internet at http://www.ap.gov. You also may obtain these forms by contacting: Treaty Compliance Division, Bureau of Industry and Security, U.S. Department...

15 CFR 782.5 - Where to obtain APR report forms.

Code of Federal Regulations, 2014 CFR

2014-01-01

... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE ADDITIONAL PROTOCOL REGULATIONS GENERAL... forms required by the APR may be downloaded from the Internet at http://www.ap.gov. You also may obtain these forms by contacting: Treaty Compliance Division, Bureau of Industry and Security, U.S. Department...

ACHP | Federal Emergency Management Agency Historic Preservation Program

Science.gov Websites

developing agreements to improve and expedite Section 106 compliance for disaster recovery activities. The developing the PPA, FEMA conducted outreach to stakeholders, including holding listening sessions with the protocols. In either case, FEMA will continue to be responsible for conducting consultation with Indian

76 FR 38457 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-30

...) conducts freight operations on 23 miles of this 33-mile rail line; and presently the only common track use... modifications requested above would follow the existing protocols such as good communication between HVRM and... is under Yard Limit Rules with good visibility conditions. The new petition states that HVRM operates...

75 FR 26842 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-12

... testing protocol of the Locomotive Safety Standards, 49 CFR 229.129(c), as it pertains to railroad... writing, before the end of the comment period and specify the basis for their request. All communications.... and 5 p.m., Monday through Friday, except Federal holidays. Communications received within 45 days of...

Cytopathology whole slide images and adaptive tutorials for postgraduate pathology trainees: a randomized crossover trial.

PubMed

Van Es, Simone L; Kumar, Rakesh K; Pryor, Wendy M; Salisbury, Elizabeth L; Velan, Gary M

2015-09-01

To determine whether cytopathology whole slide images and virtual microscopy adaptive tutorials aid learning by postgraduate trainees, we designed a randomized crossover trial to evaluate the quantitative and qualitative impact of whole slide images and virtual microscopy adaptive tutorials compared with traditional glass slide and textbook methods of learning cytopathology. Forty-three anatomical pathology registrars were recruited from Australia, New Zealand, and Malaysia. Online assessments were used to determine efficacy, whereas user experience and perceptions of efficiency were evaluated using online Likert scales and open-ended questions. Outcomes of online assessments indicated that, with respect to performance, learning with whole slide images and virtual microscopy adaptive tutorials was equivalent to using traditional methods. High-impact learning, efficiency, and equity of learning from virtual microscopy adaptive tutorials were strong themes identified in open-ended responses. Participants raised concern about the lack of z-axis capability in the cytopathology whole slide images, suggesting that delivery of z-stacked whole slide images online may be important for future educational development. In this trial, learning cytopathology with whole slide images and virtual microscopy adaptive tutorials was found to be as effective as and perceived as more efficient than learning from glass slides and textbooks. The use of whole slide images and virtual microscopy adaptive tutorials has the potential to provide equitable access to effective learning from teaching material of consistently high quality. It also has broader implications for continuing professional development and maintenance of competence and quality assurance in specialist practice. Copyright © 2015 Elsevier Inc. All rights reserved.

Enhancing self-directed learning among Italian nursing students: A pre- and post-intervention study.

PubMed

Cadorin, L; Rei, A; Dante, A; Bulfone, T; Viera, G; Palese, A

2015-06-01

In accordance with Knowles's theory, self-directed learning (SDL) may be improved with tutorial strategies focused on guided reflection and critical analysis of the learning process. No evidence on effects on SDL abilities of different tutorial strategies offered to nursing students during the 1st clinical experience is available. To evaluate the effect of different tutorial strategies offered to nursing students on their SDL abilities. A pre-post intervention non-equivalent control group design was adopted in 2013. For the treatment group, structured and intensive tutorial interventions including different strategies such as briefing, debriefing, peer support, Socratic questioning, performed by university tutors were offered during the 1st clinical experience; for the control group, unstructured and non-intensive tutorial strategies were instead offered. Two Bachelor of Nursing Degree. Students awaiting their clinical experience (n=238) were the target sample. Those students who have completed the pre- and the post-intervention evaluation (201; 84.4%) were included in the analysis. SDL abilities were measured with the SRSSDL_ITA (Self Rating Scale of Self Directed Learning-Italian Version). A multiple linear regression analysis was developed to explore the predictive effect of individual, contextual and intervention variables. Three main factors explained the 36.8% of the adjusted variance in SDL scores have emerged: a) having received a lower clinical nurse-to-student supervision (B 9.086, β 2.874), b) having received higher level and structured tutorial intervention by university tutors (B 8.011, β 2.741), and c) having reported higher SDL scores at the baseline (B .550, β .556). A lower clinical nurse-to-student ratio (1:4), accompanied by unstructured and non-intensive tutorial intervention adopted by university tutors, seemed to be equivalent to an intensive clinical supervision (1:1) accompanied by higher level and structured tutorial strategies activated by the university tutors. Copyright © 2015 Elsevier Ltd. All rights reserved.

Challenge of engaging all students via self-paced interactive electronic learning tutorials for introductory physics

NASA Astrophysics Data System (ADS)

DeVore, Seth; Marshman, Emily; Singh, Chandralekha

2017-06-01

As research-based, self-paced electronic learning tools become increasingly available, a critical issue educators encounter is implementing strategies to ensure that all students engage with them as intended. Here, we first discuss the effectiveness of electronic learning tutorials as self-paced learning tools in large enrollment brick and mortar introductory physics courses and then propose a framework for helping students engage effectively with the learning tools. The tutorials were developed via research in physics education and were found to be effective for a diverse group of introductory physics students in one-on-one implementation. Instructors encouraged the use of these tools in a self-paced learning environment by telling students that they would be helpful for solving the assigned homework problems and that the underlying physics principles in the tutorial problems would be similar to those in the in-class quizzes (which we call paired problems). We find that many students in the courses in which these interactive electronic learning tutorials were assigned as a self-study tool performed poorly on the paired problems. In contrast, a majority of student volunteers in one-on-one implementation greatly benefited from the tutorials and performed well on the paired problems. The significantly lower overall performance on paired problems administered as an in-class quiz compared to the performance of student volunteers who used the research-based tutorials in one-on-one implementation suggests that many students enrolled in introductory physics courses did not effectively engage with the tutorials outside of class and may have only used them superficially. The findings suggest that many students in need of out-of-class remediation via self-paced learning tools may have difficulty motivating themselves and may lack the self-regulation and time-management skills to engage effectively with tools specially designed to help them learn at their own pace. We conclude by proposing a theoretical framework to help students with diverse prior preparations engage effectively with self-paced learning tools.

Effectiveness of interactive tutorials in promoting "which-path" information reasoning in advanced quantum mechanics

NASA Astrophysics Data System (ADS)

Maries, Alexandru; Sayer, Ryan; Singh, Chandralekha

2017-12-01

Research suggests that introductory physics students often have difficulty using a concept in contexts different from the ones in which they learned it without explicit guidance to help them make the connection between the different contexts. We have been investigating advanced students' learning of quantum mechanics concepts and have developed interactive tutorials which strive to help students learn these concepts. Two such tutorials, focused on the Mach-Zehnder interferometer (MZI) and the double-slit experiment (DSE), help students learn how to use the concept of "which-path" information to reason about the presence or absence of interference in these two experiments in different situations. After working on a pretest that asked students to predict interference in the MZI with single photons and polarizers of various orientations placed in one or both paths of the MZI, students worked on the MZI tutorial which, among other things, guided them to reason in terms of which-path information in order to predict interference in similar situations. We investigated the extent to which students were able to use reasoning related to which-path information learned in the MZI tutorial to answer analogous questions on the DSE (before working on the DSE tutorial). After students worked on the DSE pretest they worked on a DSE tutorial in which they learned to use the concept of which-path information to answer questions about interference in the DSE with single particles with mass sent through the two slits and a monochromatic lamp placed between the slits and the screen. We investigated if this additional exposure to the concept of which-path information promoted improved learning and performance on the DSE questions with single photons and polarizers placed after one or both slits. We find evidence that both tutorials promoted which-path information reasoning and helped students use this reasoning appropriately in contexts different from the ones in which they had learned it.

Knowledge of quality performance measures associated with endoscopy among gastroenterology trainees and the impact of a web-based intervention.

PubMed

Thompson, Jennifer S; Lebwohl, Benjamin; Syngal, Sapna; Kastrinos, Fay

2012-07-01

Knowledge of quality measures in endoscopy among trainees is unknown. To assess knowledge of endoscopy-related quality indicators among U.S. trainees and determine whether it improves with a Web-based intervention. Randomized, controlled study. Multicenter. This study involved trainees identified from the American Society for Gastrointestinal Endoscopy membership database. Participants were invited to complete an 18-question online test. Respondents were randomized to receive a Web-based tutorial (intervention) or not. The test was readministered 6 weeks after randomization to determine the intervention's impact. Baseline knowledge of endoscopy-related quality indicators and impact of the tutorial. A total of 347 of 1220 trainees (28%) completed the test; the mean percentage of correct responses was 55%. For screening colonoscopy, 44% knew the adenoma detection rate benchmark, 42% identified the cecal intubation rate goal, and 74% knew the recommended minimum withdrawal time. A total of 208 of 347 trainees (59%) completed the second test; baseline scores were similar for the tutorial (n = 106) and no tutorial (n = 102) groups (56.4% vs 56.9%, respectively). Scores improved after intervention for the tutorial group (65%, P = .003) but remained unchanged in the no tutorial group. On multivariate analysis, each additional year in training (odds ratio [OR] 2.3; 95% confidence interval [CI], 1.5-3.4), training at an academic institution (OR 2.6; 95% CI, 1.1-6.3), and receiving the tutorial (OR 3.2; 95% CI, 1.7-5.9) were associated with scores in the upper tertile. Low response rate. Knowledge of endoscopy-related quality performance measures is low among trainees but can improve with a Web-based tutorial. Gastroenterology training programs may need to incorporate a formal didactic curriculum to supplement practice-based learning of quality standards in endoscopy. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Knowledge of quality performance measures associated with endoscopy among gastroenterology trainees and the impact of a web-based intervention

PubMed Central

Thompson, Jennifer S.; Lebwohl, Benjamin; Syngal, Sapna; Kastrinos, Fay

2013-01-01

Background Knowledge of quality measures in endoscopy among trainees is unknown. Objective To assess knowledge of endoscopy-related quality indicators among U.S. trainees and determine whether it improves with a Web-based intervention. Design Randomized, controlled study. Setting Multicenter. Participants This study involved trainees identified from the American Society for Gastrointestinal Endoscopy membership database. Intervention Participants were invited to complete an 18-question online test. Respondents were randomized to receive a Web-based tutorial (intervention) or not. The test was readministered 6 weeks after randomization to determine the intervention’s impact. Main Outcome Measurements Baseline knowledge of endoscopy-related quality indicators and impact of the tutorial. Results A total of 347 of 1220 trainees (28%) completed the test; the mean percentage of correct responses was 55%. For screening colonoscopy, 44% knew the adenoma detection rate benchmark, 42% identified the cecal intubation rate goal, and 74% knew the recommended minimum withdrawal time. A total of 208 of 347 trainees (59%) completed the second test; baseline scores were similar for the tutorial (n = 106) and no tutorial (n = 102) groups (56.4% vs 56.9%, respectively). Scores improved after intervention for the tutorial group (65%, P = .003) but remained unchanged in the no tutorial group. On multivariate analysis, each additional year in training (odds ratio [OR] 2.3; 95% confidence interval [CI], 1.5–3.4), training at an academic institution (OR 2.6; 95% CI, 1.1–6.3), and receiving the tutorial (OR 3.2; 95% CI, 1.7–5.9) were associated with scores in the upper tertile. Limitations Low response rate. Conclusion Knowledge of endoscopy-related quality performance measures is low among trainees but can improve with a Web-based tutorial. Gastroenterology training programs may need to incorporate a formal didactic curriculum to supplement practice-based learning of quality standards in endoscopy. (Gastrointest Endosc 2012;76:100–6.) PMID:22421498

Evaluation of Computer-aided Strategies for Teaching Medical Students Prenatal Ultrasound Diagnostic Skills.

PubMed

Amesse, Lawrence S; Callendar, Ealena; Pfaff-Amesse, Teresa; Duke, Janice; Herbert, William N P

2008-09-24

To evaluate whether computer-based learning (CBL) improves newly acquired knowledge and is an effective strategy for teaching prenatal ultrasound diagnostic skills to third-year medical students when compared with instruction by traditional paper-based methods (PBM). We conducted a randomized, prospective study involving volunteer junior (3(rd) year) medical students consecutively rotating through the Obstetrics and Gynecology clerkship during six months of the 2005-2006 academic year. The students were randomly assigned to permuted blocks and divided into two groups. Half of the participants received instruction in prenatal ultrasound diagnostics using an interactive CBL program; the other half received instruction using equivalent material by the traditional PBM. Outcomes were evaluated by comparing changes in pre-tutorial and post instruction examination scores. All 36 potential participants (100%) completed the study curriculum. Students were divided equally between the CBL (n = 18) and PBM (n = 18) groups. Pre-tutorial exam scores (mean+/-s.d.) were 44%+/-11.1% for the CBL group and 44%+/-10.8% for the PBL cohort, indicating no statistically significant differences (p>0.05) between the two groups. After instruction, post-tutorial exam scores (mean+/-s.d.) were increased from the pre-tutorial scores, 74%+/-11% and 67%+/-12%, for students in the CBL and the PBM groups, respectively. The improvement in post-tutorial exam scores from the pre-test scores was considered significant (p<0.05). When post-test scores for the tutorial groups were compared, the CBL subjects achieved a score that was, on average, 7 percentage points higher than their PBM counterparts, a statistically significant difference (p < 0.05). Instruction by either CBL or PBM strategies is associated with improvements in newly acquired knowledge as reflected by increased post-tutorial examination scores. Students that received CBL had significantlyhigher post-tutorial exam scores than those in the PBM group, indicating that CBL is an effective instruction strategy in this setting.

Protocol Coordinator | Center for Cancer Research

Cancer.gov

PROGRAM DESCRIPTION Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID), Clinical Center (CC), National Institute of Heart, Lung and Blood Institute (NHLBI), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Center for Advancing Translational Sciences (NCATS), National Institute of Neurological Disorders and Stroke (NINDS), and the National Institute of Mental Health (NIMH). Since its inception in 2001, CMRP’s ability to provide rapid responses, high-quality solutions, and to recruit and retain experts with a variety of backgrounds to meet the growing research portfolios of NCI, NIAID, CC, NHLBI, NIAMS, NCATS, NINDS, and NIMH has led to the considerable expansion of the program and its repertoire of support services. CMRP’s support services are strategically aligned with the program’s mission to provide comprehensive, dedicated support to assist National Institutes of Health researchers in providing the highest quality of clinical research in compliance with applicable regulations and guidelines, maintaining data integrity, and protecting human subjects. For the scientific advancement of clinical research, CMRP services include comprehensive clinical trials, regulatory, pharmacovigilance, protocol navigation and development, and programmatic and project management support for facilitating the conduct of 400+ Phase I, II, and III domestic and international trials on a yearly basis. These trials investigate the prevention, diagnosis, treatment of, and therapies for cancer, influenza, HIV, and other infectious diseases and viruses such as hepatitis C, tuberculosis, malaria, and Ebola virus; heart, lung, and blood diseases and conditions; parasitic infections; rheumatic and inflammatory diseases; and rare and neglected diseases. CMRP’s collaborative approach to clinical research and the expertise and dedication of staff to the continuation and success of the program’s mission has contributed to improving the overall standards of public health on a global scale. The Clinical Monitoring Research Program (CMRP) provides comprehensive clinical and administrative support to the National Cancer Institute’s Center for Cancer Research’s (CCR) Protocol Support Office (PSO) for protocol development review, regulatory review, and the implementation process as well as oversees medical writing/editing, regulatory/ compliance, and protocol coordination/navigation and administration. KEY ROLES/RESPONSIBILITIES The Protocol Coordinator III: Provides programmatic and logistical support for the operations of clinical research for Phase I and Phase II clinical trials. Provides deployment of clinical support services for clinical research. Streamlines the protocol development timeline. Provides data and documents collection and compilation for regulatory filing with the U.S. Food and Drug Administration (FDA) and other regulatory authorities.. Provides technical review and report preparation. Provides administrative coordination and general logistical support for regulatory activities. Ensures the provision of training for investigators and associate staff to reinforce and enhance a Good Clinical Practices (GCP) culture. Oversees quality assurance and quality control, performs regulatory review of clinical protocols, informed consent and other clinical documents. Tracks and facilitates a portfolio of protocols through each process step (Institutional Review Board [IRB], Regulatory Affairs Compliance [RAC], Data Safety Monitoring Board [DSMB], Office of Protocol Services). Assists clinical investigators in preparing clinical research protocols, including writing and formatting consent forms. Prepares protocol packages for review and ensures that protocol packages include all of the required material and comply with CCR, NCI and NIH policies. Collaborates with investigators to resolve any protocol/data issues. Coordinates submission of protocols for scientific and ethical review by the Branch scientific review committees, the NCI IRB, and the clinical trial sponsor or the FDA. Monitors the review process and maintains detailed, complete and accurate records for each protocol of the approvals at the various stages of the review process, including new protocol submissions, amendments to protocols, and continuing reviews, as well as other submissions such as adverse events. Attends and prepares minutes for the Branch Protocol Review Committees. Contacts coordinators at other centers for protocols that are performed there to obtain review committee approvals at those centers, maintains records of these approvals and sends protocol amendments and other reports to the participating centers. Maintains a schedule of all review committee submission deadline dates and meeting dates. Assists clinical investigators in understanding and complying with the entire review process. Works closely with the NCI Protocol Review Office in establishing and maintaining a paperless automated document and tracking system for NCI protocols. Converts protocols from Word format to .pdf with bookmarks. Maintains the .pdf version of the most current approved version of each active clinical protocol on a central server. This position is located in Rockville, Maryland.

NETGEAR ProSAFE M4300 Series 10-GbE Switch Tutorial

DTIC Science & Technology

2016-11-01

ARL-TN-0803 ● NOV 2016 US Army Research Laboratory NETGEAR ProSAFE M4300 Series 10-GbE Switch Tutorial by Benjamin Kenawell...Disclaimers The findings in this report are not to be construed as an official Department of the Army position unless so designated by other...NETGEAR ProSAFE M4300 Series 10-GbE Switch Tutorial by Benjamin Kenawell Science and Engineering Apprentice Program (SEAP), Adelphi, MD Brian

The keys to successful online continuing education programs for nurses.

PubMed

Sweeney, Nancy M; Saarmann, Lembi; Flagg, Joan; Seidman, Robert

2008-01-01

Asynchronous online tutorials that award continuing education units without cost and provide knowledge about computers and nursing informatics were made available to registered nurses in Southern California. Four hundred seventy-three nurses enrolled; 52% (246) completed tutorials. Nonsignificant differences in the number of tutorials completed were found across characteristics of participants, meaning that nurses were similarly disposed to participate regardless of age, educational preparation, experience, practice setting, or ethnicity. They tended to overestimate their computer capabilities at the time of enrollment and abandoned the tutorials when they encountered technical problems. Nurses need live workshops teaching computer basics, Internet skills, and how to enroll in and run asynchronous programs. Marketing of online programs should be multifaceted, including live and electronic strategies.

De novo transcript sequence reconstruction from RNA-Seq: reference generation and analysis with Trinity

PubMed Central

Yassour, Moran; Grabherr, Manfred; Blood, Philip D.; Bowden, Joshua; Couger, Matthew Brian; Eccles, David; Li, Bo; Lieber, Matthias; MacManes, Matthew D.; Ott, Michael; Orvis, Joshua; Pochet, Nathalie; Strozzi, Francesco; Weeks, Nathan; Westerman, Rick; William, Thomas; Dewey, Colin N.; Henschel, Robert; LeDuc, Richard D.; Friedman, Nir; Regev, Aviv

2013-01-01

De novo assembly of RNA-Seq data allows us to study transcriptomes without the need for a genome sequence, such as in non-model organisms of ecological and evolutionary importance, cancer samples, or the microbiome. In this protocol, we describe the use of the Trinity platform for de novo transcriptome assembly from RNA-Seq data in non-model organisms. We also present Trinity’s supported companion utilities for downstream applications, including RSEM for transcript abundance estimation, R/Bioconductor packages for identifying differentially expressed transcripts across samples, and approaches to identify protein coding genes. In an included tutorial we provide a workflow for genome-independent transcriptome analysis leveraging the Trinity platform. The software, documentation and demonstrations are freely available from http://trinityrnaseq.sf.net. PMID:23845962

Methods for ensuring compliance in an international greenhouse gas trading system

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

Hargrave, T.; Helme, E.A.

1998-12-31

At the third Conference of the Parties to the UN Framework Convention on Climate Change held in December, 1997, the international community established binding greenhouse gas (GHG) emissions obligations for industrialized countries. The Parties to the new Kyoto Protocol also agreed on the use of a number of market-based mechanisms, including international GHG emissions trading. These market mechanisms were of critical to the importance because they have the potential to significantly reduce the costs of treaty compliance. In principle, an international cap-and-trade system appears to be one of the most cost-effective means of reducing GHG emissions. Maintaining the integrity ofmore » the trading system is of primary importance in ensuring that trading helps countries to meet their GHG commitments. This paper explores methods for ensuring compliance in an international greenhouse gas trading system, starting with a discussion of preconditions for participation in trading and then moving to features of an international compliance system. Achieving maximum compliance with international requirements may best be accomplished by limiting participation in trading to Annex I countries that maintain strong domestic compliance systems. Prior to the climate negotiations in Kyoto in December 1997, the US Administration proposed a number of preconditions for participation in trading, including the adoption of international measurement standards and the establishment of domestic compliance and enforcement programs. This paper explores these and other preconditions, including the establishment of tough domestic financial penalties on companies that exceed allowed emissions and seller responsibility for the delivery of real reductions. The paper also discusses several necessary features of the international compliance system.« less

Geographic variation in lumbar diskectomy: a protocol for evaluation.

PubMed

Barron, M; Kazandjian, V A

1992-03-01

In 1989 the Maryland Hospital Association (MHA) began developing a protocol related to lumbar diskectomy, a procedure with widely reported geographic variation in its use. The MHA's Laminectomy Advisory Committee drafted three criteria for performance of lumbar diskectomy and also developed a data-collection instrument with which the eight hospitals participating in a pilot study could abstract the necessary data from medical records. Both individual hospital and aggregate results showed wide variation in compliance with the criteria. These findings suggest research and development activities such as refinement of the data-collection instrument, use of the protocol for bench-marking, further investigation of clinical and other determinants of rate variation, and study of the effect of new diagnostic technology on utilization rates for this procedure.

The natural lifespan of a safety policy: violations and system migration in anaesthesia.

PubMed

de Saint Maurice, Guillaume; Auroy, Yves; Vincent, Charles; Amalberti, René

2010-08-01

Safety rules continue growing rapidly, as if constraining human behaviour was the unique avenue for reaching ultimate safety. Safety rules are essential for a safe system, but their multiplication can have counterproductive effects. To monitor, in an anaesthesia ward, compliance with a process-oriented safety rule, and understand barriers and facilitators which help and hinder physicians from following guidelines. The rule stipulated that the day before surgery anaesthetists had to record in the patient's file the drugs to be used for the anaesthesia (induction, maintenance, airway control). Compliance was assessed before introduction of the rule, immediately after, at 6 months and at 12 months. All medical staff were blinded to the protocol. 717 patient records were included. The results showed an initial compliance with policy, reaching 86% for some items (never 100%). Reduction began within 6 months and returned almost to initial levels within a year. One individual showed poor compliance throughout the study but even initially compliant doctors experienced a reduction. Compliance was higher for complex surgery but lower for unscheduled surgery and when job pressure was greater. Compliance eroded over time. A major trigger of erosion seemed to be lack of continued compliance by a senior member of staff. Rules and procedures constitute fragile safety barriers, and it may be better to forego introducing a new safety rule if it is not considered as a priority by staff and is therefore vulnerable to sacrifice in case of conflict with competitive demands.

SU-E-T-581: Planning Evaluation of Step-And-Shoot IMRT, RapidArc and Helical TomoTherapy for Hippocampal-Avoidance Whole Brain Radiotherapy (HA-WBRT).

PubMed

Evans, J; Chen, Q; Wuthrick, E; Weldon, M; Rong, Y

2012-06-01

Several planning strategies are available for hippocampal- avoidance whole-brain radiotherapy (HA-WBRT) following RTOG protocol 0933, but have yet to be compared on a common set of patient data. In this inter-institutional investigation, we evaluate three modalities likely to be employed by protocol participants; step-and-shoot IMRT, volumetric modulated arc therapy, and helical tomotherapy. A common set of patients is used for comparison, including credentialing and successfully accrued patients. Eight patient datasets were selected and de-identified prior to planning. Structures were contoured by physicians per protocol using fused MRI datasets. Three plans were generated for each dataset: Philips Pinnacle 9-field non-coplanar IMRT using protocol recommended beam parameters, Varian's RapidArc using two coplanar arcs, and Accuray's TomoTherapy using a 1cm jaw width. With the goal of meeting the compliance criteria outlined in RTOG 0933 (target coverage and dose limits to the hippocampus and optic structures), three planners independently planned each modality without prior knowledge of the patient's other plans to reduce bias. The three plans for each patient were compared according to the protocol's dosimetric compliance criteria. A homogeneity index was also computed to compare target dose uniformity. All plans achieved the protocol dose criteria, except for one RapidArc plan with slightly inferior dose to the optic chiasm. TomoTherapy offered superior dose homogeneity for all patients. For the two linac based methods, RapidArc was found to provide dose homogeneity at least as good as, and in most cases superior to, 9-field step-and-shoot IMRT. Helical TomoTherapy offers superior dose homogeneity for HA-WBRT following RTOG 0933. Compared to step-and-shoot IMRT, volumetric modulated arc techniques, such as RapidArc, can offer improved homogeneity for HA- WBRT and are generally more efficient/expeditious to deliver than the noncoplanar 9-field arrangement recommended by the protocol, which uses 7 separate couch angles. © 2012 American Association of Physicists in Medicine.

Using optimal combination of teaching-learning methods (open book assignment and group tutorials) as revision exercises to improve learning outcome in low achievers in biochemistry.

PubMed

Rajappa, Medha; Bobby, Zachariah; Nandeesha, H; Suryapriya, R; Ragul, Anithasri; Yuvaraj, B; Revathy, G; Priyadarssini, M

2016-07-08

Graduate medical students of India are taught Biochemistry by didactic lectures and they hardly get any opportunity to clarify their doubts and reinforce the concepts which they learn in these lectures. We used a combination of teaching-learning (T-L) methods (open book assignment followed by group tutorials) to study their efficacy in improving the learning outcome. About 143 graduate medical students were classified into low (<50%: group 1, n = 23), medium (50-75%: group 2, n = 74), and high (>75%: group 3, n = 46) achievers, based on their internal assessment marks. After the regular teaching module on the topics "Vitamins and Enzymology", all the students attempted an open book assignment without peer consultation. Then all the students participated in group tutorials. The effects on the groups were evaluated by pre and posttests at the end of each phase, with the same set of MCQs. Gain from group tutorials and overall gain was significantly higher in the low achievers, compared to other groups. High and medium achievers obtained more gain from open book assignment, than group tutorials. The overall gain was significantly higher than the gain obtained from open book assignment or group tutorials, in all three groups. All the three groups retained the gain even after 1 week of the exercise. Hence, optimal use of novel T-L methods (open book assignment followed by group tutorials) as revision exercises help in strengthening concepts in Biochemistry in this oft neglected group of low achievers in graduate medical education. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(4):321-325, 2016. © 2016 The International Union of Biochemistry and Molecular Biology.

Compliance program data management system for The Idaho National Engineering Laboratory/Environmental Protection Agency

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

Hertzler, C.L.; Poloski, J.P.; Bates, R.A.

1988-01-01

The Compliance Program Data Management System (DMS) developed at the Idaho National Engineering Laboratory (INEL) validates and maintains the integrity of data collected to support the Consent Order and Compliance Agreement (COCA) between the INEL and the Environmental Protection Agency (EPA). The system uses dBase III Plus programs and dBase III Plus in an interactive mode to enter, store, validate, manage, and retrieve analytical information provided on EPA Contract Laboratory Program (CLP) forms and CLP forms modified to accommodate 40 CFR 264 Appendix IX constituent analyses. Data analysis and presentation is performed utilizing SAS, a statistical analysis software program. Archivingmore » of data and results is performed at appropriate stages of data management. The DMS is useful for sampling and analysis programs where adherence to EPA CLP protocol, along with maintenance and retrieval of waste site investigation sampling results is desired or requested. 3 refs.« less

Keep it clean: a visual approach to reinforce hand hygiene compliance in the emergency department.

PubMed

Wiles, Lynn L; Roberts, Chris; Schmidt, Kim

2015-03-01

Although hand hygiene strategies significantly reduce health care-associated infections, multiple studies have documented that hand hygiene is the most overlooked and poorly performed infection control intervention. Emergency nurses and technicians (n = 95) in a 41-bed emergency department in eastern Virginia completed pretests and posttests, an education module, and two experiential learning activities reinforcing hand hygiene and infection control protocols. Posttest scores were significantly higher than pretest scores (t (108) = -6.928, P = .048). Hand hygiene compliance rates improved at the conclusion of the project and 3 months after the study (F (2, 15) = 9.89, P = .002). Interfaces with staff as they completed the interactive exercise, as well as anecdotal notes collected during the study, identified key times when compliance suffered and offered opportunities to further improve hand hygiene and, ultimately, patient safety. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

An investigation into introductory astronomy students' difficulties with cosmology, and the development, validation, and efficacy of a new suite of cosmology lecture-tutorials

NASA Astrophysics Data System (ADS)

Wallace, Colin S.

This study reports the results of the first systematic investigation into Astro 101 students' conceptual and reasoning difficulties with cosmology. We developed four surveys with which we measured students' conceptual knowledge of the Big Bang, the expansion and evolution of the universe, and the evidence for dark matter. Our classical test theory and item response theory analyses of over 2300 students' pre- and post-instruction responses, combined with daily classroom observations, videotapes of students working in class, and one-on-one semi-structured think-aloud interviews with nineteen Astro 101 students, revealed several common learning difficulties. In order to help students overcome these difficulties, we used our results to inform the development of a new suite of cosmology lecture-tutorials. In our initial testing of the new lecture-tutorials at the University of Colorado at Boulder and the University of Arizona, we found many cases in which students who used the lecture-tutorials achieved higher learning gains (as measured by our surveys) at statistically significant levels than students who did not. Subsequent use of the lecture-tutorials at a variety of colleges and universities across the United States produced a wide range of learning gains, suggesting that instructors' pedagogical practices and implementations of the lecture-tutorials significantly affect whether or not students achieve high learning gains.

An assessment of the compliance of systematic review articles published in craniofacial surgery with the PRISMA statement guidelines: A systematic review.

PubMed

Pidgeon, Thomas Edward; Wellstead, Georgina; Sagoo, Harkiran; Jafree, Daniyal J; Fowler, Alexander J; Agha, Riaz A

2016-10-01

Systematic review evidence is increasing within craniofacial surgery. Compliance with recognised reporting guidelines for systematic review evidence has not been assessed. To assess the compliance of systematic reviews published in craniofacial journals with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting criteria. Thomson Reuters impact factor was used to identify three top craniofacial journals. A search for all systematic review articles published in these journals from 1st May 2010 to 30th April 2015 was conducted using MEDLINE PubMed. Two independent researchers assessed each study for inclusion and performed the data extraction. Data included the article reference information; the pathology and interventions examined and compliance of each review article with the PRISMA checklist. 97 studies were returned by the search. 62 studies proceeded to data extraction. The mean percentage of applicable PRISMA items that were met across all studies was 72.5% (range 28.6-96.2%). The area of poorest compliance was with the declaration of a study protocol (19.4% of studies). Only 37.1% of studies declared their source of funding. Compliance of systematic review articles within craniofacial surgery with areas of the PRISMA checklist could be improved. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The effectiveness of ID readers and remote age verification in enhancing compliance with the legal age limit for alcohol.

PubMed

Van Hoof, Joris J

2017-04-01

Currently, two different age verification systems (AVS) are implemented to enhance compliance with legal age limits for the sale of alcohol in the Netherlands. In this study, we tested the operational procedures and effectiveness of ID readers and remote age verification technology in supermarkets during the sale of alcohol. Following a trained alcohol purchase protocol, eight mystery shoppers (both underage and in the branch's reference age) conducted 132 alcohol purchase attempts in stores that were equipped with ID readers or remote age verification or were part of a control group. In stores equipped with an ID reader, 34% of the purchases were conducted without any mistakes (full compliance). In stores with remote age verification, full compliance was achieved in 87% of the cases. The control group reached 57% compliance, which is in line with the national average. Stores with ID readers perform worse than stores with remote age verification, and also worse than stores without any AVS. For both systems, in addition to effectiveness, public support and user friendliness need to be investigated. This study shows that remote age verification technology is a promising intervention that increases vendor compliance during the sales of age restricted products. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Individual face-to-face tutorials: the value in nurse education.

PubMed

Nathan, Martina

The individual, face-to-face tutorial is one means by which academic support can be provided to students in higher education. This mode of tutorial support has been deemed effective but it can be considered labour-intensive, which is a concern in the UK with the recession currently impacting on higher education institutions. Nevertheless, with increasing student fees come higher student expectations. With all UK pre-registration nursing study programmes at degree level and with the emphasis on widening access, students may require additional academic support to ensure success. This study aimed to examine the value of individual, face-to-face tutorials for academic support in nurse education. A descriptive and exploratory design was used, mixing qualitative and quantitative methods. The survey approach employed a web-based, self-completion questionnaire, which was distributed to lecturers and pre-registration student nurses in a UK university. Following analysis of the questionnaire results, students were invited to attend a group interview. Findings highlighted the importance of individual, face-to-face tutorials with qualitative data supplying detailed accounts regarding their value.

Tutorial videos of bioinformatics resources: online distribution trial in Japan named TogoTV.

PubMed

Kawano, Shin; Ono, Hiromasa; Takagi, Toshihisa; Bono, Hidemasa

2012-03-01

In recent years, biological web resources such as databases and tools have become more complex because of the enormous amounts of data generated in the field of life sciences. Traditional methods of distributing tutorials include publishing textbooks and posting web documents, but these static contents cannot adequately describe recent dynamic web services. Due to improvements in computer technology, it is now possible to create dynamic content such as video with minimal effort and low cost on most modern computers. The ease of creating and distributing video tutorials instead of static content improves accessibility for researchers, annotators and curators. This article focuses on online video repositories for educational and tutorial videos provided by resource developers and users. It also describes a project in Japan named TogoTV (http://togotv.dbcls.jp/en/) and discusses the production and distribution of high-quality tutorial videos, which would be useful to viewer, with examples. This article intends to stimulate and encourage researchers who develop and use databases and tools to distribute how-to videos as a tool to enhance product usability.

Tutorial videos of bioinformatics resources: online distribution trial in Japan named TogoTV

PubMed Central

Kawano, Shin; Ono, Hiromasa; Takagi, Toshihisa

2012-01-01

In recent years, biological web resources such as databases and tools have become more complex because of the enormous amounts of data generated in the field of life sciences. Traditional methods of distributing tutorials include publishing textbooks and posting web documents, but these static contents cannot adequately describe recent dynamic web services. Due to improvements in computer technology, it is now possible to create dynamic content such as video with minimal effort and low cost on most modern computers. The ease of creating and distributing video tutorials instead of static content improves accessibility for researchers, annotators and curators. This article focuses on online video repositories for educational and tutorial videos provided by resource developers and users. It also describes a project in Japan named TogoTV (http://togotv.dbcls.jp/en/) and discusses the production and distribution of high-quality tutorial videos, which would be useful to viewer, with examples. This article intends to stimulate and encourage researchers who develop and use databases and tools to distribute how-to videos as a tool to enhance product usability. PMID:21803786

Reliability and validity of a Tutorial Group Effectiveness Instrument.

PubMed

Singaram, Veena S; Van Der Vleuten, Cees P M; Van Berkel, Henk; Dolmans, Diana H J M

2010-01-01

Tutorial group effectiveness is essential for the success of learning in problem-based learning (PBL). Less effective and dysfunctional groups compromise the quality of students learning in PBL. This article aims to report on the reliability and validity of an instrument aimed at measuring tutorial group effectiveness in PBL. The items within the instrument are clustered around motivational and cognitive factors based on Slavin's theoretical framework. A confirmatory factor analysis (CFA) was carried out to estimate the validity of the instrument. Furthermore, generalizability studies were conducted and alpha coefficients were computed to determine the reliability and homogeneity of each factor. The CFA indicated that a three-factor model comprising 19 items showed a good fit with the data. Alpha coefficients per factor were high. The findings of the generalizability studies indicated that at least 9-10 student responses are needed in order to obtain reliable data at the tutorial group level. The instrument validated in this study has the potential to provide faculty and students with diagnostic information and feedback about student behaviors that enhance and hinder tutorial group effectiveness.

Nutrition Program Quality Assurance through a Formalized Process of On-Site Program Review

ERIC Educational Resources Information Center

Paddock, Joan Doyle; Dollahite, Jamie

2012-01-01

A protocol for a systematic onsite review of the Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education was developed to support quality programming and ensure compliance with state guidelines and federal regulations. Onsite review of local nutrition program operations is one strategy to meet this…

Research Nurse | Center for Cancer Research

Cancer.gov

We are looking for research nurses to join our clinical program to help us manage the care of patients participating in clinical trials. Duties include, but are not limited to, ensuring adherence to ethical practice in the conduct of clinical trials, research protocol compliance and good clinical practice, ensuring patient comprehension of informed consent, management of care

Developing a Model on Improving Maritime English Training for Maritime Transportation Safety

ERIC Educational Resources Information Center

Yercan, Funda; Fricke, Donna; Stone, Laurie

2005-01-01

Maritime services form an integral part of what regulatory agencies requires for the safe navigation and operation of vessels. Therefore, the maritime industry's compliance with governmental regulations and international protocols has been essential for maritime safety management. As a basis to this aspect, the preparation of maritime students as…

76 FR 36919 - Proof of Concept Demonstration for Electronic Reporting of Clean Water Act Compliance Monitoring...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-23

... commercial products or services of any third-party software providers. Proof of Concept Demonstration for..., protocols, and specifications for the Exchange Network's data exchange services, the software provider shall... demonstration will focus the electronic transmission of NPDES DMRs from a third-party commercial software...

The Development and Piloting of a Mobile Data Collection Protocol to Assess Compliance With a National Tobacco Advertising, Promotion, and Product Display Ban at Retail Venues in the Russian Federation

PubMed Central

Grant, Ashley S; Spires, Mark H; Cohen, Joanna E

2016-01-01

Background Tobacco control policies that lead to a significant reduction in tobacco industry marketing can improve public health by reducing consumption of tobacco and preventing initiation of tobacco use. Laws that ban or restrict advertising and promotion in point-of-sale (POS) environments, in the moment when consumers decide whether or not to purchase a tobacco product, must be correctly implemented to achieve the desired public health benefits. POS policy compliance assessments can support implementation; however, there are challenges to conducting evaluations that are rigorous, cost-effective, and timely. Data collection must be discreet, accurate, and systematic, and ideally collected both before and after policies take effect. The use of mobile phones and other mobile technology provide opportunities to efficiently collect data and support effective tobacco control policies. The Russian Federation (Russia) passed a comprehensive national tobacco control law that included a ban on most forms of tobacco advertising and promotion, effective November 15, 2013. The legislation further prohibited the display of tobacco products at retail trade sites and eliminated kiosks as a legal trade site, effective June 1, 2014. Objective The objective of the study was to develop and test a mobile data collection protocol including: (1) retailer sampling, (2) adaptation of survey instruments for mobile phones, and (3) data management protocols. Methods Two waves of observations were conducted; wave 1 took place during April-May 2014, after the advertising and promotion bans were effective, and again in August-September 2014, after the product display ban and elimination of tobacco sales in kiosks came into effect. Sampling took place in 5 Russian cities: Moscow, St. Petersburg, Novosibirsk, Yekaterinburg, and Kazan. Lack of access to a comprehensive list of licensed tobacco retailers necessitated a sampling approach that included the development of a walking protocol to identify tobacco retailers to observe. Observation instruments were optimized for use on mobile devices and included the collection of images/photos and the geographic location of retailers. Data were uploaded in real-time to a remote (“cloud-based”) server accessible via Internet and verified with the use of a data management protocol that included submission of daily field notes from the research team for review by project managers. Results The walking protocol was a practical means of identifying 780 relevant retail venues in Russia, in the absence of reliable sampling resources. Mobile phones were convenient tools for completing observation checklists discretely and accurately. Daily field notes and meticulous oversight of collected data were critical to ensuring data quality. Conclusions Mobile technology can support timely and accurate data collection and also help monitor data quality through the use of real-time uploads. These protocols can be adapted to assess compliance with other types of public health policies. PMID:27580800

The Development and Piloting of a Mobile Data Collection Protocol to Assess Compliance With a National Tobacco Advertising, Promotion, and Product Display Ban at Retail Venues in the Russian Federation.

PubMed

Grant, Ashley S; Kennedy, Ryan D; Spires, Mark H; Cohen, Joanna E

2016-08-31

Tobacco control policies that lead to a significant reduction in tobacco industry marketing can improve public health by reducing consumption of tobacco and preventing initiation of tobacco use. Laws that ban or restrict advertising and promotion in point-of-sale (POS) environments, in the moment when consumers decide whether or not to purchase a tobacco product, must be correctly implemented to achieve the desired public health benefits. POS policy compliance assessments can support implementation; however, there are challenges to conducting evaluations that are rigorous, cost-effective, and timely. Data collection must be discreet, accurate, and systematic, and ideally collected both before and after policies take effect. The use of mobile phones and other mobile technology provide opportunities to efficiently collect data and support effective tobacco control policies. The Russian Federation (Russia) passed a comprehensive national tobacco control law that included a ban on most forms of tobacco advertising and promotion, effective November 15, 2013. The legislation further prohibited the display of tobacco products at retail trade sites and eliminated kiosks as a legal trade site, effective June 1, 2014. The objective of the study was to develop and test a mobile data collection protocol including: (1) retailer sampling, (2) adaptation of survey instruments for mobile phones, and (3) data management protocols. Two waves of observations were conducted; wave 1 took place during April-May 2014, after the advertising and promotion bans were effective, and again in August-September 2014, after the product display ban and elimination of tobacco sales in kiosks came into effect. Sampling took place in 5 Russian cities: Moscow, St. Petersburg, Novosibirsk, Yekaterinburg, and Kazan. Lack of access to a comprehensive list of licensed tobacco retailers necessitated a sampling approach that included the development of a walking protocol to identify tobacco retailers to observe. Observation instruments were optimized for use on mobile devices and included the collection of images/photos and the geographic location of retailers. Data were uploaded in real-time to a remote ("cloud-based") server accessible via Internet and verified with the use of a data management protocol that included submission of daily field notes from the research team for review by project managers. The walking protocol was a practical means of identifying 780 relevant retail venues in Russia, in the absence of reliable sampling resources. Mobile phones were convenient tools for completing observation checklists discretely and accurately. Daily field notes and meticulous oversight of collected data were critical to ensuring data quality. Mobile technology can support timely and accurate data collection and also help monitor data quality through the use of real-time uploads. These protocols can be adapted to assess compliance with other types of public health policies.

Explanation of the Nagoya Protocol on Access and Benefit Sharing and its implication for microbiology.

PubMed

Smith, David; da Silva, Manuela; Jackson, Julian; Lyal, Christopher

2017-03-01

Working with genetic resources and associated data requires greater attention since the Nagoya Protocol on Access and Benefit Sharing (ABS) came into force in October 2014. Biologists must ensure that they have legal clarity in how they can and cannot use the genetic resources on which they carry out research. Not only must they work within the spirit in the Convention on Biological Diversity (https://www.cbd.int/convention/articles/default.shtml?a=cbd-02) but also they may have regulatory requirements to meet. Although the Nagoya Protocol was negotiated and agreed globally, it is the responsibility of each country that ratifies it to introduce their individual implementing procedures and practices. Many countries in Europe, such as the UK, have chosen not to put access controls in place at this time, but others already have laws enacted providing ABS measures under the Convention on Biological Diversity or specifically to implement the Nagoya Protocol. Access legislation is in place in many countries and information on this can be found at the ABS Clearing House (https://absch.cbd.int/). For example, Brazil, although not a Party to the Nagoya Protocol at the time of writing, has Law 13.123 which entered into force on 17 November 2015, regulated by Decree 8.772 which was published on 11 May 2016. In this case, export of Brazilian genetic resources is not allowed unless the collector is registered in the National System for Genetic Heritage and Associated Traditional Knowledge Management (SisGen). The process entails that a foreign scientist must first of all be registered working with someone in Brazil and have authorization to collect. The enactment of European Union Regulation po. 511/2014 implements Nagoya Protocol elements that govern compliance measures for users and offers the opportunity to demonstrate due diligence in sourcing their organisms by selecting from holdings of 'registered collections'. The UK has introduced a Statutory Instrument that puts in place enforcement measures within the UK to implement this European Union Regulation; this is regulated by Regulatory Delivery, Department for Business, Energy and Industrial Strategies. Scientific communities, including the private sector, individual institutions and organizations, have begun to design policy and best practices for compliance. Microbiologists and culture collections alike need to be aware of the legislation of the source country of the materials they use and put in place best practices for compliance; such best practice has been drafted by the Microbial Resource Research Infrastructure, and other research communities such as the Consortium of European Taxonomic Facilities, the Global Genome Biodiversity Network and the International Organisation for Biological Control have published best practice and/or codes of conduct to ensure legitimate exchange and use of genetic resources.

Environmental Justice Small Grants Program grants tutorial

EPA Pesticide Factsheets

Tutorial on the fair treatment and meaningful involvement of people of all races and incomes with respect to the development of, implementation, and enforcement of environmental laws, regulations and policies.

Forces Mobilization Model (FORCEMOB): Unclassified Training Tutorial

DTIC Science & Technology

2015-08-01

I N S T I T U T E F O R D E F E N S E A N A L Y S E S Forces Mobilization Model (FORCEMOB): Unclassified Training Tutorial James S. Thomason...Graham for review of this document and Mrs. Amberlee Mabe -Stanberry for editing and production assistance. Copyright Notice © 2015 Institute for...N S E A N A L Y S E S Forces Mobilization Model (FORCEMOB): Unclassified Training Tutorial James S. Thomason, Project Leader Robert J. Atwell

The computational linguistics of biological sequences

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

Searls, D.

1995-12-31

This tutorial was one of eight tutorials selected to be presented at the Third International Conference on Intelligent Systems for Molecular Biology which was held in the United Kingdom from July 16 to 19, 1995. Protein sequences are analogous in many respects, particularly their folding behavior. Proteins have a much richer variety of interactions, but in theory the same linguistic principles could come to bear in describing dependencies between distant residues that arise by virtue of three-dimensional structure. This tutorial will concentrate on nucleic acid sequences.

WASP Model Tutorials

EPA Pesticide Factsheets

Contains WASP tutorial videos. WASP Command Line, WASP, Modeling Dissolved Oxygen, Building a Steady State Example, Modeling Nutrients in Rivers, Nutrient Cycles, Interpreting Water Quality Models, Linking with LSPC, WRDB, BASINS, WCS, WASP Network Tool

Surveillance of Environmental and Procedural Measures of Infection Control in the Operating Theatre Setting

PubMed Central

Raggi, Alessandra; Sanna, Tiziana; Mazzetti, Magda; Orsi, Alessandra; Zanni, Angela; Farruggia, Patrizia

2017-01-01

The microbiological contamination of operating theatres and the lack of adherence to best practices by surgical staff represent some of the factors affecting Surgical Site Infections (SSIs). The aim of the present study was to assess the microbiological quality of operating settings and the staff compliance to the SSI evidence-based control measures. Ten operating rooms were examined for microbiological contamination of air and surfaces, after cleaning procedures, in “at rest” conditions. Furthermore, 10 surgical operations were monitored to assess staff compliance to the recommended practices. None of the air samples exceeded microbiological reference standards and only six of the 200 surface samples (3.0%) were slightly above recommended levels. Potentially pathogenic bacteria and moulds were never detected. Staff compliance to best practices varied depending on the type of behaviour investigated and the role of the operator. The major not compliant behaviours were: pre-operative skin antisepsis, crowding of the operating room and hand hygiene of the anaesthetist. The good environmental microbiological quality observed is indicative of the efficacy of the cleaning-sanitization procedures adopted. The major critical point was staff compliance to recommended practices. Awareness campaigns are therefore necessary, aimed at improving the organisation of work so as to facilitate compliance to operative protocols. PMID:29283367

Microprocessor controlled compliance monitor for eye drop medication

PubMed Central

Hermann, M M; Diestelhorst, M

2006-01-01

Background/aims The effectiveness of a self administered eye drop medication can only be assessed if the compliance is known. The authors studied the specificity and sensitivity of a new microprocessor controlled monitoring device. Methods The monitoring system was conducted by an 8 bit microcontroller for data acquisition and storage with sensors measuring applied pressure to the bottle, temperature, and vertical position. 10 devices were mounted under commercial 10 ml eye drops. Test subjects had to note down each application manually. A total of 15 applications each within 3 days was intended. Results Manual reports confirmed 15 applications for each of the 10 bottles. The monitoring devices detected a total of 149 events; one was missed; comprising a sensitivity of 99%. Two devices registered three applications, which did not appear in the manual protocols, indicating a specificity of about 98%. Refrigerated bottles were correctly identified. The battery lifetime exceeded 60 days. Conclusion The new monitoring device demonstrated a high reliability of the collected compliance data. The important, yet often unknown, influence of compliance in patient care and clinical trials shall be illuminated by the new device. This may lead to a better adapted patient care. Studies will profit from a higher credibility and results will be less influenced by non‐compliance. PMID:16540488

Evaluation of hand hygiene adherence in a tertiary hospital.

PubMed

Novoa, Ana M; Pi-Sunyer, Teresa; Sala, Maria; Molins, Eduard; Castells, Xavier

2007-12-01

Although hand hygiene is the most important measure in the prevention of nosocomial infection, adherence to recommendations among health care workers (HCW) is low. Evaluation of compliance with hand hygiene was carried out in a Spanish teaching hospital. In 2005, adherence to hand hygiene was evaluated hospital wide through direct observation, collecting data on hand hygiene carried out whenever indicated (opportunity for hand hygiene). Compliance was defined as handwashing/disinfection in an opportunity for hand hygiene according to hospital protocols. The results were analyzed using mixed effects models, with the HCW observed as the random effect. A total of 1254 opportunities for hand hygiene were observed in 247 HCWs. Mean compliance was 20%. Although few differences were observed among types of HCW, compliance varied according to hospital area (69% in the intensive care unit [ICU]) and timing with respect to patient contact (compliance after contact was twice that before contact). Multivariate analyses revealed a protective odds ratio (OR) for nonadherence in ICUs (OR, 0.04; 95% confidence interval (95% CI): 0.01-0.10) and after patient contact (OR, 0.25; 95% CI: 0.17-0.38). Low adherence observed suggests that new interventions should focus in modification of HCWs' habits and attitudes, working at several levels: individual and institutional.

Improving heart failure disease management in skilled nursing facilities: lessons learned.

PubMed

Dolansky, Mary A; Hitch, Jeanne A; Piña, Ileana L; Boxer, Rebecca S

2013-11-01

The purpose of the study was to design and evaluate an improvement project that implemented HF management in four skilled nursing facilities (SNFs). Kotter's Change Management principles were used to guide the implementation. In addition, half of the facilities had an implementation coach who met with facility staff weekly for 4 months and monthly for 5 months. Weekly and monthly audits were performed that documented compliance with eight key aspects of the protocol. Contextual factors were captured using field notes. Adherence to the HF management protocols was variable ranging from 17% to 82%. Facilitators of implementation included staff who championed the project, an implementation coach, and physician involvement. Barriers were high staff turnover and a hierarchal culture. Opportunities exist to integrate HF management protocols to improve SNF care.

Software Reviews.

ERIC Educational Resources Information Center

Bitter, Gary G., Ed.

1989-01-01

Describes three software packages: (1) "MacMendeleev"--database/graphic display for chemistry, grades 10-12, Macintosh; (2) "Geometry One: Foundations"--geometry tutorial, grades 7-12, IBM; (3) "Mathematics Exploration Toolkit"--algebra and calculus tutorial, grades 8-12, IBM. (MVL)

Virtual tutorials, Wikipedia books, and multimedia-based teaching for blended learning support in a course on algorithms and data structures

NASA Astrophysics Data System (ADS)

Knackmuß, Jenny; Creutzburg, Reiner

2014-02-01

The aim of this paper is to describe the benefit and support of virtual tutorials, Wikipedia books and multimedia-based teaching in a course on Algorithms and Data Structures. We describe our work and experiences gained from using virtual tutorials held in Netucate iLinc sessions and the use of various multimedia and animation elements for the support of deeper understanding of the ordinary lectures held in the standard classroom on Algorithms and Data Structures for undergraduate computer sciences students. We will describe the benefits, form, style and contents of those virtual tutorials. Furthermore, we mention the advantage of Wikipedia books to support the blended learning process using modern mobile devices. Finally, we give some first statistical measures of improved student's scores after introducing this new form of teaching support.

The International Proteomics Tutorial Programme--reaching out to the next generation proteome scientists.

PubMed

James, Peter; Marko-Varga, György A

2011-08-05

One of the most critical functions of the various Proteomics organizations is the training of young scientists and the dissemination of information to the general scientific community. The education committees of the Human Proteome Organisation (HUPO) and the European Proteomics Association (EuPA) together with the other local proteomics associations are therefore launching a joint Tutorial Program to meet these needs. The level is aimed at Masters/PhD level students with good basic training in biology, biochemistry, mathematics and statistics. The Tutorials will consist of a review/teaching article with an accompanying talk slide presentation for classroom teaching. The Tutorial Program will cover core techniques and basics as an introduction to scientists new to the field. The entire series of articles and slides will be made freely available for teaching use at the Journals and Organizations homepages.

A tutorial on the principles of harmonic intonation for trombonists

NASA Astrophysics Data System (ADS)

Keener, Michael Kenneth

A Tutorial on the Principles of Harmonic Intonation for Trombonists includes a manual containing background information, explanations of the principles of harmonic intonation, and printed musical examples for use in learning and practicing the concepts of harmonic intonation. An audio compact disk containing music files corresponding to the printed music completes the set. This tutorial is designed to allow performing musicians and students to practice intonation skills with the pitch-controlled music on the compact disc. The music on the CD was recorded in movable-comma just intonation, replicating performance parameters of wind, string, and vocal ensembles. The compact disc includes sixty tracks of ear-training exercises and interval studies with which to practice intonation perception and adjustment. Tuning notes and examples of equal-tempered intervals and just intervals are included on the CD. The intonation exercises consist of musical major scales, duets, trios, and quartet phrases to be referenced while playing the printed music. The CD tracks allow the performer to play scales in unison (or practice other harmonic intervals) or the missing part of the corresponding duet, trio, or quartet exercise. Instructions in the manual guide the user through a process that can help prepare musicians for more accurate musical ensemble performance. The contextual essay that accompanies the tutorial includes a description of the tutorial, a review of related literature, methodology of construction of the tutorial, evaluations and outcomes, conclusions and recommendations for further research, and a selected bibliography.

Good to Great: Quality-Improvement Initiative Increases and Sustains Pediatric Health Care Worker Hand Hygiene Compliance.

PubMed

McLean, Heather S; Carriker, Charlene; Bordley, William Clay

2017-04-01

The Joint Commission, the Centers for Disease Control and Prevention, and the World Health Organization challenge hospitals to achieve and sustain compliance with effective hand hygiene (HH) practice; however, many inpatient units fail to achieve a high level of reliability. The aim of the project was to increase and sustain health care worker (HCW) compliance with HH protocols from 87% (level of reliability [LOR] 1) to ≥95% (LOR 2) within 9 months on 2 pediatric inpatient units in an academic children's hospital. This study was a time-series, quality-improvement project. Interventions were tested through multiple plan-do-study-act cycles on 2 pediatric inpatient units. HH compliance audits of HCWs on these units were performed randomly each week by the hospital infection prevention program. Control charts of percentages of HCW HH compliance were constructed with 3-σ (data within 3 SDs from a mean) control limits. These control limits were adjusted after achieving significant improvements in performance over time. Charts were annotated with interventions including (1) increasing awareness, (2) providing timely feedback, (3) empowering patients and families to participate in mitigation, (4) providing focused education, and (5) developing interdisciplinary HH champions. HH compliance rates improved from an average of 87% (LOR 1) to ≥95% (LOR 2) within 9 months, and this improvement has been sustained for >2 years on both pediatric inpatient units. Significant and sustained gains in HH compliance rates of ≥95% (LOR 2) can be achieved by applying high-reliability human-factor interventions. Copyright © 2017 by the American Academy of Pediatrics.

[Not Available].

PubMed

Abril, Encarnación; Gómez-Conesa, Antonia; Gutiérrez-Santos, Manuel

2008-05-01

To assess the quality of physiotherapeutic care in patients treated for low back pain in a Primary Health Care physiotherapy unit, and to improve the quality of the care provided to these patients. The first assessment includes all patients treated in 2002 (n=83). Five criteria corresponding to the initial physiotherapeutic assessment were chosen: C1, pain; C2, disability; C3, mobility, muscle examination, and C5, palpation. In order to detect non-compliance, the Ishikawa Fishbone diagram was used. Corrective measures were established in November 2003: publication of an Oswestry questionnaire model for assessing disability and reflecting on the results obtained. The second assessment includes the period of time from 1st November 2003 to 6th April 2004 (n=32). In the initial assessment, compliances observed were: C1: 21.69%; C2: 0; C3: 69.87%; C4: 78.31%, and C5: 84.33%. After implementing corrective measures a significant improvement was observed in the compliance of C1, C2, and C3. In C4 there was an improvement, and in C5 there was a decrease in compliance, both of them without statistical significance. The carrying out of an improvement cycle has enabled non-compliances in the application of this protocol to be detected and corrected. The corrective measures implemented have led to a reduction of the variability in the records. It is advisable to ensure that compliance does not decrease in the areas that initially showed a high level of compliance. Copyright © 2008 Sociedad Española de Calidad Asistencial. Published by Elsevier Espana. All rights reserved.

Evaluation of a protocol for the non-operative management of perforated peptic ulcer.

PubMed

Marshall, C; Ramaswamy, P; Bergin, F G; Rosenberg, I L; Leaper, D J

1999-01-01

The non-operative management of perforated peptic ulcer has previously been shown to be both safe and effective although it remains controversial. A protocol for non-operative management was set up in this hospital in 1989. Adherence to the guidelines in the protocol has been audited over a 6-year period with a review of outcome. The case-notes of patients with a diagnosis of perforated peptic ulcer were reviewed. Twelve guidelines from the protocol were selected for evaluation of compliance to the protocol. Forty-nine patients underwent non-operative treatment initially. Eight patients failed to respond and underwent operation. Complications included abscess formation (seven patients), renal failure (one), gastric ileus (one), chest infection (two), and cardiac failure and stroke (one). Four deaths occurred in this group. Adherence to certain protocol guidelines was poor, notably those concerning prevention of thromboembolism, use of antibiotics, use of contrast examination to confirm the diagnosis and referral for follow-up endoscopy. Two gastric cancers were detected on subsequent endoscopy. This experience demonstrates that non-operative treatment can be used successfully in a general hospital. Adherence to protocol guidelines was found to be variable and the protocol has therefore been simplified. This study highlights the need for an accurate diagnosis and the importance of follow-up endoscopy.

Evaluation of a rapid protocol for the assessment of salt sensitivity against the blood pressure response to dietary sodium chloride restriction.

PubMed

Galletti, F; Ferrara, I; Stinga, F; Iacone, R; Noviello, F; Strazzullo, P

1997-04-01

The "gold standard" for the assessment of salt sensitivity of hypertension is the blood pressure response to dietary NaCl restriction; nevertheless, for practical purposes, a more rapid test that would not depend on the patient's compliance to the dietary prescription would be very useful in clinical research and medical practice. The aim of this study was thus to evaluate the effectiveness and reliability of a rapid, easy-to-standardize protocol for the assessment of salt sensitivity against the blood pressure response to dietary salt restriction. A total of 108 hypertensive patients were screened for salt sensitivity by the modified protocol of Grim et al. Thereafter, nine patients identified by the test as salt sensitive and nine identified as salt resistant followed, for two consecutive periods of 1 week, a diet with normal (200 mmol/day) or low (50 mmol/day) NaCl content. Compliance to the diet was checked by repeated 24-h urine collections. The group as a whole experienced a significant fall in blood pressure during the low Na diet (mean pressure = 123 +/- 3 v 118 +/- 3 mm Hg; P < .05). However, whereas patients identified as salt sensitive by the Grim protocol had a marked and significant blood pressure decrease (systolic -12 mm Hg, diastolic -7 mm Hg), no change was observed in those classified as salt resistant (systolic -2 mm Hg, diastolic -2 mm Hg). A significant correlation between changes in urinary Na excretion and changes in blood pressure was found only in salt-sensitive hypertensive patients. In conclusion, the modified Grim protocol tested in this study was able to correctly predict a significant blood pressure response to dietary salt restriction in the majority of cases. A validation of this test in a larger patient population may be advisable.

Engaging undergraduate nursing students in face-to-face tutorials.

PubMed

Elder, Ruth L; Lewis, Peter A; Windsor, Carol A; Wheeler, Margaret; Forster, Elizabeth; Foster, Joanne; Chapman, Helen

2011-09-01

Chronic nursing shortages have placed increasing pressure on many nursing schools to recruit greater numbers of students with the consequence of larger class sizes. Larger class sizes have the potential to lead to student disengagement. This paper describes a case study that examined the strategies used by a group of nursing lecturers to engage students and to overcome passivity in a Bachelor of Nursing programme. A non-participant observer attended 20 tutorials to observe five academics deliver four tutorials each. Academics were interviewed both individually and as a group following the completion of all tutorial observations. All observations, field notes, interviews and focus groups were coded separately and major themes identified. From this analysis two broad categories emerged: getting students involved; and engagement as a struggle. Academics used a wide variety of techniques to interest and involve students. Additionally, academics desired an equal relationship with students. They believed that both they and the students had some power to influence the dynamics of tutorials and that neither party had ultimate power. The findings of this study serve to re-emphasise past literature which suggests that to engage students, the academics must also engage. Copyright © 2011 Elsevier Ltd. All rights reserved.

TRI.NET Tutorial with Examples

EPA Pesticide Factsheets

This tutorial walks users through some sample TRI.NET searches to illustrate some of the ways this application can be used to access TRI data and answer basic questions about toxic chemical releases in a specific geographic area.

40 CFR 266.103 - Interim status standards for burners.

Code of Federal Regulations, 2014 CFR

2014-07-01

... complying with the CO controls of § 266.104(c), the CO limit is established based on the compliance test... testing planned, including a complete copy of the test protocol and Quality Assurance/Quality Control (QA...; (vi) In subpart G (Closure and post-closure), §§ 265.111-265.115; (vii) In subpart H (Financial...

40 CFR 266.103 - Interim status standards for burners.

Code of Federal Regulations, 2011 CFR

2011-07-01

... complying with the CO controls of § 266.104(c), the CO limit is established based on the compliance test... testing planned, including a complete copy of the test protocol and Quality Assurance/Quality Control (QA...; (vi) In subpart G (Closure and post-closure), §§ 265.111-265.115; (vii) In subpart H (Financial...

40 CFR 266.103 - Interim status standards for burners.

Code of Federal Regulations, 2010 CFR

2010-07-01

... complying with the CO controls of § 266.104(c), the CO limit is established based on the compliance test... testing planned, including a complete copy of the test protocol and Quality Assurance/Quality Control (QA...; (vi) In subpart G (Closure and post-closure), §§ 265.111-265.115; (vii) In subpart H (Financial...

40 CFR 266.103 - Interim status standards for burners.

Code of Federal Regulations, 2012 CFR

2012-07-01

... complying with the CO controls of § 266.104(c), the CO limit is established based on the compliance test... testing planned, including a complete copy of the test protocol and Quality Assurance/Quality Control (QA...; (vi) In subpart G (Closure and post-closure), §§ 265.111-265.115; (vii) In subpart H (Financial...

40 CFR 266.103 - Interim status standards for burners.

Code of Federal Regulations, 2013 CFR

2013-07-01

... complying with the CO controls of § 266.104(c), the CO limit is established based on the compliance test... testing planned, including a complete copy of the test protocol and Quality Assurance/Quality Control (QA...; (vi) In subpart G (Closure and post-closure), §§ 265.111-265.115; (vii) In subpart H (Financial...

Micromilling: A method for ultra-rapid prototyping of plastic microfluidic devices

PubMed Central

Guckenberger, David J.; de Groot, Theodorus E.; Wan, Alwin M.D.; Beebe, David J.; Young, Edmond W. K.

2015-01-01

This tutorial review offers protocols, tips, insight, and considerations for practitioners interested in using micromilling to create microfluidic devices. The objective is to provide a potential user with information to guide them on whether micromilling would fill a specific need within their overall fabrication strategy. Comparisons are made between micromilling and other common fabrication methods for plastics in terms of technical capabilities and cost. The main discussion focuses on “how-to” aspects of micromilling, to enable a user to select proper equipment and tools, and obtain usable microfluidic parts with minimal start-up time and effort. The supplementary information provides more extensive discussion on CNC mill setup, alignment, and programming. We aim to reach an audience with minimal prior experience in milling, but with strong interests in fabrication of microfluidic devices. PMID:25906246

Pectus Carinatum Evaluation Questionnaire (PCEQ): a novel tool to improve the follow-up in patients treated with brace compression.

PubMed

Pessanha, Inês; Severo, Milton; Correia-Pinto, Jorge; Estevão-Costa, José; Henriques-Coelho, Tiago

2016-03-01

A questionnaire (Pectus Carinatum Evaluation Questionnaire, PCEQ) was developed to be applied in follow-up of patients with Pectus Carinatum (PC). After validation of the PCEQ, we aimed to quantify the compliance to brace compression and to assess factors that could influence this treatment in patients with PC. From July 2008 to July 2014, 56 patients with PC were treated with the Calgary Protocol of compressive bracing at Paediatric Surgery Department of Hospital São João. Forty patients (71%) completed the questionnaire. The PCEQ was divided into four sections: (i) compliance; (ii) symptoms; (iii) social influence; (iv) activities. For the validation process of the PCEQ, principal components analysis (PCA), orthogonal varimax or oblimin rotation and Cronbach's α coefficient were used. To evaluate the association between compliance and other sections of the questionnaire, we estimated the Pearson's correlation between compliance factor scores ('Compliance Days' and 'Compliance Hours') and the final score of each new questionnaire component identified by PCA ('Chest Pain', 'Dyspnoea', 'Back Pain', 'Parents' Influence', 'Friends' Influence', 'Activities', 'Time To Compliance'). For the sections 'Symptoms', 'Social Influence' and 'Activities', we estimated final scores as the sum of the questions that constitute each component. For the section 'Compliance', the factor scores were estimated by the regression method. After PCA analysis, the PCEQ found nine different components with high reliability. When analysing the compliance of our study group, the final score for 'Activities' revealed a significant correlation with the factor score for 'Compliance Hours' (r = 0.382, P = 0.015). The final score for 'Time To Compliance' showed a significant correlation with both factor scores for 'Compliance Hours' (r = -0.765, P < 0.001) and 'Compliance Days' (r = -0.345, P < 0.029). The PCEQ seems to be an important tool to follow up patients with PC treated by brace compression. Practical steps, such as developing a tight schedule in the early follow-up period or applying the PCEQ in first visits after initiating brace therapy, can be taken in order to increase compliance with brace therapy and improve the quality of life. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Community Pharmacists Assisting in Total Cardiovascular Health (CPATCH): A Cluster-Randomized, Controlled Trial Testing a Focused Adherence Strategy Involving Community Pharmacies.

PubMed

Blackburn, David F; Evans, Charity D; Eurich, Dean T; Mansell, Kerry D; Jorgenson, Derek J; Taylor, Jeff G; Semchuk, William M; Shevchuk, Yvonne M; Remillard, Alfred J; Tran, David A; Champagne, Anne P

2016-10-01

To test a brief intervention for preventing statin nonadherence among community pharmacy patrons. Prospective, cluster-randomized, controlled trial (the Community Pharmacists Assisting in Total Cardiovascular Health [CPATCH] trial). Thirty community pharmacies in Saskatchewan, Canada. Participating pharmacies were randomized to 15 intervention pharmacies where a brief statin adherence intervention was delivered by pharmacists (intervention group [907 patients]) or 15 usual care pharmacies where no statin adherence intervention was delivered (usual care group [999 patients]) to new users of statins (defined as less than 1 yr of statin therapy). Staff (pharmacy managers, staff pharmacists, and technicians) from intervention pharmacies attended a 2.5-hour workshop on the CPATCH program that prepared pharmacists to deal with the adherence barriers most likely associated with statin use (e.g., safety, cost, patient-provider relationship, and tolerability). Intervention pharmacists screened for new statin users and assessed these adherence barriers. Pharmacists were then instructed to tailor their follow-up plan based on the individual patient's situation. Investigators contacted the intervention pharmacies monthly to assess their compliance with the protocol and to offer additional support to motivate ongoing participation. The primary outcome was mean difference in statin adherence between the intervention and usual care groups. Adherence was measured by the proportion of days covered (PDC) between 6 and 12 months following the original prescription fill date. General estimating equations were used to evaluate the difference in mean adherence between groups. Secondary outcomes included the percentage of new statin users exhibiting optimal adherence (defined as PDC of 80% or higher) and the percentage exhibiting nonpersistence (defined as the cessation of all statin dispensations within 3 mo of the first dispensation). Among 1906 eligible patients, no significant differences in mean adherence were observed between those receiving the intervention and those receiving usual care (71.6% vs 70.9%, p=0.64), the percentage of patients achieving optimal adherence (57.3% vs 55.9%, p=0.51), or the percentage exhibiting nonpersistence (9.4% vs 8.3%, p=0.41). However, compliance to the study protocol was extremely low in several intervention pharmacies. In a post hoc analysis, a higher level of protocol compliance among intervention pharmacies was significantly associated with higher adherence (p<0.01 for trend). Pharmacies falling in the highest tertile of compliance to the study protocol exhibited higher mean adherence among their patients compared with those in the usual care group (β = 0.056, 95% confidence interval [CI] 0.010-0.101, p=0.01), and a significantly higher percentage of patients achieving optimal adherence (odds ratio 1.32, 95% CI 1.08-1.61; p<0.01); however, nonpersistence did not significantly differ between the two groups (5.5% vs 8.3%, p=0.27). The CPATCH intervention was ineffective for improving patient adherence to statin therapy in community pharmacies. However, poor effectiveness may have resulted from a failure to deliver the protocol consistently in several intervention pharmacies. © 2016 Pharmacotherapy Publications, Inc.

Spontaneous Breathing Trials and Conservative Sedation Practices Reduce Mechanical Ventilation Duration in Subjects With ARDS.

PubMed

Kallet, Richard H; Zhuo, Hanjing; Yip, Vivian; Gomez, Antonio; Lipnick, Michael S

2018-01-01

Spontaneous breathing trials (SBTs) and daily sedation interruptions (DSIs) reduce both the duration of mechanical ventilation and ICU length of stay (LOS). The impact of these practices in patients with ARDS has not previously been reported. We examined whether implementation of SBT/DSI protocols reduce duration of mechanical ventilation and ICU LOS in a retrospective group of subjects with ARDS at a large, urban, level-1 trauma center. All ARDS survivors from 2002 to 2016 ( N = 1,053) were partitioned into 2 groups: 397 in the pre-SBT/DSI group (June 2002-December 2007) and 656 in the post-SBT/DSI group (January 2009-April 2016). Patients from 2008, during the protocol implementation period, were excluded. An additional SBT protocol database (2008-2010) was used to assess the efficacy of SBT in transitioning subjects with ARDS to unassisted breathing. Comparisons were assessed by either unpaired t tests or Mann-Whitney tests. Multiple comparisons were made using either one-way analysis of variance or Kruskal-Wallis and Dunn's tests. Linear regression modeling was used to determine variables independently associated with mechanical ventilation duration and ICU LOS; differences were considered statistically significant when P < .05. Compared to the pre-protocol group, subjects with ARDS managed with SBT/DSI protocols experienced pronounced reductions both in median (IQR) mechanical ventilation duration (14 [6-29] vs 9 [4-17] d, respectively, P < .001) and median ICU LOS (18 [8-33] vs 13 [7-22] d, respectively P < .001). In the final model, only treatment in the SBT/DSI period and higher baseline respiratory system compliance were independently associated with reduced mechanical ventilation duration and ICU LOS. Among subjects with ARDS in the SBT performance database, most achieved unassisted breathing with a median of 2 SBTs. Evidenced-based protocols governing weaning and sedation practices were associated with both reduced mechanical ventilation duration and ICU LOS in subjects with ARDS. However, higher respiratory system compliance in the SBT/DSI cohort also contributed to these improved outcomes. Copyright © 2018 by Daedalus Enterprises.

User Manuals for a Primary Care Electronic Medical Record System: A Mixed Methods Study of User- and Vendor-Generated Documents.

PubMed

Shachak, Aviv; Dow, Rustam; Barnsley, Jan; Tu, Karen; Domb, Sharon; Jadad, Alejandro R; Lemieux-Charles, Louise

2013-06-04

Tutorials and user manuals are important forms of impersonal support for using software applications including electronic medical records (EMRs). Differences between user- and vendor documentation may indicate support needs, which are not sufficiently addressed by the official documentation, and reveal new elements that may inform the design of tutorials and user manuals. What are the differences between user-generated tutorials and manuals for an EMR and the official user manual from the software vendor? Effective design of tutorials and user manuals requires careful packaging of information, balance between declarative and procedural texts, an action and task-oriented approach, support for error recognition and recovery, and effective use of visual elements. No previous research compared these elements between formal and informal documents. We conducted an mixed methods study. Seven tutorials and two manuals for an EMR were collected from three family health teams and compared with the official user manual from the software vendor. Documents were qualitatively analyzed using a framework analysis approach in relation to the principles of technical documentation described above. Subsets of the data were quantitatively analyzed using cross-tabulation to compare the types of error information and visual cues in screen captures between user- and vendor-generated manuals. The user-developed tutorials and manuals differed from the vendor-developed manual in that they contained mostly procedural and not declarative information; were customized to the specific workflow, user roles, and patient characteristics; contained more error information related to work processes than to software usage; and used explicit visual cues on screen captures to help users identify window elements. These findings imply that to support EMR implementation, tutorials and manuals need to be customized and adapted to specific organizational contexts and workflows. The main limitation of the study is its generalizability. Future research should address this limitation and may explore alternative approaches to software documentation, such as modular manuals or participatory design.

Implementation of Inquiry-Based Tutorials in AN Introductory Physics Course: the Role of the Graduate Teaching Assistant.

NASA Astrophysics Data System (ADS)

Thoresen, Carol Wiggins

1994-01-01

This study determined if the training provided physics teaching assistants was sufficient to accomplish the objectives of inquiry-based tutorials for an introductory physics course. Qualitative research methods were used: (1) to determine if the Physics by Inquiry method was modeled; (2) to describe the process from the teaching assistant perspective; (3) to determine TA opinions on training methods; (4) to develop a frame of reference to better understand the role of TA's as instructional support staff. The study determined that the teaching assistants verbalized appropriate instructional actions, but were observed to use a predominantly didactic teaching style. TA's held a variety of perceptions and beliefs about inquiry -based learning and how science is learned. They felt comfortable in the role of tutorial instructor. They were satisfied with the training methods provided and had few suggestions to change or improve training for future tutorial instructors. A concurrent theme of teacher action dependent on teacher beliefs was sustained throughout the study. The TA's actions, as tutorial instructors, reflected their educational beliefs, student background and learning experiences. TA's performance as tutorial instructors depended on what they think and believe about learning science. Practical implications exist for training teaching assistants to be tutorial instructors. Some recommendations may be appropriate for TA's required to use instructional methods that they have not experienced as students. Interview prospective teaching assistants to determine educational experience and beliefs. Employ inexperienced teaching assistants whose perspectives match the proposed instructional role and who might be more receptive to modeling. Incorporate training into staff meetings. Provide time for TA's to experience the instructional model with simulation or role play as students and as instructors, accompanied by conference discussion. Use strategies known to enhance adult learning and that are sensitive to the variability of adult learners. Educate for critical reflection; incorporate a system of peer coaching. Include a teaching assistant training component in group process and group management.

Mastering cognitive development theory in computer science education

NASA Astrophysics Data System (ADS)

Gluga, Richard; Kay, Judy; Lister, Raymond; Simon; Kleitman, Sabina

2013-03-01

To design an effective computer science curriculum, educators require a systematic method of classifying the difficulty level of learning activities and assessment tasks. This is important for curriculum design and implementation and for communication between educators. Different educators must be able to use the method consistently, so that classified activities and assessments are comparable across the subjects of a degree, and, ideally, comparable across institutions. One widespread approach to supporting this is to write learning objects in terms of Bloom's Taxonomy. This, or other such classifications, is likely to be more effective if educators can use them consistently, in the way experts would use them. To this end, we present the design and evaluation of our online interactive web-based tutorial system, which can be configured and used to offer training in different classification schemes. We report on results from three evaluations. First, 17 computer science educators complete a tutorial on using Bloom's Taxonomy to classify programming examination questions. Second, 20 computer science educators complete a Neo-Piagetian tutorial. Third evaluation was a comparison of inter-rater reliability scores of computer science educators classifying programming questions using Bloom's Taxonomy, before and after taking our tutorial. Based on the results from these evaluations, we discuss the effectiveness of our tutorial system design for teaching computer science educators how to systematically and consistently classify programming examination questions. We also discuss the suitability of Bloom's Taxonomy and Neo-Piagetian theory for achieving this goal. The Bloom's and Neo-Piagetian tutorials are made available as a community resource. The contributions of this paper are the following: the tutorial system for learning classification schemes for the purpose of coding the difficulty of computing learning materials; its evaluation; new insights into the consistency that computing educators can achieve using Bloom; and first insights into the use of Neo-Piagetian theory by a group of classifiers.

Orthosis noncompliance after the Ponseti method for the treatment of idiopathic clubfeet: a relevant problem that needs reevaluation.

PubMed

Ramírez, Norman; Flynn, John M; Fernández, Samuel; Seda, Wallace; Macchiavelli, Raul E

2011-09-01

Idiopathic talipes equinovarus is the most common congenital defect characterized by the presence of a congenital dysplasia of all musculoskeletal tissues distal to the knee. For many years, the treatment has been based on extensive surgery after manipulation and cast trial. Owing to poor surgical results, Ponseti developed a new treatment protocol consisting of manipulation with cast and an Achilles tenotomy. The new technique requires 4 years of orthotic management to guarantee good results. The most recent studies have emphasized how difficult it is to comply with the orthotic posttreatment protocol. Poor compliance has been attributed to parent's low educational and low income level. The purpose of the study is to evaluate if poor compliance is due to the complexity of the orthotic use or if it is related to family education, cultural, or income factors. Fifty-three patients with 73 idiopathic talipes equinovarus feet were treated with the Ponseti technique and followed for 48 months after completing the cast treatment. There was a male predominance (72%). The mean age at presentation was 1 month (range: 1 wk to 7 mo). Twenty patients (38%) had bilateral involvement, 17 patients (32%) had right side affected, and 16 patients (30%) had the left side involved. The mean time of manipulation and casting treatment was 6 weeks (range: 4 to 10 wk). Thirty-eight patients (72%) required Achilles tenotomy as stipulated by the protocol. Recurrence was considered if there was a deterioration of the Dimeglio severity score requiring remanipulation and casting. Twenty-four out of 73 feet treated by our service showed the evidence of recurrence (33%). Sex, age at presentation, cast treatment duration, unilateral or bilateral, severity score, the necessity of Achilles tenotomy, family educational, or income level did not reveal any significant correlation with the recurrence risk. Noncompliance with the orthotic use showed a significant correlation with the recurrence rate. The noncompliance rate did not show any correlation with the patient demographic data or parent's education level, insurance, or cultural factors as proposed previously. The use of the brace is extremely relevant with the Ponseti technique outcome (recurrence) in the treatment of idiopathic talipes equinovarus. Noncompliance is not related to family education, cultural, or income level. The Ponseti postcasting orthotic protocol needs to be reevaluated to a less demanding option to improve outcome and brace compliance.

The objective measurement of physical activity and sedentary behaviour in 2-3 year olds and their parents: a cross-sectional feasibility study in the bi-ethnic Born in Bradford cohort.

PubMed

Costa, Silvia; Barber, Sally E; Cameron, Noël; Clemes, Stacy A

2015-11-11

The reported lower physical activity (PA) levels of British South Asians (SA) are suggested as a key influence in their increased risk of non-communicable diseases compared to their White British peers. Differences in objectively measured PA and sedentary behaviour (SB) between these ethnic groups have been observed during childhood (ages: 8-10 years). However, no information exists on objectively measured PA/SB in younger children, or how early in life differences in these behaviours emerge. Assessing PA/SB in the Born in Bradford (BIB) cohort study provides an opportunity to address such gaps in the literature, but previous studies have found recruiting and retaining SA participants challenging, and the feasibility of using accelerometers with SA children and parents is unknown. This study investigated the feasibility of recruiting and objectively measuring the habitual PA/SB of 2-3 year old SA and White British children and parents from the BIB study. Families were informed about the study during routine BIB assessments. Consenting families were visited at home for anthropometry measurements, interviews, material delivery and collection. Participants (child and parents) were instructed to wear the ActiGraph GT3X+ for 8 days. Descriptive statistics were computed, and ethnic differences tested (Chi-square) for recruitment uptake and compliance. 160 families (30 % SA) provided contact details, and 97 (22 % SA) agreed to enter the study. White British families showed lower refusal and higher intake into the study than SA (p = 0.006). Of 89 children issued with an accelerometer, 34 % complied with the 8-day protocol (significantly less SA; p = 0.015) and 75 % provided enough days (≥ 3) to assess habitual PA/SB (no ethnic differences). Parental rates of compliance with the protocol did not differ between ethnicities. Issues experienced with the protocol and accelerometer use, and successful implementation strategies/procedures are presented. Although greater efforts may be required to recruit SA, those consenting to participate were as likely as White British to provide enough data to assess habitual PA/SB. The issues and successful strategies reported in this feasibility study represent valuable information for planning future studies, and enhance recruitment and compliance with accelerometer protocols in SA and White British toddlers and parents.

Implementation of safety checklists in surgery: a realist synthesis of evidence.

PubMed

Gillespie, Brigid M; Marshall, Andrea

2015-09-28

The aim of this review is to present a realist synthesis of the evidence of implementation interventions to improve adherence to the use of safety checklists in surgery. Surgical safety checklists have been shown to improve teamwork and patient safety in the operating room. Yet, despite the benefits associated with their use, universal implementation of and compliance with these checklists has been inconsistent. An overview of the literature from 2008 is examined in relation to checklist implementation, compliance, and sustainability. Pawson's and Rycroft-Malone's realist synthesis methodology was used to explain the interaction between context, mechanism, and outcome. This approach incorporated the following: defining the scope of the review, searching and appraising the evidence, extracting and synthesising the findings, and disseminating, implementing, and evaluating the evidence. We identified two theories a priori that explained contextual nuances associated with implementation and evaluation of checklists in surgery: the Normalisation Process Theory and Responsive Regulation Theory. We identified four a priori propositions: (1) Checklist protocols that are prospectively tailored to the context are more likely to be used and sustained in practice, (2) Fidelity and sustainability is increased when checklist protocols can be seamlessly integrated into daily professional practice, (3) Routine embedding of checklist protocols in practice is influenced by factors that promote or inhibit clinicians' participation, and (4) Regulation reinforcement mechanisms that are more contextually responsive should lead to greater compliance in using checklist protocols. The final explanatory model suggests that the sustained use of surgical checklists is discipline-specific and is more likely to occur when medical staff are actively engaged and leading the process of implementation. Involving clinicians in tailoring the checklist to better fit their context of practice and giving them the opportunity to reflect and evaluate the implementation intervention enables greater participation and ownership of the process. A major limitation in the surgical checklist literature is the lack of robust descriptions of intervention methods and implementation strategies. Despite this, two consequential findings have emerged through this realist synthesis: First, the sustained use of surgical checklists is discipline-specific and is more successful when physicians are actively engaged and leading implementation. Second, involving clinicians in tailoring the checklist to their context and encouraging them to reflect on and evaluate the implementation process enables greater participation and ownership.

Adult nutrition assessment tutorial

USDA-ARS?s Scientific Manuscript database

This tutorial presents a systematic approach to nutrition assessment based on a modern appreciation for the contributions of inflammation that serve as the foundation for newly proposed consensus definitions for malnutrition syndromes. Practical indicators of malnutrition and inflammation have been ...

Tutorial on Managing the Blocked List in the EPA Moderated Transaction System (EMTS)

EPA Pesticide Factsheets

A tutorial describing how to manage the blocked list in EMTS, which allows you to block transactions that contain Renewable Identification Numbers (RINs) generated by a specific fuel producer or importer.

Overview of the software inspection process

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

Lane, G.L.; Dabbs, R.

1997-11-01

This tutorial introduces attendees to the Inspection Process and teaches them how to organize and participate in a software inspection. The tutorial advocates the benefits of inspections and encourages attendees to socialize the inspection process in their organizations.

Interactive Problem Solving Tutorials Through Visual Programming

NASA Astrophysics Data System (ADS)

Undreiu, Lucian; Schuster, David; Undreiu, Adriana

2008-10-01

We have used LabVIEW visual programming to build an interactive tutorial to promote conceptual understanding in physics problem solving. This programming environment is able to offer a web-accessible problem solving experience that enables students to work at their own pace and receive feedback. Intuitive graphical symbols, modular structures and the ability to create templates are just a few of the advantages this software has to offer. The architecture of an application can be designed in a way that allows instructors with little knowledge of LabVIEW to easily personalize it. Both the physics solution and the interactive pedagogy can be visually programmed in LabVIEW. Our physics pedagogy approach is that of cognitive apprenticeship, in that the tutorial guides students to develop conceptual understanding and physical insight into phenomena, rather than purely formula-based solutions. We demonstrate how this model is reflected in the design and programming of the interactive tutorials.

UH-60 Airloads Program Tutorial

NASA Technical Reports Server (NTRS)

Bousman, William G.

2009-01-01

From the fall of 1993 to late winter of 1994, NASA Ames and the U.S. Army flew a flight test program using a UH-60A helicopter with extensive instrumentation on the rotor and blades, including 242 pressure transducers. Over this period, approximately 30 flights were made, and data were obtained in level flight, maneuver, ascents, and descents. Coordinated acoustic measurements were obtained with a ground-acoustic array in cooperation with NASA Langley, and in-flight acoustic measurements with a YO-3A aircraft. NASA has sponsored the creation of a "tutorial' which covers the depth and breadth of the flight test program with a mixture of text and graphics. The primary purpose of this tutorial is to introduce the student to what is known about rotor aerodynamics based on the UH-60A measurements. The tutorial will also be useful to anyone interested in helicopters who would like to have more detailed knowledge about helicopter aerodynamics.

Introduction to multifractal detrended fluctuation analysis in matlab.

PubMed

Ihlen, Espen A F

2012-01-01

Fractal structures are found in biomedical time series from a wide range of physiological phenomena. The multifractal spectrum identifies the deviations in fractal structure within time periods with large and small fluctuations. The present tutorial is an introduction to multifractal detrended fluctuation analysis (MFDFA) that estimates the multifractal spectrum of biomedical time series. The tutorial presents MFDFA step-by-step in an interactive Matlab session. All Matlab tools needed are available in Introduction to MFDFA folder at the website www.ntnu.edu/inm/geri/software. MFDFA are introduced in Matlab code boxes where the reader can employ pieces of, or the entire MFDFA to example time series. After introducing MFDFA, the tutorial discusses the best practice of MFDFA in biomedical signal processing. The main aim of the tutorial is to give the reader a simple self-sustained guide to the implementation of MFDFA and interpretation of the resulting multifractal spectra.

Introduction to Multifractal Detrended Fluctuation Analysis in Matlab

PubMed Central

Ihlen, Espen A. F.

2012-01-01

Fractal structures are found in biomedical time series from a wide range of physiological phenomena. The multifractal spectrum identifies the deviations in fractal structure within time periods with large and small fluctuations. The present tutorial is an introduction to multifractal detrended fluctuation analysis (MFDFA) that estimates the multifractal spectrum of biomedical time series. The tutorial presents MFDFA step-by-step in an interactive Matlab session. All Matlab tools needed are available in Introduction to MFDFA folder at the website www.ntnu.edu/inm/geri/software. MFDFA are introduced in Matlab code boxes where the reader can employ pieces of, or the entire MFDFA to example time series. After introducing MFDFA, the tutorial discusses the best practice of MFDFA in biomedical signal processing. The main aim of the tutorial is to give the reader a simple self-sustained guide to the implementation of MFDFA and interpretation of the resulting multifractal spectra. PMID:22675302

Impact of Science Tutoring on African Americans' Science Scores on the High School Students' Graduation Examination

NASA Astrophysics Data System (ADS)

Davis, Edward

This study investigated the relationship between an after-school tutorial program for African American high school students at a Title I school and scores on the science portion of the High School Graduation Examination (HSGE). Passing the examination was required for graduation. The target high school is 99% African American and the passing rate of the target high school was 42%---lower than the state average of 76%. The purpose of the study was to identify (a) the relationship between a science tutorial program and scores on the science portion of the HSGE, (b) the predictors of tutoring need by analyzing the relationship between biology grades and scores on the science portion of the HSGE, and (c) the findings between biology grades and scores on the science portion of the HSGE by analyzing the relationship between tutorial attendance and HSGE scores. The study was based on Piaget's cognitive constructivism, which implied the potential benefits of tutorials on high-stakes testing. This study used a 1-group pretest-posttest, quantitative methodology. Results showed a significant relationship between tutoring and scores on the biology portion of the HSGE. Results found no significant relationship between the tutorial attendance and the scores on the biology portion of the HSGE or between the biology grades and scores on the biology portion of the HSGE before tutoring. It has implications for positive social change by providing educational stakeholders with empirically-based guidance in determining the potential benefit of tutorial intervention strategies on high school graduation examination scores.

Simplifying structure analysis projects with customizable chime-based templates*.

PubMed

Thompson, Scott E; Sears, Duane W

2005-09-01

Structure/function relationships are fundamental to understanding the properties of biological molecules, and thus it is imperative that biochemistry students learn how to analyze such relationships. Here we describe Chime-based web page templates and tutorials designed to help students develop their own strategies for exploring macromolecular three-dimensional structures like those on our course website. The templates can easily be customized for any structure of interest, and some templates include a Command Entry Line and a Message Recall Box for more refined macromolecular exploration using RasMol/Chime image modification commands. The tutorials present students with an integrated overview of the image modification capabilities of the Chime plug-in and its underlying RasMol-based command structure as accessed through the Command Entry Line. The tutorial also illustrates how RasMol/Chime command syntax addresses specific formatted structural information in a standard Protein Data Bank file. Judging by the high quality of structure-based presentations given by students who have used these templates and tutorials, it appears that these resources can help students learn to analyze complex macromolecular structures while also providing them with convenient tools for creating scientifically meaningful and visually effective molecular images to share with others. (The templates, tutorials, and our course website can be viewed at the following URLs, respectively: tutor.lscf.ucsb.edu/instdev/sears/biochemistry/presentations/demos-downloads.htm, tutor.lscf.ucsb.edu/instdev/sears/biochemistry/tutorials/pdbtutorial/frontwindow.html, and tutor.lscf.ucsb.edu/instdev/sears/biochemistry/.). Copyright © 2005 International Union of Biochemistry and Molecular Biology, Inc.

Active engagement in a web-based tutorial to prevent obesity grounded in Fuzzy-Trace Theory predicts higher knowledge and gist comprehension.

PubMed

Brust-Renck, Priscila G; Reyna, Valerie F; Wilhelms, Evan A; Wolfe, Christopher R; Widmer, Colin L; Cedillos-Whynott, Elizabeth M; Morant, A Kate

2017-08-01

We used Sharable Knowledge Objects (SKOs) to create an Intelligent Tutoring System (ITS) grounded in Fuzzy-Trace Theory to teach women about obesity prevention: GistFit, getting the gist of healthy eating and exercise. The theory predicts that reliance on gist mental representations (as opposed to verbatim) is more effective in reducing health risks and improving decision making. Technical information was translated into decision-relevant gist representations and gist principles (i.e., healthy values). The SKO was hypothesized to facilitate extracting these gist representations and principles by engaging women in dialogue, "understanding" their responses, and replying appropriately to prompt additional engagement. Participants were randomly assigned to either the obesity prevention tutorial (GistFit) or a control tutorial containing different content using the same technology. Participants were administered assessments of knowledge about nutrition and exercise, gist comprehension, gist principles, behavioral intentions and self-reported behavior. An analysis of engagement in tutorial dialogues and responses to multiple-choice questions to check understanding throughout the tutorial revealed significant correlations between these conversations and scores on subsequent knowledge tests and gist comprehension. Knowledge and comprehension measures correlated with healthier behavior and greater intentions to perform healthy behavior. Differences between GistFit and control tutorials were greater for participants who engaged more fully. Thus, results are consistent with the hypothesis that active engagement with a new gist-based ITS, rather than a passive memorization of verbatim details, was associated with an array of known psychosocial mediators of preventive health decisions, such as knowledge acquisition, and gist comprehension.

Skin cancer risks avoided by the Montreal Protocol--worldwide modeling integrating coupled climate-chemistry models with a risk model for UV.

PubMed

van Dijk, Arjan; Slaper, Harry; den Outer, Peter N; Morgenstern, Olaf; Braesicke, Peter; Pyle, John A; Garny, Hella; Stenke, Andrea; Dameris, Martin; Kazantzidis, Andreas; Tourpali, Kleareti; Bais, Alkiviadis F

2013-01-01

The assessment model for ultraviolet radiation and risk "AMOUR" is applied to output from two chemistry-climate models (CCMs). Results from the UK Chemistry and Aerosols CCM are used to quantify the worldwide skin cancer risk avoided by the Montreal Protocol and its amendments: by the year 2030, two million cases of skin cancer have been prevented yearly, which is 14% fewer skin cancer cases per year. In the "World Avoided," excess skin cancer incidence will continue to grow dramatically after 2030. Results from the CCM E39C-A are used to estimate skin cancer risk that had already been inevitably committed once ozone depletion was recognized: excess incidence will peak mid 21st century and then recover or even super-recover at the end of the century. When compared with a "No Depletion" scenario, with ozone undepleted and cloud characteristics as in the 1960s throughout, excess incidence (extra yearly cases skin cancer per million people) of the "Full Compliance with Montreal Protocol" scenario is in the ranges: New Zealand: 100-150, Congo: -10-0, Patagonia: 20-50, Western Europe: 30-40, China: 90-120, South-West USA: 80-110, Mediterranean: 90-100 and North-East Australia: 170-200. This is up to 4% of total local incidence in the Full Compliance scenario in the peak year. © 2012 Wiley Periodicals, Inc. Photochemistry and Photobiology © 2012 The American Society of Photobiology.

Protocols for Late Maxillary Protraction in Cleft Lip and Palate Patients at Childrens Hospital Los Angeles

PubMed Central

Yen, Stephen L-K

2011-01-01

This paper describes the protocols used at Childrens Hospital Los Angeles (CHLA) to protract the maxilla during early adolescence. It is a modification of techniques introduced by Eric Liou with his Alternate Rapid Maxillary Expansion and Constriction (ALT-RAMEC) technique. The main differences between the CHLA protocol and previous maxillary protraction protocols are the age the protraction is attempted, the sutural loosening by alternating weekly expansion with constriction and the use of Class III elastics to support and redirect the protraction by nightly facemask wear. The CHLA protocol entirely depends on patient compliance and must be carefully taught and monitored. In a cooperative patient, the technique can correct a Class III malocclusion that previously would have been treated with LeFort 1 maxillary advancement surgery. Thus, it is not appropriate for patients requiring 2 jaw surgeries to correct mandibular prognathism, occlusal cants or facial asymmetry. The maxillary protraction appears to work by a combination of skeletal advancement, dental compensation and rotation of the occlusal planes. Microscrew/microimplant/temporary anchorage devices have been used with these maxillary protraction protocols to assist in expanding the maxilla, increasing skeletal anchorage during protraction, limiting dental compensations and reducing skeletal relapse. PMID:21765629

34 CFR 675.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... accessible to the community), literacy training, education (including tutorial services), welfare, social..., security, and social, health, and tutorial services. Student services do not have to be direct or involve personal interaction with students. For purposes of this definition, facility maintenance, cleaning...

Understanding Medical Words: A Tutorial from the National Library of Medicine

MedlinePlus

... Understanding Medical Words: A Tutorial from the National Library of Medicine To use the sharing features on ... MedlinePlus Connect for EHRs For Developers U.S. National Library of Medicine 8600 Rockville Pike, Bethesda, MD 20894 ...

Effect of Physician Tutorials on Prescribing Patterns of Graduate Physicians.

ERIC Educational Resources Information Center

Klein, Lawrence E.; And Others

1981-01-01

Physicians in an experimental group were surveyed to assess their knowledge of the effectiveness, cost, and side effects of antibiotics, and a tutorial was developed to modify some prescribing patterns. Prescribing patterns were statistically different. (Author/MLW)

Patient compliance with touchdown weight bearing after microfracture treatment of talar osteochondral lesions.

PubMed

Polat, Gökhan; Karademir, Gökhan; Akalan, Ekin; Aşık, Mehmet; Erdil, Mehmet

2017-03-20

The aim of this study was to prospectively evaluate the compliance of our patients with a touchdown weight bearing (without supporting any weight on the affected side by only touching the plantar aspect of the foot to the ground to maintain balance to protect the affected side from mechanical loading) postoperative rehabilitation protocol after treatment of talar osteochondral lesion (TOL). Fourteen patients, who had been treated with arthroscopic debridement and microfracture, were followed prospectively. The patients were evaluated for weight bearing compliance with using a stationary gait analysis and feedback system at the postoperative first day, first week, third week, and sixth week. The mean visual analog scale (VAS) scores of the patients at the preoperative, postoperative first day, first week, third week, and sixth weeks were 5.5, 5.9, 3.6, 0.9, and 0.4, respectively. The decrease in VAS scores were statistically significant (p < 0.0001). First postoperative day revealed a mean value of transmitted weight of 4.08% ±0.8 (one non-compliant patient). The mean value was 4.34% ±0.8 at the first postoperative week (two non-compliant patients), 6.95% ±2.3 at the third postoperative week (eight non-compliant patients), and 10.8% ±4.8 at the sixth postoperative week (11 non-compliant patients). In the analysis of data, we found a negative correlation between VAS scores and transmitted weight (Kendall's tau b = -0.445 and p = 0.0228). Although patients were able to learn and adjust to the touchdown weight bearing gait protocol during the early postoperative period, most patients became non-compliant when their pain was relieved. To prevent this situation of non-compliance, patients should be warned to obey the weight bearing restrictions, and patients should be called for a follow-up at the third postoperative week.

Data-Driven Design of Intelligent Wireless Networks: An Overview and Tutorial.

PubMed

Kulin, Merima; Fortuna, Carolina; De Poorter, Eli; Deschrijver, Dirk; Moerman, Ingrid

2016-06-01

Data science or "data-driven research" is a research approach that uses real-life data to gain insight about the behavior of systems. It enables the analysis of small, simple as well as large and more complex systems in order to assess whether they function according to the intended design and as seen in simulation. Data science approaches have been successfully applied to analyze networked interactions in several research areas such as large-scale social networks, advanced business and healthcare processes. Wireless networks can exhibit unpredictable interactions between algorithms from multiple protocol layers, interactions between multiple devices, and hardware specific influences. These interactions can lead to a difference between real-world functioning and design time functioning. Data science methods can help to detect the actual behavior and possibly help to correct it. Data science is increasingly used in wireless research. To support data-driven research in wireless networks, this paper illustrates the step-by-step methodology that has to be applied to extract knowledge from raw data traces. To this end, the paper (i) clarifies when, why and how to use data science in wireless network research; (ii) provides a generic framework for applying data science in wireless networks; (iii) gives an overview of existing research papers that utilized data science approaches in wireless networks; (iv) illustrates the overall knowledge discovery process through an extensive example in which device types are identified based on their traffic patterns; (v) provides the reader the necessary datasets and scripts to go through the tutorial steps themselves.

Data-Driven Design of Intelligent Wireless Networks: An Overview and Tutorial

PubMed Central

Kulin, Merima; Fortuna, Carolina; De Poorter, Eli; Deschrijver, Dirk; Moerman, Ingrid

2016-01-01

Data science or “data-driven research” is a research approach that uses real-life data to gain insight about the behavior of systems. It enables the analysis of small, simple as well as large and more complex systems in order to assess whether they function according to the intended design and as seen in simulation. Data science approaches have been successfully applied to analyze networked interactions in several research areas such as large-scale social networks, advanced business and healthcare processes. Wireless networks can exhibit unpredictable interactions between algorithms from multiple protocol layers, interactions between multiple devices, and hardware specific influences. These interactions can lead to a difference between real-world functioning and design time functioning. Data science methods can help to detect the actual behavior and possibly help to correct it. Data science is increasingly used in wireless research. To support data-driven research in wireless networks, this paper illustrates the step-by-step methodology that has to be applied to extract knowledge from raw data traces. To this end, the paper (i) clarifies when, why and how to use data science in wireless network research; (ii) provides a generic framework for applying data science in wireless networks; (iii) gives an overview of existing research papers that utilized data science approaches in wireless networks; (iv) illustrates the overall knowledge discovery process through an extensive example in which device types are identified based on their traffic patterns; (v) provides the reader the necessary datasets and scripts to go through the tutorial steps themselves. PMID:27258286

[Evaluation of a thyroid disease referral protocal in a health area of Madrid].

PubMed

López, A; Rollán, M T; Bedoya, M J; García, C

The collaboration between healthcare levels is essential for our patients. The aim of this study is to determine the suitability of a referral protocol between the different healthcare levels. A collaboration study was carried out between general practitioners, endocrinologists, and the Department of Biochemistry. After creating the protocol together and implementing it, the suitability was evaluated. A total of 284 referral sheets were evaluated, 65% were adequately sent, and 51% were referred due to laboratory abnormalities, 42% for morphological alterations, and 7% for both reasons. Just under three-quarters (72%) were referred in the normal way (adequacy 90.6%). The clinical information in the referral sheet was considered adequate in 59%, and the request for ultrasound was adequate in 78%. A significant number (16%) of patients should have been returned to Primary Care. It is considered that creating protocols is part of our task. The compliance with the protocol can be improved in Primary Care and specialised care. Publicado por Elsevier España, S.L.U.

Compliance with Antimalarial Chemoprophylaxis Recommendations for Wounded United States Military Personnel Admitted to a Military Treatment Facility

PubMed Central

Rini, Elizabeth A.; Weintrob, Amy C.; Tribble, David R.; Lloyd, Bradley A.; Warkentien, Tyler E.; Shaikh, Faraz; Li, Ping; Aggarwal, Deepak; Carson, M. Leigh; Murray, Clinton K.

2014-01-01

Malaria chemoprophylaxis is used as a preventive measure in military personnel deployed to malaria-endemic countries. However, limited information is available on compliance with chemoprophylaxis among trauma patients during hospitalization and after discharge. Therefore, we assessed antimalarial primary chemoprophylaxis and presumptive antirelapse therapy (primaquine) compliance among wounded United States military personnel after medical evacuation from Afghanistan (June 2009–August 2011) to Landstuhl Regional Medical Center in Landstuhl, Germany, and then to three U.S. military hospitals. Among admissions at Landstuhl Regional Medical Center, 74% of 2,540 patients were prescribed primary chemoprophylaxis and < 1% were prescribed primaquine. After transfer of 1,331 patients to U.S. hospitals, 93% received primary chemoprophylaxis and 33% received primaquine. Of 751 trauma patients with available post-admission data, 42% received primary chemoprophylaxis for four weeks, 33% received primaquine for 14 days, and 17% received both. These antimalarial chemoprophylaxis prescription rates suggest that improved protocols to continue malaria chemoprophylaxis in accordance with force protection guidelines are needed. PMID:24732457

Compliance revisited: pharmaceutical drug trials in the era of the contract research organization.

PubMed

Jonvallen, Petra

2009-12-01

Over the past decade, the management of clinical trials of pharmaceuticals has become a veritable industry, as evidenced by the emergence and proliferation of contract research organizations (CROs) that co-ordinate and monitor trials. This article focuses on work performed by one CRO involved in the introduction of new software, modelled on industrial production processes, into clinical trial practices. It investigates how this new management technique relates to the work performed in the clinic to ensure that trial participants comply with the protocol. Using an analytical distinction between 'classical' management work and invisible work, the article contextualizes the meaning of compliance in the clinic and suggests that the work involved in producing compliance should be taken into consideration by those concerned with validity of trials, as clinical trials are put under private industrial management. The article builds on participant observation at a Swedish university hospital and interviews the nurses, dieticians, doctors and a software engineer, all part of a team involved in pharmaceutical drug trials on a potential obesity drug.

Achievement of Audi-Tutorial and Conventional Biology Students, A Comparative Study

ERIC Educational Resources Information Center

Sparks, Phillip D.; Unbehaun, Laraine M.

1971-01-01

Students studying a biology course by audio-tutorial or conventional lecture-laboratory methods differed in achievement on course examinations, with the A-T group scoring significantly higher on the total test and 3 of the 9 subtests. (AL)

Models of Learning in ICAI.

ERIC Educational Resources Information Center

Duchastel, P.; And Others

1989-01-01

Discusses intelligent computer assisted instruction (ICAI) and presents various models of learning which have been proposed. Topics discussed include artificial intelligence; intelligent tutorial systems; tutorial strategies; learner control; system design; learning theory; and knowledge representation of proper and improper (i.e., incorrect)…

Research and Teaching: Correlations between Students' Written Responses to Lecture-Tutorial Questions and Their Understandings of Key Astrophysics Concepts

ERIC Educational Resources Information Center

Eckenrode, Jeffrey; Prather, Edward E.; Wallace, Colin S.

2016-01-01

This article reports on an investigation into the correlations between students' understandings of introductory astronomy concepts and the correctness and coherency of their written responses to targeted Lecture-Tutorial questions.

Improving the University Tutorial.

ERIC Educational Resources Information Center

Stanton, Harry E.

1982-01-01

Frequently, tutorial or seminar members take no part in discussion, a feature considered essential to this teaching method. Tutors may be largely responsible by dominating discussion. Student participation can be increased by varying teaching methods; reducing discussion group size, brainstorming, idea development techniques, and student…

Evaluating Internet Health Information: A Tutorial from the National Library of Medicine

MedlinePlus

... Internet Health Information: A Tutorial from the National Library of Medicine To use the sharing features on ... MedlinePlus Connect for EHRs For Developers U.S. National Library of Medicine 8600 Rockville Pike, Bethesda, MD 20894 ...

A High Intensity, Short-Term, Tutorial/Enrichment Program in Reading.

ERIC Educational Resources Information Center

Martin, Rita J.; And Others.

1981-01-01

The Summer Adventure in Learning (SAIL) program was developed to train prospective teachers in tutorial methods intended to improve reading achievement. The program's primary instructional objective was to decrease the pupil reading rate resulting in improved reading comprehension. (JN)

Analytic Strategies of Streaming Data for eHealth.

PubMed

Yoon, Sunmoo

2016-01-01

New analytic strategies for streaming big data from wearable devices and social media are emerging in ehealth. We face challenges to find meaningful patterns from big data because researchers face difficulties to process big volume of streaming data using traditional processing applications.1 This introductory 180 minutes tutorial offers hand-on instruction on analytics2 (e.g., topic modeling, social network analysis) of streaming data. This tutorial aims to provide practical strategies of information on reducing dimensionality using examples of big data. This tutorial will highlight strategies of incorporating domain experts and a comprehensive approach to streaming social media data.

A tutorial on the use of Excel 2010 and Excel for Mac 2011 for conducting delay-discounting analyses.

PubMed

Reed, Derek D; Kaplan, Brent A; Brewer, Adam T

2012-01-01

In recent years, researchers and practitioners in the behavioral sciences have profited from a growing literature on delay discounting. The purpose of this article is to provide readers with a brief tutorial on how to use Microsoft Office Excel 2010 and Excel for Mac 2011 to analyze discounting data to yield parameters for both the hyperbolic discounting model and area under the curve. This tutorial is intended to encourage the quantitative analysis of behavior in both research and applied settings by readers with relatively little formal training in nonlinear regression.

A TUTORIAL ON THE USE OF EXCEL 2010 AND EXCEL FOR MAC 2011 FOR CONDUCTING DELAY-DISCOUNTING ANALYSES

PubMed Central

Reed, Derek D; Kaplan, Brent A; Brewer, Adam T

2012-01-01

In recent years, researchers and practitioners in the behavioral sciences have profited from a growing literature on delay discounting. The purpose of this article is to provide readers with a brief tutorial on how to use Microsoft Office Excel 2010 and Excel for Mac 2011 to analyze discounting data to yield parameters for both the hyperbolic discounting model and area under the curve. This tutorial is intended to encourage the quantitative analysis of behavior in both research and applied settings by readers with relatively little formal training in nonlinear regression. PMID:22844143

The MaizeGDB Genome Browser tutorial: one example of database outreach to biologists via video.

PubMed

Harper, Lisa C; Schaeffer, Mary L; Thistle, Jordan; Gardiner, Jack M; Andorf, Carson M; Campbell, Darwin A; Cannon, Ethalinda K S; Braun, Bremen L; Birkett, Scott M; Lawrence, Carolyn J; Sen, Taner Z

2011-01-01

Video tutorials are an effective way for researchers to quickly learn how to use online tools offered by biological databases. At MaizeGDB, we have developed a number of video tutorials that demonstrate how to use various tools and explicitly outline the caveats researchers should know to interpret the information available to them. One such popular video currently available is 'Using the MaizeGDB Genome Browser', which describes how the maize genome was sequenced and assembled as well as how the sequence can be visualized and interacted with via the MaizeGDB Genome Browser. Database

Power Analysis Tutorial for Experimental Design Software

DTIC Science & Technology

2014-11-01

I N S T I T U T E F O R D E F E N S E A N A L Y S E S IDA Document D-5205 November 2014 Power Analysis Tutorial for Experimental Design Software...16) [Jun 2013]. I N S T I T U T E F O R D E F E N S E A N A L Y S E S IDA Document D-5205 Power Analysis Tutorial for Experimental Design ...Test and Evaluation (T&E) community is increasing its employment of Design of Experiments (DOE), a rigorous methodology for planning and evaluating

Interactive Web-based tutorials for teaching digital electronics

NASA Astrophysics Data System (ADS)

Bailey, Donald G.

2000-10-01

With a wide range of student abilities in a class, it is difficult to effectively teach and stimulate all students. A series of web based tutorials was designed to help weaker students and stretch the stronger students. The tutorials consist of a series of HTML web pages with embedded Java applets. This combination is particularly powerful for providing interactive demonstrations because any textual content may be easily provided within the web page. The applet is able to be a compete working program that dynamically illustrates the concept, or provides a working environment for the student to experiment and work through their solution. The applet is dynamic, and responds to the student through both mouse clicks and keyboard entry. These allow the student to adjust parameters, make selections, and affect the way the program is run or information is displayed. Such interaction allows each applet to provide a mini demonstration or experiment to help the student understand a particular concept or technique. The approach taken is illustrated with a tutorial that dynamically shows the relationships between a truth table, Karnaugh amp, logic circuit and Boolean algebra representations of a logic function, and dramatically illustrates the effect of minimization on the resultant circuit. Use of the tutorial has resulted in significant benefits, particularly with weaker students.

An interactive problem-solving approach to teach traumatology for medical students.

PubMed

Abu-Zidan, Fikri M; Elzubeir, Margaret A

2010-08-13

We aimed to evaluate an interactive problem-solving approach for teaching traumatology from perspectives of students and consider its implications on Faculty development. A two hour problem-solving, interactive tutorial on traumatology was structured to cover main topics in trauma management. The tutorial was based on real cases covering specific topics and objectives. Seven tutorials (5-9 students in each) were given by the same tutor with the same format for fourth and fifth year medical students in Auckland and UAE Universities (n = 50). A 16 item questionnaire, on a 7 point Likert-type scale, focusing on educational tools, tutor-based skills, and student-centered skills were answered by the students followed by open ended comments. The tutorials were highly ranked by the students. The mean values of educational tools was the highest followed by tutor-centered skills and finally student-centered skills. There was a significant increase of the rating of studied attributes over time (F = 3.9, p = 0.004, ANOVA). Students' open ended comments were highly supportive of the interactive problem-solving approach for teaching traumatology. The interactive problem-solving approach for tutorials can be an effective enjoyable alternative or supplement to traditional instruction for teaching traumatology to medical students. Training for this approach should be encouraged for Faculty development.

Using hypermedia to develop an intelligent tutorial/diagnostic system for the Space Shuttle Main Engine Controller Lab

NASA Technical Reports Server (NTRS)

Oreilly, Daniel; Williams, Robert; Yarborough, Kevin

1988-01-01

This is a tutorial/diagnostic system for training personnel in the use of the Space Shuttle Main Engine Controller (SSMEC) Simulation Lab. It also provides a diagnostic capable of isolating lab failures at least to the major lab component. The system was implemented using Hypercard, which is an program of hypermedia running on Apple Macintosh computers. Hypercard proved to be a viable platform for the development and use of sophisticated tutorial systems and moderately capable diagnostic systems. This tutorial/diagnostic system uses the basic Hypercard tools to provide the tutorial. The diagnostic part of the system uses a simple interpreter written in the Hypercard language (Hypertalk) to implement the backward chaining rule based logic commonly found in diagnostic systems using Prolog. Some of the advantages of Hypercard in developing this type of system include sophisticated graphics, animation, sound and voice capabilities, its ability as a hypermedia tool, and its ability to include digitized pictures. The major disadvantage is the slow execution time for evaluation of rules (due to the interpretive processing of the language). Other disadvantages include the limitation on the size of the cards, that color is not supported, that it does not support grey scale graphics, and its lack of selectable fonts for text fields.

Multidimensional Generalized Functions in Aeroacoustics and Fluid Mechanics. Part 1; Basic Concepts and Operations

NASA Technical Reports Server (NTRS)

Farassat, Fereidoun; Myers, Michael K.

2011-01-01

This paper is the first part of a three part tutorial on multidimensional generalized functions (GFs) and their applications in aeroacoustics and fluid mechanics. The subject is highly fascinating and essential in many areas of science and, in particular, wave propagation problems. In this tutorial, we strive to present rigorously and clearly the basic concepts and the tools that are needed to use GFs in applications effectively and with ease. We give many examples to help the readers in understanding the mathematical ideas presented here. The first part of the tutorial is on the basic concepts of GFs. Here we define GFs, their properties and some common operations on them. We define the important concept of generalized differentiation and then give some interesting elementary and advanced examples on Green's functions and wave propagation problems. Here, the analytic power of GFs in applications is demonstrated with ease and elegance. Part 2 of this tutorial is on the diverse applications of generalized derivatives (GDs). Part 3 is on generalized Fourier transformations and some more advanced topics. One goal of writing this tutorial is to convince readers that, because of their powerful operational properties, GFs are absolutely essential and useful in engineering and physics, particularly in aeroacoustics and fluid mechanics.

DEVELOPMENT, VALIDATION AND FIELD USE OF NOVEL METHOD FOR EXTRACTING AND ANALYZING ORGANOPHOSPHATE (OP) AND PYRETHROID PESTICIDE METABOLITES AND CREATININE FROM COMMERCIALLY AVAILABLE DISPOSABLE DIAPERS

EPA Science Inventory

The ability to efficiently extract urine from disposable diapers ensures an easy to use urine collection protocol and ready compliance for caregivers of very young children. The use of disposable diapers is also desirable because of their high capacity- urine is retained effecti...

Pre-Activity and Post-Activity Stretching Perceptions and Practices in NCAA Division I Volleyball Programs

ERIC Educational Resources Information Center

Judge, Lawrence W.; Bodey, Kimberly J.; Bellar, David; Bottone, Adam; Wanless, Elizabeth

2010-01-01

The purpose of this study was to determine if NCAA Division I women's volleyball programs were in compliance with suggested current pre- and post-activity stretching protocols. Questionnaires were sent to NCAA division I women's volleyball programs in the United States. Fifty six coaches (23 males & 33 females) participated in the study. Some…

Environmental Compliance Assessment Protocol - Centers for Disease Control and Prevention (ECAP-CDC), West Virginia Supplement

DTIC Science & Technology

1994-11-01

memmingeri Virginia heartleaf Asarum shuttleworthii Large-flowered heartleaf Asciepias viridis Green milkweed Asplenium septentrionale Forked spleenwort...quadrangulata Blue ash Galactia volubilis Milk pea Gaylussacia brachycera Box huckleberry Gaylussacia dumosa Dwarf huckleberry Gentiana alba Yello gentian...Name Common Name Habenaria viridis var bra cteata Long-bracted green orchid Helianthemum canadense Canada frostweed Helianthus dowellianus McDowell

OCONUS Compliance Assessment Protocols Air Force Supplement

DTIC Science & Technology

2009-09-01

that have environmental impacts (i.e., construction, mission changes, process/activity changes). Are environmental surveys and construction site...how and where does disposal occur? Has the installation conducted a complete asbestos survey ? If yes, what the date of the most recent... survey ? (Please provide a copy for the assessment team.) Has the installation prepared, coordinated, and executed an Asbestos Management Plan

A simple protocol using underwater epoxy to install annual temperature monitoring sites in rivers and streams

Treesearch

Daniel J. Isaak; Dona L. Horan; Sherry P. Wollrab

2013-01-01

Thermal regimes in rivers and streams are fundamental determinants of biological processes and are often monitored for regulatory compliance. Here, we describe a simple technique for establishing annual monitoring sites that uses underwater epoxy to attach miniature sensors to large rocks and cement bridge supports, which then serve as protective anchors. More than 500...

A Systematic Evaluation of Blood Serum and Plasma Pre-Analytics for Metabolomics Cohort Studies

PubMed Central

Jobard, Elodie; Trédan, Olivier; Postoly, Déborah; André, Fabrice; Martin, Anne-Laure; Elena-Herrmann, Bénédicte; Boyault, Sandrine

2016-01-01

The recent thriving development of biobanks and associated high-throughput phenotyping studies requires the elaboration of large-scale approaches for monitoring biological sample quality and compliance with standard protocols. We present a metabolomic investigation of human blood samples that delineates pitfalls and guidelines for the collection, storage and handling procedures for serum and plasma. A series of eight pre-processing technical parameters is systematically investigated along variable ranges commonly encountered across clinical studies. While metabolic fingerprints, as assessed by nuclear magnetic resonance, are not significantly affected by altered centrifugation parameters or delays between sample pre-processing (blood centrifugation) and storage, our metabolomic investigation highlights that both the delay and storage temperature between blood draw and centrifugation are the primary parameters impacting serum and plasma metabolic profiles. Storing the blood drawn at 4 °C is shown to be a reliable routine to confine variability associated with idle time prior to sample pre-processing. Based on their fine sensitivity to pre-analytical parameters and protocol variations, metabolic fingerprints could be exploited as valuable ways to determine compliance with standard procedures and quality assessment of blood samples within large multi-omic clinical and translational cohort studies. PMID:27929400

Evaluating Emergency Department Asthma Management Practices in Florida Hospitals.

PubMed

Nowakowski, Alexandra C H; Carretta, Henry J; Dudley, Julie K; Forrest, Jamie R; Folsom, Abbey N

2016-01-01

To assess gaps in emergency department (ED) asthma management at Florida hospitals. Survey instrument with open- and closed-ended questions. Topics included availability of specific asthma management modalities, compliance with national guidelines, employment of specialized asthma care personnel, and efforts toward performance improvement. Emergency departments at 10 large hospitals in the state of Florida. Clinical care providers and health administrators from participating hospitals. Compliance with national asthma care guideline standards, provision of specific recommended treatment modalities and resources, employment of specialized asthma care personnel, and engagement in performance improvement efforts. Our results suggest inconsistency among sampled Florida hospitals' adherence to national standards for treatment of asthma in EDs. Several hospitals were refining their emergency care protocols to incorporate guideline recommendations. Despite a lack of formal ED protocols in some hospitals, adherence to national guidelines for emergency care nonetheless remained robust for patient education and medication prescribing, but it was weaker for formal care planning and medical follow-up. Identified deficiencies in emergency asthma care present a number of opportunities for strategic mitigation of identified gaps. We conclude with suggestions to help Florida hospitals achieve success with ED asthma care reform. Team-based learning activities may offer an optimal strategy for sharing and implementing best practices.

Using environmental engineering to increase hand hygiene compliance: a cross-over study protocol

PubMed Central

Schmidtke, Kelly Ann; Aujla, Navneet; Marshall, Tom; Hussain, Abid; Hodgkinson, Gerard P; Arheart, Kristopher; Marti, Joachim; Birnbach, David J; Vlaev, Ivo

2017-01-01

Introduction Compliance with hand hygiene recommendations in hospital is typically less than 50%. Such low compliance inevitably contributes to hospital-acquired infections that negatively affect patients’ well-being and hospitals’ finances. The design of the present study is predicated on the assumption that most people who fail to clean their hands are not doing so intentionally, they just forget. The present study will test whether psychological priming can be used to increase the number of people who clean their hands on entering a ward. Here, we present the protocol for this study. Methods and analysis The study will use a randomised cross-over design. During the study, each of four wards will be observed during four conditions: olfactory prime, visual prime, both primes and neither prime. Each condition will be experienced for 42 days followed by a 7-day washout period (total duration of trial=189 days). We will record the number of people who enter each ward and whether they clean their hands during observation sessions, the amount of cleaning material used from the dispensers each week and the number of hospital-acquired infections that occur in each period. The outcomes will be compared using a regression analysis. Following the initial trail, the most effective priming condition will be rolled out for 3 months in all the wards. Ethics and dissemination Research ethics approval was obtained from the South Central—Oxford C Research Ethics Committee (16/SC/0554), the Health Regulatory Authority and the sponsor. Trial registration number ISRCTN (15397624); Edge ID 86357. PMID:28893752

Organizational performance and regulatory compliance as measured by clinical pertinence indicators before and after implementation of Anesthesia Information Management System (AIMS).

PubMed

Choi, Clark K; Saberito, Darlene; Tyagaraj, Changa; Tyagaraj, Kalpana

2014-01-01

Previous studies have suggested that electronic medical records (EMR) can lead to a greater reduction of medical errors and better adherence to regulatory compliance than paper medical records (PMR). In order to assess the organizational performance and regulatory compliance, we tracked different clinical pertinence indicators (CPI) in our anesthesia information management system (AIMS) for 5 years. These indicators comprised of the protocols from the Surgical Care Improvement Project (SCIP), elements of performance (EP) from The Joint Commission (TJC), and guidelines from the Centers for Medicare and Medicaid Services (CMS). A comprehensive AIMS was initiated and the CPI were collected from October 5, 2009 to December 31, 2010 (EMR period) and from January 1, 2006 to October 4, 2009 (PMR period). Fourteen CPI were found to be common between the EMR and PMR periods. Based on the statistical analysis of the 14 common CPI, there was a significant increase (p < 0.001) in overall compliance after the introduction of EMR compared to the PMR period. The increase in overall compliance was significantly progressive (p = 0.013) from year to year over 2006 and 2010. Of the 14 CPI, Documentation of a) medication doses, and b) monitoring of postoperative physiological status, mental status, and pain scores showed significant improvement (p < 0.001) during the EMR period compared to the PMR period.

Pilot Study to Evaluate Compliance and Tolerability of Cranberry Capsules in Pregnancy for the Prevention of Asymptomatic Bacteriuria

PubMed Central

Rumney, Pamela J.; Hindra, Sasha; Guzman, Lizette; Le, Jennifer; Nageotte, Michael

2015-01-01

Abstract Objectives: To evaluate the compliance with and tolerability of daily cranberry capsule ingestion for asymptomatic bacteriuria (ASB) prevention in pregnancy. Design: A total of 49 pregnant women from two sites were randomly assigned to cranberry or matching placebo, two doses daily, at gestational ages less than 16 weeks. Patients were followed monthly for urinary tract infection until delivery. Up to seven monthly visits were scheduled for each patient. Delivery data were evaluated. Results: Of 38 evaluable patients, the mean compliance rate over the study period was 82% (range, 20%–100%). This compliance rate and the 74% of patients achieving good (≥75%) compliance were similar between those who received cranberry capsules and placebo. Compliance evaluation revealed that most patients stopped capsule consumption after 34–38 weeks of participation. Multivariate logistic regression and longitudinal analysis showed a significant interaction time effect with cranberry treatment. However, cranberry consumption was not a significant predictor of gastrointestinal intolerance or study withdrawal. Although 30% of patients withdrew for various reasons, only 1 withdrew because of intolerance to the cranberry capsules. Loss to follow-up was mostly due to provider change (9 of 49 [18%]) and therapy disinterest (4 of 49 [8%]). Seven cases of ASB occurred in 5 patients: 2 of 24 (8%) in the cranberry group and 3 of 25 (12%) in the placebo group. No cases of cystitis or pyelonephritis were observed. Conclusion: One third of pregnant women could not complete the study protocol for various reasons. Compliance with and tolerability of cranberry capsule ingestion appear good; these capsules provide a potentially effective means to prevent ASB in pregnancy. Further studies with large samples are necessary to confirm the findings. PMID:26535612

Pilot Study to Evaluate Compliance and Tolerability of Cranberry Capsules in Pregnancy for the Prevention of Asymptomatic Bacteriuria.

PubMed

Wing, Deborah A; Rumney, Pamela J; Hindra, Sasha; Guzman, Lizette; Le, Jennifer; Nageotte, Michael

2015-11-01

To evaluate the compliance with and tolerability of daily cranberry capsule ingestion for asymptomatic bacteriuria (ASB) prevention in pregnancy. A total of 49 pregnant women from two sites were randomly assigned to cranberry or matching placebo, two doses daily, at gestational ages less than 16 weeks. Patients were followed monthly for urinary tract infection until delivery. Up to seven monthly visits were scheduled for each patient. Delivery data were evaluated. Of 38 evaluable patients, the mean compliance rate over the study period was 82% (range, 20%-100%). This compliance rate and the 74% of patients achieving good (≥75%) compliance were similar between those who received cranberry capsules and placebo. Compliance evaluation revealed that most patients stopped capsule consumption after 34-38 weeks of participation. Multivariate logistic regression and longitudinal analysis showed a significant interaction time effect with cranberry treatment. However, cranberry consumption was not a significant predictor of gastrointestinal intolerance or study withdrawal. Although 30% of patients withdrew for various reasons, only 1 withdrew because of intolerance to the cranberry capsules. Loss to follow-up was mostly due to provider change (9 of 49 [18%]) and therapy disinterest (4 of 49 [8%]). Seven cases of ASB occurred in 5 patients: 2 of 24 (8%) in the cranberry group and 3 of 25 (12%) in the placebo group. No cases of cystitis or pyelonephritis were observed. One third of pregnant women could not complete the study protocol for various reasons. Compliance with and tolerability of cranberry capsule ingestion appear good; these capsules provide a potentially effective means to prevent ASB in pregnancy. Further studies with large samples are necessary to confirm the findings.

The effectiveness of a multidisciplinary QI activity for accidental fall prevention: Staff compliance is critical

PubMed Central

2012-01-01

Background Accidental falls among inpatients are a substantial cause of hospital injury. A number of successful experimental studies on fall prevention have shown the importance and efficacy of multifactorial intervention, though success rates vary. However, the importance of staff compliance with these effective, but often time-consuming, multifactorial interventions has not been fully investigated in a routine clinical setting. The purpose of this observational study was to describe the effectiveness of a multidisciplinary quality improvement (QI) activity for accidental fall prevention, with particular focus on staff compliance in a non-experimental clinical setting. Methods This observational study was conducted from July 2004 through December 2010 at St. Luke’s International Hospital in Tokyo, Japan. The QI activity for in-patient falls prevention consisted of: 1) the fall risk assessment tool, 2) an intervention protocol to prevent in-patient falls, 3) specific environmental safety interventions, 4) staff education, and 5) multidisciplinary healthcare staff compliance monitoring and feedback mechanisms. Results The overall fall rate was 2.13 falls per 1000 patient days (350/164331) in 2004 versus 1.53 falls per 1000 patient days (263/172325) in 2010, representing a significant decrease (p = 0.039). In the first 6 months, compliance with use of the falling risk assessment tool at admission was 91.5% in 2007 (3998/4368), increasing to 97.6% in 2010 (10564/10828). The staff compliance rate of implementing an appropriate intervention plan was 85.9% in 2007, increasing to 95.3% in 2010. Conclusion In our study we observed a substantial decrease in patient fall rates and an increase of staff compliance with a newly implemented falls prevention program. A systematized QI approach that closely involves, encourages, and educates healthcare staff at multiple levels is effective. PMID:22788785

Physical Therapy Protocols for Arthroscopic Bankart Repair.

PubMed

DeFroda, Steven F; Mehta, Nabil; Owens, Brett D

Outcomes after arthroscopic Bankart repair can be highly dependent on compliance and participation in physical therapy. Additionally, there are many variations in physician-recommended physical therapy protocols. The rehabilitation protocols of academic orthopaedic surgery departments vary widely despite the presence of consensus protocols. Descriptive epidemiology study. Level 3. Web-based arthroscopic Bankart rehabilitation protocols available online from Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic surgery programs were included for review. Individual protocols were reviewed to evaluate for the presence or absence of recommended therapies, goals for completion of ranges of motion, functional milestones, exercise start times, and recommended time to return to sport. Thirty protocols from 27 (16.4%) total institutions were identified out of 164 eligible for review. Overall, 9 (30%) protocols recommended an initial period of strict immobilization. Variability existed between the recommended time periods for sling immobilization (mean, 4.8 ± 1.8 weeks). The types of exercises and their start dates were also inconsistent. Goals to full passive range of motion (mean, 9.2 ± 2.8 weeks) and full active range of motion (mean, 12.2 ± 2.8 weeks) were consistent with other published protocols; however, wide ranges existed within the reviewed protocols as a whole. Only 10 protocols (33.3%) included a timeline for return to sport, and only 3 (10%) gave an estimate for return to game competition. Variation also existed when compared with the American Society of Shoulder and Elbow Therapists' (ASSET) consensus protocol. Rehabilitation protocols after arthroscopic Bankart repair were found to be highly variable. They also varied with regard to published consensus protocols. This discrepancy may lead to confusion among therapists and patients. This study highlights the importance of attending surgeons being very clear and specific with regard to their physical therapy instructions to patients and therapists.

SMARTE 2007 TUTORIAL - JANUARY 2007 REVISION

EPA Science Inventory

SMARTe 2007 is a web-based decision support tool intended to help revitalization practitioners find information, perform data analysis, communicate, and evaluate future reuse options for a site or area. This tutorial CD was developed to help users navigate SMARTe 2007. It is appr...

Computer Tutorial "Higher Mathematics" for Engineering Specialties.

ERIC Educational Resources Information Center

Slivina, Natalia A.; Krivosheev, Anatoly O.; Fomin, Sergey S.

This paper presents a CD-ROM computer tutorial titled "Higher Mathematics," that contains 17 educational mathematical programs and is intended for use in Russian university engineering education. The first section introduces the courseware climate in Russia and outlines problems with commercially available universal mathematical…

28 CFR 92.10 - Providing tutorials and other academic assistance programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... must include academic counseling, tutorials and other academic assistance programs to enable... varied academic needs of individual applicants; and (3) Academic and guidance counseling for adults. Specific counseling programs must be designed for individuals who encounter problems with passing the...

Audio-Tutorial Instruction in Medicine.

ERIC Educational Resources Information Center

Boyle, Gloria J.; Herrick, Merlyn C.

This progress report concerns an audio-tutorial approach used at the University of Missouri-Columbia School of Medicine. Instructional techniques such as slide-tape presentations, compressed speech audio tapes, computer-assisted instruction (CAI), motion pictures, television, microfiche, and graphic and printed materials have been implemented,…

A Real-time Ventilator Management Dashboard: Toward Hardwiring Compliance with Evidence-based Guidelines

PubMed Central

Starmer, John; Giuse, Dario

2008-01-01

Care of mechanically ventilated patients requires coordination between multiple caregivers, necessitating the availability of accurate and timely information on patient status. Researchers have documented positive effects of several interventions on the rates of developing ventilator associated complications, such as providing regular oral care and elevating the head of the bed. Informatics tools, such as electronic whiteboards, reminders, and alerts have been shown to aid in clinician compliance with guidelines or protocols. The purpose of this project was to design and implement a real-time ventilator management dashboard to show patient status with respect to elements important for ventilator management and infection prevention in the adult Intensive Care Units at Vanderbilt University Medical Center. PMID:18998939

Peer-assisted learning: filling the gaps in basic science education for preclinical medical students.

PubMed

Sammaraiee, Yezen; Mistry, Ravi D; Lim, Julian; Wittner, Liora; Deepak, Shantal; Lim, Gareth

2016-09-01

In contrast to peer-assisted learning (PAL) in clinical training, there is scant literature on the efficacy of PAL during basic medical sciences teaching for preclinical students. A group of senior medical students aimed to design and deliver clinically oriented small-group tutorials after every module in the preclinical curriculum at a United Kingdom medical school. Twenty tutorials were delivered by senior students throughout the year to first- and second-year students. A baseline questionnaire was delivered to inform the development of the program followed by an end-point questionnaire the next year (n = 122). Quizzes were administered before and after five separate tutorials to assess changes in mean student scores. Additionally, each tutorial was evaluated via a questionnaire for participants (n = 949). All five posttutorial quizzes showed a significant improvement in mean student score (P < 0.05). Questionnaires showed students found the program to be relevant and useful for revision purposes and appreciated how tutorials contextualized basic science to clinical medicine. Students appreciated the interactive nature of the sessions and found receiving personalized feedback about their learning and consolidating information with someone familiar with the material to be useful. With the inclusion of the program, students felt there were now an adequate number of tutorials during the year. In conclusion, this study shows that senior medical students can design and deliver a program that adds value to the mostly lecture-based formal preclinical curriculum. We hope that our study can prompt further work to explore the effect of PAL on the teaching of basic sciences during preclinical studies. Copyright © 2016 The American Physiological Society.

Improving medical students' written communication skills: design and evaluation of an educational curriculum.

PubMed

Melvin, L; Connolly, K; Pitre, L; Dore, K L; Wasi, P

2015-06-01

Written and verbal communication skills are important skills for all physicians. While verbal skills are taught and assessed in medical school, medical students report limited instruction in written communication skills. This study examined the impact of a curriculum delivered during a 6-week clinical rotation in Internal Medicine on the objective assessment of medical students' written communication skills. The curriculum consisted of two educational programmes: a medical student communication tutorial and a resident feedback workshop. The study was conducted from March 2012 to January 2013 at McMaster University in Hamilton, Ontario, Canada. The study featured three arms: (1) control, (2) medical student communication tutorial alone and (3) student tutorial and resident feedback workshop. Data were collected on 126 students during 6-week Internal Medicine clerkship rotations. Students' written consultation notes were collected prior to the educational programmes and at 6 weeks. Blinded faculty assessors used an independently validated Assessment Checklist to evaluate consultation notes. Consultation note scores improved from week 1 to week 6 across all study arms. However, the change was statistically significant only in arm 3, featuring both the medical student tutorial and the resident feedback workshop, with mean scores improving from 4.75 (SD=1.496) to 5.56 (SD=0.984) out of 7. The mean difference between week 1 and week 6 was significantly different (0.806, p=0.002, 95% CI 0.306 to 1.058). The combination of a resident feedback workshop with medical student written communication tutorial improves objective evaluations of consultation note scores over student tutorial alone. 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.

Development of a Web-Based, Student-Centered Stereochemistry Tutorial

ERIC Educational Resources Information Center

Burrmann, Nicola J.; Moore, John W.

2013-01-01

A Web-based stereochemistry tutorial is described that details the core definitions and structural representations of stereochemistry in an organic chemistry course. The Cahn-Ingold-Prelog rules and their application for assigning "R" and "S" orientations to stereocenters and "E" and "Z" orientations to…

Hypermedia 1990 structured Hypertext tutorial

NASA Technical Reports Server (NTRS)

Johnson, J. Scott

1990-01-01

Hypermedia 1990 structured Hypertext tutorial is presented in the form of view-graphs. The following subject areas are covered: structured hypertext; analyzing hypertext documents for structure; designing structured hypertext documents; creating structured hypertext applications; structuring service and repair documents; maintaining structured hypertext documents; and structured hypertext conclusion.

Quantitative Microbial Risk Assessment Tutorial: Installation of Software for Watershed Modeling in Support of QMRA

EPA Science Inventory

This tutorial provides instructions for accessing, retrieving, and downloading the following software to install on a host computer in support of Quantitative Microbial Risk Assessment (QMRA) modeling:• SDMProjectBuilder (which includes the Microbial Source Module as part...

Designing Templates for Interactive Tasks in CALL Tutorials.

ERIC Educational Resources Information Center

Ruhlmann, Felicitas

The development of templates for computer-assisted language learning (CALL) is discussed, based on experiences with primarily linear multimedia tutorial programs. Design of templates for multiple-choice questions and interactive tasks in a prototype module is described. Possibilities of enhancing interactivity by introducing problem-oriented…

Development of a multimedia tutorial to educate how to assess the critical view of safety in laparoscopic cholecystectomy using expert review and crowd-sourcing.

PubMed

Deal, Shanley B; Stefanidis, Dimitrios; Brunt, L Michael; Alseidi, Adnan

2017-05-01

We sought to determine the feasibility of developing a multimedia educational tutorial to teach learners to assess the critical view of safety using input from expert surgeons, non-surgeons and crowd-sourcing. We intended to develop a tutorial that would teach learners how to identify the basic anatomy and physiology of the gallbladder, identify the components of the critical view of safety criteria, and understand its significance for performing a safe gallbladder removal. Using rounds of assessment with experts, laypersons and crowd-workers we developed an educational video with improving comprehension after each round of revision. We demonstrate that the development of a multimedia educational tool to educate learners of various backgrounds is feasible using an iterative review process that incorporates the input of experts and crowd sourcing. When planning the development of an educational tutorial, a step-wise approach as described herein should be considered. Copyright © 2017 Elsevier Inc. All rights reserved.

Online plagiarism training falls short in biology classrooms.

PubMed

Holt, Emily A; Fagerheim, Britt; Durham, Susan

2014-01-01

Online plagiarism tutorials are increasingly popular in higher education, as faculty and staff try to curb the plagiarism epidemic. Yet no research has validated the efficacy of such tools in minimizing plagiarism in the sciences. Our study compared three plagiarism-avoidance training regimens (i.e., no training, online tutorial, or homework assignment) and their impacts on students' ability to accurately discriminate plagiarism from text that is properly quoted, paraphrased, and attributed. Using pre- and postsurveys of 173 undergraduate students in three general ecology courses, we found that students given the homework assignment had far greater success in identifying plagiarism or the lack thereof compared with students given no training. In general, students trained with the homework assignment more successfully identified plagiarism than did students trained with the online tutorial. We also found that the summative assessment associated with the plagiarism-avoidance training formats (i.e., homework grade and online tutorial assessment score) did not correlate with student improvement on surveys through time.

Math remediation intervention for student success in the algebra-based introductory physics course

NASA Astrophysics Data System (ADS)

Forrest, Rebecca L.; Stokes, Donna W.; Burridge, Andrea B.; Voight, Carol D.

2017-12-01

Pretesting and early intervention measures to identify and remediate at-risk students were implemented in algebra-based introductory physics to help improve student success rates. Pretesting via a math and problem-solving diagnostic exam administered at the beginning of the course was employed to identify at-risk students based on their scores. At-risk students were encouraged to utilize an online math tutorial to increase their chances of passing the course. The tutorial covers the same math topics covered by the diagnostic exam. Results from 643 students enrolled in the course showed that the 61 at-risk students who successfully completed the math tutorial increased their odds of passing the course by roughly 4 times those of the at-risk students who did not. This intervention is easily implemented, short term, and can be administered concurrently with the course. Based on these results, the Department of Physics has implemented the math tutorials in all sections of the introductory algebra as well as the calculus-based physics courses.

On-Ramp: Improving students' understanding of lock-in amplifiers

NASA Astrophysics Data System (ADS)

DeVore, Seth; Singh, Chandralekha; Levy, Jeremy

2013-03-01

A lock-in amplifier is a powerful and versatile instrument which is used frequently in condensed matter physics research. However, many students struggle with the basics of a lock-in amplifier and they have difficulty in interpreting the data obtained with this device in diverse applications. To improve students' understanding, we are developing an ``On-Ramp'' tutorial based on physics education research which makes use of a computer simulation of a lock-in amplifier. During the development of the tutorial we interviewed several faculty members and graduate students. The tutorial is based on a field-tested approach in which students realize their difficulties after predicting the outcome of experiments that use a lock-in amplifier; students can check their predictions using simulations. The tutorial then guides students toward a coherent understanding of the basics of a lock-in amplifier. This poster will discuss the development and assessment process. This work is supported by NSF NEB (DMR-1124131) and NSF (PHY-1202909).

Online Plagiarism Training Falls Short in Biology Classrooms

PubMed Central

Holt, Emily A.; Fagerheim, Britt; Durham, Susan

2014-01-01

Online plagiarism tutorials are increasingly popular in higher education, as faculty and staff try to curb the plagiarism epidemic. Yet no research has validated the efficacy of such tools in minimizing plagiarism in the sciences. Our study compared three plagiarism-avoidance training regimens (i.e., no training, online tutorial, or homework assignment) and their impacts on students’ ability to accurately discriminate plagiarism from text that is properly quoted, paraphrased, and attributed. Using pre- and postsurveys of 173 undergraduate students in three general ecology courses, we found that students given the homework assignment had far greater success in identifying plagiarism or the lack thereof compared with students given no training. In general, students trained with the homework assignment more successfully identified plagiarism than did students trained with the online tutorial. We also found that the summative assessment associated with the plagiarism-avoidance training formats (i.e., homework grade and online tutorial assessment score) did not correlate with student improvement on surveys through time. PMID:24591507

Estimating cigarette tax avoidance and evasion: evidence from a national sample of littered packs

PubMed Central

Barker, Dianne C; Wang, Shu; Merriman, David; Crosby, Andrew; Resnick, Elissa A; Chaloupka, Frank J

2016-01-01

Introduction A number of recent studies document the proportion of all cigarette packs that are ‘contraband’ using discarded packs to measure tax avoidance and evasion, which we call tax non-compliance. To date, academic studies using discarded packs focused on relatively small geographical areas such as a city or a neighbourhood. Methods We visited 160 communities across 38 US states in 2012 and collected data from littered cigarette packs as part of the State and Community Tobacco Control (SCTC) Research Initiative and the Bridging the Gap Community Obesity Measures Project (BTG-COMP). Data collectors were trained in a previously tested littered pack data collection protocol. Results Field teams collected 2116 packs with cellophane across 132 communities. We estimate a national tax non-compliance rate of 18.5% with considerable variation across regions. Suburban areas had lower non-compliance than urban areas as well as areas with high and low median household income areas compared with middle income areas. Discussion We present the first academic national study of tax non-compliance using littered cigarette packs. We demonstrate the feasibility of meaningful large-scale data collection using this methodology and document considerable variation in tax non-compliance across areas, suggesting that both policy differences and geography may be important in control of illicit tobacco use. Given the geography of open borders among countries with varying tax rates, this simple methodology may be appropriate to estimate tax non-compliance in countries that use tax stamps or other pack markings, such as health warnings. PMID:27697946

Portable device technology in organ donation: new "app" for procurement coordinators.

PubMed

Cavallin, M; Bertini, P; Lopane, P; Guarracino, F

2014-09-01

Portable devices are commonly used at bedside in everyday practice. Transplant procurement coordinators routinely have to deal with protocols and flow charts and need to assess the donor condition several times. In our experience, a great part of the organ procurement management work is provided by nurses "on call." We developed an application for iOS devices to facilitate their approach to relatives and procedures for organ donation. The application, which includes algorithms, tutorials, and simple calculators, has been designed by transplant procurement coordinators to speed up the process of organ donation and at the same time to be as accurate as possible for the process. It can be used alongside all of the procedures for procurement in the emergency room, intensive care unit, operating room, and morgue in both brainstem-dead and cadaver organ donors. The application could be effective in organ procurement management for everyday practice. Copyright © 2014 Elsevier Inc. All rights reserved.

A subjective scheduler for subjective dedicated networks

NASA Astrophysics Data System (ADS)

Suherman; Fakhrizal, Said Reza; Al-Akaidi, Marwan

2017-09-01

Multiple access technique is one of important techniques within medium access layer in TCP/IP protocol stack. Each network technology implements the selected access method. Priority can be implemented in those methods to differentiate services. Some internet networks are dedicated for specific purpose. Education browsing or tutorial video accesses are preferred in a library hotspot, while entertainment and sport contents could be subjects of limitation. Current solution may use IP address filter or access list. This paper proposes subjective properties of users or applications are used for priority determination in multiple access techniques. The NS-2 simulator is employed to evaluate the method. A video surveillance network using WiMAX is chosen as the object. Subjective priority is implemented on WiMAX scheduler based on traffic properties. Three different traffic sources from monitoring video: palace, park, and market are evaluated. The proposed subjective scheduler prioritizes palace monitoring video that results better quality, xx dB than the later monitoring spots.

GRN2SBML: automated encoding and annotation of inferred gene regulatory networks complying with SBML.

PubMed

Vlaic, Sebastian; Hoffmann, Bianca; Kupfer, Peter; Weber, Michael; Dräger, Andreas

2013-09-01

GRN2SBML automatically encodes gene regulatory networks derived from several inference tools in systems biology markup language. Providing a graphical user interface, the networks can be annotated via the simple object access protocol (SOAP)-based application programming interface of BioMart Central Portal and minimum information required in the annotation of models registry. Additionally, we provide an R-package, which processes the output of supported inference algorithms and automatically passes all required parameters to GRN2SBML. Therefore, GRN2SBML closes a gap in the processing pipeline between the inference of gene regulatory networks and their subsequent analysis, visualization and storage. GRN2SBML is freely available under the GNU Public License version 3 and can be downloaded from http://www.hki-jena.de/index.php/0/2/490. General information on GRN2SBML, examples and tutorials are available at the tool's web page.

User Manuals for a Primary Care Electronic Medical Record System: A Mixed Methods Study of User- and Vendor-Generated Documents

PubMed Central

Dow, Rustam; Barnsley, Jan; Tu, Karen; Domb, Sharon; Jadad, Alejandro R.; Lemieux-Charles, Louise

2015-01-01

Research problem Tutorials and user manuals are important forms of impersonal support for using software applications including electronic medical records (EMRs). Differences between user- and vendor documentation may indicate support needs, which are not sufficiently addressed by the official documentation, and reveal new elements that may inform the design of tutorials and user manuals. Research question What are the differences between user-generated tutorials and manuals for an EMR and the official user manual from the software vendor? Literature review Effective design of tutorials and user manuals requires careful packaging of information, balance between declarative and procedural texts, an action and task-oriented approach, support for error recognition and recovery, and effective use of visual elements. No previous research compared these elements between formal and informal documents. Methodology We conducted an mixed methods study. Seven tutorials and two manuals for an EMR were collected from three family health teams and compared with the official user manual from the software vendor. Documents were qualitatively analyzed using a framework analysis approach in relation to the principles of technical documentation described above. Subsets of the data were quantitatively analyzed using cross-tabulation to compare the types of error information and visual cues in screen captures between user- and vendor-generated manuals. Results and discussion The user-developed tutorials and manuals differed from the vendor-developed manual in that they contained mostly procedural and not declarative information; were customized to the specific workflow, user roles, and patient characteristics; contained more error information related to work processes than to software usage; and used explicit visual cues on screen captures to help users identify window elements. These findings imply that to support EMR implementation, tutorials and manuals need to be customized and adapted to specific organizational contexts and workflows. The main limitation of the study is its generalizability. Future research should address this limitation and may explore alternative approaches to software documentation, such as modular manuals or participatory design. PMID:26190888

The student tutor experience in a problem-based learning course: A case study

NASA Astrophysics Data System (ADS)

Moore, Tricia Susan

This case study, conducted from an interpretive paradigm, illuminates contextual factors related to the tutor experience when senior undergraduate dental hygiene students served as tutors for beginning undergraduate dental hygiene students, or sophomores, in a 1-semester, 2-hour long problem-based learning (PBL) course in a Baccalaureate Dental Hygiene (BDH) curriculum during the spring semester of 2008. Data were collected using various sources and methods. Six tutors and three administrators were interviewed, tutees completed an anonymous questionnaire, the tutorial process and tutor training sessions were observed, and related documents were examined. Data analysis included open and axial coding, creation of tutor profiles, and identification of patterns. Tutor behaviors varied with respect to the nature of intervention (e.g., telling, asking, clarifying, acknowledging), emphasis (process, content, social), and facilitation style (directive, suggestive, empowering). Patterns in tutor behavior and attitudes emerged related to comfort and growth, persistence and lenience, and compliance, resistance, and innovation. Differences in tutor understanding and perception of their role and the purpose of PBL influenced the role the tutor assumed. Other factors that influenced tutor behavior included tutor intentions, tutor training, and environmental factors such as the nature of problems, allotted time, and tutorial group characteristics. The influence of these factors can be understood by applying Fishbein's integrated model of behavior prediction (Fishbein, 2008). Tutor training included experiencing the PBL student role, attending class, and sharing experiences with other tutors in weekly seminar sessions facilitated by a tutor supervisor. Tutor's gained confidence, knowledge, skills, and friendship. They also had the opportunity to see things from a new perspective, that of a teacher encouraging self-direction rather than a student depending on others for direction. I suggest that the PBL tutor role can be seen as a transition between dependence on external guidance and reliance on internal guidance, with the potential to prepare students for their role as professional health care providers.

Tutorial for writing systematic reviews for the Brazilian Journal of Physical Therapy (BJPT)

PubMed Central

Mancini, Marisa C.; Cardoso, Jefferson R.; Sampaio, Rosana F.; Costa, Lucíola C. M.; Cabral, Cristina M. N.; Costa, Leonardo O. P.

2014-01-01

Systematic reviews aim to summarize all evidence using very rigorous methods in order to address a specific research question with less bias as possible. Systematic reviews are widely used in the field of physical therapy, however not all reviews have good quality. This tutorial aims to guide authors of the Brazilian Journal of Physical Therapy on how systematic reviews should be conducted and reported in order to be accepted for publication. It is expected that this tutorial will help authors of systematic reviews as well as journal editors and reviewers on how to conduct, report, critically appraise and interpret this type of study design. PMID:25590440

[Tutorial functions in 1st level nursing masters: cognitive study].

PubMed

Sarli, Maria Pompea; Burrai, Francesco; Cicolini, Giancarlo

2009-01-01

Tutorial functions are becoming increasingly more respondent to the requirements of student-based training. On the basis of national and international experiences, some active learning methods seem to be suitable for tutoring. Both basic and post-basic training can be directed towards satisfying the requirements of a society that is continually changing , forming professionals who are able to guarantee and maintain suitable levels of skill.In this study the results of a cognitive study, performed in various Italian universities where Masters in Nursing have already been implemented, are described. In particular, these results have shown the need for tutorial teaching methods that actively involve students in the training process.

The MaizeGDB Genome Browser tutorial: one example of database outreach to biologists via video

PubMed Central

Harper, Lisa C.; Schaeffer, Mary L.; Thistle, Jordan; Gardiner, Jack M.; Andorf, Carson M.; Campbell, Darwin A.; Cannon, Ethalinda K.S.; Braun, Bremen L.; Birkett, Scott M.; Lawrence, Carolyn J.; Sen, Taner Z.

2011-01-01

Video tutorials are an effective way for researchers to quickly learn how to use online tools offered by biological databases. At MaizeGDB, we have developed a number of video tutorials that demonstrate how to use various tools and explicitly outline the caveats researchers should know to interpret the information available to them. One such popular video currently available is ‘Using the MaizeGDB Genome Browser’, which describes how the maize genome was sequenced and assembled as well as how the sequence can be visualized and interacted with via the MaizeGDB Genome Browser. Database URL: http://www.maizegdb.org/ PMID:21565781

Tutorial for writing systematic reviews for the Brazilian Journal of Physical Therapy (BJPT).

PubMed

Mancini, Marisa C; Cardoso, Jefferson R; Sampaio, Rosana F; Costa, Lucíola C M; Cabral, Cristina M N; Costa, Leonardo O P

2014-01-01

Systematic reviews aim to summarize all evidence using very rigorous methods in order to address a specific research question with less bias as possible. Systematic reviews are widely used in the field of physical therapy, however not all reviews have good quality. This tutorial aims to guide authors of the Brazilian Journal of Physical Therapy on how systematic reviews should be conducted and reported in order to be accepted for publication. It is expected that this tutorial will help authors of systematic reviews as well as journal editors and reviewers on how to conduct, report, critically appraise and interpret this type of study design.

How the NWC handles software as product

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

Vinson, D.

1997-11-01

This tutorial provides a hands-on view of how the Nuclear Weapons Complex project should be handling (or planning to handle) software as a product in response to Engineering Procedure 401099. The SQAS has published the document SQAS96-002, Guidelines for NWC Processes for Handling Software Product, that will be the basis for the tutorial. The primary scope of the tutorial is on software products that result from weapons and weapons-related projects, although the information presented is applicable to many software projects. Processes that involve the exchange, review, or evaluation of software product between or among NWC sites, DOE, and external customersmore » will be described.« less

Evolution of student assessment in McMaster University's MD Programme.

PubMed

Cunnington, John

2002-05-01

In response to the competitive examination culture that pervaded medical education in the 1940s and 1950s the founders of McMaster University's new MD Programme created an assessment system based on group functioning within the tutorial. While the tutorial has served the educational process well, 30 years of experience has highlighted its deficiencies as an assessment tool. This paper describes the accumulation of evidence that led to the awareness of the weakness of tutorial assessment and the attempts to provide reliable assessment by the reintroduction of examinations, but in novel formats which would not alter the goals of the curriculum.

Implementation of guidelines for management of possible multidrug-resistant pneumonia in intensive care: an observational, multicentre cohort study.

PubMed

Kett, Daniel H; Cano, Ennie; Quartin, Andrew A; Mangino, Julie E; Zervos, Marcus J; Peyrani, Paula; Cely, Cynthia M; Ford, Kimbal D; Scerpella, Ernesto G; Ramirez, Julio A

2011-03-01

The American Thoracic Society and Infectious Diseases Society of America provide guidelines for management of hospital-acquired, ventilator-associated, and health-care-associated pneumonias, consisting of empirical antibiotic regimens for patients at risk for multidrug-resistant pathogens. We aimed to improve compliance with these guidelines and assess outcomes. We implemented a performance-improvement initiative in four academic medical centres in the USA with protocol-based education and prospective observation of outcomes. Patients were assessed for severity of illness and followed up until death, hospital discharge, or day 28. We included patients in intensive-care units who were at risk for multidrug-resistant pneumonia and were treated empirically. 303 patients at risk for multidrug-resistant pneumonia were treated empirically, and prescribed treatment was guideline compliant in 129 patients and non-compliant in 174 patients. 44 (34%) patients died before 28 days in the compliance group and 35 (20%) died in the non-compliance group. Five patients in the compliance group and seven in the non-compliance group were lost to follow-up after day 14. Kaplan-Meier estimated survival to 28 days was 65% in the compliance group and 79% in the non-compliance group (p=0·0042). This difference persisted after adjustment for severity of illness. Median length of stay and duration of mechanical ventilation did not differ between groups. Compliance failures included non-use of dual treatment for Gram-negative pathogens in 154 patients and absence of meticillin-resistant Staphylococcus aureus coverage in 24 patients. For patients in whom pathogens were subsequently identified, empirical treatment was active in 79 (81%) of 97 of patients receiving compliant therapy compared with 109 (85%) of 128 of patients receiving non-compliant therapy. Because adherence with empirical treatment was associated with increased mortality, we recommend a randomised trial be done before further implementation of these guidelines. Pfizer, US Medical. Copyright © 2011 Elsevier Ltd. All rights reserved.

SWIFT MODELLER: a Java based GUI for molecular modeling.

PubMed

Mathur, Abhinav; Shankaracharya; Vidyarthi, Ambarish S

2011-10-01

MODELLER is command line argument based software which requires tedious formatting of inputs and writing of Python scripts which most people are not comfortable with. Also the visualization of output becomes cumbersome due to verbose files. This makes the whole software protocol very complex and requires extensive study of MODELLER manuals and tutorials. Here we describe SWIFT MODELLER, a GUI that automates formatting, scripting and data extraction processes and present it in an interactive way making MODELLER much easier to use than before. The screens in SWIFT MODELLER are designed keeping homology modeling in mind and their flow is a depiction of its steps. It eliminates the formatting of inputs, scripting processes and analysis of verbose output files through automation and makes pasting of the target sequence as the only prerequisite. Jmol (3D structure visualization tool) has been integrated into the GUI which opens and demonstrates the protein data bank files created by the MODELLER software. All files required and created by the software are saved in a folder named after the work instance's date and time of execution. SWIFT MODELLER lowers the skill level required for the software through automation of many of the steps in the original software protocol, thus saving an enormous amount of time per instance and making MODELLER very easy to work with.

Audi-Tutorial Instruction in Basic Business

ERIC Educational Resources Information Center

Brown, Richard D.

1974-01-01

Results of a study in which audio-tutorial instruction was compared to illustrated lecture instruction are reported. No great differences in achievement levels in the two strategies of instruction were found. The development of such an alternative teaching strategy forces better teacher organization, leading to improvement of the illustrated…

Online Bioinformatics Tutorials | Office of Cancer Genomics

Cancer.gov

Bioinformatics is a scientific discipline that applies computer science and information technology to help understand biological processes. The NIH provides a list of free online bioinformatics tutorials, either generated by the NIH Library or other institutes, which includes introductory lectures and "how to" videos on using various tools.

The Carleton University Writing Tutorial Service.

ERIC Educational Resources Information Center

Freedman, Aviva

Carleton University's writing tutorial service is staffed by trained graduate students and provides free individual instruction for students having problems writing academic English. The students submit writing samples before the first session at which both student and tutor map out a strategy for improvement. Analysis of the tutors' perceptions…

Quantitative Microbial Risk Assessment Tutorial Installation of Software for Watershed Modeling in Support of QMRA - Updated 2017

EPA Science Inventory

This tutorial provides instructions for accessing, retrieving, and downloading the following software to install on a host computer in support of Quantitative Microbial Risk Assessment (QMRA) modeling: • QMRA Installation • SDMProjectBuilder (which includes the Microbial ...

Objective and Subjective Evaluation of Computer-based Tutorial Teaching in Veterinary Pathology.

ERIC Educational Resources Information Center

Brown, Peter

2001-01-01

Describes the results of the use of computer-based tutorials to teach the pathology of the cardiovascular system in a veterinary school in the United Kingdom. Concludes that the combined worksheet and computer based learning format is suitable for teaching veterinary pathology. (LRW)

From Workbook to Web: Building an Information Literacy OASIS.

ERIC Educational Resources Information Center

Rosen, Jeff; Castro, Gina M.

2002-01-01

Describes a Web-based information literacy tutorial, OASIS (Online Advancement of Student Information Skills), developed at San Francisco State University. Discussion includes: core competencies identified; design structure and content; planning and marketing; problems and partnerships in the pilot year of OASIS; restructuring the OASIS tutorial;…

Making Accounting Tutorials Enjoyable

ERIC Educational Resources Information Center

Bargate, Karen

2018-01-01

This paper emanates from a case study which focussed on 15 Managerial Accounting and Financial Management (MAFM) students' "enjoyment" of learning MAFM in an 18-week Writing Intensive Tutorial (WIT) programme. Interactive Qualitative Analysis (IQA) was used for the research design and as a data analysis tool. Following IQA protocols…

Investigating Learning with an Interactive Tutorial: A Mixed-Methods Strategy

ERIC Educational Resources Information Center

de Villiers, M. R.; Becker, Daphne

2017-01-01

From the perspective of parallel mixed-methods research, this paper describes interactivity research that employed usability-testing technology to analyse cognitive learning processes; personal learning styles and times; and errors-and-recovery of learners using an interactive e-learning tutorial called "Relations." "Relations"…

Caught on the Web

ERIC Educational Resources Information Center

Isakson, Carol

2006-01-01

In this article, the author presents a listing of Web resources which showcases sites created by school districts to support staff use of available technologies. These include Online Technology Tutorials from the Kent School District, Tips and Tutorials from the Kenton County (Kentucky) Schools Office of Instructional Technology, and Teacher…

Systematic Evaluation of the Patient-Reported Outcome (PRO) Content of Clinical Trial Protocols

PubMed Central

Kyte, Derek; Duffy, Helen; Fletcher, Benjamin; Gheorghe, Adrian; Mercieca-Bebber, Rebecca; King, Madeleine; Draper, Heather; Ives, Jonathan; Brundage, Michael; Blazeby, Jane; Calvert, Melanie

2014-01-01

Background Qualitative evidence suggests patient-reported outcome (PRO) information is frequently absent from clinical trial protocols, potentially leading to inconsistent PRO data collection and risking bias. Direct evidence regarding PRO trial protocol content is lacking. The aim of this study was to systematically evaluate the PRO-specific content of UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme trial protocols. Methods and Findings We conducted an electronic search of the NIHR HTA programme database (inception to August 2013) for protocols describing a randomised controlled trial including a primary/secondary PRO. Two investigators independently reviewed the content of each protocol, using a specially constructed PRO-specific protocol checklist, alongside the ‘Standard Protocol Items: Recommendations for Interventional Trials’ (SPIRIT) checklist. Disagreements were resolved through discussion with a third investigator. 75 trial protocols were included in the analysis. Protocols included a mean of 32/51 (63%) SPIRIT recommendations (range 16–41, SD 5.62) and 11/33 (33%) PRO-specific items (range 4–18, SD 3.56). Over half (61%) of the PRO items were incomplete. Protocols containing a primary PRO included slightly more PRO checklist items (mean 14/33 (43%)). PRO protocol content was not associated with general protocol completeness; thus, protocols judged as relatively ‘complete’ using SPIRIT were still likely to have omitted a large proportion of PRO checklist items. Conclusions The PRO components of HTA clinical trial protocols require improvement. Information on the PRO rationale/hypothesis, data collection methods, training and management was often absent. This low compliance is unsurprising; evidence shows existing PRO guidance for protocol developers remains difficult to access and lacks consistency. Study findings suggest there are a number of PRO protocol checklist items that are not fully addressed by the current SPIRIT statement. We therefore advocate the development of consensus-based supplementary guidelines, aimed at improving the completeness and quality of PRO content in clinical trial protocols. PMID:25333349

Report on July 2015 Additional Protocol Coordinators Best Practices Workshop

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

Gitau, Ernest T.N.; Burbank, Roberta L.; Finch, Valerie A.

After 10 years of implementation experience, the Office of Nonproliferation and Arms Control (NPAC) within the Department of Energy/National Nuclear Security Administration (DOE/NNSA) conducted the Additional Protocol (AP) Coordinators Best Practices Workshop at Oak Ridge National Laboratory from July 29-30, 2015. The goal of this workshop was to identify implementation best practices, lessons learned, and compliance challenges from the various Additional Protocol Coordinators (APCs) at each laboratory in the DOE/NNSA complex and associated sites. The workshop provided the opportunity for participants to share their insights and establish networks that APCs can utilize to continue to discuss challenges (new and old),more » identify best practices, and enhance communication and coordination for reporting multi-lab research projects during review activities. Workshop participants included DOE/NNSA HQ, laboratory and site APCs, seasoned experts, members of the original implementation outreach team, and Field Element and site security representatives.« less

Department of Defense picture archiving and communication system acceptance testing: results and identification of problem components.

PubMed

Allison, Scott A; Sweet, Clifford F; Beall, Douglas P; Lewis, Thomas E; Monroe, Thomas

2005-09-01

The PACS implementation process is complicated requiring a tremendous amount of time, resources, and planning. The Department of Defense (DOD) has significant experience in developing and refining PACS acceptance testing (AT) protocols that assure contract compliance, clinical safety, and functionality. The DOD's AT experience under the initial Medical Diagnostic Imaging Support System contract led to the current Digital Imaging Network-Picture Archiving and Communications Systems (DIN-PACS) contract AT protocol. To identify the most common system and component deficiencies under the current DIN-PACS AT protocol, 14 tri-service sites were evaluated during 1998-2000. Sixteen system deficiency citations with 154 separate types of limitations were noted with problems involving the workstation, interfaces, and the Radiology Information System comprising more than 50% of the citations. Larger PACS deployments were associated with a higher number of deficiencies. The most commonly cited systems deficiencies were among the most expensive components of the PACS.

Profile and birthing practices of Maranao traditional birth attendants.

PubMed

Maghuyop-Butalid, Roselyn; Mayo, Norhanifa A; Polangi, Hania T

2015-01-01

This study determined the profile and birthing practices in both modern and traditional ways among Maranao traditional birth attendants (TBAs) in Lanao del Norte, Philippines. It employed a descriptive research design. The respondents were 50 Maranao TBAs selected through the snowball sampling technique. A questionnaire was developed by the researchers to identify the respondents' modern birthing practices utilizing the Essential Intrapartum and Newborn Care (EINC) Protocol. To determine their profile and traditional birthing practices, items from a previous study and the respondents' personal claims were adapted. This study shows that Maranao TBAs have less compliance to the EINC Protocol and they often practice the traditional birthing interventions, thus increasing the risk of complications to both mother and newborn.

Distributed radiology clerkship for the core clinical year of medical school.

PubMed

Chew, Felix S

2002-11-01

The central role that diagnostic radiology has in the modern practice of medicine has not always been reflected in radiology's place in the curriculum. We developed a new radiology clerkship for undergraduate medical students during their core clinical year that was supported by Web technology. The assumptions underlying the design of the clerkship were that radiology is best learned from radiologists and that students are most receptive to learning radiology when it is related to concurrent patient care experiences. Beginning in May 2000, a required radiology clerkship experience was incorporated into the core clinical year at Wake Forest University School of Medicine. The core clinical year was organized into three 16-week blocks of clerkships. Two or four independent half-day radiology tutorial sessions were included with each clerkship block, and attended by all students in the block (approximately 35 students), regardless of their specific clerkship assignments. There were ten different radiology tutorials, each given three times during the year as students rotated through the clerkship blocks. Thus, each student attended a radiology tutorial session every four to eight weeks during the year. The topics covered during the tutorials were correlated with the content of the clerkship blocks and included adult and pediatric chest radiology, adult and pediatric abdominal radiology, body CT, neuroradiology, obstetric ultrasound, gynecologic ultrasound, osteoporosis, adult and pediatric fractures, mammography, and cervical spine trauma. The tutorials included pre- and post-test, lectures, case presentations, and sometimes tours of the radiology department. The educational emphasis was on pragmatic case-based learning exercises, development of verbal and visual vocabulary, and learning when and where to seek more information. To provide continuity and organization, Web-based curriculum materials were designed and implemented as a component of the clerkship. The home page of the Web site provided the schedule, faculty names, attendance and grading policies, course overview, and links to individual tutorials. The pages for individual tutorials included educational objectives, glossary of radiology terminology relevant to the subject, lecture slides and handouts, and teaching cases. All students had laptop computers and access to the academic network, but did not use them during the actual tutorial sessions. Implementation of the radiology clerkship required extensive negotiation with directors of other clerkships so that students could be released from their other responsibilities in order to attend the radiology tutorials. The radiology clerkship format has proven to be complex in its administration, with faculty and students on different schedules commuting to the radiology lecture hall from various locations. Extensive use of e-mail and communication via the Web site have been instrumental in reminding faculty and students of upcoming sessions. Preliminary evaluations have indicated that students liked the radiology sessions and learned a great deal, but disliked the scheduling and the lack of continuity. An evaluation of the curriculum and its components is ongoing.

Tutorial: Assessment and Analysis of Polysyllables in Young Children

ERIC Educational Resources Information Center

Masso, Sarah; McLeod, Sharynne; Baker, Elise

2018-01-01

Purpose: Polysyllables, words of 3 or more syllables, represent almost 30% of words used in American English. The purpose of this tutorial is to support speech-language pathologists' (SLPs') assessment and analysis of polysyllables, extending the focus of published assessment tools that focus on sampling and analyzing children's segmental accuracy…

Computational Modeling for Language Acquisition: A Tutorial with Syntactic Islands

ERIC Educational Resources Information Center

Pearl, Lisa S.; Sprouse, Jon

2015-01-01

Purpose: Given the growing prominence of computational modeling in the acquisition research community, we present a tutorial on how to use computational modeling to investigate learning strategies that underlie the acquisition process. This is useful for understanding both typical and atypical linguistic development. Method: We provide a general…

Volunteer Adult Basic Reading Tutorial Program: Final Special Demonstration Project Report.

ERIC Educational Resources Information Center

Literacy Volunteers, Inc., Syracuse, NY.

A demonstration project established eight self-supporting, volunteer-staffed adult basic reading tutorial programs in Connecticut, seven in Massachusetts, and one in central New York city. Literacy Volunteers of America (LVA) tutors also helped adult basic education students, tutored inmates and trained inmate tutors in correctional institutions,…