Status Report on Speech Research: A Report on the Status and Progress of Studies on the Nature of Speech, Instrumentation for Its Investigation, and Practical Applications, October 1-December 31, 1983.

ERIC Educational Resources Information Center

Studdert-Kennedy, Michael, Ed.; O'Brien, Nancy, Ed.

One of a regular series on the status and progress of studies on the nature of speech, instrumentation for its investigation, and practical research applications, this report consists of 14 papers. Topics covered in the papers are (1) skilled actions, (2) the control of fundamental frequency declination, (3) selective effects of masking on speech…

GP wellbeing and general practice issues.

PubMed

Murfett, Amanda; Charman, Denise

2006-09-01

Studies of general practitioner wellbeing have demonstrated remarkably consistent findings. However, the implications for day-to-day general practice have been unclear. This study was based on a survey comprising items extracted from transcripts of interviews with GPs and designed to link general practice issues with self reported wellbeing. 480 GP Australian Family Physician (AFP) subscribers (2.18% response rate); aged 26-81 years (mean 45.5 years); 273 (56.9%) men and 199 (43.1%) women. A survey insert in AFP September 2003 with questions about wellbeing, demographic details and 27 items about general practice issues. Almost 15% reported poor/very poor wellbeing, 47% reported good wellbeing and 38% reported very good/excellent wellbeing. Poor wellbeing was associated with being single, divorced or widowed, and reports of being alone in an adversarial context and more negative reactions to patients. Excellent or very good wellbeing was associated with being coupled and reports of general practice as a vocation. Targeted wellbeing strategies advocating social support may ameliorate the stress of general practice, especially for those GPs who are single.

How Does Stroop Interference Change with Practice? A Reappraisal from the Musical Stroop Paradigm

ERIC Educational Resources Information Center

Grégoire, Laurent; Perruchet, Pierre; Poulin-Charronnat, Bénédicte

2015-01-01

Most earlier studies investigating the evolution of the Stroop effect with the amount of reading practice have reported data consistent with an inverted U-shaped curve, whereby the Stroop effect appears early during reading acquisition, reaches a peak after 2 or 3 years of practice, and then continuously decreases until adulthood. The downward…

Beliefs, Practices, and Reflection: Exploring a Science Teacher's Classroom Assessment through the Assessment Triangle Model

ERIC Educational Resources Information Center

Lyon, Edward G.

2011-01-01

This paper describes the Assessment Practices Framework and how I used it to study a high school Chemistry teacher as she designed, implemented, and learned from a chemistry lab report. The framework consists of exploring three teacher-centered components of classroom assessment (assessment beliefs, practices, and reflection) and analyzing…

Evaluating the Stability of Test Score Means for the "TOEIC"® Speaking and Writing Tests. Research Report. ETS RR-17-50

ERIC Educational Resources Information Center

Qu, Yanxuan; Huo, Yan; Chan, Eric; Shotts, Matthew

2017-01-01

For educational tests, it is critical to maintain consistency of score scales and to understand the sources of variation in score means over time. This practice helps to ensure that interpretations about test takers' abilities are comparable from one administration (or one form) to another. This study examines the consistency of reported scores…

Consistency of Use and Effectiveness of Household Water Treatment Practices among Urban and Rural Populations Claiming to Treat Their Drinking Water at Home: A Case Study in Zambia

PubMed Central

Rosa, Ghislaine; Kelly, Paul; Clasen, Thomas

2016-01-01

Household water treatment (HWT) can improve drinking water quality and prevent disease, if used correctly and consistently. While international monitoring suggests that 1.8 billion people practice HWT, these estimates are based on household surveys that may overstate the level of consistent use and do not address microbiological effectiveness. We sought to examine how HWT is practiced among households identified as HWT users according to international monitoring standards. Case studies were conducted in urban and rural Zambia. After a baseline survey (urban: 203 households, rural: 276 households) to identify HWT users, 95 urban and 82 rural households were followed up for 6 weeks. Consistency of HWT reporting was low; only 72.6% of urban and 50.0% of rural households reported to be HWT users in the subsequent visit. Similarly, availability of treated water was low, only 23.3% and 4.2% of urban and rural households, respectively, had treated water on all visits. Drinking water was significantly worse than source water in both settings. Only 19.6% of urban and 2.4% of rural households had drinking water free of thermotolerant coliforms on all visits. Our findings raise questions about the value of the data gathered through the international monitoring of HWT practices as predictors of water quality in the home. PMID:26572868

Consistency of Use and Effectiveness of Household Water Treatment among Indian Households Claiming to Treat Their Water.

PubMed

Rosa, Ghislaine; Clasen, Thomas

2017-07-01

Household water treatment (HWT) can improve drinking water quality and prevent disease if used correctly and consistently by populations at risk. Current international monitoring estimates by the Joint Monitoring Programme for water and sanitation suggest that at least 1.1 billion people practice HWT. These estimates, however, are based on surveys that may overstate the level of consistent use and do not address microbial effectiveness. We sought to assess how HWT is practiced among households identified as HWT users according to these monitoring standards. After a baseline survey (urban: 189 households, rural: 210 households) to identify HWT users, 83 urban and 90 rural households were followed up for 6 weeks. Consistency of reported HWT practices was high in both urban (100%) and rural (93.3%) settings, as was availability of treated water (based on self-report) in all three sampling points (urban: 98.8%, rural: 76.0%). Nevertheless, only 13.7% of urban and 25.8% of rural households identified at baseline as users of adequate HWT had water free of thermotolerant coliforms at all three water sampling points. Our findings raise questions about the value of the data gathered through the international monitoring of HWT as predictors of water quality in the home, as well as questioning the ability of HWT, as actually practiced by vulnerable populations, to reduce exposure to waterborne diseases.

Medical Physics Practice Guidelines - the AAPM's minimum practice recommendations for medical physicists.

PubMed

Mills, Michael D; Chan, Maria F; Prisciandaro, Joann I; Shepard, Jeff; Halvorsen, Per H

2013-11-04

The AAPM has long advocated a consistent level of medical physics practice, and has published many recommendations and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physics practice. Despite these concerted and enduring efforts, the profession does not have clear and concise statements of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. To this end, the AAPM has recently endorsed the development of MPPGs, which may be generated in collaboration with other professional societies. The MPPGs are intended to be freely available to the general public. Accrediting organizations, regulatory agencies, and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider prudent in clinical practice settings. Support includes, but is not limited to, staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This article has described the purpose, scope, and process for the development of MPPGs.

Evaluation of a Design Principle for Fostering Students' Epistemological Views on Models and Modelling Using Authentic Practices as Contexts for Learning in Chemistry Education

ERIC Educational Resources Information Center

Prins, Gjalt T.; Bulte, Astrid M. W.; Pilot, Albert

2011-01-01

Science education should foster students' epistemological view on models and modelling consistent with formal epistemology in science and technology practices. This paper reports the application of a curriculum unit in the classroom using an authentic chemical practice, "Modelling drinking water treatment", as the context for learning.…

The influence of international and domestic events in the evolution of forest inventory and reporting consistency in the United States

Treesearch

W. Brad Smith

2009-01-01

This article takes a brief chronological look at resource inventory and reporting and links to international influences. It explores events as drivers of more consistent data within the United States and highlights key dates and events in the evolution of inventory policy and practice. From King George to L?Ecole nationale forestiere to the Food and Agriculture...

Status of women in urology: based on a report to the Society of University Urologists.

PubMed

Lightner, Deborah J; Terris, Martha K; Tsao, Alice K; Naughton, Cathy K; Lohse, Christine M

2005-02-01

Written responses from American trained women in urological surgery were obtained to evaluate practice patterns, career choices and workplace satisfaction. A 3-page unblinded questionnaire was mailed in March 2003 to American trained women in urological surgery available through the databases of the Society of Women in Urology with subsequent statistical analysis. The response rate was 60% but inclusive of all women in current academic practice in the United States. A total of 61% reported working 51 or more hours a week whereas 2% have left practice due to retirement or medical infirmity. There were 41% who had completed fellowships including 87% reporting active practice within their subspecialty, whereas 62% of fellowship trained surgeons remained in an academic practice. Among United States women in academic urological practice, academic progression has occurred in a third of this cohort. Threats to successful practice, consistent with other workplace surveys of physicians and professional women including gender based role limitation and inadequate mentoring, were commonly reported. These correctable workplace deficiencies represent an opportunity for American urology to enhance the professional workplace for all urologists regardless of gender.

Assessing and Treating Pain in Hospices: Current State of Evidence-Based Practices

PubMed Central

Herr, Keela; Titler, Marita; Fine, Perry; Sanders, Sara; Cavanaugh, Joe; Swegle, John; Forcucci, Chris; Tang, Xiongwen

2010-01-01

The aim of this article is to report on current provider evidence-based assessment and treatment practices for older adults with cancer in community-based hospice settings. Using the Cancer Pain Practices Index (CPPI), a tool developed by the researchers to measure evidence-based pain management practices, patients received an average of 32% of the those key evidence-based practices (EBPs) that were applicable to their situation. When examining individual practices, the majority of patients had their pain assessed at admission using a valid pain scale (69.7%) and had primary components of a comprehensive assessment completed at admission (52.7%); most patients with admission reports of pain had an order for pain medication (83.5%). However, data revealed a number of practice gaps including: additional components of a comprehensive assessment completed within 48 hours of admission (0%); review of the Pain Treatment Plan at each reassessment (35.7%); reassessment of moderate or greater pain (5.3%); consecutive pain reports of 5 or greater followed by pain medication increases (15.8%); monitoring of analgesic- induced side effects (19.3%); initiation of a bowel regimen for patients with an opioid order (32.3%); and documentation of both non-pharmacological therapies (22.5%) and written pain management plans (0.6%). Findings highlight positive EBPs and areas for improving the translation of EBPs into practice. Data suggest that cancer pain is not being documented as consistently assessed, reassessed or treated in a manner consistent with current EBP recommendations for older adults with cancer in community-based hospices. PMID:20471542

Reflections on Clinical Learning in Novice Speech-Language Therapy Students

ERIC Educational Resources Information Center

Hill, Anne E.; Davidson, Bronwyn J.; Theodoros, Deborah G.

2012-01-01

Background: Reflective practice is reported to enhance clinical reasoning and therefore to maximize client outcomes. The inclusion of targeted reflective practice in academic programmes in speech-language therapy has not been consistent, although providing opportunities for speech-language therapy students to reflect during their clinical practice…

Consistency of Use and Effectiveness of Household Water Treatment Practices Among Urban and Rural Populations Claiming to Treat Their Drinking Water at Home: A Case Study in Zambia.

PubMed

Rosa, Ghislaine; Kelly, Paul; Clasen, Thomas

2016-02-01

Household water treatment (HWT) can improve drinking water quality and prevent disease, if used correctly and consistently. While international monitoring suggests that 1.8 billion people practice HWT, these estimates are based on household surveys that may overstate the level of consistent use and do not address microbiological effectiveness. We sought to examine how HWT is practiced among households identified as HWT users according to international monitoring standards. Case studies were conducted in urban and rural Zambia. After a baseline survey (urban: 203 households, rural: 276 households) to identify HWT users, 95 urban and 82 rural households were followed up for 6 weeks. Consistency of HWT reporting was low; only 72.6% of urban and 50.0% of rural households reported to be HWT users in the subsequent visit. Similarly, availability of treated water was low, only 23.3% and 4.2% of urban and rural households, respectively, had treated water on all visits. Drinking water was significantly worse than source water in both settings. Only 19.6% of urban and 2.4% of rural households had drinking water free of thermotolerant coliforms on all visits. Our findings raise questions about the value of the data gathered through the international monitoring of HWT practices as predictors of water quality in the home. © The American Society of Tropical Medicine and Hygiene.

Understanding the reporting practices of CAHPS sponsors.

PubMed

Teleki, Stephanie S; Kanouse, David E; Elliott, Marc N; Hiatt, Liisa; de Vries, Han; Quigley, Denise D

2007-01-01

This article examines the reporting of Consumer Assessment of Healthcare Providers and Systems (CAHPSO) consumer experience data by sponsors, those that fund data collection and decide how information is summarized and disseminated. We found that sponsors typically publicly reported comparative data to consumers, employers, and/or purchasers. They presented health plan-level data in print and online at least annually, usually in combination with non-CAHPS information. Many provided trend data, comparisons to individual plans, and summary scores. Most shared information consistent with known successful reporting practices. Areas meriting attention include: tailoring reports to specific audiences, assessing literacy, planning dissemination, educating vendors, and evaluating products and programs.

Reporting Fatal Neglect in Child Death Review.

PubMed

Scott, Debbie

2018-01-01

Child death reviews are conducted with the aim of preventing child deaths however, definitions, inclusion criteria for the review of child deaths and reporting practices vary across Child Death Review Teams (CDRTs). This article aims to identify a common context and understanding of fatal neglect reporting by reviewing definitional issues of fatal neglect and comparing reporting practice across a number of CDRTs. Providing a consistent context for identifying and reporting neglect-related deaths may improve the understanding of the impact of fatal neglect and the risk factors associated with it and therefore, improve the potential of CDRT review to inform prevention programs, policies, and procedures.

Associations of consistent condom use among men who have sex with men in Abuja, Nigeria.

PubMed

Strömdahl, Susanne; Onigbanjo Williams, Abimbola; Eziefule, Bede; Emmanuel, Godwin; Iwuagwu, Stella; Anene, Oliver; Orazulike, Ifeanyi; Beyrer, Chris; Baral, Stefan

2012-12-01

The objective of the study was to characterize factors associated with consistent condom use among men who had sex with men (MSM) in Abuja, Nigeria. A convenience sample consisting of 297 MSM was recruited during 2008 using a combination of peer referral and venue-based sampling. Descriptive statistics with chi square and t-test were used for demographic, sexual identity, and practices variables. Univariate and multivariate logistic regressions were used to identify factors associated with consistent condom use with male partners in the past 6 months. Approximately more than half (53%, n=155/290) reported always using condoms with male partner in the past 6 months and 43% (n=95/219) reported always using condoms with female partners in the past 6 months. In all, 11% (n=16/144) reported always engaging in safe sex defined as always using condoms with both male and female partners and always using a water-based condom compatible lubricant with male partners in the past 6 months. Independent associations with consistent condom use with male partners in the past 6 months were knowledge of at least one sexually transmitted infection (STI) that can be transmitted through unprotected anal intercourse (OR 2.47, 95% CI: 1.27-4.83, p<0.01) and having been tested for HIV (OR 2.40, 95% CI: 1.27-4.54, p<0.01). MSM who had been HIV tested at least once were more likely to use condoms consistently during anal intercourse in multivariate analyses. In addition, STI knowledge was also associated with consistent condom use during anal intercourse implying that interventions targeting high-risk practices are effective as HIV prevention for this high-risk group. Future directions include intervention research to determine the appropriate package of services for MSM in Nigeria. In addition, implementation science evaluations of how best to operationalize combination HIV prevention interventions for MSM given the criminalization and stigmatization of same-sex practices are crucial.

Impact of human resource management practices on nursing home performance.

PubMed

Rondeau, K V; Wagar, T H

2001-08-01

Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain optimal organizational performance.

Methodological strategies in using home sleep apnea testing in research and practice.

PubMed

Miller, Jennifer N; Schulz, Paula; Pozehl, Bunny; Fiedler, Douglas; Fial, Alissa; Berger, Ann M

2017-11-14

Home sleep apnea testing (HSAT) has increased due to improvements in technology, accessibility, and changes in third party reimbursement requirements. Research studies using HSAT have not consistently reported procedures and methodological challenges. This paper had two objectives: (1) summarize the literature on use of HSAT in research of adults and (2) identify methodological strategies to use in research and practice to standardize HSAT procedures and information. Search strategy included studies of participants undergoing sleep testing for OSA using HSAT. MEDLINE via PubMed, CINAHL, and Embase with the following search terms: "polysomnography," "home," "level III," "obstructive sleep apnea," and "out of center testing." Research articles that met inclusion criteria (n = 34) inconsistently reported methods and methodological challenges in terms of: (a) participant sampling; (b) instrumentation issues; (c) clinical variables; (d) data processing; and (e) patient acceptability. Ten methodological strategies were identified for adoption when using HSAT in research and practice. Future studies need to address the methodological challenges summarized in this paper as well as identify and report consistent HSAT procedures and information.

Invited review: effect of udder health management practices on herd somatic cell count.

PubMed

Dufour, S; Fréchette, A; Barkema, H W; Mussell, A; Scholl, D T

2011-02-01

A systematic review of the scientific literature on relationships between management practices used on dairy farms and herd somatic cell count (SCC) was undertaken to distinguish those management practices that have been consistently shown to be associated with herd SCC from those lacking evidence of association. Relevant literature was identified using a combination of database searches (PubMed, Medline, CAB, Agricola, and Web of Science) and iterative screening of references. To be included in the review, a manuscript had to be published after 1979 in French, English, or Dutch; study design had to be other than case report or case series; herds studied had to be composed of ≥ 40 milking cows producing on average ≥ 7,000kg of milk in 305 d; interventions studied had to be management practices applied at the herd level and used as udder health control strategies; and SCC had to be measured using electronic cell counting methods. The 36 manuscripts selected were mainly observational cross-sectional studies; 8 manuscripts dealt exclusively with automatic milking systems and 4 with management of calves and heifers and its effect on SCC in early lactation heifers. Most practices having consistent associations with SCC were related to milking procedures: wearing gloves during milking, using automatic take-offs, using postmilking teat dipping, milking problem cows last, yearly inspection of the milking system, and use of a technique to keep cows standing following milking; all were consistently associated with lower herd SCC. Other practices associated with lower SCC were the use of a freestall system, sand bedding, cleaning the calving pen after each calving, surveillance of dry-cow udders for mastitis, use of blanket dry-cow therapy, parenteral selenium supplementation, udder hair management, and frequent use of the California Mastitis Test. Regarding SCC of heifers, most of the consistent associations reported were related to interventions made during the peripartum period. Studies on automatic milking systems have frequently reported elevation of the herd SCC following transition to the new system. These elevations seemed to be mediated both by the lack of monitoring of chronically infected cows and by an elevated incidence of intramammary infections. By assembling the results reported in many different studies, this review generates a more comprehensive understanding of the management practices influencing SCC and highlights areas of SCC control knowledge that lack evidence of effectiveness. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Implementing Summative Assessment with a Formative Flavour: A Case Study in a Large Class

ERIC Educational Resources Information Center

Broadbent, Jaclyn; Panadero, Ernesto; Boud, David

2018-01-01

Teaching a large class can present real challenges in design, management and standardisation of assessment practices. One of the main dilemmas for university teachers is how to implement effective formative assessment practices with accompanying high-quality feedback consistently over time with large classroom groups. This article reports on how…

Grammar Teaching in Secondary School Foreign Language Learning in England: Teachers' Reported Beliefs and Observed Practices

ERIC Educational Resources Information Center

Liviero, Sara

2017-01-01

This study investigates teachers' beliefs relating to grammar teaching in modern foreign language (MFL) learning in England. Focus on grammatical form has been consistently supported by linguistic research and teacher practice, and has progressively been reinstated in England's National Curriculum. However, MFL learning assessment in England has…

An Innovative Program in Social Work Education

ERIC Educational Resources Information Center

Peleg-Oren, Neta; Aran, Ofra; Even-Zahav, Ronit; Macgowan, Mark J.; Stanger, Varda

2007-01-01

This paper is a report of an innovative program in social work education to enrich field supervisors and students with the latest theories and practices related to social work practice in health care settings. This program consists of a study day organized jointly by academic faculty, field supervisors, and students, conducted once a year between…

Histologic processing and reporting of cutaneous pigmented lesions: recommendations based on a survey of 94 dermatopathologists.

PubMed

Kolman, Olga; Hoang, Mai P; Piris, Adriano; Mihm, Martin C; Duncan, Lyn M

2010-10-01

Standard operating procedures for laboratory processing and reporting of margins of cutaneous pigmented lesions do not exist. We conducted a survey of 94 dermatopathologists to evaluate these practices. We sought to: (1) identify dominant practices among dermatopathologists; (2) determine the impact of the procedure, intent to excise, and histologic diagnosis on the process of margin evaluation; and (3) propose guidelines based on these findings. The survey consisted of 44 questions focused on the impact of procedure (punch, shave, or ellipse), intent (excision or biopsy), and histologic diagnosis (common nevus, congenital nevus, atypical nevus, melanoma) on processing and margin reporting. For ellipses, or specimens indicated as excisions, the majority practice (76%-98%) was to ink the specimens. Although more than 90% of observers report the margins on all melanomas and atypical nevi, fewer than 50% of respondents report margins on all nonatypical nevi. The study consists of a survey sample of dermatopathologists and does not represent the practices of those who did not respond to the survey. Based on the results of this survey we have arrived at the following recommendations: (1) ink all specimens that are ellipses or designated as excisions; (2) tips should be evaluated separately if the specimen is an ellipse; (3) obtain levels in cases with tumor in the tip but not at ink if the specimen is an ellipse or excision and the diagnosis is atypical nevus or melanoma; and (4) report margins on all atypical nevi and melanomas. Copyright © 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Relationship between meditative practice and self-reported mindfulness: the MINDSENS composite index.

PubMed

Soler, Joaquim; Cebolla, Ausiàs; Feliu-Soler, Albert; Demarzo, Marcelo M P; Pascual, Juan C; Baños, Rosa; García-Campayo, Javier

2014-01-01

Mindfulness has been described as an inherent human capability that can be learned and trained, and its improvement has been associated with better health outcomes in both medicine and psychology. Although the role of practice is central to most mindfulness programs, practice-related improvements in mindfulness skills is not consistently reported and little is known about how the characteristics of meditative practice affect different components of mindfulness. The present study explores the role of practice parameters on self-reported mindfulness skills. A total of 670 voluntary participants with and without previous meditation experience (n = 384 and n = 286, respectively) responded to an internet-based survey on various aspects of their meditative practice (type of meditation, length of session, frequency, and lifetime practice). Participants also completed the Five Facets Mindfulness Questionnaire (FFMQ), and the Experiences Questionnaire (EQ). The group with meditation experience obtained significantly higher scores on all facets of FFMQ and EQ questionnaires compared to the group without experience. However different effect sizes were observed, with stronger effects for the Observing and Non-Reactivity facets of the FFMQ, moderate effects for Decentering in EQ, and a weak effect for Non-judging, Describing, and Acting with awareness on the FFMQ. Our results indicate that not all practice variables are equally relevant in terms of developing mindfulness skills. Frequency and lifetime practice--but not session length or meditation type--were associated with higher mindfulness skills. Given that these 6 mindfulness aspects show variable sensitivity to practice, we created a composite index (MINDSENS) consisting of those items from FFMQ and EQ that showed the strongest response to practice. The MINDSENS index was able to correctly discriminate daily meditators from non-meditators in 82.3% of cases. These findings may contribute to the understanding of the development of mindfulness skills and support trainers and researchers in improving mindfulness-oriented practices and programs.

Relationship between Meditative Practice and Self-Reported Mindfulness: The MINDSENS Composite Index

PubMed Central

Soler, Joaquim; Cebolla, Ausiàs; Feliu-Soler, Albert; Demarzo, Marcelo M. P.; Pascual, Juan C.; Baños, Rosa; García-Campayo, Javier

2014-01-01

Mindfulness has been described as an inherent human capability that can be learned and trained, and its improvement has been associated with better health outcomes in both medicine and psychology. Although the role of practice is central to most mindfulness programs, practice-related improvements in mindfulness skills is not consistently reported and little is known about how the characteristics of meditative practice affect different components of mindfulness. The present study explores the role of practice parameters on self-reported mindfulness skills. A total of 670 voluntary participants with and without previous meditation experience (n = 384 and n = 286, respectively) responded to an internet-based survey on various aspects of their meditative practice (type of meditation, length of session, frequency, and lifetime practice). Participants also completed the Five Facets Mindfulness Questionnaire (FFMQ), and the Experiences Questionnaire (EQ). The group with meditation experience obtained significantly higher scores on all facets of FFMQ and EQ questionnaires compared to the group without experience. However different effect sizes were observed, with stronger effects for the Observing and Non-Reactivity facets of the FFMQ, moderate effects for Decentering in EQ, and a weak effect for Non-judging, Describing, and Acting with awareness on the FFMQ. Our results indicate that not all practice variables are equally relevant in terms of developing mindfulness skills. Frequency and lifetime practice – but not session length or meditation type – were associated with higher mindfulness skills. Given that these 6 mindfulness aspects show variable sensitivity to practice, we created a composite index (MINDSENS) consisting of those items from FFMQ and EQ that showed the strongest response to practice. The MINDSENS index was able to correctly discriminate daily meditators from non-meditators in 82.3% of cases. These findings may contribute to the understanding of the development of mindfulness skills and support trainers and researchers in improving mindfulness-oriented practices and programs. PMID:24466175

A descriptive inquiry of the definitions of critical thinking and enhancers and barriers reported by nurses working in long-term care facilities.

PubMed

Raterink, Ginger

2008-09-01

Critical thinking has been an outcome of nursing education since the 1980s. There remains a lack of agreement on definitions, methods of teaching, and methods of evaluation among practicing nurses. This study asked practicing nurses to define critical thinking. It also asked nurses to describe what work-related factors enhanced or posed barriers to the use of critical thinking in practice. Elements of the definitions presented were found to be consistent with current nursing definitions of critical thinking. Enhancers and barriers overlapped and were found to be consistent among the nurses at all facilities studied, with implications for continuing education and staff development.

Variations in patient safety climate and perceived quality of collaboration between professions in out-of-hours care

PubMed Central

Klemenc-Ketis, Zalika; Deilkås, Ellen Tveter; Hofoss, Dag; Bondevik, Gunnar Tschudi

2017-01-01

Purpose To get an overview of health care workers perceptions of patient safety climates and the quality of collaboration in Slovenian out-of-hours health care (OOHC) between professional groups. Materials and methods This was a cross-sectional study carried out in all (60) Slovenian OOHC clinics; 37 (61.7%) agreed to participate with 438 employees. The questionnaire consisted of the Slovenian version of the Safety Attitudes Questionnaire – Ambulatory Version (SAQ-AV). Results The study sample consisted of 175 (70.0%) physicians, nurse practitioners, and practice nurses. Practice nurses reported the highest patient safety climate scores in all dimensions. Total mean (standard deviation) SAQ-AV score was 60.9±15.2. Scores for quality of collaboration between different professional groups were high. The highest mean scores were reported by nurse practitioners on collaboration with practice nurses (4.4±0.6). The lowest mean scores were reported by practice nurses on collaboration with nurse practitioners (3.8±0.9). Conclusion Due to large variations in Slovenian OOHC clinics with regard to how health care workers from different professional backgrounds perceive safety culture, more attention should be devoted to improving the team collaboration in OOHC. A clearer description of professional team roles should be provided. PMID:29184416

H. pylori and Barrett's Esophagus: Implications for Populations and Practice.

PubMed

Howden, Colin W

2018-06-19

In this edition of the American Journal of Gastroenterology, Wang and colleagues report the results of an analysis of six different case-control studies examining the relationship between Helicobacter pylori (H. pylori) infection and Barrett's esophagus. They present a cogent argument that there is an inverse association between these two that is mediated via GERD. This is broadly consistent with previous reports. While further establishing this inverse association, the findings should not materially influence our routine clinical practice regarding GERD or H. pylori infection.

Physicians who use social media and other internet-based communication technologies.

PubMed

Cooper, Crystale Purvis; Gelb, Cynthia A; Rim, Sun Hee; Hawkins, Nikki A; Rodriguez, Juan L; Polonec, Lindsey

2012-01-01

The demographic and practice-related characteristics of physicians who use social networking websites, portable devices to access the internet, email to communicate with patients, podcasts, widgets, RSS feeds, and blogging were investigated. Logistic regression was used to analyze a survey of US primary care physicians, pediatricians, obstetrician/gynecologists, and dermatologists (N=1750). Reported technology use during the last 6 months ranged from 80.6% using a portable device to access the internet to 12.9% writing a blog. The most consistent predictors of use were being male, being younger, and having teaching hospital privileges. Physician specialty, practice setting, years in practice, average number of patients treated per week, and number of physicians in practice were found to be inconsistently associated or unassociated with use of the technologies examined. Demographic characteristics, rather than practice-related characteristics, were more consistent predictors of physician use of seven internet-based communication technologies with varying levels of uptake.

Nursing practice. Report of a WHO expert committee.

PubMed

1996-01-01

Nursing is remarkable for the scope of activities that it includes. Nursing practice involves so many things in so many places that finding a definition that includes everything and applies everywhere is no easy task. This report by the WHO Expert Committee on Nursing Practice describes the basic functions of nursing practice and how they are manifested in different socioeconomic situations. Whatever the environment, the report concludes, there are certain core elements that are the responsibility of nurses the world over. The influence that social attitudes and political and economic policies have on nursing practice is examined. The report is honest in its admission that the situation in many places is far from ideal and that in most there is clear room for improvement. Policy-makers, legislators, managers, educators, researchers, other professionals and nurses themselves have important roles to play in a comprehensive approach to the development of nursing practice proposed by the Expert Committee. The report emphasizes the importance of a well educated and highly skilled nursing workforce that is consistent in maintaining quality of care but is also responsive to change. It points the way to international standards in nursing practice and lays the foundation for new strategies to ensure that nurses will be fully equipped to meet future challenges in the delivery of health care.

Score Reliability of Adolescent Alcohol Screening Measures: A Meta-Analytic Inquiry

ERIC Educational Resources Information Center

Shields, Alan L.; Campfield, Delia C.; Miller, Christopher S.; Howell, Ryan T.; Wallace, Kimberly; Weiss, Roger D.

2008-01-01

This study describes the reliability reporting practices in empirical studies using eight adolescent alcohol screening tools and characterizes and explores variability in internal consistency estimates across samples. Of 119 observed administrations of these instruments, 40 (34%) reported usable reliability information. The Personal Experience…

A systematic review of HIV partner counseling and referral services: client and provider attitudes, preferences, practices, and experiences.

PubMed

Passin, Warren F; Kim, Angela S; Hutchinson, Angela B; Crepaz, Nicole; Herbst, Jeffrey H; Lyles, Cynthia M

2006-05-01

The objectives of this study were to understand client and provider attitudes, experiences, and practices regarding HIV partner notification in the United States and to help identify future research and program needs. The goals of this study were to synthesize the literature reporting client and provider attitudes, experiences, and practices and to identify potential negative effects of HIV partner notification. This study consisted of a systematic qualitative review. Clients were willing to self-notify partners and participate in provider notification, and few reported negative effects. The majority of health care providers were in favor of HIV partner notification; however, they did not consistently refer index clients to HIV partner notification programs. Considering that clients have positive attitudes toward self- and provider referral, local HIV prevention programs need to ensure that all HIV-positive clients are offered partner notification services. Additional research is needed to assess the potential risks of notifying partners and to identify effective techniques to improve client and provider participation.

Report of a Study of Ontario Medical School Admissions Policies and Practices, 1975.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

Presented are the results of a study of admissions policies and practices in the five Ontario schools of medicine. The study consists of a review of published information and a detailed examination of 1975 statistics from the Ontario Medical School Application Service, supplemented by a series of interviews with medical school admissions officers,…

The Statistics Teaching Inventory: A Survey on Statistics Teachers' Classroom Practices and Beliefs

ERIC Educational Resources Information Center

Zieffler, Andrew; Park, Jiyoon; Garfield, Joan; delMas, Robert; Bjornsdottir, Audbjorg

2012-01-01

This paper reports on an instrument designed to assess the practices and beliefs of instructors of introductory statistics courses across the disciplines. Funded by a grant from the National Science Foundation, this project developed, piloted, and gathered validity evidence for the Statistics Teaching Inventory (STI). The instrument consists of 50…

Investigating Cognitive Transfer within the Framework of Music Practice: Genetic Pleiotropy Rather than Causality

ERIC Educational Resources Information Center

Mosing, Miriam A.; Madison, Guy; Pedersen, Nancy L.; Ullén, Fredrik

2016-01-01

The idea of far transfer effects in the cognitive sciences has received much attention in recent years. One domain where far transfer effects have frequently been reported is music education, with the prevailing idea that music practice entails an increase in cognitive ability (IQ). While cross-sectional studies consistently find significant…

Strategies for preventing group B streptococcal infections in newborns: a nation-wide survey of Italian policies.

PubMed

Tzialla, Chryssoula; Berardi, Alberto; Farina, Claudio; Clerici, Pierangelo; Borghesi, Alessandro; Viora, Elsa; Scollo, Paolo; Stronati, Mauro

2017-11-02

There are no Italian data regarding the strategies for preventing neonatal group B streptococcal (GBS) infection. We conducted a national survey in order to explore obstetrical, neonatal and microbiological practices for the GBS prevention. Three distinct questionnaires were sent to obstetricians, neonatologists and microbiologists. Questionnaires included data on prenatal GBS screening, maternal risk factors, intrapartum antibiotic prophylaxis, microbiological information concerning specimen processing and GBS antimicrobial susceptibility. All respondent obstetrical units used the culture-based screening approach to identify women who should receive intrapartum antibiotic prophylaxis, and more than half of the microbiological laboratories (58%) reported using specimen processing consistent with CDC guidelines. Most neonatal units (89 out of 107, 82%) reported using protocols for preventing GBS early-onset sepsis consistent with CDC guidelines. The screening-based strategy is largely prevalent in Italy, and most protocols for preventing GBS early-onset sepsis are consistent with CDC guidelines. However, we found discrepancies in practices among centers that may reflect the lack of Italian guidelines issued by public health organizations.

Little Association Between Wellness Policies and School-Reported Nutrition Practices

PubMed Central

Lucarelli, Jennifer F.; Alaimo, Katherine; Belansky, Elaine S.; Mang, Ellen; Miles, Richard; Kelleher, Deanne K.; Bailey, Deborah; Drzal, Nicholas B.; Liu, Hui

2017-01-01

Background The Child Nutrition and WIC Reauthorization Act of 2004 mandated written school wellness policies. Little evidence exists to evaluate the impact of such policies. This study assessed the quality (comprehensiveness of topics addressed and strength of wording) of wellness policies and the agreement between written district-level policies and school-reported nutrition policies and practices in 48 low-income Michigan school districts participating in the School Nutrition Advances Kids study. Method Written wellness policy quality was assessed using the School Wellness Policy Evaluation Tool. School nutrition policies and practices were assessed using the School Environment and Policy Survey. Analysis of variance determined differences in policy quality, and Fisher’s exact test examined agreement between written policies and school-reported practices. Results Written wellness policies contained ambiguous language and addressed few practices, indicating low comprehensiveness and strength. Most districts adopted model wellness policy templates without modification, and the template used was the primary determinant of policy quality. Written wellness policies often did not reflect school-reported nutrition policies and practices. Conclusions School health advocates should avoid assumptions that written wellness policies accurately reflect school practices. Encouraging policy template customization and stronger, more specific language may enhance wellness policy quality, ensure consistency between policy and practice, and enhance implementation of school nutrition initiatives. PMID:25249567

77 FR 76400 - Disclosure or Use of Information by Preparers of Returns

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-28

... in any evaluative reports or recommendations that may be accessible to any person other than the... evaluative reports or recommendations that may be accessible to any person other than those responsible for... consistent with good business practices and designed to maintain the confidentiality of the disclosed tax...

Duration of luteal support after IVF is important, so why is there no consistency in practice? The results of a dynamic survey of practice in the United Kingdom.

PubMed

Russell, Richard; Kingsland, Charles; Alfirevic, Zarko; Gazvani, Rafet

2015-03-01

Luteal support is considered as an essential component of IVF treatment following ovarian stimulation and embryo transfer. Several studies have consistently demonstrated a benefit of luteal support compared with no treatment and whilst a number of preparations are available, no product has been demonstrated as superior. There is an emerging body of evidence which suggests that extension of luteal support beyond biochemical pregnancy does not confer a benefit in terms of successful pregnancy outcome. We performed two surveys separated by 5 years of practice evolution, with the latter reporting on the use of luteal support in all IVF clinics in the UK. All clinics reported utilising luteal support with the majority favouring the use of Cyclogest 400 mg twice daily. In contrast, there was no consensus on the optimal duration of luteal support. Whilst 24% of clinics withdrew luteal support at biochemical confirmation of pregnancy, 40% continued treatment until 12 weeks gestation. Several clinics even extended luteal support beyond 12 weeks gestation. We observed no difference in practice based on the size of the IVF unit or treatment funding source. Although there was some change in practice between surveys in many clinics, there was no uniformity in the direction of change.

[Alcohol and illicit drug use and its influence on the sexual behavior of teenagers from Minas Gerais State, Brazil].

PubMed

Bertoni, Neilane; Bastos, Francisco I; Mello, Maeve Brito de; Makuch, Maria Yolanda; Sousa, Maria Helena de; Osis, Maria José; Faúndes, Anibal

2009-06-01

This article summarizes the findings of a survey including 5,981 students from public schools in Minas Gerais State, Brazil. The analysis assessed the influence of drug use on sexual practices. Among the boys engaged in relationships with casual partners who stated having used illicit drugs, 55.7% reported consistent condom use, as compared to 65.4% among those not reporting such habits. Among boys engaged in relationships with stable partners who reported illicit drug use, consistent condom use was reported by 42.7%, versus 64.1% among those not reporting such habits. In the subgroup of boys engaged in stable relationships who did not report illicit drug use, consistent condom use was less frequent among those that used alcohol/cigarettes, compared to those who did not drink or smoke (60.7% vs. 71.1%). Girls were less likely than boys to use condoms consistently, regardless of the nature of their relationships, without a noticeable influence of drug use. Policies to prevent drug abuse, sexually transmitted diseases, and unplanned pregnancy should be fully integrated.

Employers' Views on Hiring and Training. A Non-Statistical Approach to Data-Gathering. Third Annual Report, 1980-81.

ERIC Educational Resources Information Center

Lynton, Edith F.; Seldin, Joel R.

This report consists primarily of employer views on hiring practices and training needs in 17 occupations in five occupational areas (office work, distribution, service, communications, and crafts). Described first are the activities of the Labor Market Information Network that resulted in the compilation of data presented in the report. The…

Assessing curriculum effectiveness: a survey of Uniformed Services University medical school graduates.

PubMed

Picho, Katherine; Gilliland, William R; Artino, Anthony R; DeZee, Kent J; Dong, Ting; McManigle, John E; Cruess, David F; Durning, Steven J

2015-04-01

This study assessed alumni perceptions of their preparedness for clinical practice using the Accreditation Council for Graduate Medical Education (ACGME) competencies. We hypothesized that our alumni's perception of preparedness would be highest for military-unique practice and professionalism and lowest for system-based practice and practice-based learning and improvement. 1,189 alumni who graduated from the Uniformed Services University (USU) between 1980 and 2001 completed a survey modeled to assess the ACGME competencies on a 5-point, Likert-type scale. Specifically, self-reports of competencies related to patient care, communication and interpersonal skills, medical knowledge, professionalism, systems-based practice, practice-based learning and improvement, and military-unique practice were evaluated. Consistent with our expectations as the nation's military medical school, our graduates were most confident in their preparedness for military-unique practice, which included items assessing military leadership (M = 4.30, SD = 0.65). USU graduates also indicated being well prepared for the challenges of residency education in the domain of professionalism (M = 4.02, SD = 0.72). Self-reports were also high for competencies related to patient care (M = 3.86, SD = 0.68), communication and interpersonal skills (M = 3.88, SD = 0.66), and medical knowledge (M = 3.78, SD = 0.73). Consistent with expectations, systems-based practice (M = 3.50, SD = 0.70) and practice-based learning and improvement (M = 3.57, SD = 0.62) were the lowest rated competencies, although self-reported preparedness was still quite high. Our findings suggest that, from the perspective of our graduates, USU is providing both an effective military-unique curriculum and is preparing trainees for residency training. Further, these results support the notion that graduates are prepared to lead and to practice medicine in austere environments. Compared to other competencies that were assessed, self-ratings for systems-based practice and practice-based learning and improvement were the lowest, which suggests the need to continue to improve USU education in these areas. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Do as We Do and Not as We Say: Teacher Educators Supporting Student Teachers to Learn on Teaching Practice

ERIC Educational Resources Information Center

Chambers, Fiona C.; Armour, Kathleen M.

2011-01-01

This paper reports data from a larger study into the ways in which Physical Education Teacher Education (PETE) students engaged in professional learning during teaching practice (TP) in Ireland. The study comprised one umbrella case study of Greendale University, schools and PETE students that consisted of five individual cases: tetrads of PETE…

Development of a Repeatable Regional Protocol for Performance-Based Monitoring of Forestry Best Management Practices

Treesearch

Roger Ryder; Pamela J. Edwards; Pamela J. Edwards

2005-01-01

There has been a long-standing interest in improving Best Management Practice (BMP) monitoring within and among states. States monitoring the implementation and effectiveness of BMPs for forest operations take a variety of approaches. This creates inconsistencies in data collection and how results are reported. Since 1990 attempts have been made to develop a consistent...

Improving Synthetic Biology Communication: Recommended Practices for Visual Depiction and Digital Submission of Genetic Designs.

PubMed

Hillson, Nathan J; Plahar, Hector A; Beal, Jacob; Prithviraj, Ranjini

2016-06-17

Research is communicated more effectively and reproducibly when articles depict genetic designs consistently and fully disclose the complete sequences of all reported constructs. ACS Synthetic Biology is now providing authors with updated guidance and piloting a new tool and publication workflow that facilitate compliance with these recommended practices and standards for visual representation and data exchange.

Self-Efficacy: A South African Case Study on Teachers' Commitment to Integrate Climate Change Resilience into Their Teaching Practices

ERIC Educational Resources Information Center

Raath, Schalk; Hay, Anette

2016-01-01

A strong sense of self-efficacy in teachers has in many studies been consistently related to positive teaching behaviours and learner outcomes. This research reports on the differences among teachers regarding their self-efficacy and how this relates to their confidence and commitment to integrate climate change in their teaching practice. A…

Knowledge, perceptions, and practices of methicillin-resistant Staphylococcus aureus transmission prevention among health care workers in acute-care settings.

PubMed

Seibert, Dorothy J; Speroni, Karen Gabel; Oh, Kyeung Mi; DeVoe, Mary C; Jacobsen, Kathryn H

2014-03-01

Health care workers (HCWs) play a critical role in prevention of health care-associated infections such as methicillin-resistant Staphylococcus aureus (MRSA), but glove and gown contact precautions and hand hygiene may not be consistently used with vulnerable patients. A cross-sectional survey of MRSA knowledge, attitudes/perceptions, and practices among 276 medical, nursing, allied health, and support services staff at an acute-care hospital in the eastern United States was completed in 2012. Additionally, blinded observations of hand hygiene behaviors of 104 HCWs were conducted. HCWs strongly agreed that preventive behaviors reduce the spread of MRSA. The vast majority reported that they almost always engage in preventive practices, but observations of hand hygiene found lower rates of adherence among nearly all HCW groups. HCWs who reported greater comfort with telling others to take action to prevent MRSA transmission were significantly more likely to self-report adherence to recommended practices. It is important to reduce barriers to adherence with preventive behaviors and to help all HCWs, including support staff who do not have direct patient care responsibilities, to translate knowledge about MRSA transmission prevention methods into consistent adherence of themselves and their coworkers to prevention guidelines. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Preschool Teachers’ Language and Literacy Practices with Dual Language Learners

PubMed Central

Sawyer, Brook E.; Hammer, Carol Scheffner; Cycyk, Lauren M.; López, Lisa; Blair, Clancy; Sandilos, Lia; Komaroff, Eugene

2016-01-01

The purposes of this study were to (a) examine the degree to which teachers used linguistically responsive practices to support the language and literacy development of Spanish-speaking Dual Language Learners (DLL) and (b) to investigate the associations between these practices and select teacher-level factors. The sample consisted of 72 preschool teachers. Observational data were collected on practices. Teachers self-reported on language and culture beliefs, Spanish speaking ability, and classroom composition. Results indicated that teachers, including those who spoke Spanish, used few linguistically responsive practices to support preschool DLLs. Only Spanish-speaking ability was related to practices. Implications for targeted professional development are discussed. PMID:27667968

Preschool Teachers' Language and Literacy Practices with Dual Language Learners.

PubMed

Sawyer, Brook E; Hammer, Carol Scheffner; Cycyk, Lauren M; López, Lisa; Blair, Clancy; Sandilos, Lia; Komaroff, Eugene

The purposes of this study were to (a) examine the degree to which teachers used linguistically responsive practices to support the language and literacy development of Spanish-speaking Dual Language Learners (DLL) and (b) to investigate the associations between these practices and select teacher-level factors. The sample consisted of 72 preschool teachers. Observational data were collected on practices. Teachers self-reported on language and culture beliefs, Spanish speaking ability, and classroom composition. Results indicated that teachers, including those who spoke Spanish, used few linguistically responsive practices to support preschool DLLs. Only Spanish-speaking ability was related to practices. Implications for targeted professional development are discussed.

Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India.

PubMed

Diwan, Vishal; Gustafsson, Charlotte; Rosales Klintz, Senia; Joshi, Sudhir Chandra; Joshi, Rita; Sharma, Megha; Shah, Harshada; Pathak, Ashish; Tamhankar, Ashok J; Stålsby Lundborg, Cecilia

2016-01-01

To describe self-reported practices and assess knowledge and attitudes regarding hand hygiene among healthcare workers in a rural Indian teaching hospital. A rural teaching hospital and its associated medical and nursing colleges in the district of Ujjain, India. The study population consisted of physicians, nurses, teaching staff, clinical instructors and nursing students. Self-administered questionnaires based on the World Health Organization Guidelines on Hand Hygiene in Healthcare were used. Out of 489 healthcare workers, 259 participated in the study (response rate = 53%). The proportion of healthcare workers that reported to 'always' practice hand hygiene in the selected situations varied from 40-96% amongst categories. Reported barriers to maintaining good hand hygiene were mainly related to high workload, scarcity of resources, lack of scientific information and the perception that priority is not given to hand hygiene, either on an individual or institutional level. Previous training on the topic had a statistically significant association with self-reported practice (p = 0.001). Ninety three per cent of the respondents were willing to attend training on hand hygiene in the near future. Self-reported knowledge and adherence varied between situations, but hand hygiene practices have the potential to improve if the identified constraints could be reduced. Future training should focus on enhancing healthcare workers' knowledge and understanding regarding the importance of persistent practice in all situations.

Confirmatory factor analysis of the Chinese Breast Cancer Screening Beliefs Questionnaire.

PubMed

Kwok, Cannas; Fethney, Judith; White, Kate

2012-01-01

Chinese women have been consistently reported as having low breast cancer screening practices. The Chinese Breast Cancer Screening Beliefs Questionnaire (CBCSB) was designed to assess Chinese Australian women's beliefs, knowledge, and attitudes toward breast cancer and screening practices. The objectives of the study were to confirm the factor structure of the CBCSB with a new, larger sample of immigrant Chinese Australian women and to report its clinical validity. A convenience sample of 785 Chinese Australian women was recruited from Chinese community organizations and shopping malls. Cronbach α was used to assess internal consistency reliability, and Amos v18 was used for confirmatory factor analysis. Clinical validity was assessed through linear regression using SPSS v18. The 3-factor structure of the CBCSB was confirmed, although the model required respecification to arrive at a suitable model fit as measured by the goodness-of-fit index (0.98), adjusted goodness-of-fit index (0.97), normed fit index (0.95), and root mean square error of approximation (0.031). Internal consistency reliability coefficients were satisfactory (>.6). Women who engaged in all 3 types of screening had more proactive attitudes to health checkups and perceived less barriers to mammographic screening. The CBCSB is a valid and reliable tool for assessing Chinese women's beliefs, knowledge, and attitudes about breast cancer and breast cancer screening practices. The CBCSB can be used for providing practicing nurses with insights into the provision of culturally sensitive breast health education.

Improved Delivery of Cardiovascular Care (IDOCC): Findings from Narrative Reports by Practice Facilitators.

PubMed

Liddy, Clare; Rowan, Margo; Valiquette-Tessier, Sophie-Claire; Drosinis, Paul; Crowe, Lois; Hogg, William

2017-03-01

Practice facilitation can help family physicians adopt evidence-based guidelines. However, many practices struggle to effectively implement practice changes that result in meaningful improvement. Building on our previous research, we examined the barriers to and enablers of implementation perceived by practice facilitators (PF) in helping practices to adopt the Improved Delivery of Cardiovascular Care (IDOCC) program, which took place at 84 primary care practices in Ottawa, Canada between April 2008 and March 2012. We conducted a qualitative analysis of PFs' narrative reports using a multiple case study design. We used a combined purposeful sampling approach to identify cases that 1) reflected experiences typical of the broader sample and 2) presented sufficient breadth of experience from each project step and family practice model. Sampling continued until data saturation was reached. Team members conducted a qualitative analysis of reports using an open and axial coding style and a constant comparative approach. Barriers and enablers were divided into five constructs: structural, organizational, provider, patient, and innovation. Narratives from 13 practice sites were reviewed. A total of 8 barriers and 11 enablers were consistently identified across practices. Barriers were most commonly reported at the organizational (n = 3) and structural level, (n = 2) while enablers were most common at the innovation level (n = 6). While physicians responded positively to PFs' presence and largely supported their recommendations for practice change, organizational and structural aspects such as lack of time, minimal staff engagement, and provider reimbursement remained too great for practices to successfully implement practice-level changes. Trial Registration: ClinicalTrials.gov, NCT00574808.

Harmful practices in the management of childhood diarrhea in low- and middle-income countries: a systematic review.

PubMed

Carter, Emily; Bryce, Jennifer; Perin, Jamie; Newby, Holly

2015-08-18

Harmful practices in the management of childhood diarrhea are associated with negative health outcomes, and conflict with WHO treatment guidelines. These practices include restriction of fluids, breast milk and/or food intake during diarrhea episodes, and incorrect use of modern medicines. We conducted a systematic review of English-language literature published since 1990 to assess the documented prevalence of these four harmful practices, and beliefs, motivations, and contextual factors associated with harmful practices in low- and middle-income countries. We electronically searched PubMed, Embase, Ovid Global Health, and the WHO Global Health Library. Publications reporting the prevalence or substantive findings on beliefs, motivations, or context related to at least one of the four harmful practices were included, regardless of study design or representativeness of the sample population. Of the 114 articles included in the review, 79 reported the prevalence of at least one harmful practice and 35 studies reported on beliefs, motivations, or context for harmful practices. Most studies relied on sub-national population samples and many were limited to small sample sizes. Study design, study population, and definition of harmful practices varied across studies. Reported prevalence of harmful practices varied greatly across study populations, and we were unable to identify clearly defined patterns across regions, countries, or time periods. Caregivers reported that diarrhea management practices were based on the advice of others (health workers, relatives, community members), as well as their own observations or understanding of the efficacy of certain treatments for diarrhea. Others reported following traditionally held beliefs on the causes and cures for specific diarrheal diseases. Available evidence suggests that harmful practices in diarrhea treatment are common in some countries with a high burden of diarrhea-related mortality. These practices can reduce correct management of diarrheal disease in children and result in treatment failure, sustained nutritional deficits, and increased diarrhea mortality. The lack of consistency in sampling, measurement, and reporting identified in this literature review highlights the need to document harmful practices using standard methods of measurement and reporting for the continued reduction of diarrhea mortality.

Bioethics consultation practices and procedures: a survey of a large Canadian community of practice.

PubMed

Greenberg, R A; Anstey, K W; Macri, R; Heesters, A; Bean, S; Zlotnik Shaul, R

2014-06-01

The literature fails to reflect general agreement over the nature of the services and procedures provided by bioethicists, and the training and core competencies this work requires. If bioethicists are to define their activities in a consistent way, it makes sense to look for common ground in shared communities of practice. We report results of a survey of the services and procedures among bioethicists affiliated with the University of Toronto Joint Centre for Bioethics (JCB). This is the largest group of bioethicists working in healthcare organizations in Canada. The results suggest there are many common services and procedures of JCB bioethicists. This survey can serve as a baseline for further exploration of the work of JCB bioethicists. Common practices exist with respect to the domains of practice, individual reporting relationships, service availability within business hours and the education and training of the bioethicist.

Tools for Linking Research and Practice in the Helping Professions: Research Abstract Worksheets and Personal Reviews of the Literature.

ERIC Educational Resources Information Center

Burlingame, Martin

This document is comprised of four chapters that show how to use research-abstract worksheets and personal reviews of the literature as tools for linking research and practice in the helping professions. The research tools help to condense lengthy reports, place them into a consistent format, and actively involve the information seeker. Chapter 1…

Expanding the Repertoire: An Anthology of Practical Approaches for the Teaching of Writing (Reading-to-Write Report No. 11). Technical Report No. 30.

ERIC Educational Resources Information Center

McCormick, Kathleen; And Others

This study is the 11th and last report from the Reading-to-Write Project, a collaborative study of students' cognitive processes at one critical point of entry into academic performance. The report consists of an Introduction and seven essays, each of which discusses ways to teach a variety of aspects of reading and writing which have been tried…

A qualitative evaluation of scalpel skill teaching of podiatry students.

PubMed

Causby, Ryan S; McDonnell, Michelle N; Reed, Lloyd; Fryer, Caroline E; Hillier, Susan L

2017-01-01

Degrees in health disciplines need a balance of theoretical knowledge and sufficient clinical practice to meet registration requirements, in particular those requiring specialist skills such as the use of scalpels and other small instruments, such as podiatry. However, despite this requirement there is a scarcity of literature and research to inform teaching of these particular manual clinical skills. Therefore, the aims of this study were to determine the current approaches being used to teach manual skills, in particular scalpel skills, in university podiatry programs in Australia and New Zealand, and to explore what issues, challenges and innovations exist. A qualitative study, consisting of semi-structured interviews with staff at eight university podiatry programs in Australia and New Zealand was undertaken to determine how these skills are taught and evaluated, and how poor performers are managed. A conventional content analysis technique was used to analyse and code interview data, with the resultant categories reported. Approaches to teaching manual clinical skills, in particular scalpel skills, appear to be consistent between university programs in Australia and New Zealand in utilising didactic-style content, demonstration, physical practice on inanimate objects and real skin, and often the use of supplementary audio-visual material. The main reported differences between programs were in methods and processes of practice, with controversy regarding the use of inanimate objects versus real skin for practice. Despite a lack of research and literature surrounding this topic, the approach to teaching is relatively consistent between programs with greatest disparity being the structure and duration of practice. Key issues for teaching staff in teaching manual skills were students' clinical exposure, motivation, levels of anxiety and dexterity.

Relationship between parent knowledge of child sleep, and child sleep practices and problems: A pilot study in a children's hospital cohort.

PubMed

McDowall, Philippa S; Elder, Dawn E; Campbell, Angela J

2017-08-01

To describe parent reports of sleep practices, and examine associations with parent knowledge of child sleep, and whether children's sleep practices differ between parents who underestimated, overestimated or accurately estimated children's sleep needs. Parents of children aged 2-12 years (n = 115) attending hospital inpatient or day wards were approached and asked to report child sleep routines, sleep problems, parent education, household income and parent knowledge of child sleep via questionnaire. Younger age was associated with earlier bedtimes and wake times, shorter sleep latencies, longer sleep durations and greater sleep problems (P < 0.05). Parents from higher income homes reported earlier bedtimes and wake times, shorter sleep latencies and fewer sleep problems (P < 0.05). Parents with higher education reported shorter sleep latencies (P < 0.05). Parents with greater knowledge about child sleep reported earlier weekday and weekend bedtimes (r s  ≥ 0.26) and wake times (r s  ≥ 0.21) and greater consistency between their child's weekend and weekday sleep routines (P < 0.05). In comparison with parents who correctly estimated their child's sleep needs: parents who underestimated reported later weekday bedtimes (on average, 46 min), and longer sleep latencies (17 min); parents who overestimated reported longer sleep latencies (22 min). These findings remained significant when controlling for child age (P < 0.05). Parents with increased sleep knowledge, higher incomes and higher levels of education were more likely to report earlier bedtimes, wake times and more consistent sleep routines for their children. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Using Critical Incident Reporting to Promote Objectivity and Self-Knowledge in Pre-Service School Psychologists

ERIC Educational Resources Information Center

Griffin, Maureen L.; Scherr, Tracey G.

2010-01-01

This longitudinal project consisted of exploring the usefulness of Critical Incident Reporting (CIR) as an instructional tool (Griffin, 2003) to first increase objectivity and self-knowledge among practicum students and then to guide practices when those students became interns the following academic year. Analysis included 120 CIRs written by 15…

Knowledge, Practices and Attitudes Towards Adverse Drug Reaction Reporting by Private Practitioners from Klang Valley in Malaysia

PubMed Central

Agarwal, Renu; Daher, Aqil Mohammad; Mohd Ismail, Nafeeza

2013-01-01

Background: The study aimed to determine current status of knowledge, practices, and attitudes towards adverse drug reaction (ADR) reporting among private practitioners in Klang region of Malaysia. Methods: A total of 238 private practitioners in Klang valley were distributed a questionnaire consisting of seven questions, two knowledge-related, two practice-related and three attitude-related. Each favourable and unfavourable response was given a score of 1 and 0 respectively. Total score of 70% or more for each domain was considered “satisfactory” whereas less than 70% as “unsatisfactory”. Results: One hundred forty-five participants completed questionnaire. Knowledge assessment showed 83.4% responses stating that ADR reporting helps to identify safe drugs and 91.7% responded that it measures ADR incidence. Regarding practices, 76.6% respondents were willing to report only if confident that reaction is an ADR. Regarding attitudes, 81.9%, 66.9% and 23.5% participants showed complacency, ignorance, and indifference respectively. Unsatisfactory knowledge, practices, and attitudes were observed in 57.2%, 56.6%, and 73.1% respondents respectively. Satisfactory knowledge was significantly higher in respondent with higher qualification with odds ratio of 2.96 with 95% confidence interval of 1.48–5.93. Conclusion: The study showed unsatisfactory level of knowledge, practices, and attitudes towards ADR reporting among high proportion of private practitioners in Klang valley, Malaysia. PMID:23983578

Food safety educational intervention positively influences college students' food safety attitudes, beliefs, knowledge, and self-reported practices.

PubMed

Yarrow, Linda; Remig, Valentina M; Higgins, Mary Meck

2009-01-01

In this study, the authors evaluated college students' food safety attitudes, beliefs, knowledge, and self-reported practices and explored whether these variables were positively influenced by educational intervention. Students (n=59), were mostly seniors, health or non-health majors, and responsible for meal preparation. Subjects completed a food safety questionnaire (FSQ) prior to educational intervention, which consisted of three interactive modules. Subjects completed module pre-, post-, and post-posttests. The FSQ was also administered after exposure to intervention and five weeks later to determine changes in food safety attitudes, beliefs, knowledge, and self-reported practices. Students' FSQ attitude scores increased from 114 to 122 (p < or = .001); FSQ belief and knowledge scores improved from 86 to 98 (p < or = .001) and from 11 to 13 (p < or = .001), respectively. Food safety knowledge was also measured by module pre- and posttests, and improved significantly after intervention for all students, with health majors having the greatest increase. Intervention resulted in improved food safety self-reported practices for health majors only. The educational intervention appeared effective in improving food safety beliefs and knowledge. For health majors, attitudes and some self-reported practices improved. For all areas, the strongest effects were seen in health majors.

Non-surgical care in patients with hip or knee osteoarthritis is modestly consistent with a stepped care strategy after its implementation.

PubMed

Smink, Agnes J; Bierma-Zeinstra, Sita M A; Schers, Henk J; Swierstra, Bart A; Kortland, Joke H; Bijlsma, Johannes W J; Teerenstra, Steven; Voorn, Theo B; Dekker, Joost; Vliet Vlieland, Thea P M; van den Ende, Cornelia H M

2014-08-01

To improve the management of hip or knee osteoarthritis (OA), a stepped care strategy (SCS) has been developed that presents the optimal sequence for care in three steps. This study evaluates the extent to which clinical practice is consistent with the strategy after implementation and identifies determinants of SCS-consistent care. A 2-year observational prospective cohort study. General practices in the region of Nijmegen in the Netherlands. Three hundred and thirteen patients with hip or knee OA and their general practitioner (GP). Multifaceted interventions were developed to implement the strategy. Consistency between clinical practice and the strategy was examined regarding three aspects of care: (i) timing of radiological assessment, (ii) sequence of non-surgical treatment options and (iii) making follow-up appointments. Out of the 212 patients who reported to have had an X-ray, 92 (44%) received it in line with the SCS. The sequence of treatment was inconsistent with the SCS in 58% of the patients, which was mainly caused by the underuse of lifestyle advice and dietary therapy. In 57% of the consultations, the patient reported to have been advised to make a follow-up appointment. No determinants that influenced all three aspects of care were identified. Consistency with the SCS was found in about half of the patients for each of the three aspects of care. Health care can be further optimized by encouraging GP s to use X-rays more appropriately and to make more use of lifestyle advice, dietary therapy and follow-up appointments. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Interpretation of medical information acts by UK occupational physicians.

PubMed

Batty, Lucia; Glozier, Nick; Holland-Elliott, Kevin

2009-05-01

Difficulties arise in applying the Data Protection Act 1998 and the Access to Medical Reports Act 1988 in occupational health practice. There is no guidance on detailed aspects of applying these Acts in practice and consistent advice has proved difficult to obtain. To audit the understanding and practice of UK occupational physicians to see if a consensus view existed. A postal questionnaire sent to all UK-based Society of Occupational Medicine (SOM) members between December 2005 and June 2006. Responses were analysed using the SPSS 13.0 software. Responses were received from 726 SOM members, a response rate of 48%. The study revealed wide variation and a limited consensus in practice. Significant differences existed between doctors with a Diploma in Occupational Medicine and those with higher Faculty qualifications, between part-time and full-time practitioners and between doctors who qualified pre- and post-1974. The audit revealed wide variation in responding to clinical scenarios in relation to both the Access to Medical Reports and the Data Protection Acts. The findings have implications for clinical practice, policy and research. The majority of respondents reported that national guidance is needed.

Variations in guideline use and practice relating to diagnosis and management of infection in paediatric burns services in England and Wales: A national survey.

PubMed

Davies, Anna; Spickett-Jones, Francesca; Brock, Paula; Coy, Karen; Young, Amber

2017-02-01

Wound infection causes morbidity and mortality in burns. UK National Burns Care Standards state that guidance should be used to diagnose and treat burn wound infection. However, surveys of senior staff about standard operating procedures or guidance in UK burns services indicate that they are infrequently available (Papini et al., 1995; Lymperopoulos et al., 2015). Staff may have differing views and experiences of guidance use according to their role. This survey investigated the extent to which guidance is available, and current practices used for diagnosis and treatment of burn wound infection, both within and between paediatric burns services. Staff from paediatric burns services in England and Wales were individually interviewed by two nurses about guidance and practices around antibiotic prophylaxis, diagnosis and management of burn wound infection and toxic shock syndrome, and antibiotic use. In each service staff from three categories were interviewed: lead consultant/burns specialist nurse, junior doctor/senior nurse, ward based nurse. Data were subjected to content analysis and reliably coded by two researchers using a coding frame. Guidance documents were also requested. Thirteen services took part. Staff in fewer than half of services reported that they had guidance for antibiotic prophylaxis, diagnosis, and management of burn wound infection. In nine services at least one staff member reported that they had guidance for antibiotic use. Guidance was available for diagnosis and management of toxic shock syndrome in ten services, and staff in five were consistently aware of it. One service routinely used antibiotic prophylaxis, but had no written guidance for it. In five services where at least one member of staff reported that they had guidance for diagnosing infection, at least one interviewed staff member was unaware of it. Swabbing practice varied between and within services, with 10 staff across six services cleaning before swabbing, and four staff in three services cleaning after swabbing. Staff from fewer than half of burns services report that they have guidance for diagnosing and managing burn wound infection, and there is variation between and within services relating to staff awareness of available guidance. There are some consistencies in practice; the majority of services do not use antibiotic prophylaxis, and there is consistent prescribing for suspected infection and tests used for infection diagnosis. Swabbing practices are less consistent. This survey indicates a need for evidence-based guidelines to be developed in order to meet national burns care standards, and for staff to be made aware of them and trained in their use. Guidelines do not need to replace clinical judgement and should be developed with the involvement of those who will implement them. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Effect Of Naturopathy Treatments And Yogic Practices On Cervical Spondylosis--A Case Report.

PubMed

Rastogi, Rajiv; Bendore, Priti

2015-01-01

Cervical spondylosis is a degenerative disease of cervical spine. The conventional management offered in this condition focuses upon pain, muscle relaxation and restoration of movements. This approach however has not been found adequate in many cases. This is a case of cervical spondylosis treated with naturopathy and yogic practices in an OP set up. Earlier to this treatment, the patient was on conventional medicine. The patient was given naturopathy treatments in form of cold spinal pack followed by other procedures and some yogic practices consisting of asanas, pranayam and relaxation for 30 minutes for a period of one month with an improvement in symptoms. The present case report showed encouraging effects of naturopathic and yogic intervention on cervical spondylosis.

Psychometric Properties of the Breast Cancer Screening Beliefs Questionnaire Among Women of Indian Ethnicity Living in Australia.

PubMed

Kwok, Cannas; Pillay, Rona; Lee, Chun Fan

2016-01-01

Indian women have been consistently reported as having low participation in breast cancer screening practices. A valid and reliable instrument to explore their breast cancer beliefs is essential for development of interventions to promote breast cancer screening practices. The aim of this study was to report the psychometric properties of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) in an Indian community in Australia. A convenience sample of 242 Indian Australian women was recruited from Indian community organizations and personal networking. Explanatory factor analysis was conducted to study the factor structure. Clinical validity was examined by Cuzick's nonparametric test, and Cronbach's α was used to assess internal consistency reliability. Exploratory factor analysis showed a similar fit to the hypothesized 3-factor structure. The frequency of breast cancer screening practices was significantly associated with attitudes toward general health check-up. Knowledge and perceptions about the breast cancer scale were not significantly associated with clinical breast examinations and mammography. Perceived barriers to mammography were much less evident among women who engaged in breast awareness and clinical breast examination. Results indicated that the BCSBQ had satisfactory validity and internal consistency. Cronbach's α of the 3 subscales ranged from .81 to .91. The BCSBQ is a culturally appropriate, valid, and reliable instrument for assessing the beliefs, knowledge, and attitudes about breast cancer and breast cancer screening practices among women of Indian ethnic extraction living in Australia. The BCSBQ can be used to provide nurses with information relevant for the development of culturally sensitive breast health education programs.

Delivery of care consistent with the psychosocial standards in pediatric cancer: Current practices in the United States.

PubMed

Scialla, Michele A; Canter, Kimberly S; Chen, Fang Fang; Kolb, E Anders; Sandler, Eric; Wiener, Lori; Kazak, Anne E

2018-03-01

With published evidence-based Standards for Psychosocial Care for Children with Cancer and their Families, it is important to know the current status of their implementation. This paper presents data on delivery of psychosocial care related to the Standards in the United States. Pediatric oncologists, psychosocial leaders, and administrators in pediatric oncology from 144 programs completed an online survey. Participants reported on the extent to which psychosocial care consistent with the Standards was implemented and was comprehensive and state of the art. They also reported on specific practices and services for each Standard and the extent to which psychosocial care was integrated into broader medical care. Participants indicated that psychosocial care consistent with the Standards was usually or always provided at their center for most of the Standards. However, only half of the oncologists (55.6%) and psychosocial leaders (45.6%) agreed or strongly agreed that their psychosocial care was comprehensive and state of the art. Types of psychosocial care provided included evidence-based and less established approaches but were most often provided when problems were identified, rather than proactively. The perception of state of the art care was associated with practices indicative of integrated psychosocial care and the extent to which the Standards are currently implemented. Many oncologists and psychosocial leaders perceive that the delivery of psychosocial care at their center is consistent with the Standards. However, care is quite variable, with evidence for the value of more integrated models of psychosocial services. © 2017 Wiley Periodicals, Inc.

Laboratory medicine handoff gaps experienced by primary care practices: A report from the shared networks of collaborative ambulatory practices and partners (SNOCAP).

PubMed

West, David R; James, Katherine A; Fernald, Douglas H; Zelie, Claire; Smith, Maxwell L; Raab, Stephen S

2014-01-01

The majority of errors in laboratory medicine testing are thought to occur in the pre- and postanalytic testing phases, and a large proportion of these errors are secondary to failed handoffs. Because most laboratory tests originate in ambulatory primary care, understanding the gaps in handoff processes within and between laboratories and practices is imperative for patient safety. Therefore, the purpose of this study was to understand, based on information from primary care practice personnel, the perceived gaps in laboratory processes as a precursor to initiating process improvement activities. A survey was used to assess perceptions of clinicians, staff, and management personnel of gaps in handoffs between primary care practices and laboratories working in 21 Colorado primary care practices. Data were analyzed to determine statistically significant associations between categorical variables. In addition, qualitative analysis of responses to open-ended survey questions was conducted. Primary care practices consistently reported challenges and a desire/need to improve their efforts to systematically track laboratory test status, confirm receipt of laboratory results, and report results to patients. Automated tracking systems existed in roughly 61% of practices, and all but one of those had electronic health record-based tracking systems in place. One fourth of these electronic health record-enabled practices expressed sufficient mistrust in these systems to warrant the concurrent operation of an article-based tracking system as backup. Practices also reported 12 different procedures used to notify patients of test results, varying by test result type. The results highlight the lack of standardization and definition of roles in handoffs in primary care laboratory practices for test ordering, monitoring, and receiving and reporting test results. Results also identify high-priority gaps in processes and the perceptions by practice personnel that practice improvement in these areas is needed. Commonalities in these areas warrant the development and support of tools for use in primary care settings. © Copyright 2014 by the American Board of Family Medicine.

Development and Testing of an Experimental Polysensory Instructional System for Teaching Electric Arc Welding Processes. Report No. 24. Final Report.

ERIC Educational Resources Information Center

Sergeant, Harold A.

The population of the study consisted of 15 high school industrial arts students, 10 freshman and sophomore college students, and 10 adults. A polysensory, self-pacing instructional system was developed which included (1) pretests and post tests, (2) a general instruction book, (3) equipment to practice arc welding, (4) programed instruction…

The American Government Information Unit: A Pilot Program to Improve Information Flow Between Research and Development and Practice in Education. Final Report.

ERIC Educational Resources Information Center

Adelson, Nancy C.; And Others

The Laboratory staff reported the unit development and field test activities in their effort to collect, analyze, synthesize, and disseminate new curriculum developments in secondary level social studies to school curriculum decision makers. The audience consisted primarily of social studies teachers and department chairmen. To further refine and…

Designing a valid randomized pragmatic primary care implementation trial: the my own health report (MOHR) project.

PubMed

Krist, Alex H; Glenn, Beth A; Glasgow, Russell E; Balasubramanian, Bijal A; Chambers, David A; Fernandez, Maria E; Heurtin-Roberts, Suzanne; Kessler, Rodger; Ory, Marcia G; Phillips, Siobhan M; Ritzwoller, Debra P; Roby, Dylan H; Rodriguez, Hector P; Sabo, Roy T; Sheinfeld Gorin, Sherri N; Stange, Kurt C

2013-06-25

There is a pressing need for greater attention to patient-centered health behavior and psychosocial issues in primary care, and for practical tools, study designs and results of clinical and policy relevance. Our goal is to design a scientifically rigorous and valid pragmatic trial to test whether primary care practices can systematically implement the collection of patient-reported information and provide patients needed advice, goal setting, and counseling in response. This manuscript reports on the iterative design of the My Own Health Report (MOHR) study, a cluster randomized delayed intervention trial. Nine pairs of diverse primary care practices will be randomized to early or delayed intervention four months later. The intervention consists of fielding the MOHR assessment--addresses 10 domains of health behaviors and psychosocial issues--and subsequent provision of needed counseling and support for patients presenting for wellness or chronic care. As a pragmatic participatory trial, stakeholder groups including practice partners and patients have been engaged throughout the study design to account for local resources and characteristics. Participatory tasks include identifying MOHR assessment content, refining the study design, providing input on outcomes measures, and designing the implementation workflow. Study outcomes include the intervention reach (percent of patients offered and completing the MOHR assessment), effectiveness (patients reporting being asked about topics, setting change goals, and receiving assistance in early versus delayed intervention practices), contextual factors influencing outcomes, and intervention costs. The MOHR study shows how a participatory design can be used to promote the consistent collection and use of patient-reported health behavior and psychosocial assessments in a broad range of primary care settings. While pragmatic in nature, the study design will allow valid comparisons to answer the posed research question, and findings will be broadly generalizable to a range of primary care settings. Per the pragmatic explanatory continuum indicator summary (PRECIS) framework, the study design is substantially more pragmatic than other published trials. The methods and findings should be of interest to researchers, practitioners, and policy makers attempting to make healthcare more patient-centered and relevant. Clinicaltrials.gov: NCT01825746.

48 CFR 30.201-4 - Contract clauses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... established cost accounting practices consistently. (b) Disclosure and consistency of cost accounting practices. (1) Insert the clause at FAR 52.230-3, Disclosure and Consistency of Cost Accounting Practices... follow consistently its established cost accounting practices. (c) Disclosure and Consistency of Cost...

Effect Size Estimates in Chemical Aversion Treatments of Alcoholism.

ERIC Educational Resources Information Center

Thurber, Steven

1985-01-01

Reports that aggregate studies on alcohol aversion therapy tended to support a moderate level of treatment impact that may have noteworthy practical import. Emetics appeared to generate fairly consistent findings; a paralysis-inducing chemical may produce variable results. (Author/NRB)

New Beginnings: Ensuring Quality Bilingual/ESL Instruction in New York City Public Schools. Executive Summary [and] Report of the Chancellor's Bilingual/ESL Education Practitioners' Workgroup and Policy/Research Panels.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Office of Bilingual Education.

The report presents a conceptual framework and related strategies designed to help policymakers and practitioners re-examine, and when necessary, rework the basic assumptions and practices defining the educational experiences of bilingual/English-as-a-Second-Language (ESL) learners in New York City (New York) public schools. The report consists of…

Nursing students' perceptions of learning in practice environments: a review.

PubMed

Henderson, Amanda; Cooke, Marie; Creedy, Debra K; Walker, Rachel

2012-04-01

Effective clinical learning requires integration of nursing students into ward activities, staff engagement to address individual student learning needs, and innovative teaching approaches. Assessing characteristics of practice environments can provide useful insights for development. This study identified predominant features of clinical learning environments from nursing students' perspectives across studies using the same measure in different countries over the last decade. Six studies, from three different countries, using the Clinical Leaning Environment Inventory (CLEI) were reviewed. Studies explored consistent trends about learning environment. Students rated sense of task accomplishment high. Affiliation also rated highly though was influenced by models of care. Feedback measuring whether students' individual needs and views were accommodated consistently rated lower. Across different countries students report similar perceptions about learning environments. Clinical learning environments are most effective in promoting safe practice and are inclusive of student learners, but not readily open to innovation and challenges to routine practices. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Exploring the relationship between client perspectives, clinical expertise and research evidence.

PubMed

Roulstone, Sue

2015-06-01

This paper examines the relationship between components of evidence-based practice (clinical expertise, patient perspective and research evidence). Findings are examined from two research programs: the Better Communication Research Program and Child Talk, including exploratory studies of the views of parents and children regarding speech-language pathology and studies of current practice by SLPs in England. Systematic reviews of the research literature were also undertaken. The paper analyses relationships between outcomes valued by children and parents and those reported in the literature and in practice, parents' perspectives regarding intervention in comparison with clinicians' reports of practice and the extent to which research evidence underpins current practice is examined. Parents and children value functional outcomes and positive experiences; these are not routinely measured in research or practice. Therapy is perceived positively by most parents; however, some are ambivalent and less clear about the rationale. Commonly used interventions are supported by evidence, but there are gaps regarding some critical therapy components. The paper discusses four challenges to evidence-based practice: the consistency and clarity of descriptions of interventions; consensus based models of practice; understanding of the mechanisms of change; and, finally, the operationalization of client preferences within an evidence-based practice framework.

Stormwater Management Decision Support System for Using Low Impact Development Best Management Practices in Industrial Areas

DTIC Science & Technology

2015-05-30

particulates can be trapped in the inlet then washed into the drainage system in a large storm event...and P. Matin. 2005. Performance and Whole-Life Costs of Best Management Practices and Sustainable Urban Drainage Systems . Report #01CTS21TA. Water...subsurface drainage system consisting of a parallel perforated PVC pipe system in a stone bed that connects to the third chamber, which is the discharge

Practice-specific risk perceptions and self-reported food safety practices.

PubMed

Levy, Alan S; Choinière, Conrad J; Fein, Sara B

2008-06-01

The relationship between risk perception and risk avoidance is typically analyzed using self-reported measures. However, in domains such as driving or food handling, the validity of responses about usual behavior is threatened because people think about the situations in which they are self-aware, such as when they encounter a hazard. Indeed, researchers have often noted a divergence between what people say about their behavior and how they actually behave. Thus, in order to draw conclusions about risk perceptions and risk avoidance from survey data, it is important to identify particular cognitive elements, such as those measured by questions about risk and safety knowledge, risk perceptions, or information search behavior, which may be effective antecedents of self-reported safety behavior. It is also important to identify and correct for potential sources of bias that may exist in the data. The authors analyze the Food and Drug Administration's 1998 Food Safety Survey to determine whether there are consistent cognitive antecedents for three types of safe food practices: preparation, eating, and cooling of foods. An assessment of measurement biases shows that endogeneity of food choices affects reports of food preparation. In addition, response bias affects reports of cooling practices as evidenced by its relation to knowledge and information search, a pattern of cognitive effects unique to cooling practices. After correcting for these biases, results show that practice-specific risk perceptions are the primary cognitive antecedents of safe food behavior, which has implications for the design of effective education messages about food safety.

Reporting Multiple Individual Injuries in Studies of Team Ball Sports: A Systematic Review of Current Practice.

PubMed

Fortington, Lauren V; van der Worp, Henk; van den Akker-Scheek, Inge; Finch, Caroline F

2017-06-01

To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and reported in prospective, long-term, injury studies in team ball sports. A systematic search of three online databases for articles published before 2016. Publications were included if (1) they collected prospective data on musculoskeletal injuries in individual participants; (2) the study duration was >1 consecutive calendar year/season; and (3) individuals were the unit of analysis. Key study features were summarised, including definitions of injury, how multiple individual injuries were reported and results relating to multiple injuries. Of the 71 publications included, half did not specifically indicate multiple individual injuries; those that did were largely limited to reporting recurrent injuries. Eight studies reported the number/proportion of athletes with more than one injury, and 11 studies presented the mean/number of injuries per athlete. Despite it being relatively common to collect data on individuals across more than one season, the reporting of multiple injuries within individuals is much more limited. Ultimately, better addressing of multiple injuries will improve the accuracy of injury incidence studies and enable more precise targeting and monitoring of the effectiveness of preventive interventions.

A systematic review of recent clinical practice guidelines and best practice statements for the evaluation of the infertile male.

PubMed

Esteves, Sandro C; Chan, Peter

2015-09-01

We systematically identified and reviewed the methods and consistency of recommendations of recently developed clinical practice guidelines (CPG) and best practice statements (BPS) on the evaluation of the infertile male. MEDLINE and related engines as well as guidelines' Web sites were searched for CPG and BPS written in English on the general evaluation of male infertility published between January 2008 and April 2015. Four guidelines were identified, all of which reported to have been recently updated. Systematic review was not consistently used in the BPS despite being reported in the CPG. Only one of them reported having a patient representative in its development team. The CPG issued by the European Association of Urology (EAU) graded some recommendations and related that to levels (but not quality) of evidence. Overall, the BPS issued respectively by the American Urological Association and American Society for Reproductive Medicine concurred with each other, but both differed from the EAU guidelines with regard to methods of collection, extraction and interpretation of data. None of the guidelines incorporated health economics. Important specific limitations of conventional semen analysis results were ignored by all guidelines. Besides variation in the methodological quality, implementation strategies were not reported in two out of four guidelines. While the various panels of experts who contributed to the development of the CPG and BPS reviewed should be commended on their tremendous efforts aiming to establish a clinical standard in both the evaluation and management of male infertility, we recognized inconsistencies in the methodology of their synthesis and in the contents of their final recommendations. These discrepancies pose a barrier in the general implementation of these guidelines and may limit their utility in standardizing clinical practice or improving health-related outcomes. Continuous efforts are needed to generate high-quality evidence to allow further development of these important guidelines for the evaluation and management of males suffering from infertility.

Best-practice checklists for tephra collection, analysis and reporting - a draft consensus from the Tephra 2014 workshop

NASA Astrophysics Data System (ADS)

Wallace, K.; Bursik, M. I.; Kuehn, S. C.

2015-12-01

The Tephra 2014 Workshop (3-7 August 2014) discussed major developments, best practices, future directions, and critical needs in tephra studies from both volcanological and tephrochronological perspectives. In a consensus-seeking session held at the end of the workshop, the international group of over 70 tephra scientists focused on two complementary themes: (A) the need for common best practices in tephra data collection and reporting among different scientific disciplines, and (B) the need to establish common, accessible mechanisms for tephra data archiving and retrieval. Tephra is the focus of a wide range of research in volcanology, petrology, tephrochronology and tephrostratigraphy (with applications in studies of environmental/climate change, surface processes, paleolimnology, etc.), ash dispersion and fallout modeling, and archaeology, paleoanthropology, and human origins. Researchers in each field have specific objectives that may or may not overlap. The focus on best practices is a first step towards standardized protocols for the collection, analysis and reporting of tephra data across and within disciplines. Such uniformity will facilitate the development and population of useful tephra databases. Current initiatives include the development of best practice checklists as a starting point for ensuring uniformity and completeness. The goals of the checklists are to: 1) ensure consistency among tephra scientists, regardless of research focus, 2) provide basic, comprehensible, metadata requirements, especially those who collect tephra as a peripheral part of their research, 3) help train students, and 4) help journal editors to know which essential metadata should be included in published works. Consistency in tephra sample collection, analysis, and reporting attained by use of these checklists should ultimately aid in improving correlation of tephras across geographically large areas, and facilitate collaborative tephra research. Current and future versions of the checklists will be made available at: https://vhub.org/groups/tephra2014/resources

Dietitians' views of overweight and obese people and reported management practices.

PubMed

Harvey, E L; Summerbell, C D; Kirk, S F L; Hill, A J

2002-10-01

To examine dietitians' views of overweight and obese people, to explore the role of level of severity on these perceptions (overweight vs. obesity), and to explore the relationship between dietitians' views and their reported weight management practices. An independent measures survey, questioning dietitians about either overweight or obese people. One-hundred and eighty-seven members of the British Dietetic Association. A questionnaire exploring beliefs about the causes, attitudes, perceptions of responsibility and reported weight management practices. Physical inactivity was identified as an important causative factor for both overweight and obesity. Mood, eating too much of the wrong foods, repeated dieting and interpersonal factors were also seen as relatively important for both groups. Attitudes were mixed, but were generally neutral to positive. The most negative attitudes were described in terms of perceived reduced self-esteem, sexual attractiveness and health. Dietitians rated obese people more negatively than overweight people. They viewed both overweight and obese people as being responsible for their excess weight. They also reported very similar management practices for overweight and obese people. Beliefs about the causes of overweight explained more of the variance in practice than dietitians' attitudes towards or perceived responsibility of overweight and obese people. However, these associations were not consistent and strong, and other factors not investigated here are likely to have a greater influence on weight management practices.

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

PubMed

Dolan, T A

1991-01-01

This paper reviews three recent reports of national gender trends in dental practice patterns. Although the three independent cross-sectional studies were conducted at different points in time, used different sampling strategies, and used similar but independent survey instruments, findings were consistent across studies. In summary: Women dentists are less likely to be married and have fewer children. Women are more likely to assume child rearing and household responsibilities. Women are less likely to be practice owners. Women worked slightly fewer hours per week and weeks per year, and were more likely to take a leave of absence for illness or child rearing. However, women dentists demonstrate a far greater professional work commitment than was previously reported in the literature. Women earn significantly less income from the practice of dentistry, even after controlling for age, practice ownership, hours worked per week, and other personal characteristics. The most current "Gender Wage Gap" estimates range from 57.7% for specialists to 75.4% for general practitioners (8). delta.

Authorship, plagiarism and conflict of interest: views and practices from low/middle-income country health researchers

PubMed Central

Young, Taryn; Garner, Paul

2017-01-01

Objectives To document low/middle-income country (LMIC) health researchers’ views about authorship, redundant publication, plagiarism and conflicts of interest and how common poor practice was in their institutions. Design We developed a questionnaire based on scenarios about authorship, redundant publication, plagiarism and conflicts of interest. We asked participants whether the described practices were acceptable and whether these behaviours were common at their institutions. We conducted in-depth interviews with respondents who agreed to be interviewed. Participants We invited 607 corresponding authors of Cochrane reviews working in LMICs. From the 583 emails delivered, we obtained 199 responses (34%). We carried out in-depth interviews with 15 respondents. Results Seventy-seven per cent reported that guest authorship occurred at their institution, 60% reported text recycling. For plagiarism, 12% of respondents reported that this occurred ‘occasionally’, and 24% ‘rarely’. Forty per cent indicated that their colleagues had not declared conflicts of interest in the past. Respondents generally recognised poor practice in scenarios but reported that they occurred at their institutions. Themes identified from in-depth interviews were (1) authorship rules are simple in theory, but not consistently applied; (2) academic status and power underpin behaviours; (3) institutions and culture fuel bad practices and (4) researchers are uncertain about what conflict of interests means and how this may influence research. Conclusions LMIC researchers report that guest authorship is widely accepted and common. While respondents report that plagiarism and undeclared conflicts of interest are unacceptable in practice, they appear common. Determinants of poor practice relate to academic status and power, fuelled by institutional norms and culture. PMID:29170291

Authorship, plagiarism and conflict of interest: views and practices from low/middle-income country health researchers.

PubMed

Rohwer, Anke; Young, Taryn; Wager, Elizabeth; Garner, Paul

2017-11-22

To document low/middle-income country (LMIC) health researchers' views about authorship, redundant publication, plagiarism and conflicts of interest and how common poor practice was in their institutions. We developed a questionnaire based on scenarios about authorship, redundant publication, plagiarism and conflicts of interest. We asked participants whether the described practices were acceptable and whether these behaviours were common at their institutions. We conducted in-depth interviews with respondents who agreed to be interviewed. We invited 607 corresponding authors of Cochrane reviews working in LMICs. From the 583 emails delivered, we obtained 199 responses (34%). We carried out in-depth interviews with 15 respondents. Seventy-seven per cent reported that guest authorship occurred at their institution, 60% reported text recycling. For plagiarism, 12% of respondents reported that this occurred 'occasionally', and 24% 'rarely'. Forty per cent indicated that their colleagues had not declared conflicts of interest in the past. Respondents generally recognised poor practice in scenarios but reported that they occurred at their institutions. Themes identified from in-depth interviews were (1) authorship rules are simple in theory, but not consistently applied; (2) academic status and power underpin behaviours; (3) institutions and culture fuel bad practices and (4) researchers are uncertain about what conflict of interests means and how this may influence research. LMIC researchers report that guest authorship is widely accepted and common. While respondents report that plagiarism and undeclared conflicts of interest are unacceptable in practice, they appear common. Determinants of poor practice relate to academic status and power, fuelled by institutional norms and culture. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Data Management & Decision Making. Technical Report No. 14.

ERIC Educational Resources Information Center

Speedie, Stuart M.; Sanders, Susan

"Data Management and Decision Making" is a set of instructional materials designed to teach practicing and potential educational administrators about the uses of operations research in educational administration. It consists of five units--"Operations Research in Education,""PERT/CPM: A Planning and Analysis…

40 CFR 31.45 - Quality assurance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Quality assurance. 31.45 Section 31.45... Requirements Reports, Records, Retention, and Enforcement § 31.45 Quality assurance. If the grantee's project... quality assurance practices consisting of policies, procedures, specifications, standards, and...

Explaining the amount and consistency of medical care and self-management support in asthma: a survey of primary care providers in France and the United Kingdom.

PubMed

de Bruin, Marijn; Dima, Alexandra L; Texier, Nathalie; van Ganse, Eric

2018-05-09

The quality of asthma primary care may vary between countries, health care practices, and health care professionals (HCPs). Identifying and explaining such differences is critical for health services improvement. To examine the quality of asthma primary care in France and United Kingdom, and identify within-country and between-country predictors amenable to intervention. An online questionnaire to capture asthma medical care and self-management support, practice characteristics, and psychosocial determinants, was completed by 276 HCPs. Mokken Scaling analyses were used to examine item structure and consistency. Hierarchical regression analyses were used to identify predictors of the amount (number of asthma care activities HCPs delivered) and consistency (the degree to which HCPs deliver similar care) of asthma medical care and self-management support. On average, HCPs reported delivering 74,2% of guideline-recommended care. Consistency of medical care and self-management support was lower among HCPs delivering a lower amount of care (r=.58 and r=.57, p<.001). UK HCPs provided more and more consistent asthma self-management support -but not medical care- than French HCPs, which was explained by the presence of practice nurses in the UK. More training, positive social norms, and higher behavioural control explained better quality of care across all HCPs. Using carefully-developed questionnaires and advanced psychometric analyses, this study suggests that involving practice nurses, making social expectations visible, and providing more training to enhance skills and confidence in asthma care delivery could enhance the amount and consistency of asthma primary care. This needs to be corroborated in a future intervention trial. Copyright © 2018. Published by Elsevier Inc.

Enhancing the quality of antibiotic prescribing in Primary Care: Qualitative evaluation of a blended learning intervention

PubMed Central

2010-01-01

Background The Stemming the Tide of Antibiotic Resistance (STAR) Educational Program aims to enhance the quality of antibiotic prescribing and raise awareness about antibiotic resistance among general medical practitioners. It consists of a seven part, theory-based blended learning program that includes online reflection on clinicians' own practice, presentation of research evidence and guidelines, a practice-based seminar focusing on participants' own antibiotic prescribing and resistance rates in urine samples sent from their practice, communication skills training using videos of simulated patients in routine surgeries, and participation in a web forum. Effectiveness was evaluated in a randomised controlled trial in which 244 GPs and Nurse Practitioners and 68 general practices participated. This paper reports part of the process evaluation of that trial. Methods Semi-structured, digitally recorded, and transcribed telephone interviews with 31 purposively sampled trial participants analysed using thematic content analysis. Results The majority of participants reported increased awareness of antibiotic resistance, greater self-confidence in reducing antibiotic prescribing and at least some change in consultation style and antibiotic prescribing behaviour. Reported practical changes included adopting a practice-wide policy of antibiotic prescription reduction. Many GPs also reported increased insight into patients' expectations, ultimately contributing to improved doctor-patient rapport. The components of the intervention put forward as having the greatest influence on changing clinician behaviour were the up-to-date research evidence resources, simple and effective communication skills presented in on-line videos, and presentation of the practice's own antibiotic prescribing levels combined with an overview of local resistance data. Conclusion Participants regarded this complex blended learning intervention acceptable and feasible, and reported wide-ranging, positive changes in attitudes and clinical practice as a result of participating in the STAR Educational Program. Trial registration Current Controlled Trials ISRCTN63355948 PMID:20459655

Musculoskeletal Injuries Affecting Radiologists According to the 2017 ACR Human Resources Commission Workforce Survey.

PubMed

Parikh, Jay R; Bender, Claire; Bluth, Edward

2018-05-01

Practice leaders surveyed in the 2017 ACR Human Resources Commission workforce survey reported that 25% of the radiologists or radiation oncologists they supervised had neck pain, 32% had low back pain, and 16% were dealing with a repetitive stress injury. The prevalence rates of these musculoskeletal ailments among radiologists and radiation oncologists were consistent with those reported in the literature in other populations. However, these prevalence rates may be underestimated because practice leaders, not the radiologists themselves, were surveyed, and the leaders may not be aware of all injuries. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Impact of targeted counseling on reported vaginal hygiene practices and bacterial vaginosis: the HIV Prevention Trials Network 035 study.

PubMed

Kasaro, Margaret P; Husnik, Marla J; Chi, Benjamin H; Reid, Cheri; Magure, Tsitsi; Makanani, Bonus; Tembo, Tchangani; Ramjee, Gita; Maslankowski, Lisa; Rabe, Lorna; Brad Guffey, M

2017-04-01

The objective of this study was to describe the impact of intense counseling to reduce vaginal hygiene practices and its effect on bacterial vaginosis. A secondary data analysis of the HIV Prevention Trials Network 035 study was undertaken, focusing on HIV-negative, nonpregnant women who were at least 18 years old, in seven African sites and one US site. At enrollment and during follow-up quarterly visits, vaginal hygiene practices were determined by face-to-face administration of a behavioral assessment questionnaire. Vaginal hygiene practices were categorized as insertion into the vagina of (1) nothing, (2) water only, and (3) other substances with or without water. Each practice was quantified by frequency and type/combination of inserted substances. At quarterly visits, diagnosis of bacterial vaginosis was made using the Nugent score. Trends for vaginal hygiene practices and bacterial vaginosis were evaluated using generalized estimating equation models. A total of 3087 participants from the HIV Prevention Trials Network 035 study were eligible for this analysis. At enrollment, 1859 (60%) reported recent vaginal hygiene practices. By one year, this figure had decreased to 1019 (33%) with counseling. However, bacterial vaginosis prevalence remained consistent across the study observation period, with 36%-38% of women testing positive for the condition ( p for trend = 0.27). Overall, those who reported douching with water only (AOR = 1.03, 95%CI: 0.94-1.13) and those who reported inserting other substances (AOR= 0.98, 95%CI: 0.88-1.09) in the past quarter were not more likely to have bacterial vaginosis compared to those who reported no insertions. However, in South Africa, an increase in bacterial vaginosis was seen among those who reported inserting other substances (AOR: 1.48, 95%CI: 1.17, 1.88). In conclusion, targeted counseling against vaginal hygiene practices resulted in change in self-reported behavior but did not have an impact on bacterial vaginosis diagnosis in all but one site.

PROJECT TALENT, IDENTIFICATION, DEVELOPMENT, AND UTILIZATION OF HUMAN TALENTS--SELECTED PUPIL AND SCHOOL CHARACTERISTICS IN RELATION TO PERCENTAGE OF NEGROES IN SCHOOL ENROLLMENT. FINAL REPORT.

ERIC Educational Resources Information Center

BURKET, GEORGE R.; FLANAGAN, JOHN C.

CONSISTING MAINLY OF TABLES, THIS REPORT PRESENTS THE FINDINGS OF A STATISTICAL STUDY WHICH EXAMINED THE DIFFERENCES AND SIMILARITIES AMONG 733 PROJECT TALENT SENIOR HIGH SCHOOLS WITH VARYING PROPORTIONS OF NEGRO ENROLLMENT. THE FACTORS STUDIED IN THESE SCHOOLS WERE EDUCATIONAL OUTCOMES, SCHOOL PRACTICES, STUDENT BODY CHARACTERISTICS, AND SCHOOL…

Oral and anal sex practices among high school youth in Addis Ababa, Ethiopia.

PubMed

Cherie, Amsale; Berhane, Yemane

2012-01-04

Understanding the full range of sexual behaviors of young people is crucial in developing appropriate interventions to prevent and control sexually transmitted infections including HIV. However, such information is meager in developing countries. The objective of this study was to describe oral and anal sex practices and identify associated factors among high school youth. A cross-sectional study was conducted among high school youth in Addis Ababa, Ethiopia. A multi-stage sampling procedure was followed to select a representative sample of school youth. The total sample size for this study was 3840. Data were collected using a self-administered questionnaire. Data analysis was guided by the ecological framework. The overall proportion of people who reported ever having oral sex was 5.4% (190) and that of anal sex was 4.3% (154). Of these 51.6% (98) had oral sex and 57.1% (87) had anal sex in the past 12 months. Multiple partnerships were reported by 61.2% of the respondents who had oral sex and 51.1% of students practicing anal sex. Consistent condom use was reported by 12.2% of those practicing oral sex and 26.1% of anal sex. Reasons for oral and anal sex included prevention of pregnancy, preserving virginity, and reduction of HIV and STIs transmission. Oral sex practice was strongly and significantly associated with perception of best friends engagement in oral sex (AOR = 5.7; 95% CI 3.6-11.2) and having illiterate mothers (AOR = 11.5; 95%CI 6.4-18.5). Similarly, anal sex practice was strongly and significantly associated with favorable attitude towards anal sex (AOR = 6.2; 95%CI 3.8-12.4), and perceived best friends engagement in anal sex (AOR = 9.7; 95%CI 5.4-17.7). Considerable proportion of adolescents had engaged in oral and anal sex practices. Multiple sexual partnerships were common while consistent condom use was low. Sexual health education and behavior change communication strategies need to cover a full range of sexual practices.

MO-D-211-01: Medical Physics Practice Guidelines - The Minimum Level of Medical Physics Support in Clinical Practice Settings.

PubMed

Chan, M; Fontenot, J; Halvorsen, P

2012-06-01

The American Association of Physicists in Medicine (AAPM) has long advocated a consistent level of medical physics practice, and has published many guidelines and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physicspractice. Despite these concerted and enduring efforts, the profession does not have a clear and concise statement of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. The AAPM will lead the development of MPPGs in collaboration with other professional societies. The MPPGs will be freely available to the general public. Accrediting organizations, regulatory agencies and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider to be prudent in all clinical practice settings. Support includes but is not limited to staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This course will describe the purpose and scope of MPPGs, the procedure for the development of a MPPG, as well as the progress of Therapy MPPG TG #1 on "Evaluation and quality assurance of x-ray based image guided radiotherapy systems" and Diagnostic MPPG TG #2 on "CT Protocol management and review". 1. Understand the concept and scope of MPPG from the AAPM 2. Understand the benefits and process of the development of MPPG by the AAPM 3. Understand the goals and methodology of the Therapy MPPG Task Group #14. 4. Understand the strategic plans from Professional Council towards the AAPM initiatives. © 2012 American Association of Physicists in Medicine.

Oral and anal sex practices among high school youth in Addis Ababa, Ethiopia

PubMed Central

2012-01-01

Background Understanding the full range of sexual behaviors of young people is crucial in developing appropriate interventions to prevent and control sexually transmitted infections including HIV. However, such information is meager in developing countries. The objective of this study was to describe oral and anal sex practices and identify associated factors among high school youth. Methods A cross-sectional study was conducted among high school youth in Addis Ababa, Ethiopia. A multi-stage sampling procedure was followed to select a representative sample of school youth. The total sample size for this study was 3840. Data were collected using a self-administered questionnaire. Data analysis was guided by the ecological framework. Results The overall proportion of people who reported ever having oral sex was 5.4% (190) and that of anal sex was 4.3% (154). Of these 51.6% (98) had oral sex and 57.1% (87) had anal sex in the past 12 months. Multiple partnerships were reported by 61.2% of the respondents who had oral sex and 51.1% of students practicing anal sex. Consistent condom use was reported by 12.2% of those practicing oral sex and 26.1% of anal sex. Reasons for oral and anal sex included prevention of pregnancy, preserving virginity, and reduction of HIV and STIs transmission. Oral sex practice was strongly and significantly associated with perception of best friends engagement in oral sex (AOR = 5.7; 95% CI 3.6-11.2) and having illiterate mothers (AOR = 11.5; 95%CI 6.4-18.5). Similarly, anal sex practice was strongly and significantly associated with favorable attitude towards anal sex (AOR = 6.2; 95%CI 3.8-12.4), and perceived best friends engagement in anal sex (AOR = 9.7; 95%CI 5.4-17.7). Conclusion Considerable proportion of adolescents had engaged in oral and anal sex practices. Multiple sexual partnerships were common while consistent condom use was low. Sexual health education and behavior change communication strategies need to cover a full range of sexual practices. PMID:22216887

Initial investigation of organisational factors associated with the implementation of active support.

PubMed

Fyffe, Chris; McCubbery, Jeffrey; Reid, Katharine J

2008-09-01

Active support (AS) has been shown to increase the amount of time that residents in shared residential settings are involved in purposeful activities. The organisational processes required to implement AS have been less well researched. Staff in community houses answered questions about the occurrence of organisational activities and processes thought to assist AS implementation (e.g., training and teamwork), their understanding of engagement, and their experience of changes in staff practice consistent with AS (including implementation problems). Non-house-based managers were also interviewed about their role in AS implementation. Reported occurrence of organisational activities and processes (e.g., training and teamwork) and understanding of engagement were associated with more reports of changes in staff practice and fewer staff reports of implementation problems. Staff reports on the role of non-house-based managers were not associated with reports of changes in staff practice or with reports of fewer AS implementation problems. Non-house-based managers' reports overestimated their role in AS implementation when compared with reports from house-based staff groups. While there are limitations in the research design (including the reliance on staff reports), the findings support the importance of wider organisational factors (beyond training programs for direct support staff) as integral to the implementation of AS. There is a need for further research on AS implementation.

Peer Learning in Instrumental Practicing

PubMed Central

Nielsen, Siw G.; Johansen, Guro G.; Jørgensen, Harald

2018-01-01

In higher music education (HME), the notion of “private teaching, private learning” has a long tradition, where the learning part rests on the student's individual practicing between instrumental lessons. However, recent research suggests that collaborative learning among peers is beneficial in several aspects, such as sense of belonging, motivation and self-efficacy. This is consistent with the concept of vicarious learning. In this study, we conducted a survey among bachelor music students in church music, performance or music education programs enrolled in a music academy (N = 96), where parts of the questionnaire addressed peer learning and peer's influence on the students's instrumental practicing, and the degree of satisfaction with their practicing. These issues were seen in relation to gender, musical genre and study program. Overall, the students reported engaging in peer learning related to their instrumental practicing, to various degrees. This involved discussing practicing matters with peers, and practicing together with peers. However, student's reports of their views on peer learning, show that they perceive it more beneficial than the amount of time reported doing it would indicate. No significant gender differences were found, but students within improvised music/jazz engaged the most in peer learning, and church music students the least. Neither the degree of engaging in peer learning nor reported influence from peers correlated significantly with the degree of satisfaction. We discuss whether a general dissatisfaction is caused by being in a competitive learning environment combined with a privatized culture for learning. Finally, we suggest that collaborative forums for instrumental practicing within HME institutions can function as constructive and supportive arenas to enhance students learning and inner motivation. PMID:29599738

Development of the Consumer Refrigerator Safety Questionnaire: A Measure of Consumer Perceptions and Practices.

PubMed

Cairnduff, Victoria; Dean, Moira; Koidis, Anastasios

2016-09-01

Food preparation and storage behaviors in the home deviating from the "best practice" food safety recommendations may result in foodborne illnesses. Currently, there are limited tools available to fully evaluate the consumer knowledge, perceptions, and behavior in the area of refrigerator safety. The current study aimed to develop a valid and reliable tool in the form of a questionnaire, the Consumer Refrigerator Safety Questionnaire (CRSQ), for assessing systematically all these aspects. Items relating to refrigerator safety knowledge (n =17), perceptions (n =46), and reported behavior (n =30) were developed and pilot tested by an expert reference group and various consumer groups to assess face and content validity (n =20), item difficulty and consistency (n =55), and construct validity (n =23). The findings showed that the CRSQ has acceptable face and content validity with acceptable levels of item difficulty. Item consistency was observed for 12 of 15 in refrigerator safety knowledge. Further, all 5 of the subscales of consumer perceptions of refrigerator safety practices relating to risk of developing foodborne disease showed acceptable internal consistency (Cronbach's α value > 0.8). Construct validity of the CRSQ was shown to be very good (P = 0.022). The CRSQ exhibited acceptable test-retest reliability at 14 days with the majority of knowledge items (93.3%) and reported behavior items (96.4%) having correlation coefficients of greater than 0.70. Overall, the CRSQ was deemed valid and reliable in assessing refrigerator safety knowledge and behavior; therefore, it has the potential for future use in identifying groups of individuals at increased risk of deviating from recommended refrigerator safety practices, as well as the assessment of refrigerator safety knowledge and behavior for use before and after an intervention.

Improvisational Practices in Elementary General Music Classrooms

ERIC Educational Resources Information Center

Gruenhagen, Lisa M.; Whitcomb, Rachel

2014-01-01

Despite historic and ongoing support for the inclusion of improvisation in the elementary general music curriculum, music educators consistently report challenges with implementation of improvisational activities in their classes. This study was designed to examine (a) the extent to which improvisational activities were occurring in the…

Addressing Intimate Partner Violence: Reducing Barriers and Improving Residents' Attitudes, Knowledge, and Practices.

PubMed

LaPlante, Laura Marie; Gopalan, Priya; Glance, Jody

2016-10-01

This study aims to assess residents' attitudes, knowledge, practices, and barriers in addressing intimate partner violence and create a curriculum targeting self-identified deficits. The authors developed and distributed a survey to residents across multiple specialties at a large academic institution. A workshop was developed using obstetrics/gynecology residents' data, with post-intervention data collected to assess for changes. One hundred forty-seven residents (41 %) completed the survey. Though all identified assessing intimate partner violence as physicians' responsibility, only 40 % reported consistent screening with new female patients, 36 % with pregnant patients, and 18 % with post-partum patients. Half reported inadequate training and felt unprepared to counsel patients regarding intimate partner violence. Post-intervention data suggest gains in knowledge and perceived preparedness. Although residents appreciate the significance of intimate partner violence assessment, in this particular institution few consistently perform or feel comfortable screening. Development of comprehensive intimate partner violence curricula is therefore critical.

Qualitative evaluation of suicide and overdose risk assessment procedures among veterans in substance use disorder treatment clinics.

PubMed

Webster, Linda; Eisenberg, Anna; Bohnert, Amy S B; Kleinberg, Felicia; Ilgen, Mark A

2012-01-01

The objective of this study was to examine risk assessment practices for suicide and unintentional overdose to inform ongoing care in substance use disorder clinics. Focus groups were conducted via telephone among a random sample of treatment providers (N = 19) from Veterans Health Administration substance use disorder clinics across the nation. Themes were coded by research staff. Treatment providers reported consistent and clear guidelines for risk assessment of suicide among patients. Unintentional overdose questions elicited dissimilar responses which indicated a lack of cohesion and uniformity in risk assessment practices across clinics. Suicide risk assessment protocols are cohesively implemented by treatment providers. Unintentional overdose risk, however, may be less consistently assessed in clinics.

Hearing aid patients in private practice and public health (Veterans Affairs) clinics: are they different?

PubMed

Cox, Robyn M; Alexander, Genevieve C; Gray, Ginger A

2005-12-01

In hearing aid research, it is commonplace to combine data across subjects whose hearing aids were provided in different service delivery models. There is reason to question whether these types of patients are always similar enough to justify this practice. To explore this matter, this investigation evaluated similarities and differences in self-report data obtained from hearing aid patients derived from public health (Veterans Affairs, VA) and private practice (PP) settings. The study was a multisite, cross-sectional survey in which 230 hearing aid patients from VA and PP audiology clinic settings provided self-report data on a collection of questionnaires both before and after the hearing aid fitting. Subjects were all older adults with mild to moderately severe hearing loss. About half of them had previous experience wearing hearing aids. All subjects were fitted with wide-dynamic-range-compression instruments and received similar treatment protocols. Numerous statistically significant differences were observed between the VA and PP subject groups. Before the fitting, VA patients reported higher expectations from the hearing aids and more severe unaided problems compared with PP patients with similar audiograms. Three wks after the fitting, VA patients reported more satisfaction with their hearing aids. On some measures VA patients reported more benefit, but different measures of benefit did not give completely consistent results. Both groups reported using the hearing aids an average of approximately 8 hrs per day. VA patients reported age-normal physical and mental health, but PP patients tended to report better than typical health for their age group. These data indicate that hearing aid patients seen in the VA public health hearing services are systematically different in self-report domains from those seen in private practice services. It is therefore risky to casually combine data from these two types of subjects or to generalize research results from one group to the other. Further, compared with PP patients, VA patients consistently reported more favorable hearing aid fitting outcomes. Additional study is indicated to explore the determinants of this result and its generalizability to other public health service delivery systems such as those in other countries. Moreover, efforts should be made to assess the potential for transferring positive elements from the VA system to the PP service delivery system, if possible.

A metadata reporting framework (FRAMES) for synthesis of ecohydrological observations

DOE PAGES

Christianson, Danielle S.; Varadharajan, Charuleka; Christoffersen, Bradley; ...

2017-06-20

Metadata describe the ancillary information needed for data interpretation, comparison across heterogeneous datasets, and quality control and quality assessment (QA/QC). Metadata enable the synthesis of diverse ecohydrological and biogeochemical observations, an essential step in advancing a predictive understanding of earth systems. Environmental observations can be taken across a wide range of spatiotemporal scales in a variety of measurement settings and approaches, and saved in multiple formats. Thus, well-organized, consistent metadata are required to produce usable data products from diverse observations collected in disparate field sites. However, existing metadata reporting protocols do not support the complex data synthesis needs of interdisciplinarymore » earth system research. We developed a metadata reporting framework (FRAMES) to enable predictive understanding of carbon cycling in tropical forests under global change. FRAMES adheres to best practices for data and metadata organization, enabling consistent data reporting and thus compatibility with a variety of standardized data protocols. We used an iterative scientist-centered design process to develop FRAMES. The resulting modular organization streamlines metadata reporting and can be expanded to incorporate additional data types. The flexible data reporting format incorporates existing field practices to maximize data-entry efficiency. With FRAMES’s multi-scale measurement position hierarchy, data can be reported at observed spatial resolutions and then easily aggregated and linked across measurement types to support model-data integration. FRAMES is in early use by both data providers and users. Here in this article, we describe FRAMES, identify lessons learned, and discuss areas of future development.« less

A metadata reporting framework (FRAMES) for synthesis of ecohydrological observations

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

Christianson, Danielle S.; Varadharajan, Charuleka; Christoffersen, Bradley

Metadata describe the ancillary information needed for data interpretation, comparison across heterogeneous datasets, and quality control and quality assessment (QA/QC). Metadata enable the synthesis of diverse ecohydrological and biogeochemical observations, an essential step in advancing a predictive understanding of earth systems. Environmental observations can be taken across a wide range of spatiotemporal scales in a variety of measurement settings and approaches, and saved in multiple formats. Thus, well-organized, consistent metadata are required to produce usable data products from diverse observations collected in disparate field sites. However, existing metadata reporting protocols do not support the complex data synthesis needs of interdisciplinarymore » earth system research. We developed a metadata reporting framework (FRAMES) to enable predictive understanding of carbon cycling in tropical forests under global change. FRAMES adheres to best practices for data and metadata organization, enabling consistent data reporting and thus compatibility with a variety of standardized data protocols. We used an iterative scientist-centered design process to develop FRAMES. The resulting modular organization streamlines metadata reporting and can be expanded to incorporate additional data types. The flexible data reporting format incorporates existing field practices to maximize data-entry efficiency. With FRAMES’s multi-scale measurement position hierarchy, data can be reported at observed spatial resolutions and then easily aggregated and linked across measurement types to support model-data integration. FRAMES is in early use by both data providers and users. Here in this article, we describe FRAMES, identify lessons learned, and discuss areas of future development.« less

To what extent do nurses use research in clinical practice? A systematic review.

PubMed

Squires, Janet E; Hutchinson, Alison M; Boström, Anne-Marie; O'Rourke, Hannah M; Cobban, Sandra J; Estabrooks, Carole A

2011-03-17

In the past forty years, many gains have been made in our understanding of the concept of research utilization. While numerous studies exist on professional nurses' use of research in practice, no attempt has been made to systematically evaluate and synthesize this body of literature with respect to the extent to which nurses use research in their clinical practice. The objective of this study was to systematically identify and analyze the available evidence related to the extent to which nurses use research findings in practice. This study was a systematic review of published and grey literature. The search strategy included 13 online bibliographic databases: Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, EMBASE, HAPI, Web of Science, SCOPUS, OCLC Papers First, OCLC WorldCat, ABI Inform, Sociological Abstracts, and Dissertation Abstracts. The inclusion criteria consisted of primary research reports that assess professional nurses' use of research in practice, written in the English or Scandinavian languages. Extent of research use was determined by assigning research use scores reported in each article to one of four quartiles: low, moderate-low, moderate-high, or high. Following removal of duplicate citations, a total of 12,418 titles were identified through database searches, of which 133 articles were retrieved. Of the articles retrieved, 55 satisfied the inclusion criteria. The 55 final reports included cross-sectional/survey (n = 51) and quasi-experimental (n = 4) designs. A sensitivity analysis, comparing findings from all reports with those rated moderate (moderate-weak and moderate-strong) and strong quality, did not show significant differences. In a majority of the articles identified (n = 38, 69%), nurses reported moderate-high research use. According to this review, nurses' reported use of research is moderate-high and has remained relatively consistent over time until the early 2000's. This finding, however, may paint an overly optimistic picture of the extent to which nurses use research in their practice given the methodological problems inherent in the majority of studies. There is a clear need for the development of standard measures of research use and robust well-designed studies examining nurses' use of research and its impact on patient outcomes. The relatively unchanged self-reports of moderate-high research use by nurses is troubling given that over 40 years have elapsed since the first studies in this review were conducted and the increasing emphasis in the past 15 years on evidence-based practice. More troubling is the absence of studies in which attempts are made to assess the effects of varying levels of research use on patient outcomes.

To what extent do nurses use research in clinical practice? A systematic review

PubMed Central

2011-01-01

Background In the past forty years, many gains have been made in our understanding of the concept of research utilization. While numerous studies exist on professional nurses' use of research in practice, no attempt has been made to systematically evaluate and synthesize this body of literature with respect to the extent to which nurses use research in their clinical practice. The objective of this study was to systematically identify and analyze the available evidence related to the extent to which nurses use research findings in practice. Methods This study was a systematic review of published and grey literature. The search strategy included 13 online bibliographic databases: Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, EMBASE, HAPI, Web of Science, SCOPUS, OCLC Papers First, OCLC WorldCat, ABI Inform, Sociological Abstracts, and Dissertation Abstracts. The inclusion criteria consisted of primary research reports that assess professional nurses' use of research in practice, written in the English or Scandinavian languages. Extent of research use was determined by assigning research use scores reported in each article to one of four quartiles: low, moderate-low, moderate-high, or high. Results Following removal of duplicate citations, a total of 12,418 titles were identified through database searches, of which 133 articles were retrieved. Of the articles retrieved, 55 satisfied the inclusion criteria. The 55 final reports included cross-sectional/survey (n = 51) and quasi-experimental (n = 4) designs. A sensitivity analysis, comparing findings from all reports with those rated moderate (moderate-weak and moderate-strong) and strong quality, did not show significant differences. In a majority of the articles identified (n = 38, 69%), nurses reported moderate-high research use. Conclusions According to this review, nurses' reported use of research is moderate-high and has remained relatively consistent over time until the early 2000's. This finding, however, may paint an overly optimistic picture of the extent to which nurses use research in their practice given the methodological problems inherent in the majority of studies. There is a clear need for the development of standard measures of research use and robust well-designed studies examining nurses' use of research and its impact on patient outcomes. The relatively unchanged self-reports of moderate-high research use by nurses is troubling given that over 40 years have elapsed since the first studies in this review were conducted and the increasing emphasis in the past 15 years on evidence-based practice. More troubling is the absence of studies in which attempts are made to assess the effects of varying levels of research use on patient outcomes. PMID:21414206

Literacy across the Curriculum, 1996-1997.

ERIC Educational Resources Information Center

Shohet, Linda, Ed.

1997-01-01

This volume consists of four issues. Issue 1 looks at some recent research on practice and is composed of these articles: "Reflection on Literacy," a summary of the World Conference on Literacy; "How Effective Is Adult Literacy Education?" that reports outcomes of Ontario Literacy Coalition studies; "UK Trends: Assessing…

Teachers' Voices 2: Teaching Disparate Learner Groups.

ERIC Educational Resources Information Center

Burns, Anne, Ed.; Hood, Susan, Ed.

The collection of papers was written by teacher researchers from an adult migrant English program, and consists of reports and discussions of action research on teaching heterogeneous learner groups. Papers include: "Disparate Groups: Exploring Diversity in Practice through Collaborative Action Research" (Anne Burns, Susan Hood); "A Profile of…

40 CFR 30.54 - Quality assurance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Quality assurance. 30.54 Section 30.54... NON-PROFIT ORGANIZATIONS Post-Award Requirements Reports and Records § 30.54 Quality assurance. If the... data generation, the grantee shall develop and implement quality assurance practices consisting of...

JPRS Report, Soviet Union, Political Affairs.

DTIC Science & Technology

1989-12-01

Romansh consists of several highly distinct dialects which can for all practical purposes be regarded as separate languages. In the Grisons Canton...canton’s native population which is about 40,000. According to Alain Pichard, a Swiss academic and writer, it was exactly this Grisons polyphony that pre

Resilience in the context of child maltreatment: connections to the practice of mandatory reporting.

PubMed

Wekerle, Christine

2013-01-01

A human rights perspective places the care for children in the obligation sphere. The duty to protect from violence is an outcome of having a declaration confirming inalienable human rights. Nationally, rights may be reflected in constitutions, charters, and criminal codes. Transnationally, the United Nation's (UN) Convention on the Rights of the Child (CRC) prioritizes a child's basic human rights, given their dependent status. UN CRC signatory countries commit to implementing minimal standards of care for minors. Laws requiring professionals to report child maltreatment to authorities is one practical strategy to implement minimal child protection and service standards. Mandatory reporting laws officially affirm the wrong of maltreatment and the right of children. Mandatory reporting can be conceptualized as part of a resilience process, where the law sets the stage for child safety and well-being planning. Although widely enacted law, sizeable research gaps exist in terms of statistics on mandatory reporting compliance in key settings; obstacles and processes in mandatory reporting; the provision of evidence-based training to support the duty to report; and the training-reporting-child outcomes relationship, this latter area being virtually non-existent. The fact that mandatory reporting is not presently evidence-based cannot be separated from this lack of research activity in mandatory reporting. Reporting is an intervention that requires substantial inter-professional investment in research to guide best practices, with methodological expectations of any clinical intervention. Child abuse reporting is consistent with a clinician's other duties to report (i.e., suicidality, homicidality), practice-based skills (e.g., delivering "bad" news, giving assessment feedback), and the pervasive professional principle of best interests of the child. Resilience requires the presence of resources and, mandated reporting, is one such resource to the maltreated child. Practice strategies identified in the literature are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development of a Lifespan-Based Novel Composite Person-Reported Outcome Measure Using Data from the CINRG Duchenne Natural History Study

DTIC Science & Technology

2016-10-01

and should not be construed as an official Department of the Army position, policy or decision unless so designated by other documentation. REPORT...Applicability: Well- designed CAT-PRO questionnaires can be used in both clinical trials and day-to-day clinical practice. For clinical trials, they provide...confirm that items are responsive to self-reported changes in milestone ability over a time period consistent with design of contemporary clinical

Understanding the Effect of KIPP as It Scales: Volume II, Leadership Practices at KIPP. Final Report of KIPP's Investing in Innovation Grant Evaluation

ERIC Educational Resources Information Center

Knechtel, Virginia; Anderson, Mary Anne; Burnett, Alyson; Coen, Thomas; Sullivan, Margaret; Tuttle, Christina Clark; Gleason, Philip

2015-01-01

The Knowledge is Power Program (KIPP) charter schools' consistently positive impacts on student achievement (detailed in Volume I of this report) have prompted efforts to scale up the KIPP model to serve more students. According to the KIPP model, highly qualified and autonomous principals, supported by national and regional staff, drive the…

Therapist self-report of evidence-based practices in usual care for adolescent behavior problems: factor and construct validity.

PubMed

Hogue, Aaron; Dauber, Sarah; Henderson, Craig E

2014-01-01

This study introduces a therapist-report measure of evidence-based practices for adolescent conduct and substance use problems. The Inventory of Therapy Techniques-Adolescent Behavior Problems (ITT-ABP) is a post-session measure of 27 techniques representing four approaches: cognitive-behavioral therapy (CBT), family therapy (FT), motivational interviewing (MI), and drug counseling (DC). A total of 822 protocols were collected from 32 therapists treating 71 adolescents in six usual care sites. Factor analyses identified three clinically coherent scales with strong internal consistency across the full sample: FT (8 items; α = .79), MI/CBT (8 items; α = .87), and DC (9 items, α = .90). The scales discriminated between therapists working in a family-oriented site versus other sites and showed moderate convergent validity with therapist reports of allegiance and skill in each approach. The ITT-ABP holds promise as a cost-efficient quality assurance tool for supporting high-fidelity delivery of evidence-based practices in usual care.

Computer use in primary care practices in Canada.

PubMed

Anisimowicz, Yvonne; Bowes, Andrea E; Thompson, Ashley E; Miedema, Baukje; Hogg, William E; Wong, Sabrina T; Katz, Alan; Burge, Fred; Aubrey-Bassler, Kris; Yelland, Gregory S; Wodchis, Walter P

2017-05-01

To examine the use of computers in primary care practices. The international Quality and Cost of Primary Care study was conducted in Canada in 2013 and 2014 using a descriptive cross-sectional survey method to collect data from practices across Canada. Participating practices filled out several surveys, one of them being the Family Physician Survey, from which this study collected its data. All 10 Canadian provinces. A total of 788 family physicians. A computer use scale measured the extent to which family physicians integrated computers into their practices, with higher scores indicating a greater integration of computer use in practice. Analyses included t tests and 2 tests comparing new and traditional models of primary care on measures of computer use and electronic health record (EHR) use, as well as descriptive statistics. Nearly all (97.5%) physicians reported using a computer in their practices, with moderately high computer use scale scores (mean [SD] score of 5.97 [2.96] out of 9), and many (65.7%) reported using EHRs. Physicians with practices operating under new models of primary care reported incorporating computers into their practices to a greater extent (mean [SD] score of 6.55 [2.64]) than physicians operating under traditional models did (mean [SD] score of 5.33 [3.15]; t 726.60 = 5.84; P < .001; Cohen d = 0.42, 95% CI 0.808 to 1.627) and were more likely to report using EHRs (73.8% vs 56.7%; [Formula: see text]; P < .001; odds ratio = 2.15). Overall, there was a statistically significant variability in computer use across provinces. Most family physicians in Canada have incorporated computers into their practices for administrative and scholarly activities; however, EHRs have not been adopted consistently across the country. Physicians with practices operating under the new, more collaborative models of primary care use computers more comprehensively and are more likely to use EHRs than those in practices operating under traditional models of primary care. Copyright© the College of Family Physicians of Canada.

Validity of therapist self-report ratings of fidelity to evidence-based practices for adolescent behavior problems: correspondence between therapists and observers.

PubMed

Hogue, Aaron; Dauber, Sarah; Lichvar, Emily; Bobek, Molly; Henderson, Craig E

2015-03-01

Developing therapist-report fidelity tools to support quality delivery of evidence-based practices in usual care is a top priority for implementation science. This study tested the reliability and accuracy of two groups of community therapists who reported on their use of family therapy (FT) and motivational interviewing/cognitive-behavioral therapy (MI/CBT) interventions during routine treatment of inner-city adolescents with conduct and substance use problems. Study cases (n = 45) were randomized into two conditions: (a) Routine Family Therapy (RFT), consisting of a single site that featured family therapy as its standard of care for behavioral treatment; or (b) Treatment As Usual (TAU), consisting of five sites that featured non-family approaches. Therapists and trained observational raters provided FT and MI/CBT adherence ratings on 157 sessions (104 RFT, 53 TAU). Overall therapist reliability was adequate for averaged FT ratings (ICC = .66) but almost non-existent for MI/CBT (ICC = .06); moreover, both RFT and TAU therapists were more reliable in reporting on FT than on MI/CBT. Both groups of therapists overestimated the extent to which they implemented FT and MI/CBT interventions. Results offer support for the feasibility of using existing therapist-report methods to anchor quality assurance procedures for FT interventions in real-world settings, though not for MI/CBT.

Translating Pressure Ulcer Prevention Into Intensive Care Nursing Practice: Overlaying a Care Bundle Approach With a Model for Research Implementation.

PubMed

Tayyib, Nahla; Coyer, Fiona

This article reports on the development and implementation process used to integrate a care bundle approach (a pressure ulcer [PU] prevention bundle to improve patients' skin integrity in intensive care) and the Ottawa Model of Research Use (OMRU). The PU prevention care bundle demonstrated significant reduction in PU incidence, with the OMRU model providing a consolidated framework for the implementation of bundled evidence in an effective and consistent manner into daily clinical nursing practice.

Practical, Asymmetric Route to Sitagliptin and Derivatives: Development and Origin of Diastereoselectivity

PubMed Central

2016-01-01

The development of a practical and scalable process for the asymmetric synthesis of sitagliptin is reported. Density functional theory calculations reveal that two noncovalent interactions are responsible for the high diastereoselection. The first is an intramolecular hydrogen bond between the enamide NH and the boryl mesylate S=O, consistent with MsOH being crucial for high selectivity. The second is a novel C–H···F interaction between the aryl C5-fluoride and the methyl of the mesylate ligand. PMID:25799267

Vaccines provided by family physicians.

PubMed

Campos-Outcalt, Doug; Jeffcott-Pera, Michelle; Carter-Smith, Pamela; Schoof, Bellinda K; Young, Herbert F

2010-01-01

This study was conducted to document current immunization practices by family physicians. In 2008 the American Academy of Family Physicians (AAFP) conducted a survey among a random sample of 2,000 of its members who reported spending 80% or more of their time in direct patient care. The survey consisted of questions regarding the demographics of the practice, vaccines that are provided at the physicians' clinical site, whether the practice refers patients elsewhere for vaccines, and participation in the Vaccines for Children (VFC) program. The response rate was 38.5%, 31.8% after non-office-based respondents were deleted. A high proportion of respondents (80% or more) reported providing most routinely recommended child, adolescent, and adult vaccines at their practice sites. The exceptions were rotavirus vaccine for children and herpes zoster vaccine for adults., A significant proportion, however, reported referring elsewhere for some vaccines (44.1% for children and adolescent vaccines and 53.5% for adult vaccines), with the most frequent referral location being a public health department. A higher proportion of solo and 2-physician practices than larger practices reported referring patients. A lack of adequate payment was listed as the reason for referring patients elsewhere for vaccines by one-half of those who refer patients. One-half of responders do not participate in the VFC program. Provision of recommended vaccines by most family physicians remains an important service. Smaller practices have more difficulty offering a full array of vaccine products, and lack of adequate payment contributes to referring patients outside the medical home. The reasons behind the lack of participation in the VFC program deserve further study.

48 CFR 9905.501 - Cost accounting standard-consistency in estimating, accumulating and reporting costs by...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard....501 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST...

Efficiency in Resource Utilization in Education. Education and Development Technical Reports.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France). Directorate for Scientific Affairs.

This volume consists of papers presented at a meeting of scientific and technical personnel who examined and evaluated applications of systems analysis and operational research, and who related techniques to practical educational planning. Topics represent a variety of new management techniques available to educational administrators including…

Honeywell's Working Parents Task Force. Final Report and Recommendations.

ERIC Educational Resources Information Center

Honeywell, Inc., Minneapolis, Minn.

This publication provides a summary of the Honeywell Working Parent Task Force's recommendations on how to solve problems experienced by working parents. The Task Force consisted of three committees: the Employment Practices Committee (EPC); the Parent Education Committee (PEC); and the Child Care Facilities Committee (CCFC). After examining a…

Marketing the Arts: A Selected and Annotated Bibliography.

ERIC Educational Resources Information Center

Nakamoto, Kent, Comp.; Levin, Kathi, Comp.

Compiled from the marketing, arts, and arts management literature, this selected list includes materials ranging from theoretical articles and reports of studies to practical guides for marketing techniques. It consists of three sections: Primary Sources, Secondary Sources, and Surveys. Of particular interest to the arts administrator, the first…

How to reduce tire-pavement noise : better practices for constructing and texturing concrete pavement surfaces.

DOT National Transportation Integrated Search

2012-08-01

Concrete pavements can be designed and constructed to be as quiet as any other conventional pavement type in use today. This report provides an overview of how this can be doneand done consistently. In order to construct a quieter concrete pavemen...

DEVELOPMENT OF GUIDELINES FOR CALIBRATING, VALIDATING, AND EVALUATING HYDROLOGIC AND WATER QUALITY MODELS: ASABE ENGINEERING PRACTICE 621

USDA-ARS?s Scientific Manuscript database

Information to support application of hydrologic and water quality (H/WQ) models abounds, yet modelers commonly use arbitrary, ad hoc methods to conduct, document, and report model calibration, validation, and evaluation. Consistent methods are needed to improve model calibration, validation, and e...

48 CFR 9904.401 - Cost accounting standard-consistency in estimating, accumulating and reporting costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.401 Cost... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard...

Implementing Dialogic Teaching in a Singapore English Language Classroom

ERIC Educational Resources Information Center

Lee, Rachel

2016-01-01

Despite the fact that Singaporean students consistently perform well in literacy tests such as the Progress in International Reading Literacy Study, employers have reported that Singaporean employees in general lack confidence in articulating their views in the workplace. This may be attributed to the practice of teacher-fronted and monologic…

Mother/Child, Father/Child Relationships.

ERIC Educational Resources Information Center

Stevens, Joseph H., Jr., Ed.; Mathews, Marilyn, Ed.

This collection of papers on parent-child relationships consists of three research reports, six research reviews and two position papers on issues critical to research and practice. Papers included were selected on the basis of their relevance to the work of practitioners who counsel parents. The volume's four thematic sections are entitled: (1)…

Perceptual experience and posttest improvements in perceptual accuracy and consistency.

PubMed

Wagman, Jeffrey B; McBride, Dawn M; Trefzger, Amanda J

2008-08-01

Two experiments investigated the relationship between perceptual experience (during practice) and posttest improvements in perceptual accuracy and consistency. Experiment 1 investigated the potential relationship between how often knowledge of results (KR) is provided during a practice session and posttest improvements in perceptual accuracy. Experiment 2 investigated the potential relationship between how often practice (PR) is provided during a practice session and posttest improvements in perceptual consistency. The results of both experiments are consistent with previous findings that perceptual accuracy improves only when practice includes KR and that perceptual consistency improves regardless of whether practice includes KR. In addition, the results showed that although there is a relationship between how often KR is provided during a practice session and posttest improvements in perceptual accuracy, there is no relationship between how often PR is provided during a practice session and posttest improvements in consistency.

“At 150 kg, you can't run” men's weight loss stories in a popular health magazine provide appropriate examples of good health practice

PubMed Central

Couch, Danielle; Han, Gil-Soo; Robinson, Priscilla; Komesaroff, Paul

2014-01-01

We explore weight loss stories from 47 men collected from the Australian edition of Men's Health magazine between January 2009 and December 2012. Our analysis uses a mixed methods approach that combines thematic analysis and descriptive statistics to examine weight loss strategies against clinical practice guidelines for the management of overweight and obesity. All the stories reported the use of physical activity for weight loss and most stories detailed dietary changes for weight loss. Our findings indicate that most of the men reportedly used some form of behavioural strategies to assist them in their behaviour change efforts. The weight loss methods used were consistent with clinical practice guidelines, with the exception of some dietary practices. As narratives may assist with behaviour change, stories like those examined in this study could prove to be very useful in promoting weight loss to men. PMID:25750780

Society for Academic Continuing Medical Education Intervention Guideline Series: Guideline 2, Practice Facilitation.

PubMed

Van Hoof, Thomas J; Grant, Rachel E; Campbell, Craig; Colburn, Lois; Davis, David; Dorman, Todd; Fischer, Michael; Horsley, Tanya; Jacobs-Halsey, Virginia; Kane, Gabrielle; LeBlanc, Constance; Moore, Donald E; Morrow, Robert; Olson, Curtis A; Silver, Ivan; Thomas, David C; Turco, Mary; Kitto, Simon

2015-01-01

The Society for Academic Continuing Medical Education commissioned a study to clarify and, if possible, standardize the terminology for a set of important educational interventions. In the form of a guideline, this article describes one such intervention, practice facilitation, which is a common strategy in primary care to help practices develop capacity and infrastructure to support their ability to improve patient care. Based on a review of recent evidence and a facilitated discussion with US and Canadian experts, we describe practice facilitation, its terminology, and other important information about the intervention. We encourage leaders and researchers to consider and build on this guideline as they plan, implement, evaluate, and report practice facilitation efforts. Clear and consistent use of terminology is imperative, along with complete and accurate descriptions of interventions, to improve the use and study of practice facilitation.

Variation in Acceptable Child Discipline Practices by Child Age: Perceptions of Community Norms by Medical and Legal Professionals

PubMed Central

Block, Stephanie D.; Poplin, Ashlee Burgess; Wang, Eric; Widaman, Keith F.; Runyan, Desmond K.

2016-01-01

Mandated child abuse reporters may judge specific disciplinary practices as unacceptable for young children, whereas child law professionals arbitrating allegations may be less inclusive. Do the views of these groups diverge, by child age, regarding physical discipline? Judgments of community norms across a wide range of children’s ages were obtained from 380 medical and legal professionals. Because the Parent-Child Conflict Tactics Scale (PC-CTS) can be used to assess the epidemiology of child disciplinary behaviors and as a proxy to examine the incidence or prevalence of child abuse, the disciplinary practices described on the PC-CTS were presented as triggers for questions. Significant child age effects were found for disciplinary practices classified as “harsh.” The consistencies between legal and medical professionals were striking. Both groups reflected changes in United States norms, as non-physical approaches were the most approved. We conclude that instruments estimating the prevalence of child maltreatment by parent-report should consider modifying how specific disciplinary practices are classified. PMID:27117603

Characterizing Behavioral and Brain Changes Associated with Practicing Reasoning Skills

PubMed Central

Mackey, Allyson P.; Miller Singley, Alison T.; Wendelken, Carter; Bunge, Silvia A.

2015-01-01

We have reported previously that intensive preparation for a standardized test that taxes reasoning leads to changes in structural and functional connectivity within the frontoparietal network. Here, we investigated whether reasoning instruction transfers to improvement on unpracticed tests of reasoning, and whether these improvements are associated with changes in neural recruitment during reasoning task performance. We found behavioral evidence for transfer to a transitive inference task, but no evidence for transfer to a rule generation task. Across both tasks, we observed reduced lateral prefrontal activation in the trained group relative to the control group, consistent with other studies of practice-related changes in brain activation. In the transitive inference task, we observed enhanced suppression of task-negative, or default-mode, regions, consistent with work suggesting that better cognitive skills are associated with more efficient switching between networks. In the rule generation task, we found a pattern consistent with a training-related shift in the balance between phonological and visuospatial processing. Broadly, we discuss general methodological considerations related to the analysis and interpretation of training-related changes in brain activation. In summary, we present preliminary evidence for changes in brain activation associated with practice of high-level cognitive skills. PMID:26368278

Clinical Nurse Leader Integration Into Practice: Developing Theory To Guide Best Practice.

PubMed

Bender, Miriam

2016-01-01

Numerous policy bodies have identified the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards. Although there is growing evidence of improved care environment and patient safety and quality outcomes after redesigning care delivery microsystems to integrate CNL practice, significant variation in CNL implementation has been noted across reports, making it difficult to causally link CNL practice to reported outcomes. This variability reflects the overall absence in the literature of a well-defined CNL theoretical framework to help guide standardized application in practice. To address this knowledge gap, an interpretive synthesis with a grounded theory analysis of CNL narratives was conducted to develop a theoretical model for CNL practice. The model clarifies CNL practice domains and proposes mechanisms by which CNL-integrated care delivery microsystems improve health care quality. The model highlights the need for a systematic approach to CNL implementation including a well-thought out strategy for care delivery redesign; a consistent, competency-based CNL workflow; and sustained macro-to-micro system leadership support. CNL practice can be considered an effective approach to organizing nursing care that maximizes the scope of nursing to influence the ways care is delivered by all professions within a clinical microsystem. Copyright © 2016 Elsevier Inc. All rights reserved.

Beliefs, identities and educational practice: a Q methodology study of general practice supervisors.

PubMed

Dory, Valérie; Audétat, Marie-Claude; Rees, Charlotte

2015-03-01

Quality of supervisory practices varies. According to the integrative model of behaviour prediction, supervisors' beliefs may influence practice. This study aimed to examine the belief profiles of general practice supervisors, and their potential relationship with supervisory practice. A cross-sectional study was conducted using Q-methodology to explore supervisors' beliefs and the Maastricht Clinical Teaching Questionnaire to measure self-reported supervisory practice. One-hundred and thirty-nine supervisors took part (76%). The most common belief profile (36.7%) comprised a proactive view of supervisors' roles, strong self-efficacy beliefs and awareness of university norms. It revealed merged identities as clinicians and teachers. The second profile (18.0%) included a belief that supervision essentially involved sharing one's experience, uncertainty about the impact of supervision and about university norms. This profile was consistent with a pre-eminence of supervisors' identities as clinicians. Supervisors with merged identities were more likely to have more experience as supervisors and to engage in other teaching activities. Differences in self-reported supervisory practice were observed but did not reach statistical significance (P = 0.053). Supervisors' beliefs reveal differences in the way they manage their multiple professional identities. Further research should be conducted into whether these differences are developmental and if so how development occurs.

Development and initial validation of the internalization of Asian American stereotypes scale.

PubMed

Shen, Frances C; Wang, Yu-Wei; Swanson, Jane L

2011-07-01

This research consists of four studies on the initial reliability and validity of the Internalization of Asian American Stereotypes Scale (IAASS), a self-report instrument that measures the degree Asian Americans have internalized racial stereotypes about their own group. The results from the exploratory and confirmatory factor analyses support a stable four-factor structure of the IAASS: Difficulties with English Language Communication, Pursuit of Prestigious Careers, Emotional Reservation, and Expected Academic Success. Evidence for concurrent and discriminant validity is presented. High internal-consistency and test-retest reliability estimates are reported. A discussion of how this scale can contribute to research and practice regarding internalized stereotyping among Asian Americans is provided.

Assessing the quality of corporate social responsibility reports: the case of reporting practices in selected European Union member states.

PubMed

Hąbek, Patrycja; Wolniak, Radosław

The organization may communicate its engagement in sustainability and may presents results achieved in this field by creating and publishing corporate social responsibility (CSR) reports. Today, we can observe a growing number of companies issuing such reports as a part of their annual reports or as stand-alone CSR reports. Despite the increase in the number of such reports their quality is different. CSR reports do not always provide complete data that readers desire, which in turn intensifies the problem with the evaluation and comparison of the organization's results achieved in this scope. Differences also occur between reporting models used in different EU countries caused by, inter alia, differently applied EU legislation on the disclosure of non-financial information in different Member States. This paper is one of the first attempts to perform a quantitative and qualitative analysis of corporate sustainability reporting practices in several European Union countries. The purpose of this article is to present the current state of CSR reporting practices in selected EU Member States and identify the differences in the quality and level of this kind of practices, taking into account the mandatory and voluntary model of disclosure. The study included separate CSR reports as well as annual reports with CSR sections and integrated reports published in 2012 in six selected EU Member States. The authors have used a specific evaluation tool in the examination of the individual reports. The assessment questionnaire consists of seventeen criteria grouped into two categories (relevance and credibility of information). In order to assess the quality of examined reports, the authors aggregated the indicators related with the reporting practices. The findings show that the quality level of the studied reports is generally low. Referring to its components, the relevance of the information provided in the assessed reports is at the higher level than its credibility. The study also indicates that the legal obligation of CSR data disclosure has a positive effect on the quality of CSR reports.

A Household Is Not a Person: Consistency of Pro-Environmental Behavior in Adult Couples and the Accuracy of Proxy-Reports

PubMed Central

Seebauer, Sebastian; Fleiß, Jürgen; Schweighart, Markus

2016-01-01

Studies on environmental behavior commonly assume single respondents to represent their entire household or employ proxy-reporting, where participants answer for other household members. It is contested whether these practices yield valid results. Therefore, we interviewed 84 couples, wherein both household members provided self- and proxy-reports for their partner. For use of electrical household appliances, consumption of hot water, space heating, everyday mobility, and environmental values, many variables fail to achieve criteria for validity. Consistency (agreement between self-reports of household members) is higher if behaviors are undertaken jointly or negotiated between partners. Accuracy (agreement of proxy-reports with corresponding self-reports) is higher for routine behaviors and for behaviors easily observable by the partner. Overall, indices perform better than items on single behaviors. We caution against employing individual responses in place of the entire household. Interventions for energy conservation should approach the specific person undertaking the target behavior. PMID:28670000

Johns Hopkins Perceptual Test; Technical Report 9. Disadvantaged Children and Their First School Experiences. ETS-Head Start Longitudinal Study. Technical Report Series.

ERIC Educational Resources Information Center

Gilbert, Lynn E.; Shipman, Virginia C.

The Johns Hopkins Perceptual Test, a brief measure of intelligence in children, requires the child to choose a form identical to a standard. It consists of 3 practice and 30 test items, all involving black geometric figures printed on white cards. There is one booklet for stimulus cards and one for response cards. The child is presented with a…

REFLECTIONS ON THE ROLE OF THE PHARMACY REGULATORY AUTHORITY IN ENHANCING QUALITY RELATED EVENT REPORTING IN COMMUNITY PHARMACIESi

PubMed Central

Boyle, Todd A.; Bishop, Andrea C.; Mahaffey, Thomas; MacKinnon, Neil J.; Ashcroft, Darren; Zwicker, Bev; Reid, Carolyn

2016-01-01

Background Given the demanding nature of providing pharmacy services, coupled with the expanded scope of practice of the professions in jurisdictions around the world, greater commitment to continuous quality improvement through adoption of quality related event (QRE) reporting is necessary to ensure patient safety. Pharmacy regulatory authorities (PRAs) are in a unique position to enhance QRE reporting and learning through the standardization of expected practice Objective This study aims to better understand the perceived roles of PRAs in enhancing QRE reporting and learning in community pharmacies and identifying regulatory best practices to execute such roles. Methods A purposive case sampling approach was used to identify PRA staff members from two groups (deputy registrars and pharmacy inspectors) in 10 Canadian jurisdictions to participate in focus groups in the fall of 2011. Focus groups were used to explore perceptions of the role of PRAs in enhancing and promoting QRE reporting and learning, and perceived barriers to effective implementation in practice. Thematic analysis was used to analyze the qualitative data. Results Two focus groups were conducted, one with seven deputy registrars/practice managers and one with nine pharmacy inspectors. Five themes were identified, including (1) defining QRE reporting and compliance, (2) navigating role conflict, (3) educating for enhanced QRE reporting and learning, (4) promoting the positive/removing the fear of QREs, and (5) tailoring QRE reporting and learning consistency. Conclusions Overall, participants perceived a strong role for PRAs in enhancing QRE reporting and learning and providing education for pharmacies to support their compliance with reporting standards. However, PRAs must navigate the conflict inherent in both educating and promoting a process for achieving a standard while simultaneously inspecting compliance to that standard. Ensuring pharmacies have autonomy in operationalizing standards may help to mitigate this conflict. Finally, greater education for PRAs themselves to better inspect compliance and in order to better communicate the benefits of QRE reporting and learning to pharmacies would be beneficial. PMID:23830506

Bringing central line-associated bloodstream infection prevention home: CLABSI definitions and prevention policies in home health care agencies.

PubMed

Rinke, Michael L; Bundy, David G; Milstone, Aaron M; Deuber, Kristin; Chen, Allen R; Colantuoni, Elizabeth; Miller, Marlene R

2013-08-01

A study was conducted to investigate health care agency central line-associated bloodstream infection (CLABSI) definitions and prevention policies and pare them to the Joint Commission National Patient Safety Goal (NPSG.07.04.01), the Centers for Disease Control and Prevention (CDC) CLABSI prevention recommendations, and a best-practice central line care bundle for inpatients. A telephone-based survey was conducted in 2011 of a convenience sample of home health care agencies associated with children's hematology/oncology centers. Of the 97 eligible home health care agencies, 57 (59%) completed the survey. No agency reported using all five aspects of the National Healthcare and Safety Network/Association for Professionals in Infection Control and Epidemiology CLABSI definition and adjudication process, and of the 50 agencies that reported tracking CLABSI rates, 20 (40%) reported using none. Only 10 agencies (18%) had policies consistent with all elements of the inpatient-focused NPSG.07.04.01, 10 agencies (18%) were consistent with all elements of the home care targeted CDC CLABSI prevention recommendations, and no agencies were consistent with all elements of the central line care bundle. Only 14 agencies (25%) knew their overall CLABSI rate: mean 0.40 CLABSIs per 1,000 central line days (95% confidence interval [CI], 0.18 to 0.61). Six agencies (11%) knew their agency's pediatric CLABSI rate: mean 0.54 CLABSIs per 1,000 central line days (95% CI, 0.06 to 1.01). The policies of a national sample of home health care agencies varied significantly from national inpatient and home health care agency targeted standards for CLABSI definitions and prevention. Future research should assess strategies for standardizing home health care practices consistent with evidence-based recommendations.

Reported use of evidence in clinical practice: a survey of rehabilitation practices in Norway.

PubMed

Moore, Jennifer L; Friis, Svein; Graham, Ian D; Gundersen, Elisabeth Troøyen; Nordvik, Jan E

2018-05-25

The South Eastern Health Region in Norway serves approximately 2.8 million people, which is more than half of Norway's population. Physical medicine and rehabilitation services are provided by 9 public hospital trusts and 30 private rehabilitation facilities. The purposes of this study were to conduct a psychometric analysis of the EBP Implementation Scale (EBPIS) and describe rehabilitation clinicians' self-reported 1) use of evidence-based practices (EBPs), 2) use of EBPs across hospitals, and 3) determine factors associated with use of EBPs in the South Eastern Health Region in Norway. A cross-sectional study using an online survey was conducted with public hospitals and private rehabilitation centers. The survey, which was distributed throughout the region, included the EBPIS, 8 questions related to EBP in the health region, and demographics. Response frequencies were calculated and described. Internal consistency and factor structure of the EBPIS and its subscales were determined. Associations and differences in groups with similar demographics, EBPIS scores, and use of EBPs were identified. A total of 316 individuals completed the survey, including allied health clinicians, nurses, psychologists, social workers, and physicians. The EBPIS mean score was 30/72. A factor analysis identified that the EBPIS can be divided into 3 subscales: literature search and critical appraisal (α = .80), knowledge sharing (α = .83), and practice evaluation (α = .74). EBP activities reported were primarily related to literature searches, critical appraisal, and discussing evidence. Approximately 65 and 75% of respondents agreed that the same OMs and evidence based interventions were used within the local clinic respectively. Fewer agreed that the same OMs (13%) and evidence-based interventions (39%) are used regionally. The EBPIS and its subscales demonstrated excellent internal consistency. Practice variability exists in rehabilitation throughout Southeastern Norway. An increased emphasis on use of EBP throughout the region is needed.

Validation of the Korean Version of the Breast Cancer Screening Beliefs Questionnaire.

PubMed

Kwok, Cannas; Lee, Mi-Joung; Lee, Chun Fan

Korean immigrant women have been consistently reported as having low participation in breast cancer screening practices. A valid and reliable instrument to explore factors that affect their cancer screening behaviors is essential. The aim of this study was to report the psychometric properties of the Korean version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). A convenience sample of 249 Korean Australian women was recruited through a number of Korean community organizations in Sydney. Exploratory factor analysis supports a similar fit for the original 3-factor structure of our data set. A significant association was found between the attitudes of these women toward general health checkups and the frequency of their performance of the breast awareness practices and having mammograms. Furthermore, it was found that knowledge and perceptions about the breast cancer scales were significantly associated with education level and that barriers to mammographic screening were much less evident among women who engaged in the 3 screening practices. The results indicated that the Korean version of the BCSBQ had satisfactory validity and internal consistency. The Cronbach's α of the 3 subscales ranged between .80 and .88. The Korean version of the BCSBQ was confirmed to be a culturally appropriate, valid, and reliable instrument for assessing the beliefs, knowledge, and attitudes to breast cancer and breast cancer screening practices among women of Korean background living in Australia. The Korean version of the BCBSQ can provide nurses with insights into the development of culturally sensitive breast health education programs.

Salmonella Knowledge, Attitudes and Practices: A Survey of Backyard Poultry Owners Residing in Seattle, Washington and the Surrounding Metropolitan Area.

PubMed

Kauber, K; Fowler, H; Lipton, B; Meschke, J S; Rabinowitz, P

2017-02-01

Raising poultry flocks in urban backyard settings is becoming increasingly popular across the United States, but carries a risk of zoonotic infection. In the United States from 1990 to 2014, 53 outbreaks of human salmonellosis linked to live poultry have been documented resulting in 2611 known illnesses, 387 known hospitalizations and five known deaths (Centers for Disease Control and Prevention 2015a, http://www.cdc.gov/healthypets/resources/dont-play-chicken-with-your-health-poster-24x36_508.pdf). A cross-sectional descriptive study was developed to better understand knowledge, attitudes and practices of urban backyard poultry owners regarding Salmonella risk and prevention. The study included a survey of bird health, animal husbandry and hygiene practices, and knowledge, attitudes and practices relating to Salmonella risk. Participants were videotaped while caring for their birds, and the recordings were transcribed using notational analysis to determine whether reported practices differed from observed practices. The results indicated that while a large proportion of participants knew that exposure to Salmonella is an inherent risk associated with raising poultry and harvesting eggs, their reported and observed practices would not consistently reduce risk of transmission of Salmonella and other zoonotic diseases. Approximately one in four participants reported performing practices that increase risk of inoculation, such as snuggling and kissing birds or eating/drinking near them. None of the participants were observed kissing their birds on video; however, snuggling (holding birds to clothes) or touching their face during routine care was observed in approximately two-thirds of the video recordings. The video data provided a unique opportunity to compare reported practices with actions recorded during site visits. While the differences were not statistically significant, findings from our study suggest that flock owners may not accurately report the frequency with which risky practices are performed during routine animal care. Education and outreach targeting backyard flock owners should aim to improve husbandry and hygiene practices and reduce risk of zoonotic diseases associated with raising poultry in the backyard setting. © 2016 Blackwell Verlag GmbH.

From SOPs to Reports to Evaluations: Learning and Memory ...

EPA Pesticide Factsheets

In an era of global trade and regulatory cooperation, consistent and scientifically based interpretation of developmental neurotoxicity (DNT) studies is essential. Because there is flexibility in the selection of test method(s), consistency can be especially challenging for learning and memory tests required by EPA and OECD DNT guidelines (chemicals and pesticides) and recommended for ICH prenatal/postnatal guidelines (pharmaceuticals). A well­ reasoned uniform approach is particularly important for variable endpoints and if non-standard tests are used. An understanding of the purpose behind the tests and expected outcomes is critical, and attention to elements of experimental design, conduct, and reporting can improve study design by the investigator as well as accuracy and consistency of interpretation by evaluators. This understanding also directs which information must be clearly described in study reports. While missing information may be available in standardized operating procedures (SOPs), if not clearly reflected in report submissions there may be questions and misunderstandings by evaluators which could impact risk assessments. A practical example will be presented to provide insights into important variables and reporting approaches. Cognitive functions most often tested in guidelines studies include associative, positional, sequential, and spatial learning and memory in weanling and adult animals. These complex behaviors tap different bra

Instrument development, data collection, and characteristics of practices, staff, and measures in the Improving Quality of Care in Diabetes (iQuaD) Study.

PubMed

Eccles, Martin P; Hrisos, Susan; Francis, Jill J; Stamp, Elaine; Johnston, Marie; Hawthorne, Gillian; Steen, Nick; Grimshaw, Jeremy M; Elovainio, Marko; Presseau, Justin; Hunter, Margaret

2011-06-09

Type 2 diabetes is an increasingly prevalent chronic illness and an important cause of avoidable mortality. Patients are managed by the integrated activities of clinical and non-clinical members of primary care teams. This study aimed to: investigate theoretically-based organisational, team, and individual factors determining the multiple behaviours needed to manage diabetes; and identify multilevel determinants of different diabetes management behaviours and potential interventions to improve them. This paper describes the instrument development, study recruitment, characteristics of the study participating practices and their constituent healthcare professionals and administrative staff and reports descriptive analyses of the data collected. The study was a predictive study over a 12-month period. Practices (N = 99) were recruited from within the UK Medical Research Council General Practice Research Framework. We identified six behaviours chosen to cover a range of clinical activities (prescribing, non-prescribing), reflect decisions that were not necessarily straightforward (controlling blood pressure that was above target despite other drug treatment), and reflect recommended best practice as described by national guidelines. Practice attributes and a wide range of individually reported measures were assessed at baseline; measures of clinical outcome were collected over the ensuing 12 months, and a number of proxy measures of behaviour were collected at baseline and at 12 months. Data were collected by telephone interview, postal questionnaire (organisational and clinical) to practice staff, postal questionnaire to patients, and by computer data extraction query. All 99 practices completed a telephone interview and responded to baseline questionnaires. The organisational questionnaire was completed by 931/1236 (75.3%) administrative staff, 423/529 (80.0%) primary care doctors, and 255/314 (81.2%) nurses. Clinical questionnaires were completed by 326/361 (90.3%) primary care doctors and 163/186 (87.6%) nurses. At a practice level, we achieved response rates of 100% from clinicians in 40 practices and > 80% from clinicians in 67 practices. All measures had satisfactory internal consistency (alpha coefficient range from 0.61 to 0.97; Pearson correlation coefficient (two item measures) 0.32 to 0.81); scores were generally consistent with good practice. Measures of behaviour showed relatively high rates of performance of the six behaviours, but with considerable variability within and across the behaviours and measures. We have assembled an unparalleled data set from clinicians reporting on their cognitions in relation to the performance of six clinical behaviours involved in the management of people with one chronic disease (diabetes mellitus), using a range of organisational and individual level measures as well as information on the structure of the practice teams and across a large number of UK primary care practices. We would welcome approaches from other researchers to collaborate on the analysis of this data.

Personal values of family physicians, practice satisfaction, and service to the underserved.

PubMed

Eliason, B C; Guse, C; Gottlieb, M S

2000-03-01

Personal values are defined as "desirable goals varying in importance that serve as guiding principles in people's lives," and have been shown to influence specialty choice and relate to practice satisfaction. We wished to examine further the relationship of personal values to practice satisfaction and also to a physician's willingness to care for the underserved. We also wished to study associations that might exist among personal values, practice satisfaction, and a variety of practice characteristics. We randomly surveyed a stratified probability sample of 1224 practicing family physicians about their personal values (using the Schwartz values questionnaire), practice satisfaction, practice location, breadth of practice, demographics, board certification status, teaching involvement, and the payor mix of the practice. Family physicians rated the benevolence (motivation to help those close to you) value type highest, and the ratings of the benevolence value type were positively associated with practice satisfaction (correlation coefficient = 0.14, P = .002). Those involved in teaching medical trainees were more satisfied than those who were not involved (P = .009). Some value-type ratings were found to be positively associated with caring for the underserved. Those whose practices consisted of more than 40% underserved (underserved defined as Medicare, Medicaid, and indigent populations) rated the tradition (motivation to maintain customs of traditional culture and religion) value type significantly higher (P = .02). Those whose practices consisted of more than 30% indigent care rated the universalism (motivation to enhance and protect the well-being of all people) value type significantly higher (P = .03). Family physicians who viewed benevolence as a guiding principle in their lives reported a higher level of professional satisfaction. Likewise, physicians involved in the teaching of medical trainees were more satisfied with their profession. Family physicians who rate the universalism values highly are more likely to provide care to the indigent.

Traffic management centers : the state-of-the-practice : task A : final working paper for design of support systems for advanced traffic management systems

DOT National Transportation Integrated Search

1999-02-01

The goal of the Federal Highway Administration (FHWA) Expert Systems for Crash Data Collection Program was to use expert system technology to improve the accuracy and consistency of police-reported data. The program included the development and evalu...

The Portable Patient Problem Pack: A Problem-Based Learning Unit

ERIC Educational Resources Information Center

Barrows, Howard S.; Tamblyn, Robyn M.

1977-01-01

The Portable Patient Problem Pack (P4), a method of simulating a patient's problem in a card deck format, is designed to develop the student's problem-solving or diagnostic skills in a manner consistent with the skills of the practicing clinician. Its effectiveness at McMaster University is reported. (LBH)

Teacher Control over Interagency Collaboration: A Roadblock for Effective Transitioning of Youth with Disabilities

ERIC Educational Resources Information Center

Meadows, Denis; Davies, Michael; Beamish, Wendi

2014-01-01

Poor post-school outcomes for youth with disabilities have consistently been reported internationally. Interagency collaboration between school systems and post-school services is critical and key to improving post-school life for these youth. An initial Queensland study that benchmarked the teacher practice of 104 transition teachers and…

[A case report on mobbing in a school child].

PubMed

Holtz, S

2012-08-01

Forty percent of the work of a paediatrician in private practice consists of counselling parents and children. There is a danger that behavioural symptoms are not taken seriously and brushed away with simple advices. This case vignette demonstrates that difficult and complex symptoms can be solved by using a concept-oriented approach.

Psychosocial Risk Factors for Upper Respiratory Infections: Assessment of Upper Respiratory Illness during Basic Training

DTIC Science & Technology

1988-05-23

association was low enough to ensure that the URI composite was not merely an index of somatic stress reactions or hypochondriasis . The eight-item...report somatic symptoms in response to stress. Adjusted URI Severity also is consistent with the clinical practice of ruling out other possible types

Male and Female Superintendents: A Comparison of Differences in Salaries, Interview Experiences, and Contract Negotiations

ERIC Educational Resources Information Center

Long, Alan

2010-01-01

This study reports the results of a comparison of differences in salary, interview experiences, and contract negotiations for male and female superintendents. Other variables of interest include educational attainment and educational experiences. The study participants (N = 161) consisted of practicing superintendents from four regions of the…

Statewide traffic safety study phase I : review of current traffic safety research, practice, analytical procedures, and databases [technical summary report].

DOT National Transportation Integrated Search

2008-03-01

In the last decade, Louisianas traffic related fatality rate has consistently put Louisiana within the : top eight highest ranking states in the nation with regard to such; in 2001, Louisiana tied with : Montana and South Carolina as states with t...

Of Tilting Earths, Ruler Swans, and Fighting Mosquitoes: First Graders Writing Nonfiction

ERIC Educational Resources Information Center

Wilson, Melissa I.

2012-01-01

Using discourse analysis methodology, this dissertation describes the literacy practices of first grade students as they engaged in researching, writing and illustrating nonfiction. The research focused on two instructional units on writing nonfiction that included a poster unit and a research report unit. The data consisted of 27 days of video…

Discovering the Literacy Gap: A Systematic Review of Reading and Writing Theories in Research

ERIC Educational Resources Information Center

Hodges, Tracey S.; Feng, Luxi; Kuo, Li-Jen; McTigue, Erin

2016-01-01

Research is failing to consistently report theoretical frameworks, increasing the gap between research and practice, and increasing the difficulty teachers face in effectively matching interventions with student needs. However, this lack of theoretical understanding has not been well documented in the current literature. The purpose of this…

7 CFR 800.75 - Kinds of official inspection and weighing services.

Code of Federal Regulations, 2012 CFR

2012-01-01

... carrier or container is clean; dry; free of infestation, rodents, toxic substances, and foreign odor; and... containers loaded aboard a carrier; and (3) if practicable, sealing the carrier for security. (k) Test weight... Report of Test. (l) Railroad track scale testing service. This service consists of official personnel (1...

7 CFR 800.75 - Kinds of official inspection and weighing services.

Code of Federal Regulations, 2011 CFR

2011-01-01

... carrier or container is clean; dry; free of infestation, rodents, toxic substances, and foreign odor; and... containers loaded aboard a carrier; and (3) if practicable, sealing the carrier for security. (k) Test weight... Report of Test. (l) Railroad track scale testing service. This service consists of official personnel (1...

7 CFR 800.75 - Kinds of official inspection and weighing services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... carrier or container is clean; dry; free of infestation, rodents, toxic substances, and foreign odor; and... containers loaded aboard a carrier; and (3) if practicable, sealing the carrier for security. (k) Test weight... Report of Test. (l) Railroad track scale testing service. This service consists of official personnel (1...

7 CFR 800.75 - Kinds of official inspection and weighing services.

Code of Federal Regulations, 2013 CFR

2013-01-01

... carrier or container is clean; dry; free of infestation, rodents, toxic substances, and foreign odor; and... containers loaded aboard a carrier; and (3) if practicable, sealing the carrier for security. (k) Test weight... Report of Test. (l) Railroad track scale testing service. This service consists of official personnel (1...

7 CFR 800.75 - Kinds of official inspection and weighing services.

Code of Federal Regulations, 2014 CFR

2014-01-01

... carrier or container is clean; dry; free of infestation, rodents, toxic substances, and foreign odor; and... containers loaded aboard a carrier; and (3) if practicable, sealing the carrier for security. (k) Test weight... Report of Test. (l) Railroad track scale testing service. This service consists of official personnel (1...

A Media Policies Handbook for Rosholt Public Schools.

ERIC Educational Resources Information Center

Adams, Helen R.

Policies and guidelines designed to provide media program consistency and continuity in the Rosholt School District (Wisconsin) are presented together with a report on a study conducted to determine policies conducive to good media practice. Each of the ten policy statements follows a review of the literature especially pertinent to that area.…

Lessons from Research: The Quality of Professional Learning Will Influence Its Results

ERIC Educational Resources Information Center

Killion, Joellen

2014-01-01

Joellen Killion reports on the results of a five-year professional development intervention consisting of workshops and curriculum units conducted in six elementary schools in an urban district to gauge teacher knowledge and practices in science instruction for English language learners. The study looked at predictors of teacher change that…

Drugs Used for Parenteral Sedation in Dental Practice

PubMed Central

Dionne, Raymond A.; Gift, Helen C.

1988-01-01

The relative efficacy and safety of drugs and combinations used clinically in dentistry as premedicants to alleviate patient apprehension are largely unsubstantiated. To evaluate the efficacy and safety of agents used for parenteral sedation through controlled clinical trials, it is first necessary to identify which drugs, doses, and routes of administration are actually used in practice. A survey instrument was developed to characterize the drugs used clinically for anesthesia and sedation by dentists with advanced training in pain control. A random sample of 500 dentists who frequently use anesthesia and sedation in practice was selected from the Fellows of the American Dental Society of Anesthesiology. The first mailing was followed by a second mailing to nonrespondents after 30 days. The respondents report a variety of parenteral sedation techniques in combination with local anesthesia (the response categories are not mutually exclusive): nitrous oxide (64%), intravenous conscious sedation (59%), intravenous “deep” sedation (47%), and outpatient general anesthesia (27%). Drugs most commonly reported for intravenous sedation include diazepam, methohexital, midazolam, and combinations of these drugs with narcotics. A total of 82 distinct drugs and combinations was reported for intravenous sedation and anesthesia. Oral premedication and intramuscular sedation are rarely used by this group. Most general anesthesia reported is done on an outpatient basis in private practice. These results indicate that a wide variety of drugs is employed for parenteral sedation in dental practice, but the most common practice among dentists with advanced training in anesthesia is local anesthesia supplemented with intravenous sedation consisting of a benzodiazepine and an opioid or a barbiturate. PMID:3250279

Creating a Toolkit to Reduce Disparities in Patient Engagement.

PubMed

Keddem, Shimrit; Agha, Aneeza Z; Long, Judith A; Werner, Rachel M; Shea, Judy A

2017-09-01

Patient engagement has become a major focus of health care improvement efforts nationally. Although evidence suggests patient engagement can be beneficial to patients, it has not been consistently defined, operationalized, or translated into practice. Our objective was to develop a toolkit to help providers increase patient engagement and reduce disparities in patient engagement. We used qualitative interviews and observations with staff at primary care sites nationally to identify patient engagement practices and resources used to engage patients. We then used a modified Delphi process, that included a series of conference calls and surveys, where stakeholders reduced lists of engagement practices based on perceived feasibility and importance to develop a toolkit for patient engagement. Sites were selected for interviews and site visits based on the concentration of minority patients served and performance on a measure of patient engagement, with the goal of highlighting practices at sites that successfully serve minority patients. We created a toolkit consisting of patient engagement practices and resources. No identified practice or resource specifically targeted patient engagement of minorities or addressed disparities. However, high-performing, high-minority-serving sites tended to describe more staff training opportunities and staff feedback mechanisms. In addition, low-performing and high-minority-serving sites more often reported barriers to implementation of patient engagement practices. Stakeholders agreed on feasible and important engagement practices. Implementation of this toolkit will be tracked to better understand patient engagement and its effect on patient-centered care and related disparities in care.

Surveying the Knowledge and Practices of Health Professionals in China, India, Iran, and Mexico on Treating Tuberculosis.

PubMed

Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Randhawa, Harkanwal; Becerra-Posada, Francisco; Dejman, Masoumeh; Falahat, Katayoun; Malek-Afzali, Hossein; Ramachandran, Parasurama; Shi, Guang; Yesudian, C A K

2016-05-04

Research evidence continues to reveal findings important for health professionals' clinical practices, yet it is not consistently disseminated to those who can use it. The resulting deficits in knowledge and service provision may be especially pronounced in low- and middle-income countries that have greater resource constraints. Tuberculosis treatment is an important area for assessing professionals' knowledge and practices because of the effectiveness of existing treatments and recognized gaps in professionals' knowledge about treatment. This study surveyed 384 health professionals in China, India, Iran, and Mexico on their knowledge and practices related to tuberculosis treatment. Few respondents correctly answered all five knowledge questions (12%) or self-reported performing all five recommended clinical practices "often or very often" (3%). Factors associated with higher knowledge scores included clinical specialization and working with researchers. Factors associated with better practices included training in the care of tuberculosis patients, being based in a hospital, trusting systematic reviews of randomized controlled double-blind trials, and reading summaries of articles, reports, and reviews. This study highlights several strategies that may prove effective in improving health professionals' knowledge and practices related to tuberculosis treatment. Facilitating interactions with researchers and training in acquiring systematic reviews may be especially helpful. © The American Society of Tropical Medicine and Hygiene.

Surveying the Knowledge and Practices of Health Professionals in China, India, Iran, and Mexico on Treating Tuberculosis

PubMed Central

Hoffman, Steven J.; Guindon, G. Emmanuel; Lavis, John N.; Randhawa, Harkanwal; Becerra-Posada, Francisco; Dejman, Masoumeh; Falahat, Katayoun; Malek-Afzali, Hossein; Ramachandran, Parasurama; Shi, Guang; Yesudian, C. A. K.

2016-01-01

Research evidence continues to reveal findings important for health professionals' clinical practices, yet it is not consistently disseminated to those who can use it. The resulting deficits in knowledge and service provision may be especially pronounced in low- and middle-income countries that have greater resource constraints. Tuberculosis treatment is an important area for assessing professionals' knowledge and practices because of the effectiveness of existing treatments and recognized gaps in professionals' knowledge about treatment. This study surveyed 384 health professionals in China, India, Iran, and Mexico on their knowledge and practices related to tuberculosis treatment. Few respondents correctly answered all five knowledge questions (12%) or self-reported performing all five recommended clinical practices “often or very often” (3%). Factors associated with higher knowledge scores included clinical specialization and working with researchers. Factors associated with better practices included training in the care of tuberculosis patients, being based in a hospital, trusting systematic reviews of randomized controlled double-blind trials, and reading summaries of articles, reports, and reviews. This study highlights several strategies that may prove effective in improving health professionals' knowledge and practices related to tuberculosis treatment. Facilitating interactions with researchers and training in acquiring systematic reviews may be especially helpful. PMID:26903613

Treatment outcomes in 4 modes of orthodontic practice.

PubMed

Poulton, Donald; Vlaskalic, Vicki; Baumrind, Sheldon

2005-03-01

This study is a continuation of a previously published report on the outcome of orthodontic treatment provided in offices representing different modes of practice. The sample consisted of duplicate pretreatment (T1) and posttreatment (T2) dental casts of 348 patients from traditional private orthodontic practices (5 offices, 134 patients), company-owned practices (5 offices, 107 patients), offices associated with practice-management organizations (2 offices, 60 patients), and general dental practices (2 offices, 47 patients). Methods were used to obtain random, representative samples from each office, starting with lists of patients who were treated consecutively with full fixed orthodontic appliances. The dental casts were measured by 2 independent judges who used the unweighted PAR score. Good interjudge agreement was shown on the initial casts, but the agreement was not as strong on the final casts. The measurements showed that treatment outcomes were generally satisfactory, although some significant differences between offices and management modes were shown.

Impact of an Event Reporting System on Resident Complication Reporting in Plastic Surgery Training: Addressing an ACGME and Plastic Surgery Milestone Project Core Competency.

PubMed

Parikh, Rajiv P; Snyder-Warwick, Alison; Naidoo, Sybill; Skolnick, Gary B; Patel, Kamlesh B

2017-11-01

The Accreditation Council for Graduate Medical Education and Plastic Surgery Milestone Project has identified practice-based learning and improvement, which involves systematically analyzing current practices and implementing changes, as a core competency in residency education. In surgical care, complication reporting is an essential component of practice-based learning and improvement as complications are analyzed in morbidity and mortality conference for quality improvement. Unfortunately, current methods for capturing a comprehensive profile of complications may significantly underestimate the true occurrence of complications. Therefore, the objectives of this study are to evaluate an intervention for complication reporting and compare this to current practice, in a plastic surgery training program. This is a preintervention and postintervention study evaluating resident reporting of complications on a plastic surgery service. The intervention was an online event reporting system developed by department leadership and patient safety experts. The cohorts consisted of all patients undergoing surgery during two separate 3-month blocks bridged by an implementation period. A trained reviewer recorded complications, and this served as the reference standard. Fisher's exact test was used for binary comparisons. There were 32 complications detected in 219 patients from June to August of 2015 and 35 complications in 202 patients from October to December of 2015. The proportion of complications reported in the preintervention group was nine of 32 (28.1 percent). After the intervention, this significantly increased to 32 of 35 (91.4 percent) (p < 0.001). An intervention using an event reporting system, supported by departmental leadership, led to significant improvements in complication reporting by plastic surgery residents.

Prevalence and Significance of Unrecognized Lower Extremity Peripheral Arterial Disease in General Medicine Practice

PubMed Central

McGrae McDermott, Mary; Kerwin, Diana R; Liu, Kiang; Martin, Gary J; O'Brien, Erin; Kaplan, Heather; Greenland, Philip

2001-01-01

OBJECTIVE To determine the prevalence of unrecognized lower extremity peripheral arterial disease (PAD) among men and women aged 55 years and older in a general internal medicine (GIM) practice and to identify characteristics and functional performance associated with unrecognized PAD. DESIGN Cross-sectional. SETTING Academic medical center. PARTICIPANTS We identified 143 patients with known PAD from the noninvasive vascular laboratory, and 239 men and women aged 55 and older with no prior PAD history from a GIM practice. Group 1 consisted of patients with PAD consecutively identified from the noninvasive vascular laboratory (n = 143). Group 2 included GIM practice patients found to have an ankle brachial index less than 0.90, consistent with PAD (n = 34). Group 3 consisted of GIM practice patients without PAD (n = 205). MEASUREMENTS AND MAIN RESULTS Leg functioning was assessed with the 6-minute walk, 4-meter walking velocity, and Walking Impairment Questionnaire (WIQ). Of GIM practice patients, 14% had unrecognized PAD. Only 44% of patients in Group 2 had exertional leg symptoms. Distances achieved in the 6-minute walk were 1,130, 1,362, and 1,539 feet for Groups 1, 2, and 3, respectively, adjusting for age, gender, and race (P < .001). The degree of difficulty walking due to leg symptoms as reported on the WIQ was comparable between Groups 2 and 3 and significantly greater in Group 1 than Group 2. In multiple logistic regression analysis including Groups 2 and 3, current cigarette smoking was associated independently with unrecognized PAD (odds ratio [OR], 6.82; 95% confidence interval [95% CI], 1.55 to 29.93). Aspirin therapy was nearly independently associated with absence of PAD (OR, 0.37; 95% CI, 0.12 to 1.12). CONCLUSION Unrecognized PAD is common among men and women aged 55 years and older in GIM practice and is associated with impaired lower extremity functioning. Ankle brachial index screening may be necessary to diagnose unrecognized PAD in a GIM practice. PMID:11422635

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

PubMed

Buckley, Thomas A; Burdette, Glenn; Kelly, Kassandra

2015-08-01

The National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited. To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers. Cross-sectional study. Web-based questionnaire. A total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions. The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination. Most respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%, n = 473; Division III = 76.0%, n = 467) and determination of recovery (Division II = 65.0%, n = 194; Division III = 63.1%, n = 288) but not at baseline (Division II = 43.1%, n = 122; Division III = 41.0%, n = 176). Typically, when a postconcussion assessment was initiated, testing occurred daily until baseline values were achieved, and most respondents (80.6% [244/278]) reported using a graded exercise protocol before return to participation. We found limited use of the multifaceted assessment battery at baseline but higher rates at both acute assessment and return-to-participation time points. A primary reason cited for not using test-battery components was a lack of staffing or funding for the assessments. We observed limited use of neuropsychologists to interpret neuropsychological testing. Otherwise, most respondents reported concussion-management protocols consistent with recommendations, including a high level of use of objective measures and incorporation of a progressive return-to-participation protocol.

Refeeding syndrome or refeeding hypophosphatemia: a systematic review of cases.

PubMed

Skipper, Annalynn

2012-02-01

Nutrition support clinicians refer to the abnormalities in laboratory data and changes in clinical signs and symptoms that follow refeeding of starved or malnourished patients as refeeding syndrome. Theoretical descriptions of refeeding syndrome include a complex and extensive list of changes, such as hypophosphatemia, hypomagnesemia, hypokalemia, hyponatremia, hypocalcemia, hyperglycemia, and vitamin deficiency--all of which are accompanied by clinical signs and symptoms. In practice, clinicians see asymptomatic refeeding hypophosphatemia more often than a full-blown syndrome with multiple laboratory and clinical abnormalities. Confusion results because there is no widely accepted or uniformly applied set of defining characteristics for diagnosing refeeding syndrome. To gain insight into the clinical characteristics of refeeding syndrome described in the literature, a systematic review of reported cases and case series was conducted. Since 2000, 20 authors described 27 cases that contained sufficient data for review. Hypophosphatemia occurred in 26 patients (96%). While 19 patients (71%) experienced at least 1 other laboratory abnormality, only 14 (51%) exhibited a consistent pattern of abnormally low phosphorus and magnesium levels. Seven patients had hypocalcemia (26%), and hyponatremia was reported in 3 patients (11%). There were no reports of hyperglycemia. Mean data reported in case series containing data from 63 patients showed that hypophosphatemia was a consistent finding but that other abnormalities were not consistently identified. Findings suggest that refeeding hypophosphatemia is not accompanied by a consistent pattern of biochemical or clinical abnormalities among case reports or case series of patients reported to have refeeding syndrome.

Exploring the role of organizational policies and procedures in promoting research utilization in registered nurses

PubMed Central

Squires, Janet E; Moralejo, Donna; LeFort, Sandra M

2007-01-01

Background Policies and procedures (P&Ps) have been suggested as one possible strategy for moving research evidence into practice among nursing staff in hospitals. Research in the area of P&Ps is limited, however. This paper explores: 1) nurses' use of eight specific research-based practices (RBPs) and RBP overall, 2) nurses' use and understanding of P&Ps, and 3) the role of P&Ps in promoting research utilization. Methods Staff nurses from the eight health regions governing acute care services across the Canadian province of Newfoundland and Labrador completed an anonymous questionnaire regarding their use of eight RBPs and associated P&Ps. Data were also obtained from authorities in six of the eight regions about existing relevant P&Ps. We used descriptive statistics and multivariate regression analysis to assess the relationship between key independent variables and self-reported use of RBP. Results Use of the eight RBPs ranged from 7.8% to 88.6%, depending on the practice. Nurses ranked P&P manuals as their number one source of practice knowledge. Most respondents (84.8%) reported that the main reason they consult the P&P manual is to confirm they are practicing according to agency rules. Multivariate regression analysis identified three significant predictors of being a user versus non-user of RBP overall: awareness, awareness by regular use, and persuasion. Six significant predictors of being a consistent versus less consistent user of RBP overall were also identified: perception of P&P existence, unit, nursing experience, personal experience as a source of practice knowledge, number of existing research-based P&Ps, and lack of time as a barrier to consulting P&P manuals. Conclusion Findings suggest that nurses use P&Ps to guide their practice. However, the mere existence of P&Ps is not sufficient to translate research into nursing practice. Individual and organizational factors related to nurses' understanding and use of P&Ps also play key roles. Thus, moving research evidence into practice will require careful interplay between the organization and the individual. P&Ps may be the interface through which this occurs. PMID:17550597

Conflicts in the Doctor/Patient Relationship: A Short Research Report

PubMed Central

Warner, Morton M.

1975-01-01

The data for this paper come from the study initiated by the Lay Advisory and Research Committees of the British Columbia Chapter, College of Family Physicians of Canada. It recognizes that the practice of family medicine cannot exist without clients and that those clients will often have markedly different ideas about what they want and expect from those supposedly held by the professionals they consult. Thus a system operates in which representatives of the medical profession practice in local communities of prospective clients.1 Practitioners claim that their skills are so esoteric that the patient is in no position to evaluate them; this is described as the prerogative of his peers. But the practitioner will be evaluated by the patient, albeit on an unprofessional basis with non-professional criteria. Hence, practice may consist of an interaction between two different and sometimes conflicting sets of norms.2 A full report, “Family Medicine in a Consumer Age”, pp. 245 is available from the author for $7.50 (prepaid). This present paper summarizes a small portion of the major report.

Disability management practices in education, hotel/motel, and health care workplaces.

PubMed

Williams, Renee M; Westmorland, Muriel G; Shannon, Harry S; Rasheed, Farah; Amick, Benjamin C

2005-03-01

The high costs and the impact of work disability have become a growing concern for workplaces. As a result, workplace disability management approaches have been developed to lower disability costs, protect the employability of workers, and promote early return to work. A stratified random sample of 455 employers in education (n = 157), hotel/motel (n = 110), and health care (n = 188) sectors who completed a mailed Organizational Policies and Practices (OPP) questionnaire is reported. The OPP questionnaire asked questions about eight workplace disability management practices. The article examined the multi-dimensionality, internal consistency, and discriminant validity of the OPP and compares disability management practices across the three sectors. The OPP questionnaire showed good internal consistency (Cronbach's alpha = 0.95) and discriminant validity. A one-way analysis of variance (ANOVA) for each of the eight subscales demonstrated that there were statistically significant differences between the sectors in ergonomic practices (F (2,452) = 15.8, P < 0.001), disability case management (F (2,452) = 4.6, P < 0.01), return to work (F (2,452) = 10.3, P < 0.001), and people-oriented culture (F (2,452) = 4.5, P < 0.01). On examining disability management practices in education, hotel/motel, and health care sectors, the OPP seems to be a promising instrument that can be used to assess and monitor how employers are managing disability.

Oncology practice trends from the national practice benchmark.

PubMed

Barr, Thomas R; Towle, Elaine L

2012-09-01

In 2011, we made predictions on the basis of data from the National Practice Benchmark (NPB) reports from 2005 through 2010. With the new 2011 data in hand, we have revised last year's predictions and projected for the next 3 years. In addition, we make some new predictions that will be tracked in future benchmarking surveys. We also outline a conceptual framework for contemplating these data based on an ecological model of the oncology delivery system. The 2011 NPB data are consistent with last year's prediction of a decrease in the operating margins necessary to sustain a community oncology practice. With the new data in, we now predict these reductions to occur more slowly than previously forecast. We note an ease to the squeeze observed in last year's trend analysis, which will allow more time for practices to adapt their business models for survival and offer the best of these practices an opportunity to invest earnings into operations to prepare for the inevitable shift away from historic payment methodology for clinical service. This year, survey respondents reported changes in business structure, first measured in the 2010 data, indicating an increase in the percentage of respondents who believe that change is coming soon, but the majority still have confidence in the viability of their existing business structure. Although oncology practices are in for a bumpy ride, things are looking less dire this year for practices participating in our survey.

Computer use in primary care practices in Canada

PubMed Central

Anisimowicz, Yvonne; Bowes, Andrea E.; Thompson, Ashley E.; Miedema, Baukje; Hogg, William E.; Wong, Sabrina T.; Katz, Alan; Burge, Fred; Aubrey-Bassler, Kris; Yelland, Gregory S.; Wodchis, Walter P.

2017-01-01

Abstract Objective To examine the use of computers in primary care practices. Design The international Quality and Cost of Primary Care study was conducted in Canada in 2013 and 2014 using a descriptive cross-sectional survey method to collect data from practices across Canada. Participating practices filled out several surveys, one of them being the Family Physician Survey, from which this study collected its data. Setting All 10 Canadian provinces. Participants A total of 788 family physicians. Main outcome measures A computer use scale measured the extent to which family physicians integrated computers into their practices, with higher scores indicating a greater integration of computer use in practice. Analyses included t tests and 2 tests comparing new and traditional models of primary care on measures of computer use and electronic health record (EHR) use, as well as descriptive statistics. Results Nearly all (97.5%) physicians reported using a computer in their practices, with moderately high computer use scale scores (mean [SD] score of 5.97 [2.96] out of 9), and many (65.7%) reported using EHRs. Physicians with practices operating under new models of primary care reported incorporating computers into their practices to a greater extent (mean [SD] score of 6.55 [2.64]) than physicians operating under traditional models did (mean [SD] score of 5.33 [3.15]; t726.60 = 5.84; P < .001; Cohen d = 0.42, 95% CI 0.808 to 1.627) and were more likely to report using EHRs (73.8% vs 56.7%; χ12=25.43; P < .001; odds ratio = 2.15). Overall, there was a statistically significant variability in computer use across provinces. Conclusion Most family physicians in Canada have incorporated computers into their practices for administrative and scholarly activities; however, EHRs have not been adopted consistently across the country. Physicians with practices operating under the new, more collaborative models of primary care use computers more comprehensively and are more likely to use EHRs than those in practices operating under traditional models of primary care. PMID:28500211

Reliability reporting across studies using the Buss Durkee Hostility Inventory.

PubMed

Vassar, Matt; Hale, William

2009-01-01

Empirical research on anger and hostility has pervaded the academic literature for more than 50 years. Accurate measurement of anger/hostility and subsequent interpretation of results requires that the instruments yield strong psychometric properties. For consistent measurement, reliability estimates must be calculated with each administration, because changes in sample characteristics may alter the scale's ability to generate reliable scores. Therefore, the present study was designed to address reliability reporting practices for a widely used anger assessment, the Buss Durkee Hostility Inventory (BDHI). Of the 250 published articles reviewed, 11.2% calculated and presented reliability estimates for the data at hand, 6.8% cited estimates from a previous study, and 77.1% made no mention of score reliability. Mean alpha estimates of scores for BDHI subscales generally fell below acceptable standards. Additionally, no detectable pattern was found between reporting practices and publication year or journal prestige. Areas for future research are also discussed.

Predicting the child-rearing practices of mothers sexually abused in childhood.

PubMed

Ruscio, A M

2001-03-01

Although empirical investigations have established a relationship between childhood sexual abuse and numerous long-term consequences, surprisingly little research has addressed the possible effects of childhood victimization on the later child-rearing practices of adult survivors. The present study examined hypothesized predictors of three parenting styles among adult survivors of sexual abuse as compared with adult children of alcoholic parents. Forty-five clinical outpatients completed a questionnaire battery assessing experiences of childhood abuse, current economic and social resources, and parenting attitudes and practices. The child-rearing practices of participants were compared with those reported by a community sample of 717 mothers. Additional analyses examined the extent to which sexual abuse and its adult sequelae predicted the parenting behaviors reported by the present sample. Both sexual abuse survivors and children of alcoholics reported significantly higher rates of permissive parenting practices than mothers in the community sample. Multiple regression analyses further revealed unique relationships between sexual abuse and parenting, over and above the variance explained by physical abuse, current socioeconomic status, and the experience of growing up in an alcoholic home. Mothers' sexual abuse severity, social support satisfaction, and dysfunctional parenting attitudes moderated several of these relationships. The present findings suggest that sexual abuse and its adult sequelae may have negative consequences for the parenting practices of survivors, particularly for survivors' ability to provide their children with appropriate structure, consistent discipline, and clear behavioral expectations. Implications for the psychosocial development of survivors' children are discussed.

Power system restoration - A task force report

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

Adibi, M.; Clelland, P.; Fink, L.

1986-01-01

The IEEE PES System Operation Subcommittee has established the Power System Restoration Task Force to: review operating practices, conduct a literature search, prepare relevant glossaries and bibliographies, and promote information exchange through technical papers. This is the first report of the Task Force. The problem of bulk power system restoration following a complete or partial collapse is practically as old as the electric utility industry itself. Many electric utilities have developed over the years system restoration schemes that meet the needs of their particular systems. These plans provide a great deal of insight into how the restorative process is viewedmore » by operating and planning personnel and what concerns and constraints any plan must operate under. The body of the report consists of notes prepared by members of the Task Force. It should not be interred that a complete reporting on Power System Restoration is undertaken here. The intent is to report upon work of the Task Force to date. The report also reviews several different restoration plans and shows their common concerns and constraints.« less

Do management practices support or constrain safe driving behaviour? A multi-level investigation in a sample of occupational drivers.

PubMed

Newnam, Sharon; Warmerdam, Amanda; Sheppard, Dianne; Griffin, Mark; Stevenson, Mark

2017-05-01

It has been estimated that one-third of all work-related deaths occur while driving for work-related purposes. Despite this, many organisations are unaware of the practices, beyond those that identify and control the impact of unforeseen events (i.e., risk management), that predispose drivers to risk. This study addresses the issue by identifying the management practices operationalised as, High Performance Workplace Systems (HPWS) that influence safe driver behaviour. The study also explores the value given to safety by senior level management as a moderator of the relationship between HPWS practices and driver behaviour. Each factor was tested within a two level hierarchical model consisting of 911 drivers, nested within 161 supervisors and 83 organisations. The findings highight that under conditions of high investment in job and work design, communication and selection practices, drivers reported poorer driving behaviour. An interaction effect also demonstrated that under conditions of high investment in remuneration, drivers reported safer behaviour, but only when they perceived that managers valued and prioritised safety. The findings challenge current thinking in the management of workplace road safety. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sex, price and preferences: accounting for unsafe sexual practices in prostitution markets.

PubMed

Adriaenssens, Stef; Hendrickx, Jef

2012-06-01

Unsafe sexual practices are persistent in prostitution interactions: one in four contacts can be called unsafe. The determinants of this are still matter for debate. We account for the roles played by clients' preferences and the hypothetical price premium of unsafe sexual practices with the help of a large dataset of clients' self-reported commercial sexual transactions in Belgium and The Netherlands. Almost 25,000 reports were collected, representing the whole gamut of prostitution market segments. The first set of explanations consists of an analysis of the price-fixing elements of paid sex. With the help of the so-called hedonic pricing method we test for the existence of a price incentive for unsafe sex. In accordance with the results from studies in some prostitution markets in the developing world, the study replicates a significant wage penalty for condom use of an estimated 7.2 per cent, confirmed in both multilevel and fixed-effects regressions. The second part of the analysis reconstructs the demand side basis of this wage penalty: the consistent preference of clients of prostitution for unsafe sex. This study is the first to document empirically clients' preference for intercourse without a condom, with the help of a multilevel ordinal regression. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

76 FR 34046 - Non-Market Economy Antidumping Proceedings: Assessment of Antidumping Duties

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-10

...In antidumping duty (``AD'') administrative reviews involving non-market economy countries (``NME''), the Department of Commerce (``the Department'') currently instructs U.S. Customs and Border Protection (``CBP'') to liquidate entries from non-reviewed exporters at the cash-deposit rate required at the time the subject merchandise entered into the United States, consistent with 19 CFR 351.212(c)(i). The Department is aware of instances where merchandise from a non- reviewed exporter enters the United States at the cash-deposit rate of an exporter subject to review but where the basis for that cash deposit is not consistent with information subsequently reported to the Department during an administrative review. Accordingly, to ensure that entries are liquidated at appropriate rates and in accordance with the information reported to the Department during an administrative review, the Department is proposing to refine its practice with respect to the rate at which it instructs CBP to liquidate certain entries from non- reviewed exporters. Specifically, the Department proposes to instruct CBP to liquidate such entries at the NME-wide rate. Through this notice, the Department invites the public to comment on the proposed refinement to its practice. Effective Date: The Department proposes that this refinement in practice apply to all entries for which the anniversary for requesting an administrative review of an AD order is on or after the date of publication of a final notice on this issue.

Room for improvement? Leadership, innovation culture and uptake of quality improvement methods in general practice.

PubMed

Apekey, Tanefa A; McSorley, Gerry; Tilling, Michelle; Siriwardena, A Niroshan

2011-04-01

Leadership and innovation are currently seen as essential elements for the development and maintenance of high-quality care. Little is known about the relationship between leadership and culture of innovation and the extent to which quality improvement methods are used in general practice. This study aimed to assess the relationship between leadership behaviour, culture of innovation and adoption of quality improvement methods in general practice. Self-administered postal questionnaires were sent to general practitioner quality improvement leads in one county in the UK between June and December 2007. The questionnaire consisted of background information, a 12-item scale to assess leadership behaviour, a seven-dimension self-rating scale for culture of innovation and questions on current use of quality improvement tools and techniques. Sixty-three completed questionnaires (62%) were returned. Leadership behaviours were not commonly reported. Most practices reported a positive culture of innovation, featuring relationship most strongly, followed by targets and information but rated lower on other dimensions of rewards, risk and resources. There was a significant positive correlation between leadership behaviour and the culture of innovation (r = 0.57; P < 0.001). Apart from clinical audit and significant event analysis, quality improvement methods were not adopted by most participating practices. Leadership behaviours were infrequently reported and this was associated with a limited culture of innovation in participating general practices. There was little use of quality improvement methods beyond clinical and significant event audit. Practices need support to enhance leadership skills, encourage innovation and develop quality improvement skills if improvements in health care are to accelerate. © 2010 Blackwell Publishing Ltd.

Exploring the Adult Learning Research Field by Analysing Who Cites Whom

ERIC Educational Resources Information Center

Nylander, Erik; Österlund, Lovisa; Fejes, Andreas

2018-01-01

In this article we report on findings from a large-scale bibliographic study conducted based on the citation practices within the field of research on adult learning. Our data consist of 151,261 citation links between more than 33,000 different authors whose papers were published in five leading international journals in the field of adult…

75 FR 48 - Amendments to the Section 7216 Regulations-Disclosure or Use of Information by Preparers of Returns

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-04

... place that are consistent with good business practices and designed to maintain the confidentiality of... of a review. No tax return information identifying a taxpayer may be disclosed in any evaluative... review. No tax return information identifying a taxpayer may be disclosed in any evaluative reports or...

Improving the Preparation of Professional Personnel for Vocational Education in Metropolitan Areas. Volume VII, Final Report.

ERIC Educational Resources Information Center

Righthand, Herbert

This institute was designed to study the needs and problems of vocational teaching in metropolitan areas and to recommend model teacher preparation practices. A total of 60 participants, representing 23 states, Washington, D.C., and the Virgin Islands, took part in this program, which consisted of general sessions, homogeneous and heterogeneous…

A Head Start Control Group. Part of the Final Report.

ERIC Educational Resources Information Center

Cunningham, Grover

A study was conducted to determine if the observed changes in Head Start children were related to the practice effects inherent in a test-retest situation. The "control" group consisted of 64 children who had been eligible for a Head Start program. They roughly matched a group of Head Start (HS) children in IQ scores, age, and…

RaPAL Bulletin, Numbers 5-13, 1988-1990.

ERIC Educational Resources Information Center

RaPAL Bulletin, 1988

1988-01-01

This document consists of a 3-year compilation (9 issues) of the RaPAL (Research and Practice in Adult Literacy) Bulletin. Typical articles are: "Student Involvement in Research" (a report of a workshop by Alex Golightly, Nick Nicola, and Marilyn Stone); part of a dialogue between Paolo Freire and Ira Shor, writer/educators of Brazil and…

Now You See It: Using Documentation to Make Learning Visible in LCs

ERIC Educational Resources Information Center

Mino, Jack J.

2014-01-01

The practice of documentation is discussed as a means of making learning visible in the LC classroom. A documentation heuristic consisting of a four-stage cycle was used to capture, analyze and report what Bass and Eynon (2009) refer to as the "visible evidence of invisible learning" (p. 5). A variety of documentation samples are…

What Is Next for Functional Requirements for Bibliographic Records? A Delphi Study

ERIC Educational Resources Information Center

Zhang, Yin; Salaba, Athena

2009-01-01

This article reports on a Delphi study conducted to determine key issues and challenges facing Functional Requirements for Bibliographic Records (FRBR) research and practice. The Delphi panel consisted of thirty-three experts in the field who participated in a three-round issue-raising and consensus-building process via a Web-based survey…

The Centrality of Teachers' Judgement Practice in Assessment: A Study of Standards in Moderation

ERIC Educational Resources Information Center

Wyatt-Smith, Claire; Klenowski, Val; Gunn, Stephanie

2010-01-01

There is a strong quest in several countries including Australia for greater national consistency in education and intensifying interest in standards for reporting. Given this, it is important to make explicit the intended and unintended consequences of assessment reform strategies and the pressures to pervert and conform. In a policy context that…

Grappling with Discipline in Autonomous Schools: New Approaches from D.C. and New Orleans

ERIC Educational Resources Information Center

Gross, Betheny; Tuchman, Sivan; Yatsko, Sarah

2016-01-01

This report profiles leading efforts by two cities to bring consistency and fairness to discipline practices in both district and charter schools--with promising early results: (1) Washington, D.C.--Leaders focused on boosting transparency and leveraging public scrutiny of high discipline rates in all public schools by producing School Equity…

40 CFR 63.8248 - What other requirements must I meet?

Code of Federal Regulations, 2011 CFR

2011-07-01

... startup, shutdown, and malfunction. (2) You must report each instance in which you did not meet each work practice standard in § 63.8192 that applies to you. This includes periods of startup, shutdown, and... value was out of range. (b) Startups, shutdowns, and malfunctions. (1) Consistent with §§ 63.6(e) and 63...

40 CFR 63.8248 - What other requirements must I meet?

Code of Federal Regulations, 2013 CFR

2013-07-01

... startup, shutdown, and malfunction. (2) You must report each instance in which you did not meet each work practice standard in § 63.8192 that applies to you. This includes periods of startup, shutdown, and... value was out of range. (b) Startups, shutdowns, and malfunctions. (1) Consistent with §§ 63.6(e) and 63...

40 CFR 63.8248 - What other requirements must I meet?

Code of Federal Regulations, 2014 CFR

2014-07-01

... startup, shutdown, and malfunction. (2) You must report each instance in which you did not meet each work practice standard in § 63.8192 that applies to you. This includes periods of startup, shutdown, and... value was out of range. (b) Startups, shutdowns, and malfunctions. (1) Consistent with §§ 63.6(e) and 63...

Motivating Student Reading Through Read-Alouds and Home-School Independent Reading.

ERIC Educational Resources Information Center

Wojciechowski, Linda; Zweig, Deborah

This report describes a plan for motivating students to read in order to allow them to enjoy and appreciate literature and to provide the practice necessary to become effective readers. The targeted population consisted of first and fourth grade students in a middle class community, located in the Middle West. The problems of minimal time engaged…

Making Work Pay in the Child Care Industry: Promising Practices for Improving Compensation.

ERIC Educational Resources Information Center

Bellm, Dan; And Others

Based on the finding that the most important determinant of child care quality is the presence of consistent, well-trained, and well-compensated caregivers, this report discusses strategies to improve compensation in child care. It analyzes structural and social barriers to investing in decent-paying child care jobs; profiles a wide range of…

Thai Undergraduate Chemistry Practical Learning Experiences Using the Jigsaw IV Method

ERIC Educational Resources Information Center

Jansoon, Ninna; Somsook, Ekasith; Coll, Richard K.

2008-01-01

The research reported in this study consisted of an investigation of student learning experiences in Thai chemistry laboratories using the Jigsaw IV method. A hands-on experiment based on the Jigsaw IV method using a real life example based on green tea beverage was designed to improve student affective variables for studying topics related to…

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

ERIC Educational Resources Information Center

GOLDBERG, MIRIAM L.; AND OTHERS

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

Exploring Organizational Barriers to Strengthening Clinical Supervision of Psychiatric Nursing Staff: A Longitudinal Controlled Intervention Study.

PubMed

Gonge, Henrik; Buus, Niels

2016-05-01

This article reports findings from a longitudinal controlled intervention study of 115 psychiatric nursing staff. The twofold objective of the study was: (a) To test whether the intervention could increase clinical supervision participation and effectiveness of existing supervision practices, and (b) To explore organizational constraints to implementation of these strengthened practices. Questionnaire responses and registration of participation in clinical supervision were registered prior and subsequent to the intervention consisting of an action learning oriented reflection on staff's existing clinical supervision practices. Major organizational changes in the intervention group during the study period obstructed the implementation of strengthened clinical supervision practices, but offered an opportunity for studying the influences of organizational constraints. The main findings were that a) diminishing experience of social support from colleagues was associated with reduced participation in clinical supervision, while b) additional quantitative demands were associated with staff reporting difficulties finding time for supervision. This probably explained a negative development in the experienced effectiveness of supervision. It is concluded that organizational support is an imperative for implementation of clinical supervision.

Evaluation of Winter Operational Runway Friction Measurement Equipment, Procedures, and Research

NASA Technical Reports Server (NTRS)

1995-01-01

This document produced by the FAA/Industry Winter Runway Friction Measurement and Reporting Working Group, is designed to provide an overview of current information on the present guidance, practices, and procedures for reporting runway pavement surface conditions during winter operations at airports. It contains recommendations on the desirability of providing the best procedural consistency and standardization and discusses the available means to implement the guidance that will result in improved aviation safety at airports during hazardous winter conditions.

Auditing the Immunization Data Quality from Routine Reports in Shangyu District, East China

PubMed Central

Hu, Yu; Zhang, Xinpei; Li, Qian; Chen, Yaping

2016-01-01

Objective: To evaluate the immunization data quality in Shangyu District, East China. Methods: An audit for immunization data for the year 2014 was conducted in 20 vaccination clinics of Shangyu District. The consistency of immunization data was estimated by verification factors (VFs), which was the proportion of vaccine doses reported as being administered that could be verified by written documentation at vaccination clinics. The quality of monitoring systems was evaluated using the quality index (QI). Results: The VFs of 20 vaccine doses ranged from 0.94 to 1.04 at the district level. The VFs for the 20 vaccination clinics ranged from 0.57 to 1.07. The VFs for Shangyu District was 0.98. The mean of total QI score of the 20 vaccination clinics was 80.32%. A significant correlation between the VFs of the 3rd dose of the diphtheria–tetanus–pertussis combined vaccine (DTP) and QI scores was observed at the vaccination clinic level. Conclusions: Deficiencies in data consistency and immunization reporting practice in Shangyu District were observed. Targeted measures are suggested to improve the quality of the immunization reporting system in vaccination clinics with poor data consistency. PMID:27869729

Auditing the Immunization Data Quality from Routine Reports in Shangyu District, East China.

PubMed

Hu, Yu; Zhang, Xinpei; Li, Qian; Chen, Yaping

2016-11-18

Objective: To evaluate the immunization data quality in Shangyu District, East China. Methods: An audit for immunization data for the year 2014 was conducted in 20 vaccination clinics of Shangyu District. The consistency of immunization data was estimated by verification factors (VFs), which was the proportion of vaccine doses reported as being administered that could be verified by written documentation at vaccination clinics. The quality of monitoring systems was evaluated using the quality index (QI). Results: The VFs of 20 vaccine doses ranged from 0.94 to 1.04 at the district level. The VFs for the 20 vaccination clinics ranged from 0.57 to 1.07. The VFs for Shangyu District was 0.98. The mean of total QI score of the 20 vaccination clinics was 80.32%. A significant correlation between the VFs of the 3rd dose of the diphtheria-tetanus-pertussis combined vaccine (DTP) and QI scores was observed at the vaccination clinic level. Conclusions: Deficiencies in data consistency and immunization reporting practice in Shangyu District were observed. Targeted measures are suggested to improve the quality of the immunization reporting system in vaccination clinics with poor data consistency.

An international effort towards developing standards for best practices in analysis, interpretation and reporting of clinical genome sequencing results in the CLARITY Challenge.

PubMed

Brownstein, Catherine A; Beggs, Alan H; Homer, Nils; Merriman, Barry; Yu, Timothy W; Flannery, Katherine C; DeChene, Elizabeth T; Towne, Meghan C; Savage, Sarah K; Price, Emily N; Holm, Ingrid A; Luquette, Lovelace J; Lyon, Elaine; Majzoub, Joseph; Neupert, Peter; McCallie, David; Szolovits, Peter; Willard, Huntington F; Mendelsohn, Nancy J; Temme, Renee; Finkel, Richard S; Yum, Sabrina W; Medne, Livija; Sunyaev, Shamil R; Adzhubey, Ivan; Cassa, Christopher A; de Bakker, Paul I W; Duzkale, Hatice; Dworzyński, Piotr; Fairbrother, William; Francioli, Laurent; Funke, Birgit H; Giovanni, Monica A; Handsaker, Robert E; Lage, Kasper; Lebo, Matthew S; Lek, Monkol; Leshchiner, Ignaty; MacArthur, Daniel G; McLaughlin, Heather M; Murray, Michael F; Pers, Tune H; Polak, Paz P; Raychaudhuri, Soumya; Rehm, Heidi L; Soemedi, Rachel; Stitziel, Nathan O; Vestecka, Sara; Supper, Jochen; Gugenmus, Claudia; Klocke, Bernward; Hahn, Alexander; Schubach, Max; Menzel, Mortiz; Biskup, Saskia; Freisinger, Peter; Deng, Mario; Braun, Martin; Perner, Sven; Smith, Richard J H; Andorf, Janeen L; Huang, Jian; Ryckman, Kelli; Sheffield, Val C; Stone, Edwin M; Bair, Thomas; Black-Ziegelbein, E Ann; Braun, Terry A; Darbro, Benjamin; DeLuca, Adam P; Kolbe, Diana L; Scheetz, Todd E; Shearer, Aiden E; Sompallae, Rama; Wang, Kai; Bassuk, Alexander G; Edens, Erik; Mathews, Katherine; Moore, Steven A; Shchelochkov, Oleg A; Trapane, Pamela; Bossler, Aaron; Campbell, Colleen A; Heusel, Jonathan W; Kwitek, Anne; Maga, Tara; Panzer, Karin; Wassink, Thomas; Van Daele, Douglas; Azaiez, Hela; Booth, Kevin; Meyer, Nic; Segal, Michael M; Williams, Marc S; Tromp, Gerard; White, Peter; Corsmeier, Donald; Fitzgerald-Butt, Sara; Herman, Gail; Lamb-Thrush, Devon; McBride, Kim L; Newsom, David; Pierson, Christopher R; Rakowsky, Alexander T; Maver, Aleš; Lovrečić, Luca; Palandačić, Anja; Peterlin, Borut; Torkamani, Ali; Wedell, Anna; Huss, Mikael; Alexeyenko, Andrey; Lindvall, Jessica M; Magnusson, Måns; Nilsson, Daniel; Stranneheim, Henrik; Taylan, Fulya; Gilissen, Christian; Hoischen, Alexander; van Bon, Bregje; Yntema, Helger; Nelen, Marcel; Zhang, Weidong; Sager, Jason; Zhang, Lu; Blair, Kathryn; Kural, Deniz; Cariaso, Michael; Lennon, Greg G; Javed, Asif; Agrawal, Saloni; Ng, Pauline C; Sandhu, Komal S; Krishna, Shuba; Veeramachaneni, Vamsi; Isakov, Ofer; Halperin, Eran; Friedman, Eitan; Shomron, Noam; Glusman, Gustavo; Roach, Jared C; Caballero, Juan; Cox, Hannah C; Mauldin, Denise; Ament, Seth A; Rowen, Lee; Richards, Daniel R; San Lucas, F Anthony; Gonzalez-Garay, Manuel L; Caskey, C Thomas; Bai, Yu; Huang, Ying; Fang, Fang; Zhang, Yan; Wang, Zhengyuan; Barrera, Jorge; Garcia-Lobo, Juan M; González-Lamuño, Domingo; Llorca, Javier; Rodriguez, Maria C; Varela, Ignacio; Reese, Martin G; De La Vega, Francisco M; Kiruluta, Edward; Cargill, Michele; Hart, Reece K; Sorenson, Jon M; Lyon, Gholson J; Stevenson, David A; Bray, Bruce E; Moore, Barry M; Eilbeck, Karen; Yandell, Mark; Zhao, Hongyu; Hou, Lin; Chen, Xiaowei; Yan, Xiting; Chen, Mengjie; Li, Cong; Yang, Can; Gunel, Murat; Li, Peining; Kong, Yong; Alexander, Austin C; Albertyn, Zayed I; Boycott, Kym M; Bulman, Dennis E; Gordon, Paul M K; Innes, A Micheil; Knoppers, Bartha M; Majewski, Jacek; Marshall, Christian R; Parboosingh, Jillian S; Sawyer, Sarah L; Samuels, Mark E; Schwartzentruber, Jeremy; Kohane, Isaac S; Margulies, David M

2014-03-25

There is tremendous potential for genome sequencing to improve clinical diagnosis and care once it becomes routinely accessible, but this will require formalizing research methods into clinical best practices in the areas of sequence data generation, analysis, interpretation and reporting. The CLARITY Challenge was designed to spur convergence in methods for diagnosing genetic disease starting from clinical case history and genome sequencing data. DNA samples were obtained from three families with heritable genetic disorders and genomic sequence data were donated by sequencing platform vendors. The challenge was to analyze and interpret these data with the goals of identifying disease-causing variants and reporting the findings in a clinically useful format. Participating contestant groups were solicited broadly, and an independent panel of judges evaluated their performance. A total of 30 international groups were engaged. The entries reveal a general convergence of practices on most elements of the analysis and interpretation process. However, even given this commonality of approach, only two groups identified the consensus candidate variants in all disease cases, demonstrating a need for consistent fine-tuning of the generally accepted methods. There was greater diversity of the final clinical report content and in the patient consenting process, demonstrating that these areas require additional exploration and standardization. The CLARITY Challenge provides a comprehensive assessment of current practices for using genome sequencing to diagnose and report genetic diseases. There is remarkable convergence in bioinformatic techniques, but medical interpretation and reporting are areas that require further development by many groups.

An international effort towards developing standards for best practices in analysis, interpretation and reporting of clinical genome sequencing results in the CLARITY Challenge

PubMed Central

2014-01-01

Background There is tremendous potential for genome sequencing to improve clinical diagnosis and care once it becomes routinely accessible, but this will require formalizing research methods into clinical best practices in the areas of sequence data generation, analysis, interpretation and reporting. The CLARITY Challenge was designed to spur convergence in methods for diagnosing genetic disease starting from clinical case history and genome sequencing data. DNA samples were obtained from three families with heritable genetic disorders and genomic sequence data were donated by sequencing platform vendors. The challenge was to analyze and interpret these data with the goals of identifying disease-causing variants and reporting the findings in a clinically useful format. Participating contestant groups were solicited broadly, and an independent panel of judges evaluated their performance. Results A total of 30 international groups were engaged. The entries reveal a general convergence of practices on most elements of the analysis and interpretation process. However, even given this commonality of approach, only two groups identified the consensus candidate variants in all disease cases, demonstrating a need for consistent fine-tuning of the generally accepted methods. There was greater diversity of the final clinical report content and in the patient consenting process, demonstrating that these areas require additional exploration and standardization. Conclusions The CLARITY Challenge provides a comprehensive assessment of current practices for using genome sequencing to diagnose and report genetic diseases. There is remarkable convergence in bioinformatic techniques, but medical interpretation and reporting are areas that require further development by many groups. PMID:24667040

Perioperative care for lumbar microdiscectomy: a survey of Australasian neurosurgeons

PubMed Central

Lim, Kai Zheong; Ghosh, Peter; Goldschlager, Tony

2018-01-01

Background Lumbar microdiscectomy is the most commonly performed spine surgery procedure. Over time it has evolved to a minimally invasive procedure. Traditionally patients were advised to restrict activity following lumbar spine surgery. However, post-operative instructions are heterogeneous. The purpose of this report is to assess, by survey, the perioperative care practices of Australasian neurosurgeons in the minimally invasive era. Methods A survey was conducted by email invitation sent to all full members of the Neurosurgical Society of Australasia (NSA). This consisted of 11 multi-choice questions relating to operative indications, technique, and post-operative instructions for lumbar microdiscectomy answered by an electronically distributed anonymized online survey. Results The survey was sent to all Australasian Neurosurgeons. In total, 68 complete responses were received (28.9%). Most surgeons reported they would consider a period of either 4 to 8 weeks (42.7%) or 8 to 12 weeks (32.4%) as the minimum duration of radicular pain adequate to offer surgery. Unilateral muscle dissection with unilateral discectomy was practiced by 76.5%. Operative microscopy was the most commonly employed method of magnification (76.5%). The majority (55.9%) always refer patients to undergo inpatient physiotherapy. Sitting restrictions were advised by 38.3%. Lifting restrictions were advised by 83.8%. Conclusions Australasian neurosurgical lumbar microdiscectomy perioperative care practices are generally consistent with international practices and demonstrate a similar degree of heterogeneity. Recommendation of post-operative activity restrictions by Australasian neurosurgeons is still common. This suggests a role for the investigation of the necessity of such restrictions in the era of minimally invasive spine surgery. PMID:29732417

Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey

PubMed Central

Laverty, Anthony A; Harris, Matthew J; Watt, Hilary C; Greaves, Felix; Majeed, Azeem

2017-01-01

Objective To examine associations between the contract and ownership type of general practices and patient experience in England. Design Multilevel linear regression analysis of a national cross-sectional patient survey (General Practice Patient Survey). Setting All general practices in England in 2013–2014 (n = 8017). Participants 903,357 survey respondents aged 18 years or over and registered with a general practice for six months or more (34.3% of 2,631,209 questionnaires sent). Main outcome measures Patient reports of experience across five measures: frequency of consulting a preferred doctor; ability to get a convenient appointment; rating of doctor communication skills; ease of contacting the practice by telephone; and overall experience (measured on four- or five-level interval scales from 0 to 100). Models adjusted for demographic and socioeconomic characteristics of respondents and general practice populations and a random intercept for each general practice. Results Most practices had a centrally negotiated contract with the UK government (‘General Medical Services’ 54.6%; 4337/7949). Few practices were limited companies with locally negotiated ‘Alternative Provider Medical Services’ contracts (1.2%; 98/7949); these practices provided worse overall experiences than General Medical Services practices (adjusted mean difference −3.04, 95% CI −4.15 to −1.94). Associations were consistent in direction across outcomes and largest in magnitude for frequency of consulting a preferred doctor (−12.78, 95% CI −15.17 to −10.39). Results were similar for practices owned by large organisations (defined as having ≥20 practices) which were uncommon (2.2%; 176/7949). Conclusions Patients registered to general practices owned by limited companies, including large organisations, reported worse experiences of their care than other patients in 2013–2014. PMID:29096580

Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey.

PubMed

Cowling, Thomas E; Laverty, Anthony A; Harris, Matthew J; Watt, Hilary C; Greaves, Felix; Majeed, Azeem

2017-11-01

Objective To examine associations between the contract and ownership type of general practices and patient experience in England. Design Multilevel linear regression analysis of a national cross-sectional patient survey (General Practice Patient Survey). Setting All general practices in England in 2013-2014 ( n = 8017). Participants 903,357 survey respondents aged 18 years or over and registered with a general practice for six months or more (34.3% of 2,631,209 questionnaires sent). Main outcome measures Patient reports of experience across five measures: frequency of consulting a preferred doctor; ability to get a convenient appointment; rating of doctor communication skills; ease of contacting the practice by telephone; and overall experience (measured on four- or five-level interval scales from 0 to 100). Models adjusted for demographic and socioeconomic characteristics of respondents and general practice populations and a random intercept for each general practice. Results Most practices had a centrally negotiated contract with the UK government ('General Medical Services' 54.6%; 4337/7949). Few practices were limited companies with locally negotiated 'Alternative Provider Medical Services' contracts (1.2%; 98/7949); these practices provided worse overall experiences than General Medical Services practices (adjusted mean difference -3.04, 95% CI -4.15 to -1.94). Associations were consistent in direction across outcomes and largest in magnitude for frequency of consulting a preferred doctor (-12.78, 95% CI -15.17 to -10.39). Results were similar for practices owned by large organisations (defined as having ≥20 practices) which were uncommon (2.2%; 176/7949). Conclusions Patients registered to general practices owned by limited companies, including large organisations, reported worse experiences of their care than other patients in 2013-2014.

Impact of Pharmacy Residency Research Training on Residents' Actual Versus Perceived Ability and Interest to Identify and Solve Practice-Related Problems.

PubMed

Pinelli, Nicole R; Sikora, Andrea N; Witherspoon, Leigh A; Rao, Kamakshi V; Rhoney, Denise H

2016-08-01

The American Society of Health-System Pharmacists (ASHP) requires that accredited residency programs provide pharmacy residents the opportunity to perform a practice-based project. The objective of this study was to evaluate the impact of pharmacy residency research training on residents' actual versus perceived ability to solve practice-related problems in their professional careers. This cross-sectional study surveyed postgraduate year 1 (PGY1) pharmacy practice residents who completed training at a large academic medical center between 2007 and 2013. The survey consisted of 3 areas of assessment, that is, (1) general demographics, (2) perceived research abilities, and (3) self-reported research productivity. A total of 39 residents were eligible; of those, 27 completed the survey (69.2% response rate). Participants reported low perceived ability for conductance of some research activities including study design development, implementation, and publication. No association between perceived research ability and self-reported research productivity was found. Research experience prior to residency training strongly predicted for subsequent publication after completion of PGY1 residency training (P < .0001). New training mechanisms may be needed to optimize research training that will provide residents with greater emphasis on areas of perceived deficiency. © The Author(s) 2015.

Preventing weight gain: a population cohort study of the nature and effectiveness of mid-age women's weight control practices.

PubMed

Williams, L; Germov, J; Young, A

2007-06-01

To examine women's weight control practices and their effectiveness in preventing weight gain. Retrospective cohort study of weight control practices and 2-year weight change among mid-age women participating in the Australian Longitudinal Study on Women's Health (ALSWH). 11,589 Australian women (aged 47-52 years). The prevalence and types of self-reported weight control practices used were assessed by a nine-item instrument. Two-year weight change was self-reported and adjusted for baseline body mass index (BMI) and other potential confounders. Seventy-four per cent of the cohort (N=8556) reported actively trying to control their weight. Dietary modification was used more frequently than exercise. Two-thirds of the weight-controlling women used a combination of practices, the two most common being 'decreased food quantity, cut down on fats/sugars and exercise' (32%, baseline BMI 25.87(0.10)), and 'decreased food quantity and cut down on fats/sugars without exercise' (15.6%, baseline BMI 27.04(0.14)). Potentially health-damaging practices (smoking, laxatives, fasting) were relatively uncommon, at 7.9%. Only one combination of practices (decreased food quantity, cut down on fats/sugars, use of a commercial weight loss programme and exercise) prevented mean weight gain (-0.03 kg), whereas the mean (s.d.) weight of the cohort increased (+1.19(4.78)) over the 2-year period. The majority of mid-age women attempting weight control used practices consistent with public health messages. Despite their efforts, the group was mostly unsuccessful in preventing weight gain. Public health authorities and health practitioners may need to make more quantitative recommendations and emphasize the importance of balancing physical activity with dietary intake to achieve successful weight control for women at this life stage.

Implementation of a module to promote competency in adverse drug reaction reporting in undergraduate medical students.

PubMed

Tripathi, Raakhi Kaliprasad; Jalgaonkar, Sharmila Vinayak; Sarkate, Pankaj V; Rege, Nirmala Narayan

2016-10-01

Underreporting and poor quality of adverse drug reaction (ADR) reports pose a challenge for the Pharmacovigilance Program of India. A module to impart knowledge and skills of ADR reporting to MBBS students was developed and evaluated. The module consisted of (a) e-mailing an ADR narrative and online filling of the "suspected ADR reporting form" (SARF) and (b) a week later, practical on ADR reporting was conducted followed by online filling of SARF postpractical at 1 and 6 months. SARF was an 18-item form with a total score of 36. The module was implemented in the year 2012-2013. Feedback from students and faculty was taken using 15-item prevalidated feedback questionnaires. The module was modified based on the feedback and implemented for the subsequent batch in the year 2013-2014. The evaluation consisted of recording the number of students responding and the scores achieved. A total of 171 students in 2012-2013 batch and 179 in 2013-2014 batch participated. In the 2012-2013 batch, the number of students filling the SARF decreased from basal: 171; 1 month: 122; 6 months: 17. The average scores showed improvement from basal 16.2 (45%) to 26.4 (73%) at 1 month and to 27.3 (76%) at 6 months. For the 2013-2014 batch, the number ( n = 179) remained constant throughout and the average score progressively increased from basal 10.5 (30%) to 27.8 (77%) at 1 month and 30.3 (84%) at 6 months. This module improved the accuracy of filling SARF by students and this subsequently will led to better ADR reporting. Hence, this module can be used to inculcate better ADR reporting practices in budding physicians.

The eccentricity effect of inhibition of return is resistant to practice.

PubMed

Bao, Yan; Sander, Tilmann; Trahms, Lutz; Pöppel, Ernst; Lei, Quan; Zhou, Bin

2011-08-01

Inhibition of return (IOR) refers to a delayed responding to targets appeared at previously cued location relative to an uncued novel location. In a recent study, Bao and Pöppel reported a functional dissociation of inhibitory processing in the visual field with much stronger IOR magnitude in the far periphery relative to the perifoveal visual field up to 15° eccentricity. The present study aimed to examine whether this effect is sensitive to participant experience or practice. Consistent with previous findings, our data demonstrated a larger IOR magnitude at 21° relative to 7° stimulus eccentricity. More importantly, no practice-related IOR magnitude changes were observed for both perifoveal and peripheral stimuli, although response times did decrease significantly with practice. These results suggest that the eccentricity effect of IOR is a robust phenomenon which is resistant to practice. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Structured data quality reports to improve EHR data quality.

PubMed

Taggart, Jane; Liaw, Siaw-Teng; Yu, Hairong

2015-12-01

To examine whether a structured data quality report (SDQR) and feedback sessions with practice principals and managers improve the quality of routinely collected data in EHRs. The intervention was conducted in four general practices participating in the Fairfield neighborhood electronic Practice Based Research Network (ePBRN). Data were extracted from their clinical information systems and summarised as a SDQR to guide feedback to practice principals and managers at 0, 4, 8 and 12 months. Data quality (DQ) metrics included completeness, correctness, consistency and duplication of patient records. Information on data recording practices, data quality improvement, and utility of SDQRs was collected at the feedback sessions at the practices. The main outcome measure was change in the recording of clinical information and level of meeting Royal Australian College of General Practice (RACGP) targets. Birth date was 100% and gender 99% complete at baseline and maintained. DQ of all variables measured improved significantly (p<0.01) over 12 months, but was not sufficient to comply with RACGP standards. Improvement was greatest with allergies. There was no significant change in duplicate records. SDQRs and feedback sessions support general practitioners and practice managers to focus on improving the recording of patient information. However, improved practice DQ, was not sufficient to meet RACGP targets. Randomised controlled studies are required to evaluate strategies to improve data quality and any associated improved safety and quality of care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Psychotherapy in Contemporary Psychiatric Practice

PubMed Central

Hadjipavlou, George; Hernandez, Carlos A Sierra; Ogrodniczuk, John S

2015-01-01

Objective: American data suggest a declining trend in the provision of psychotherapy by psychiatrists. Nevertheless, the extent to which such findings generalize to psychiatric practice in other countries is unclear. We surveyed psychiatrists in British Columbia to examine whether the reported decline in psychotherapy provision extends to the landscape of Canadian psychiatric practice. Method: A survey was mailed to the entire population of fully licensed psychiatrists registered in British Columbia (n = 623). The survey consisted of 30 items. Descriptive statistics were used to characterize the sample and psychotherapy practice patterns. Associations between variables were evaluated using nonparametric tests. Results: A total of 423 psychiatrists returned the survey, yielding a response rate of 68%. Overall, 80.9% of psychiatrists (n = 342) reported practicing psychotherapy. A decline in the provision of psychotherapy was not observed; in fact, there was an increase in psychotherapy provision among psychiatrists entering practice in the last 10 years. Individual therapy was the predominant format used by psychiatrists. The most common primary theoretical orientation was psychodynamic (29.9%). Regarding actual practice, supportive psychotherapy was practiced most frequently. Professional time constraints were perceived as the most significant barrier to providing psychotherapy. The majority (85%) of clinicians did not view remuneration as a significant barrier to treating patients with psychotherapy. Conclusions: Our findings challenge the prevailing view that psychotherapy is in decline among psychiatrists. Psychiatrists in British Columbia continue to integrate psychotherapy and pharmacotherapy in clinical practice, thus preserving their unique place in the spectrum of mental health services. PMID:26175328

A Policy-into-Practice Intervention to Increase the Uptake of Evidence-Based Management of Low Back Pain in Primary Care: A Prospective Cohort Study

PubMed Central

Slater, Helen; Davies, Stephanie Joy; Parsons, Richard; Quintner, John Louis; Schug, Stephan Alexander

2012-01-01

Background Persistent non-specific low back pain (nsLBP) is poorly understood by the general community, by educators, researchers and health professionals, making effective care problematic. This study evaluated the effectiveness of a policy-into-practice intervention developed for primary care physicians (PCPs). Methods To encourage PCPs to adopt practical evidence-based approaches and facilitate time-efficient, integrated management of patients with nsLBP, we developed an interdisciplinary evidence-based, practical pain education program (gPEP) based on a contemporary biopsychosocial framework. One hundred and twenty six PCPs from primary care settings in Western Australia were recruited. PCPs participated in a 6.5-hour gPEP. Self-report measures recorded at baseline and at 2 months post-intervention included PCPs' attitudes, beliefs (modified Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS), evidence-based clinical practices (knowledge and skills regarding nsLBP management: 5-point Likert scale with 1 =  nil and 5 =  excellent) and practice behaviours (recommendations based on a patient vignette; 5-point Likert scale). Results Ninety one PCPs participated (attendance rate of 72%; post-intervention response rate 88%). PCP-responders adopted more positive, guideline-consistent beliefs, evidenced by clinically significant HC-PAIRS score differences (mean change  = −5.6±8.2, p<0.0001; 95% confidence interval: −7.6 to −3.6) and significant positive shifts on all measures of clinical knowledge and skills (p<0.0001 for all questions). Self management strategies were recommended more frequently post-intervention. The majority of responders who were guideline-inconsistent for work and bed rest recommendations (82% and 62% respectively) at pre-intervention, gave guideline-consistent responses at post-intervention. Conclusion An interprofessional pain education program set within a framework that aligns health policy and practice, encourages PCPs to adopt more self-reported evidence-based attitudes, beliefs and clinical behaviours in their management of patients with nsLBP. However, further research is required to determine cost effectiveness of this approach when compared with other modes of educational delivery and to examine PCP behaviours in actual clinical practice. PMID:22662264

A policy-into-practice intervention to increase the uptake of evidence-based management of low back pain in primary care: a prospective cohort study.

PubMed

Slater, Helen; Davies, Stephanie Joy; Parsons, Richard; Quintner, John Louis; Schug, Stephan Alexander

2012-01-01

Persistent non-specific low back pain (nsLBP) is poorly understood by the general community, by educators, researchers and health professionals, making effective care problematic. This study evaluated the effectiveness of a policy-into-practice intervention developed for primary care physicians (PCPs). To encourage PCPs to adopt practical evidence-based approaches and facilitate time-efficient, integrated management of patients with nsLBP, we developed an interdisciplinary evidence-based, practical pain education program (gPEP) based on a contemporary biopsychosocial framework. One hundred and twenty six PCPs from primary care settings in Western Australia were recruited. PCPs participated in a 6.5-hour gPEP. Self-report measures recorded at baseline and at 2 months post-intervention included PCPs' attitudes, beliefs (modified Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS), evidence-based clinical practices (knowledge and skills regarding nsLBP management: 5-point Likert scale with 1  =  nil and 5  =  excellent) and practice behaviours (recommendations based on a patient vignette; 5-point Likert scale). Ninety one PCPs participated (attendance rate of 72%; post-intervention response rate 88%). PCP-responders adopted more positive, guideline-consistent beliefs, evidenced by clinically significant HC-PAIRS score differences (mean change  =  -5.6±8.2, p<0.0001; 95% confidence interval: -7.6 to -3.6) and significant positive shifts on all measures of clinical knowledge and skills (p<0.0001 for all questions). Self management strategies were recommended more frequently post-intervention. The majority of responders who were guideline-inconsistent for work and bed rest recommendations (82% and 62% respectively) at pre-intervention, gave guideline-consistent responses at post-intervention. An interprofessional pain education program set within a framework that aligns health policy and practice, encourages PCPs to adopt more self-reported evidence-based attitudes, beliefs and clinical behaviours in their management of patients with nsLBP. However, further research is required to determine cost effectiveness of this approach when compared with other modes of educational delivery and to examine PCP behaviours in actual clinical practice.

Frequency, Patterns and Preferences of Lubricant Use During Anal Intercourse Within Male Sexual Partnerships in Lima, Peru: Implications for a Rectal Microbicide HIV Prevention Intervention

PubMed Central

Clark, J; Salvatierra, Hector Javier; Segura, Eddy Roberto; Salazar, Ximena; Konda, Kelika; Galea, Jerome; Klausner, Jeffrey D; Coates, Thomas; Caceres, Carlos Fernando

2012-01-01

Understanding current practices of lubricant use during anal intercourse can help to assess the contexts for the introduction of topical rectal microbicides as an HIV prevention tool for men who have sex with men (MSM). We used quantitative and qualitative methods to assess: current patterns of lubricant use; preferred characteristics of commercial lubricant formulations; and social and behavioral contexts of lubricant use within male sexual partnerships in Lima, Peru. Between 2007 and 2008, we conducted a quantitative behavioral survey with 547 MSM followed by qualitative individual and group interviews with 36 MSM from Lima, Peru. Approximately half of all participants in the quantitative survey (50.3%) reported using commercial lubricant during intercourse occasionally or consistently during the preceding two months, with lack of availability at the time of intercourse the most commonly reported reason for non-use. No clear preferences regarding the color, smell, taste, or viscosity of commercial lubricants were identified, and all participants who reported using a commercial lubricant used the same product (“Love-Lub”). In the qualitative analysis, participants characterized lubricant use as a sexual practice consistently controlled by the receptive partner, who typically obtained and applied lubricant independently, with or without the consent of the insertive partner. Quantitative findings supported this differential pattern of lubricant use, with men who reported sexual identities or roles consistent with receptive anal intercourse, including unprotected receptive intercourse, more likely to report lubricant use than MSM who claimed an exclusively insertive sexual role. Given the social, behavioral, and biological factors contributing to increased vulnerability for HIV and STI acquisition by the receptive partner in anal intercourse, delivery of a topical rectal microbicide as a lubricant formulation could provide an important HIV prevention resource for at-risk MSM in Lima, Peru. PMID:23082796

Instrument development, data collection, and characteristics of practices, staff, and measures in the Improving Quality of Care in Diabetes (iQuaD) Study

PubMed Central

2011-01-01

Background Type 2 diabetes is an increasingly prevalent chronic illness and an important cause of avoidable mortality. Patients are managed by the integrated activities of clinical and non-clinical members of primary care teams. This study aimed to: investigate theoretically-based organisational, team, and individual factors determining the multiple behaviours needed to manage diabetes; and identify multilevel determinants of different diabetes management behaviours and potential interventions to improve them. This paper describes the instrument development, study recruitment, characteristics of the study participating practices and their constituent healthcare professionals and administrative staff and reports descriptive analyses of the data collected. Methods The study was a predictive study over a 12-month period. Practices (N = 99) were recruited from within the UK Medical Research Council General Practice Research Framework. We identified six behaviours chosen to cover a range of clinical activities (prescribing, non-prescribing), reflect decisions that were not necessarily straightforward (controlling blood pressure that was above target despite other drug treatment), and reflect recommended best practice as described by national guidelines. Practice attributes and a wide range of individually reported measures were assessed at baseline; measures of clinical outcome were collected over the ensuing 12 months, and a number of proxy measures of behaviour were collected at baseline and at 12 months. Data were collected by telephone interview, postal questionnaire (organisational and clinical) to practice staff, postal questionnaire to patients, and by computer data extraction query. Results All 99 practices completed a telephone interview and responded to baseline questionnaires. The organisational questionnaire was completed by 931/1236 (75.3%) administrative staff, 423/529 (80.0%) primary care doctors, and 255/314 (81.2%) nurses. Clinical questionnaires were completed by 326/361 (90.3%) primary care doctors and 163/186 (87.6%) nurses. At a practice level, we achieved response rates of 100% from clinicians in 40 practices and > 80% from clinicians in 67 practices. All measures had satisfactory internal consistency (alpha coefficient range from 0.61 to 0.97; Pearson correlation coefficient (two item measures) 0.32 to 0.81); scores were generally consistent with good practice. Measures of behaviour showed relatively high rates of performance of the six behaviours, but with considerable variability within and across the behaviours and measures. Discussion We have assembled an unparalleled data set from clinicians reporting on their cognitions in relation to the performance of six clinical behaviours involved in the management of people with one chronic disease (diabetes mellitus), using a range of organisational and individual level measures as well as information on the structure of the practice teams and across a large number of UK primary care practices. We would welcome approaches from other researchers to collaborate on the analysis of this data. PMID:21658211

Reflections on the role of the pharmacy regulatory authority in enhancing quality related event reporting in community pharmacies.

PubMed

Boyle, Todd A; Bishop, Andrea C; Mahaffey, Thomas; Mackinnon, Neil J; Ashcroft, Darren M; Zwicker, Bev; Reid, Carolyn

2014-01-01

Given the demanding nature of providing pharmacy services, coupled with the expanded scope of practice of the professions in jurisdictions around the world, greater commitment to continuous quality improvement through adoption of quality-related event (QRE) reporting is necessary to ensure patient safety. Pharmacy regulatory authorities (PRAs) are in a unique position to enhance QRE reporting and learning through the standardization of expected practice. This study was aimed to gain a better understanding of the perceived roles of PRAs in enhancing QRE reporting and learning in community pharmacies, and identifying regulatory best practices to execute such roles. A purposive case sampling approach was used to identify PRA staff members from two groups (Deputy registrars and pharmacy inspectors) in 10 Canadian jurisdictions to participate in focus groups in the fall of 2011. Focus groups were used to explore perceptions of the role of PRAs in enhancing and promoting QRE reporting and learning, and perceived barriers to effective implementation in practice. Thematic analysis was used to analyze the qualitative data. Two focus groups were conducted, one with seven Deputy registrars/Practice managers, and one with nine pharmacy inspectors. Five themes were identified, including (1) defining QRE reporting and compliance, (2) navigating role conflict, (3) educating for enhanced QRE reporting and learning, (4) promoting the positive/removing the fear of QREs, and (5) tailoring QRE reporting and learning consistency. Overall, participants perceived a strong role for PRAs in enhancing QRE reporting and learning and providing education for pharmacies to support their compliance with reporting standards. However, PRAs must navigate the conflict inherent in both educating and promoting a process for achieving a standard while simultaneously inspecting compliance to that standard. Ensuring pharmacies have autonomy in operationalizing standards may help to mitigate this conflict. Finally, greater education for PRAs themselves to better inspect compliance and in order to better communicate the benefits of QRE reporting and learning to pharmacies would be beneficial. Copyright © 2014 Elsevier Inc. All rights reserved.

Change in Reported Lyme Disease Incidence in the Northeast and Upper Midwest, 1991-2014

EPA Pesticide Factsheets

This indicator shows how reported Lyme disease incidence has changed by state since 1991, based on the number of new cases per 100,000 people. The total change has been estimated from the average annual rate of change in each state. This map is limited to the 14 states where Lyme disease is most common, where annual rates are consistently above 10 cases per 100,000. Connecticut, New York, and Rhode Island had too much year-to-year variation in reporting practices to allow trend calculation. For more information: www.epa.gov/climatechange/science/indicators

Roogle: an information retrieval engine for clinical data warehouse.

PubMed

Cuggia, Marc; Garcelon, Nicolas; Campillo-Gimenez, Boris; Bernicot, Thomas; Laurent, Jean-François; Garin, Etienne; Happe, André; Duvauferrier, Régis

2011-01-01

High amount of relevant information is contained in reports stored in the electronic patient records and associated metadata. R-oogle is a project aiming at developing information retrieval engines adapted to these reports and designed for clinicians. The system consists in a data warehouse (full-text reports and structured data) imported from two different hospital information systems. Information retrieval is performed using metadata-based semantic and full-text search methods (as Google). Applications may be biomarkers identification in a translational approach, search of specific cases, and constitution of cohorts, professional practice evaluation, and quality control assessment.

Effect of e-learning and repeated performance feedback on spirometry test quality in family practice: a cluster trial.

PubMed

Schermer, Tjard R; Akkermans, Reinier P; Crockett, Alan J; van Montfort, Marian; Grootens-Stekelenburg, Joke; Stout, Jim W; Pieters, Willem

2011-01-01

Spirometry has become an indispensable tool in primary care to exclude, diagnose, and monitor chronic respiratory conditions, but the quality of spirometry tests in family practices is a reason for concern. Aim of this study was to investigate whether a combination of e-learning and bimonthly performance feedback would improve spirometry test quality in family practices in the course of 1 year. Our study was a cluster trial with 19 family practices allocated to intervention or control conditions through minimization. Intervention consisted of e-learning and bimonthly feedback reports to practice nurses. Control practices received only the joint baseline workshop. Spirometry quality was assessed by independent lung function technicians. Two outcomes were defined, with the difference between rates of tests with 2 acceptable and repeatable blows being the primary outcome and the difference between rates of tests with 2 acceptable blows being the secondary outcome. We used multilevel logistic regression analysis to calculate odds ratios (ORs) for an adequate test in intervention group practices. We analyzed 1,135 tests. Rate of adequate tests was 33% in intervention and 30% in control group practices (OR = 1.3; P=.605). Adequacy of tests did not differ between groups but tended to increase with time: OR = 2.2 (P = .057) after 3 and OR = 2.0 (P = .086) in intervention group practices after 4 feedback reports. When ignoring test repeatability, these differences between the groups were slightly more pronounced: OR = 2.4 (P = .033) after 3 and OR=2.2 (P = .051) after 4 feedback reports. In the course of 1 year, we observed a small and late effect of e-learning and repeated feedback on the quality of spirometry as performed by family practice nurses. This intervention does not seem to compensate the lack of rigorous training and experience in performing spirometry tests in most practices.

Association of both consistency and strength of self-reported clinician recommendation for HPV vaccination and HPV vaccine uptake among 11- to 12-year-old children.

PubMed

Finney Rutten, Lila J; St Sauver, Jennifer L; Beebe, Timothy J; Wilson, Patrick M; Jacobson, Debra J; Fan, Chun; Breitkopf, Carmen Radecki; Vadaparampil, Susan T; MacLaughlin, Kathy L; Jacobson, Robert M

2017-10-27

We tested the hypotheses that consistency and strength of clinician recommendation of the human papillomavirus (HPV) vaccination would be associated with vaccine delivery rates. From October 2015 through January 2016, we conducted a survey of primary care clinicians (n=227) in Southeastern Minnesota to evaluate clinician behaviors regarding HPV vaccination. The survey response rate was 41.0% (51 clinical sites). We used the Rochester Epidemiology Project, a clinical data linkage infrastructure, to ascertain clinical site-level HPV vaccination rates. We examined associations of clinician self-reports of both the consistency and strength of their recommendations for HPV vaccination for patients aged 11-12years (n=14,406) with site-level vaccination rates. The majority of clinicians reported consistently (always or usually) recommending the HPV vaccine to females (79.0%) and to males (62.2%); 71.9% of clinicians reported strongly recommending the vaccine to females while 58.6% reported strongly recommending to males. Consistency and strength of recommending the HPV vaccine was significantly higher among those practicing in pediatrics and board certified in pediatrics compared to family medicine. Higher rates of initiation (1 dose) [Incidence Rate Ratio (IRR)=1.05; 95% CI (1.01-1.09)] and completion (3 doses) [IRR=1.08; 95% CI (1.02-1.13)] were observed among clinical sites where, on average, clinicians more frequently reported always or usually recommending the vaccine for females compared to sites where, on average, clinicians reported recommending the vaccine less frequently. Similarly, higher rates of initiation [IRR=1.03; 95% CI (1.00-1.06)] and completion [IRR=1.04; CI (1.00, 1.08)] were observed among sites where clinicians reported strongly recommending the vaccine to females more frequently compared to sites where, on average, clinicians reported strongly recommending the HPV vaccine less frequently; similar associations were observed for male initiation [IRR=1.05; CI (1.02,1.08)] and completion [IRR=1.05; 95% CI (1.01, 1.09)]. Consistency and strength of HPV vaccination recommendation was associated with higher vaccination rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

Practice-based learning and improvement: a two-year experience with the reporting of morbidity and mortality cases by general surgery residents.

PubMed

Falcone, John L; Lee, Kenneth K W; Billiar, Timothy R; Hamad, Giselle G

2012-01-01

The Accreditation Council for Graduate Medical Education (ACGME) core competency of practice-based learning and improvement can be assessed with surgical Morbidity and Mortality Conference (MMC). We aim to describe the MMC reporting patterns of general surgery residents, describe the adverse event rate for patients and compare that with existing published rates, and describe the nature of our institutional adverse events. We hypothesize that reporting patterns and incidence rates will remain constant over time. In this retrospective cohort study, archived MMC case lists were evaluated from January 1, 2009 to December 31, 2010. The reporting patterns of the residents, the adverse event ratios, and the specific categories of adverse events were described over the academic years. χ(2) and Fisher's exact tests were used to compare across academic years, using an α = 0.05. There were 85 surgical MMC case lists evaluated. Services achieved a reporting rate above 80% (p < 0.001). The most consistent reporting was done by postgraduate year (PGY) 5 level chief residents for all services (p > 0.05). Out of 11,368 patients evaluated from complete MMC submissions, 289 patients had an adverse event reported (2.5%). This was lower than published reporting rates for patient adverse event rates (p < 0.001). Adverse event rates were consistent for residents at the postgraduate year 2, 4, and 5 levels for all services (p > 0.05). Over 2 years, 522 adverse events were reported for 461 patients. A majority of adverse events were from death (24.1%), hematologic and/or vascular events (16.7%), and gastrointestinal system events (16.1%). Surgery resident MMC reporting patterns and adverse event rates are generally stable over time. This study shows which adverse event cases are important for chief residents to report. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

NASAwide electronic publishing system: Prototype STI electronic document distribution, stage-4 evaluation report

NASA Technical Reports Server (NTRS)

Tuey, Richard C.; Collins, Mary; Caswell, Pamela; Haynes, Bob; Nelson, Michael L.; Holm, Jeanne; Buquo, Lynn; Tingle, Annette; Cooper, Bill; Stiltner, Roy

1996-01-01

This evaluation report contains an introduction, seven chapters, and five appendices. The Introduction describes the purpose, conceptual frame work, functional description, and technical report server of the STI Electronic Document Distribution (EDD) project. Chapter 1 documents the results of the prototype STI EDD in actual operation. Chapter 2 documents each NASA center's post processing publication processes. Chapter 3 documents each center's STI software, hardware, and communications configurations. Chapter 7 documents STI EDD policy, practices, and procedures. The appendices, which arc contained in Part 2 of this document, consist of (1) STI EDD Project Plan, (2) Team members, (3) Phasing Schedules, (4) Accessing On-line Reports, and (5) Creating an HTML File and Setting Up an xTRS. In summary, Stage 4 of the NASAwide Electronic Publishing System is the final phase of its implementation through the prototyping and gradual integration of each NASA center's electronic printing systems, desktop publishing systems, and technical report servers to be able to provide to NASA's engineers, researchers, scientists, and external users the widest practicable and appropriate dissemination of information concerning its activities and the result thereof to their work stations.

NASAwide electronic publishing system-prototype STI electronic document distribution: Stage-4 evaluation report. Part 2; Appendices

NASA Technical Reports Server (NTRS)

Tuey, Richard C.; Collins, Mary; Caswell, Pamela; Haynes, Bob; Nelson, Michael L.; Holm, Jeanne; Buquo, Lynn; Tingle, Annette; Cooper, Bill; Stiltner, Roy

1996-01-01

This evaluation report contains an introduction, seven chapters, and five appendices. The Introduction describes the purpose, conceptual framework, functional description, and technical report server of the Scientific and Technical Information (STI) Electronic Document Distribution (EDD) project. Chapter 1 documents the results of the prototype STI EDD in actual operation. Chapter 2 documents each NASA center's post processing publication processes. Chapter 3 documents each center's STI software, hardware. and communications configurations. Chapter 7 documents STI EDD policy, practices, and procedures. The appendices consist of (A) the STI EDD Project Plan, (B) Team members, (C) Phasing Schedules, (D) Accessing On-line Reports, and (E) Creating an HTML File and Setting Up an xTRS. In summary, Stage 4 of the NASAwide Electronic Publishing System is the final phase of its implementation through the prototyping and gradual integration of each NASA center's electronic printing systems, desk top publishing systems, and technical report servers, to be able to provide to NASA's engineers, researchers, scientists, and external users, the widest practicable and appropriate dissemination of information concerning its activities and the result thereof to their work stations.

Advancing antimicrobial stewardship: Summary of the 2015 CIDSC Report.

PubMed

Khan, F; Arthur, J; Maidment, L; Blue, D

2016-11-03

Antimicrobial resistance (AMR) is recognized as an important global public health concern that has a cross-cutting impact on human health, animal health, food and agriculture and the environment. The Communicable and Infectious Disease Steering Committee (CIDSC) of the Pan-Canadian Public Health Network (PHN) created a Task Group on Antimicrobial Stewardship to look at this issue from a Canadian perspective. To summarize the key findings of the Task Group Report that identified core components of antimicrobial stewardship programs, best practices, key challenges, gaps and recommendations to advance stewardship across jurisdictions. Search strategies were developed to identify scientific literature, grey literature and relevant websites on antimicrobial stewardship. The information was reviewed and based on this evidence, expert opinion and consensus-building, the Task Group identified core components, best practices, key challenges and gaps and developed recommendations to advance stewardship in Canada. The four components of a promising antimicrobial stewardship initiative were: leadership, interventions, monitoring/evaluation and future research. Best practices include a multi-sectoral/multipronged approach involving a wide range of stakeholders at the national, provincial/territorial, local and health care organizational levels. Key challenges and gaps identified were: the success and sustainability of stewardship undertakings require appropriate and sustained resourcing and expertise; there is limited evidence about how to effectively implement treatment guidance; and there is a challenge in ensuring accessibility, standardization and consistency of use among professionals. ​: Recommendations to the CIDSC about how to advance stewardship across jurisdictions included the following: institute a national infrastructure; develop best practices to implement stewardship programs; develop education and promote awareness; establish consistent evidence-based guidance, resources, tools and training; mandate the incorporation of stewardship education; develop audit and feedback tools; establish benchmarks and performance targets for stewardship; and conduct timely evaluation of stewardship programs. Findings of this report will inform a more systematic approach to addressing antimicrobial stewardship Canada-wide.

Influenza Infection Control Practices in Labor and Delivery Units During the 2009 H1N1 Influenza Pandemic

PubMed Central

Williams, Jennifer L.; Mersereau, Patricia W.; Ruch-Ross, Holly; Zapata, Lauren B.; Ruhl, Catherine

2015-01-01

Objective To assess the presence and usefulness of written policies and practices on infection control consistent with the Center for Disease Control and Prevention’s (CDC) guidance in hospital labor and delivery (L&D) units during the 2009 H1N1 influenza pandemic. Setting Online survey. Participants Of 11,845 eligible nurses, 2,641 (22%) participated. This analysis includes a subset of 1,866 nurses who worked exclusively in L&D units. Methods A cross-sectional descriptive evaluation was sent to 12,612 members from the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) who reported working in labor, delivery, postpartum, or newborn care settings during the 2009 H1N1 influenza pandemic. Results Respondents (73.8%) reported that CDC guidance was very useful for infection control in L&D settings during the pandemic. We assessed the presence of the following infection control written policies, consistent with CDC’s guidance in hospital L&D units, during the 2009 H1N1 influenza pandemic and their rate of implementation most of the time: questioning women upon arrival about recent flu-like symptoms (89.4%, 89.9%), immediate initiation of antiviral medicines if flu suspected or confirmed (65.2%, 49%), isolating ill women from healthy women immediately (90.7%, 84.7%), ask ill women to wear masks during L&D (67%, 57.7%), immediately separating healthy newborns from ill mothers (50.9%, 42.4%), and bathing healthy infants when stable (58.4%, 56.9%). Reported written policies for five of the six practices increased during the pandemic. Five of six written policies remained above baseline after the pandemic. Conclusions Respondents considered CDC guidance very useful. The presence of written policies is important for the implementation of infection control practices by L&D nurses. PMID:24020478

An ORCID based synchronization framework for a national CRIS ecosystem.

PubMed

Mendes Moreira, João; Cunha, Alcino; Macedo, Nuno

2015-01-01

PTCRIS (Portuguese Current Research Information System) is a program aiming at the creation and sustained development of a national integrated information ecosystem, to support research management according to the best international standards and practices. This paper reports on the experience of designing and prototyping a synchronization framework for PTCRIS based on ORCID (Open Researcher and Contributor ID). This framework embraces the "input once, re-use often" principle, and will enable a substantial reduction of the research output management burden by allowing automatic information exchange between the various national systems. The design of the framework followed best practices in rigorous software engineering, namely well-established principles in the research field of consistency management, and relied on formal analysis techniques and tools for its validation and verification. The notion of consistency between the services was formally specified and discussed with the stakeholders before the technical aspects on how to preserve said consistency were explored. Formal specification languages and automated verification tools were used to analyze the specifications and generate usage scenarios, useful for validation with the stakeholder and essential to certificate compliant services.

Characteristics of Medical Practices in Three Developed Managed Care Markets

PubMed Central

Landon, Bruce E; Normand, Sharon-Lise T; Frank, Richard; McNeil, Barbara J

2005-01-01

Objective To describe physician practices, ranging from solo and two-physician practices to large medical groups, in three geographically diverse parts of the country with strong managed care presences. Data Sources/Study Design Surveys of medical practices in three managed care markets conducted in 2000–2001. Study Design We administered questionnaires to all medical practices affiliated with two large health plans in Boston, MA, and Portland, OR, and to all practices providing primary care for cardiovascular disease patients admitted to five large hospitals in Minneapolis, MN. We offer data on how physician practices are structured under managed care in these geographically diverse regions of the country with a focus on the structural characteristics, financial arrangements, and care management strategies adopted by practices. Data Collection A two-staged survey consisting of an initial telephone survey that was undertaken using CATI (computerized assisted telephone interviewing) techniques followed by written modules triggered by specific responses to the telephone survey. Principal Findings We interviewed 468 practices encompassing 668 distinct sites of care (overall response rate 72 percent). Practices had an average of 13.9 member physicians (range: 1–125). Most (80.1 percent) medium- (four to nine physicians) and large-size (10 or more physicians) groups regularly scheduled meetings to discuss resource utilization and referrals. Almost 90 percent of the practices reported that these meetings occurred at least once per month. The predominant method for paying practices was via fee-for-service payments. Most other payments were in the form of capitation. Overall, 75 percent of physician practices compensated physicians based on productivity, but there was substantial variation related to practice size. Nonetheless, of the practices that did not use straight productivity methods (45 percent of medium-sized practices and 54 percent of large practices), most used arrangements consisting of combinations of salary and productivity formulas. Conclusions We found diversity in the characteristics and capabilities of medical practices in these three markets with high managed care involvement. Financial practices of most practices are geared towards rewarding productivity, and care management practices and capabilities such as electronic medical records remain underdeveloped. PMID:15960686

Characteristics of medical practices in three developed managed care markets.

PubMed

Landon, Bruce E; Normand, Sharon-Lise T; Frank, Richard; McNeil, Barbara J

2005-06-01

To describe physician practices, ranging from solo and two-physician practices to large medical groups, in three geographically diverse parts of the country with strong managed care presences. Surveys of medical practices in three managed care markets conducted in 2000-2001. We administered questionnaires to all medical practices affiliated with two large health plans in Boston, MA, and Portland, OR, and to all practices providing primary care for cardiovascular disease patients admitted to five large hospitals in Minneapolis, MN. We offer data on how physician practices are structured under managed care in these geographically diverse regions of the country with a focus on the structural characteristics, financial arrangements, and care management strategies adopted by practices. A two-staged survey consisting of an initial telephone survey that was undertaken using CATI (computerized assisted telephone interviewing) techniques followed by written modules triggered by specific responses to the telephone survey. We interviewed 468 practices encompassing 668 distinct sites of care (overall response rate 72 percent). Practices had an average of 13.9 member physicians (range: 1-125). Most (80.1 percent) medium- (four to nine physicians) and large-size (10 or more physicians) groups regularly scheduled meetings to discuss resource utilization and referrals. Almost 90 percent of the practices reported that these meetings occurred at least once per month. The predominant method for paying practices was via fee-for-service payments. Most other payments were in the form of capitation. Overall, 75 percent of physician practices compensated physicians based on productivity, but there was substantial variation related to practice size. Nonetheless, of the practices that did not use straight productivity methods (45 percent of medium-sized practices and 54 percent of large practices), most used arrangements consisting of combinations of salary and productivity formulas. We found diversity in the characteristics and capabilities of medical practices in these three markets with high managed care involvement. Financial practices of most practices are geared towards rewarding productivity, and care management practices and capabilities such as electronic medical records remain underdeveloped.

76 FR 14570 - Federal Acquisition Regulation; Disclosure and Consistency of Cost Accounting Practices for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

...] RIN 9000-AL58 Federal Acquisition Regulation; Disclosure and Consistency of Cost Accounting Practices... Regulation (FAR) to align it with a Cost Accounting Standards (CAS) Board clause, Disclosure and Consistency of Cost Accounting Practices-Foreign Concerns. DATES: Effective Date: March 16, 2011. FOR FURTHER...

Does Believing in "Use It or Lose It" Relate to Self-Rated Memory Control, Strategy Use, and Recall?

ERIC Educational Resources Information Center

Hertzog, Christopher; McGuire, Christy L.; Horhota, Michelle; Jopp, Daniela

2010-01-01

After an oral free recall task, participants were interviewed about their memory. Despite reporting similar levels of perceived personal control over memory, older and young adults differed in the means in which they believed memory could be controlled. Older adults cited health and wellness practices and exercising memory, consistent with a "use…

Ad-Hoc Numbers Forming Provision and Policy: Round and Round of Universal Access in an Australian Preschool

ERIC Educational Resources Information Center

Millei, Zsuzsa; Gallagher, Jannelle

2017-01-01

Australian early childhood education still labours with the achievement of universal access and the production of comprehensive and consistent data to underpin a national evidence base. In this article, we attend to the processes led by numbers whereby new practices of quantification, rationalization and reporting are introduced and mastered in a…

Unearthing Metaphors: Figurativeness in Teacher-Child Talk about Soil and Related Matters

ERIC Educational Resources Information Center

Pramling, Niklas

2010-01-01

This article reports an empirical study of an important but under-studied feature of learning practices with young children: the use of metaphors and other kinds of figurative language. The data consist of video-recordings of children (3-5 years old) and their teacher engaged in thematic work about soil. The analysis revealed that the teacher and…

Generating, Comparing, Manipulating, Categorizing: Reporting, and Sometimes Fabricating Data to Comply with No Child Left Behind Mandates

ERIC Educational Resources Information Center

Koyama, Jill P.

2011-01-01

This article ethnographically examines the ways in which No Child Left Behind (NCLB) links local practices to the centralized processing of data through its narrowing of procedures and measurements aimed at accountability. Framed by actor-network theory, it draws upon data consistently collected between June 2005 and October 2008, and then…

The Emotions in Teaching and Learning Nature Sciences and Physics/Chemistry in Pre-Service Primary Teachers

ERIC Educational Resources Information Center

Brigido, Maria; Bermejo, M. Luisa; Conde, M. Carmen; Mellado, Vicente

2010-01-01

A study was made of different emotions that prospective primary school teachers report with respect to science subjects, when they were pupils, and during their practice teaching, taking into account the variables gender and the specialty they studied in the secondary education. The study consisted of a questionnaire completed by 63 primary…

School Accounting, Budgeting and Finance Challenges. Programs to Help Your School District Improve Its Accounting Procedures, Budgeting Methods and Financial Reporting.

ERIC Educational Resources Information Center

Stolberg, Charles G., Ed.

To help improve school district financial management, the Association of School Business Officials at its 1980 annual meeting held a special session consisting of 20 "mini-workshops" about successful, field-proven practices in school budgeting, accounting, auditing, and other financial tasks. This document provides summaries of the…

Exploring the effects of adolescent perceptions of parenting in free time and gender on adolescent motivation in free time

Treesearch

Clifton E., Jr. Watts; Linda L. Caldwell

2007-01-01

This study examined how gender and perceptions of parenting related to adolescent motivation during free-time. The sample consisted of 377 ninthgraders from high schools in eastern Massachusetts. Significant gender differences were found for rules enacted, with females reporting more rules in place than males. When examining the relationship between parenting practices...

Sustainability in Health care by Allocating Resources Effectively (SHARE) 8: developing, implementing and evaluating an evidence dissemination service in a local healthcare setting.

PubMed

Harris, Claire; Garrubba, Marie; Melder, Angela; Voutier, Catherine; Waller, Cara; King, Richard; Ramsey, Wayne

2018-03-02

This is the eighth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for disinvestment within a large Australian health service. One of the aims was to explore methods to deliver existing high quality synthesised evidence directly to decision-makers to drive decision-making proactively. An Evidence Dissemination Service (EDS) was proposed. While this was conceived as a method to identify disinvestment opportunities, it became clear that it could also be a way to review all practices for consistency with current evidence. This paper reports the development, implementation and evaluation of two models of an in-house EDS. Frameworks for development of complex interventions, implementation of evidence-based change, and evaluation and explication of processes and outcomes were adapted and/or applied. Mixed methods including a literature review, surveys, interviews, workshops, audits, document analysis and action research were used to capture barriers, enablers and local needs; identify effective strategies; develop and refine proposals; ascertain feedback and measure outcomes. Methods to identify, capture, classify, store, repackage, disseminate and facilitate use of synthesised research evidence were investigated. In Model 1, emails containing links to multiple publications were sent to all self-selected participants who were asked to determine whether they were the relevant decision-maker for any of the topics presented, whether change was required, and to take the relevant action. This voluntary framework did not achieve the aim of ensuring practice was consistent with current evidence. In Model 2, the need for change was established prior to dissemination, then a summary of the evidence was sent to the decision-maker responsible for practice in the relevant area who was required to take appropriate action and report the outcome. This mandatory governance framework was successful. The factors influencing decisions, processes and outcomes were identified. An in-house EDS holds promise as a method of identifying disinvestment opportunities and/or reviewing local practice for consistency with current evidence. The resource-intensive nature of delivery of the EDS is a potential barrier. The findings from this study will inform further exploration.

Human Milk Handling and Storage Practices Among Peer Milk-Sharing Mothers.

PubMed

Reyes-Foster, Beatriz M; Carter, Shannon K; Hinojosa, Melanie Sberna

2017-02-01

Peer milk sharing, the noncommercial sharing of human milk from one parent or caretaker directly to another for the purposes of feeding a child, appears to be an increasing infant-feeding practice. Although the U.S. Food and Drug Administration has issued a warning against the practice, little is known about how people who share human milk handle and store milk and whether these practices are consistent with clinical safety protocols. Research aim: This study aimed to learn about the milk-handling practices of expressed human milk by milk-sharing donors and recipient caretakers. In this article, we explore the degree to which donors and recipients adhere to the Academy of Breastfeeding Medicine clinical recommendations for safe handling and storage. Online surveys were collected from 321 parents engaged in peer milk sharing. Univariate descriptive statistics were used to describe the safe handling and storage procedures for milk donors and recipients. A two-sample t-test was used to compare safety items common to each group. Multivariate ordinary least squares regression analysis was used to examine sociodemographic correlates of milk safety practices within the sample group. Findings indicate that respondents engaged in peer milk sharing report predominantly positive safety practices. Multivariate analysis did not reveal any relationship between safety practices and sociodemographic characteristics. The number of safe practices did not differ between donors and recipients. Parents and caretakers who participate in peer human milk sharing report engaging in practices that should reduce risk of bacterial contamination of expressed peer shared milk. More research on this particular population is recommended.

Good research practices for measuring drug costs in cost-effectiveness analyses: a societal perspective: the ISPOR Drug Cost Task Force report--Part II.

PubMed

Garrison, Louis P; Mansley, Edward C; Abbott, Thomas A; Bresnahan, Brian W; Hay, Joel W; Smeeding, James

2010-01-01

Major guidelines regarding the application of cost-effectiveness analysis (CEA) have recommended the common and widespread use of the "societal perspective" for purposes of consistency and comparability. The objective of this Task Force subgroup report (one of six reports from the International Society for Pharmacoeconomics and Outcomes Research [ISPOR] Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis [Drug Cost Task Force (DCTF)]) was to review the definition of this perspective, assess its specific application in measuring drug costs, identify any limitations in theory or practice, and make recommendations regarding potential improvements. Key articles, books, and reports in the methodological literature were reviewed, summarized, and integrated into a draft review and report. This draft report was posted for review and comment by ISPOR membership. Numerous comments and suggestions were received, and the report was revised in response to them. The societal perspective can be defined by three conditions: 1) the inclusion of time costs, 2) the use of opportunity costs, and 3) the use of community preferences. In practice, very few, if any, published CEAs have met all of these conditions, though many claim to have taken a societal perspective. Branded drug costs have typically used actual acquisition cost rather than the much lower social opportunity costs that would reflect only short-run manufacturing and distribution costs. This practice is understandable, pragmatic, and useful to current decision-makers. Nevertheless, this use of CEA focuses on static rather than dynamic efficacy and overlooks the related incentives for innovation. Our key recommendation is that current CEA practice acknowledge and embrace this limitation by adopting a new standard for the reference case as one of a "limited societal" or "health systems" perspective, using acquisition drug prices while including indirect costs and community preferences. The field of pharmacoeconomics also needs to acknowledge the limitations of this perspective when it comes to important questions of research and development costs, and incentives for innovation.

Oncology Practice Trends From the National Practice Benchmark

PubMed Central

Barr, Thomas R.; Towle, Elaine L.

2012-01-01

In 2011, we made predictions on the basis of data from the National Practice Benchmark (NPB) reports from 2005 through 2010. With the new 2011 data in hand, we have revised last year's predictions and projected for the next 3 years. In addition, we make some new predictions that will be tracked in future benchmarking surveys. We also outline a conceptual framework for contemplating these data based on an ecological model of the oncology delivery system. The 2011 NPB data are consistent with last year's prediction of a decrease in the operating margins necessary to sustain a community oncology practice. With the new data in, we now predict these reductions to occur more slowly than previously forecast. We note an ease to the squeeze observed in last year's trend analysis, which will allow more time for practices to adapt their business models for survival and offer the best of these practices an opportunity to invest earnings into operations to prepare for the inevitable shift away from historic payment methodology for clinical service. This year, survey respondents reported changes in business structure, first measured in the 2010 data, indicating an increase in the percentage of respondents who believe that change is coming soon, but the majority still have confidence in the viability of their existing business structure. Although oncology practices are in for a bumpy ride, things are looking less dire this year for practices participating in our survey. PMID:23277766

Diabetes in the Cape Coast metropolis of Ghana: an assessment of risk factors, nutritional practices and lifestyle changes.

PubMed

Gato, Worlanyo E; Acquah, Samuel; Apenteng, Bettye A; Opoku, Samuel T; Boakye, Blessed K

2017-09-01

Despite the significant increase in the incidence of diabetes in Ghana, research in this area has been lagging. The purpose of the study was to assess the risk factors associated with diabetes in the Cape Coast metropolis of Ghana, and to describe nutritional practices and efforts toward lifestyle change. A convenient sample of 482 adults from the Cape Coast metropolis was surveyed using a self-reported questionnaire. The survey collected information on the demographic, socioeconomic characteristics, health status and routine nutritional practices of respondents. The aims of the study were addressed using multivariable regression analyses. A total of 8% of respondents reported that they had been diagnosed with diabetes. Older age and body weight were found to be independently associated with diabetes. Individuals living with diabetes were no more likely than those without diabetes to have taken active steps at reducing their weight. The percentage of self-reported diabetes in this population was consistent with what has been reported in previous studies in Ghana. The findings from this study highlight the need for more patient education on physical activity and weight management. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Low back pain-related beliefs and likely practice behaviours among final-year cross-discipline health students.

PubMed

Briggs, A M; Slater, H; Smith, A J; Parkin-Smith, G F; Watkins, K; Chua, J

2013-05-01

Evidence points to clinicians' beliefs and practice behaviours related to low back pain (LBP), which are discordant with contemporary evidence. While interventions to align beliefs and behaviours with evidence among clinicians have demonstrated effectiveness, a more sustainable and cost-effective approach to positively developing workforce capacity in this area may be to target the emerging workforce. The aim of this study was to investigate beliefs and clinical recommendations for LBP, and their alignment to evidence, in Australian university allied health and medical students. Final-year students in chiropractic, medicine, occupational therapy, pharmacy and physiotherapy disciplines in three Western Australian universities responded to a survey. Demographic data, LBP-related beliefs data [modified Health Care Providers Pain and Impact Relationship Scale (HC-PAIRS) and the Back Pain Beliefs Questionnaire (BBQ)] and activity, rest and work clinical recommendations for an acute LBP clinical vignette were collected. Six hundred two students completed the survey (response rate 74.6%). Cross-discipline differences in beliefs and clinical recommendations were observed (p > 0.001). Physiotherapy and chiropractic students reported significantly more helpful beliefs compared with the other disciplines, while pharmacy students reported the least helpful beliefs. A greater proportion of chiropractic and physiotherapy students reported guideline-consistent recommendations compared with other disciplines. HC-PAIRS and BBQ scores were strongly associated with clinical recommendations, independent to the discipline of study and prior experience of LBP. Aligning cross-discipline university curricula with current evidence may provide an opportunity to facilitate translation of this evidence into practice with a focus on a consistent, cross-discipline approach to LBP management. © 2012 European Federation of International Association for the Study of Pain Chapters.

Utilisation and Safety of Deferasirox: Results from an Observational Cohort Study in England.

PubMed

Osborne, Vicki; Davies, Miranda; Layton, Deborah; Shakir, Saad A W

2018-03-01

Deferasirox (EXJADE ® , Novartis, UK) is an oral iron-chelating agent primarily used to reduce chronic iron overload in patients receiving blood transfusions for various chronic anaemias and some non-transfusion dependant anaemias. The aim of this study was to examine the utilisation and safety of deferasirox used in general practice in England. A single exposure observational cohort study design was used. Patients were identified from dispensed prescriptions for deferasirox between September 2006 and September 2014. Outcome data were collected via postal questionnaires sent to prescribers ≥ 6 months after first dispensed prescription for an individual patient. Summary descriptive statistics were calculated. The evaluable cohort consisted of 122 patients, of which 41.8% were aged 2-17 years. Frequent reasons for prescribing were sickle cell anaemia (27/103 where specified, 26.2%) and beta thalassaemia (26, 25.2%). The majority of patients (43/51, 84.3%) were prescribed the licensed doses of 10 or 20 mg/kg/day at start. Prior measurements of serum creatinine were only reported for a small proportion this study (18/122, 14.8%). In total, 91 incident events were reported, including two of raised serum creatinine. These results show that deferasirox is largely being prescribed for its licensed indications in general practice in England and events reported were consistent with the known safety profile.

[Quality standards for ultrasound assessment of the superficial venous system of the lower limbs. Report of the French Society for Vascular Medicine].

PubMed

Auvert, J-F; Chleir, F; Coppé, G; Hamel-Desnos, C; Moraglia, L; Pichot, O

2014-02-01

The quality standards of the French Society for Vascular Medicine for the ultrasound assessment of the superficial venous system of the lower limbs are based on the two following requirements: technical know-how (mastering the use of ultrasound devices and the method of examination); medical know-how (ability to adapt the methods and scope of the examination to its clinical indications and purpose and to rationally analyze and interpret its results). To describe an optimal method of examination in relation to the clinical question and hypothesis; to achieve consistent practice, methods, glossary terminologies and reporting; to provide good practice reference points and to promote a high quality process. The three levels of examination. Their clinical indications and goals. The reference standard examination (level 2) and its variants according to clinical needs. The minimal content of the examination report, the letter to the referring physician (synthesis, conclusion and management suggestions) and iconography. Commented glossary (anatomy, hemodynamics, semiology). Technical basis. Ultrasound devices settings. We discuss of use of Duplex ultrasound for the assessment of the superficial veins of the lower limbs in vascular medicine practice. Copyright © 2014. Published by Elsevier Masson SAS.

Sexual Behavior and Contraceptive Use among 18- to 19-Year-Old Adolescent Women by Weight Status: A Longitudinal Analysis.

PubMed

Chang, Tammy; Davis, Matthew M; Kusunoki, Yasamin; Ela, Elizabeth J; Hall, Kelli S; Barber, Jennifer S

2015-09-01

To describe the association between weight status and sexual practices among 18- to 19-year-old women. We analyzed a population-based longitudinal study of 18- to 19-year-old women residing in a Michigan county at cohort inception. Weekly journal surveys measured sexual practices, including contraceptive behaviors. Outcomes included proportion of weeks with a partner, proportion of weeks with sexual intercourse, number of partners, average length of relationships, proportion of weeks with contraception use, and proportion of weeks where contraception was used consistently. We examined 26,545 journal surveys from 900 women over the first study year. Ordinary least squares regression models for each outcome examined differences by weight status, controlling for sociodemographic characteristics. The mean proportion of weeks in which adolescents reported sexual intercourse was 52%; there was no difference by weight status. Among weeks in which adolescents reported sexual activity, obese adolescents had a lower proportion of weeks where any contraception was used compared with normal weight adolescents (84% vs 91%, P = .011). Among weeks in which adolescents reported sexual activity and contraceptive use, obese adolescents had a lower proportion of weeks with consistent contraceptive use (68% vs 78%, P = .016) and oral contraceptive pill use (27% vs 45%, P = .001) compared with normal weight adolescents. All other relationships by weight status were not statistically significant. In this longitudinal study, obese adolescent women were less likely to use contraception, and less likely to use it consistently when compared with normal weight peers. Findings suggest obesity may be an important factor associated with adolescent women's sexual behavior. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Sexual Behavior and Contraceptive Use Among 18 to 19 year old Adolescent Women By Weight Status: A Longitudinal Analysis

PubMed Central

Chang, Tammy; Davis, Matthew M.; Kusunoki, Yasamin; Ela, Elizabeth J.; Hall, Kelli S.; Barber, Jennifer S.

2015-01-01

Objective To describe the association between weight status and sexual practices among 18-19 year-old women. Study design We analyzed a population-based longitudinal study of 18-19 year-old women residing in a Michigan county at cohort inception. Weekly journal surveys measured sexual practices, including contraceptive behaviors. Outcomes included proportion of weeks with a partner, proportion of weeks with sexual intercourse, number of partners, average length of relationships, proportion of weeks with contraception use, and proportion of weeks where contraception was used consistently. We examined 26,545 journal surveys from 900 women over the first study year. Ordinary least squares regression models for each outcome examined differences by weight status, controlling for sociodemographic characteristics. Results The mean proportion of weeks in which adolescents reported sexual intercourse was 52%; there was no difference by weight status. Among weeks in which adolescents reported sexual activity, obese adolescents had a lower proportion of weeks where any contraception was used compared with normal-weight adolescents (84% vs 91%, p=0.011). Among weeks in which adolescents reported sexual activity and contraceptive use, obese adolescents had a lower proportion of weeks with consistent contraceptive use (68% vs 78%, p=0.016) and oral contraceptive pill use (27% vs 45%, p=0.001) compared with normal-weight adolescents. All other relationships by weight status were not statistically significant. Conclusions In this longitudinal study, obese adolescent women were less likely to use contraception, and less likely to use it consistently when compared with normal-weight peers. Findings suggest obesity may be an important factor associated with adolescent women’s sexual behavior. PMID:26143383

Understanding diagnosis and management of dementia and guideline implementation in general practice: a qualitative study using the theoretical domains framework.

PubMed

Murphy, Kerry; O'Connor, Denise A; Browning, Colette J; French, Simon D; Michie, Susan; Francis, Jill J; Russell, Grant M; Workman, Barbara; Flicker, Leon; Eccles, Martin P; Green, Sally E

2014-03-03

Dementia is a growing problem, causing substantial burden for patients, their families, and society. General practitioners (GPs) play an important role in diagnosing and managing dementia; however, there are gaps between recommended and current practice. The aim of this study was to explore GPs' reported practice in diagnosing and managing dementia and to describe, in theoretical terms, the proposed explanations for practice that was and was not consistent with evidence-based guidelines. Semi-structured interviews were conducted with GPs in Victoria, Australia. The Theoretical Domains Framework (TDF) guided data collection and analysis. Interviews explored the factors hindering and enabling achievement of 13 recommended behaviours. Data were analysed using content and thematic analysis. This paper presents an in-depth description of the factors influencing two behaviours, assessing co-morbid depression using a validated tool, and conducting a formal cognitive assessment using a validated scale. A total of 30 GPs were interviewed. Most GPs reported that they did not assess for co-morbid depression using a validated tool as per recommended guidance. Barriers included the belief that depression can be adequately assessed using general clinical indicators and that validated tools provide little additional information (theoretical domain of 'Beliefs about consequences'); discomfort in using validated tools ('Emotion'), possibly due to limited training and confidence ('Skills'; 'Beliefs about capabilities'); limited awareness of the need for, and forgetting to conduct, a depression assessment ('Knowledge'; 'Memory, attention and decision processes'). Most reported practising in a manner consistent with the recommendation that a formal cognitive assessment using a validated scale be undertaken. Key factors enabling this were having an awareness of the need to conduct a cognitive assessment ('Knowledge'); possessing the necessary skills and confidence ('Skills'; 'Beliefs about capabilities'); and having adequate time and resources ('Environmental context and resources'). This is the first study to our knowledge to use a theoretical approach to investigate the barriers and enablers to guideline-recommended diagnosis and management of dementia in general practice. It has identified key factors likely to explain GPs' uptake of the guidelines. The results have informed the design of an intervention aimed at supporting practice change in line with dementia guidelines, which is currently being evaluated in a cluster randomised trial.

Interinstitutional review of slides for forensic pathology: types of inconsistencies.

PubMed

Ersoy, Gokhan; Akyildiz, Elif Ulker; Korkmaz, Gulay; Albek, Emre

2010-09-01

Because of the specific structure of forensic medicine in Turkey, reexamination of histopathologic specimens is a frequent practice. The aim of the present study is the assessment of microscopic diagnostic consistency in forensic pathology between different laboratories. Reports of the Council of Forensic Medicine between 2001 and 2004 were examined, and 150 cases with second pathologic examination were found. Results of histopathologic reports from peripheral laboratories were compared with those made by the Council pathologists with regard to diagnostic consistency. Consistency was assessed in 3 groups and 1 subgroup. Group 1, consistent and minor inconsistency; includes a major consistency subgroup. Group 2, major inconsistency, is the second diagnosis which is lethal; group 3, major inconsistency, is the first diagnosis which is lethal. The lung was found to be the organ with the highest frequency of diagnostic major inconsistency (group 2 and 3) and major consistency. Bronchopneumonia was the most common diagnosis. The brain had the highest frequency of intercenter diagnostic overall consistency (90.2%, group 1). Myocardial infarction was the diagnosis most frequently rejected on reevaluation (group 3). In conclusion, forensic pathology requires different experience than surgical ones. In cases of discrepancy between the anamnesis of the lethal event and pathologic findings, reevaluation of specimen is mandatory to avoid any diagnostic errors. Quality assurance systems with all include internal and external control mechanisms will improve the diagnostic reliability.

Rural Disparities in the Distribution of Policies that Support Healthy Eating in US Secondary Schools

PubMed Central

Nanney, Marilyn S.; Davey, Cynthia S.; Kubik, Martha Y.

2017-01-01

The distribution of food and nutrition policies and practices from 28 US states representing 6,732 secondary schools was evaluated using data from the 2008 School Health Profiles principal survey. School policies and practices evaluated were: availability of low-nutrient, energy-dense (LNED) snacks/drinks; use of healthy eating strategies; banning food marketing; availability of fruits and vegetables; and food package sizes. For each school, school-level demographic characteristics (percentage of students enrolled in free/reduced-price meals, minority enrollment, and geographic location) were also evaluated. Schools in small town/rural locations had significantly fewer policies that support healthy eating strategies and ban food marketing, and were less likely to serve fruits and vegetables at school celebrations, have fruits and vegetables available in vending or school stores, and limit serving-size packages. Schools serving the highest percentage of minority students consistently reported the same or better school food environments. However, schools serving the highest percentage of low-income students had varied results: vending and LNED vending policies were consistently better and fruit and vegetable availability–related policies were consistently worse. Disparities in the distribution of policies and practices that promote healthy school food environments seem most pronounced in small town/rural schools. The data also support the need for continued reinforcement and the potential for expansion of these efforts in urban and suburban areas and schools with highest minority enrollment. PMID:23885703

Artificial Intelligence for Pathologists Is Not Near--It Is Here: Description of a Prototype That Can Transform How We Practice Pathology Tomorrow.

PubMed

Ye, Jay J

2015-07-01

Pathologists' daily tasks consist of both the professional interpretation of slides and the secretarial tasks of translating these interpretations into final pathology reports, the latter of which is a time-consuming endeavor for most pathologists. To describe an artificial intelligence that performs secretarial tasks, designated as Secretary-Mimicking Artificial Intelligence (SMILE). The underling implementation of SMILE is a collection of computer programs that work in concert to "listen to" the voice commands and to "watch for" the changes of windows caused by slide bar code scanning; SMILE responds to these inputs by acting upon PowerPath Client windows (Sunquest Information Systems, Tucson, Arizona) and its Microsoft Word (Microsoft, Redmond, Washington) Add-In window, eventuating in the reports being typed and finalized. Secretary-Mimicking Artificial Intelligence also communicates relevant information to the pathologist via the computer speakers and message box on the screen. Secretary-Mimicking Artificial Intelligence performs many secretarial tasks intelligently and semiautonomously, with rapidity and consistency, thus enabling pathologists to focus on slide interpretation, which results in a marked increase in productivity, decrease in errors, and reduction of stress in daily practice. Secretary-Mimicking Artificial Intelligence undergoes encounter-based learning continually, resulting in a continuous improvement in its knowledge-based intelligence. Artificial intelligence for pathologists is both feasible and powerful. The future widespread use of artificial intelligence in our profession is certainly going to transform how we practice pathology.

The Role of Unconditional Parental Regard in Autonomy-Supportive Parenting.

PubMed

Roth, Guy; Kanat-Maymon, Yaniv; Assor, Avi

2016-12-01

Two studies explored the role of parents' unconditional positive regard (UCPR) as perceived by adolescents and young adults in promoting the effectiveness of specific parenting practices that may support offspring's academic autonomous motivation. Study 1 tested the hypothesis that UCPR predicts rationale-giving and choice-provision practices and, at the same time, moderates their relations with adolescents' autonomous motivation. Study 2 replicated the association between UCPR and the parental practices, and further explored the role of parents' authenticity as an antecedent of UCPR and parental autonomy support. Study 1 included 125 adolescents and Study 2 considered 128 college-students and their mothers. The offspring reported on their perceptions of their mothers and on their autonomous motivation, and the mothers reported on their sense of authenticity. Both studies found consistent associations between UCPR and parenting practices that may support autonomous motivation. Moreover, Study 1 demonstrated that the rationale giving and choice provision were more strongly related to adolescents' autonomous motivation when adolescents perceived mothers as high on UCPR. Finally, Study 2 demonstrated that mothers' authenticity predicted UCPR, which in turn was related to autonomy-supportive parenting. Findings support the assumption that parents' autonomy-supportive practices are more effective when accompanied by UCPR. © 2015 Wiley Periodicals, Inc.

School-based practice patterns: a survey of occupational therapists in Colorado.

PubMed

Spencer, Karen C; Turkett, Amanda; Vaughan, Roberta; Koenig, Sandra

2006-01-01

This purpose of this study was to describe school-based occupational therapy practice for kindergarten through twelfth-grade students in Colorado and to examine occupational therapy practice in light of current education policy and published views of best practice. Study data were provided by 105 occupational therapists and occupational therapy assistants who completed a 24-item questionnaire. Occupational therapists carried an average caseload of 43.68 students; most frequently served kindergarten through third-grade students with perceptual or communicative disabilities; and delivered services most often in pullout treatment areas. Practitioners spent most of their work week providing direct services. Remedial or developmental approaches were used 62% of the time and compensatory and educational approaches 37% of the time. Individualized education program goals addressed by occupational therapists were most frequently developed by the occupational therapist and targeted students' sensory or motor impairments. Workshops on autism and sensorimotor intervention techniques were reported as the primary and preferred forms of professional development. The strong majority of reported occupational therapy services contrasted with emerging views of best practice. They were, however, consistent with the Colorado Department of Education's guidelines for "motor specialists" that address occupational therapy, physical therapy, and adaptive physical educators working in schools. Study findings are discussed.

Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review.

PubMed

Jünger, Saskia; Payne, Sheila A; Brine, Jenny; Radbruch, Lukas; Brearley, Sarah G

2017-09-01

The Delphi technique is widely used for the development of guidance in palliative care, having impact on decisions with relevance for patient care. To systematically examine the application of the Delphi technique for the development of best practice guidelines in palliative care. A methodological systematic review was undertaken using the databases PubMed, CINAHL, Web of Science, Academic Search Complete and EMBASE. Original articles (English language) were included when reporting on empirical studies that had used the Delphi technique to develop guidance for good clinical practice in palliative care. Data extraction included a quality appraisal on the rigour in conduct of the studies and the quality of reporting. A total of 30 empirical studies (1997-2015) were considered for full-text analysis. Considerable differences were identified regarding the rigour of the design and the reporting of essential process and outcome parameters. Furthermore, discrepancies regarding the use of terms for describing the method were observed, for example, concerning the understanding of a 'round' or a 'modified Delphi study'. Substantial variation was found concerning the quality of the study conduct and the transparency of reporting of Delphi studies used for the development of best practice guidance in palliative care. Since credibility of the resulting recommendations depends on the rigorous use of the Delphi technique, there is a need for consistency and quality both in the conduct and reporting of studies. To allow a critical appraisal of the methodology and the resulting guidance, a reporting standard for Conducting and REporting of DElphi Studies (CREDES) is proposed.

Public health leadership development: factors contributing to growth.

PubMed

Olson, Linda G

2013-01-01

This study compares pre- and posttest Leadership Practices Inventory (LPI-Self) scores for public health leaders who completed the Regional Institute for Health and Environmental Leadership (RIHEL) training program at least 2 years earlier; it seeks to identify factors contributing to changes in practices and overall leadership development for public health and environment leaders. Sixty-seven alumni who completed the yearlong RIHEL program between 1999 and 2002 participated through mailed surveys and phone interviews. The Leadership Practices Inventory, an alumni leadership development survey, and interviews provided evidence for positive change in leadership practices. Alumni experienced significant increases in pre- to post-LPI scores, collaborative leadership practices, and communication skills consistent with those taught in the RIHEL program. Women presented higher Encourage the Heart scores than men. Years of public health service negatively correlated with Total Change scores of LPI. The RIHEL program as a training intervention was credited significantly with changes in leadership practices for alumni studied. Nine influencing factors were identified for leadership development and are embedded in a Leadership Development Influence Model. These include self-awareness, a leadership development framework, and skills important in multiple leadership situations. Confidence was both an encouraging factor and a resulting factor to the increased exemplary leadership practices. Leadership development in public health must include multiple factors to create consistent increases in exemplary leadership practices. While the study focused on the leadership development process itself, RIHEL training was reported as having a positive, significant impact overall in participant leadership development. This study adds research data as a foundation for training content areas of focus. Studies to further test the Leadership Development Influence Model will allow public health training programs to pinpoint training where it can make a difference to improve leadership development in the public health sector.

How do Australian patients rate their general practitioner? A descriptive study using the General Practice Assessment Questionnaire.

PubMed

Potiriadis, Maria; Chondros, Patty; Gilchrist, Gail; Hegarty, Kelsey; Blashki, Grant; Gunn, Jane M

2008-08-18

To report patient responses to the General Practice Assessment Questionnaire (GPAQ) as a measure of satisfaction with health care received from Australian general practitioners. A clustered cross-sectional study involving general practice patients from 30 randomly selected general practices in Victoria. Between January and December 2005, a screening survey, including a postal version of the GPAQ, was mailed to 17 780 eligible patients. Scores on the six GPAQ items. We analysed data from 7130 patients who completed the screening survey and fulfilled our eligibility criteria. Levels of patient satisfaction with general practice care were generally high: mean GPAQ scores ranged from 68.6 (95% CI, 66.1-71.0) for satisfaction with access to the practice to 84.0 (95% CI, 82.2-85.4) for satisfaction with communication. Intracluster correlations for the GPAQ items ranged from 0.016 for overall satisfaction with the practice to 0.163 for satisfaction with access to the practice. Compared with national benchmarks in the United Kingdom, the GPs and practices participating in our study were rated higher on all six GPAQ items. Multivariable mixed effects linear regression showed that patients who were older, rated their health more highly, visited their GP more frequently and saw the same GP each time tended to express greater satisfaction with their care. Generally patients reported high levels of satisfaction with GP care. Greater satisfaction with care was associated with older patients, good health, more frequent contact with the GP, and seeing the one GP consistently.

Investigating cognitive transfer within the framework of music practice: genetic pleiotropy rather than causality.

PubMed

Mosing, Miriam A; Madison, Guy; Pedersen, Nancy L; Ullén, Fredrik

2016-05-01

The idea of far transfer effects in the cognitive sciences has received much attention in recent years. One domain where far transfer effects have frequently been reported is music education, with the prevailing idea that music practice entails an increase in cognitive ability (IQ). While cross-sectional studies consistently find significant associations between music practice and IQ, randomized controlled trials, however, report mixed results. An alternative to the hypothesis of cognitive transfer effects is that some underlying factors, such as shared genes, influence practice behaviour and IQ causing associations on the phenotypic level. Here we explored the hypothesis of far transfer within the framework of music practice. A co-twin control design combined with classical twin-modelling based on a sample of more than 10,500 twins was used to explore causal associations between music practice and IQ as well as underlying genetic and environmental influences. As expected, phenotypic associations were moderate (r = 0.11 and r = 0.10 for males and females, respectively). However, the relationship disappeared when controlling for genetic and shared environmental influences using the co-twin control method, indicating that a highly practiced twin did not have higher IQ than the untrained co-twin. In line with that finding, the relationship between practice and IQ was mostly due to shared genetic influences. Findings strongly suggest that associations between music practice and IQ in the general population are non-causal in nature. The implications of the present findings for research on plasticity, modularity, and transfer are discussed. © 2015 John Wiley & Sons Ltd.

Observing practice leadership in intellectual and developmental disability services.

PubMed

Beadle-Brown, J; Bigby, C; Bould, E

2015-12-01

Improving staff performance is an issue in services for people with intellectual disability. Practice leadership, where the front line leader of a staff team focuses on service user outcomes in everything they do and provides coaching, modeling, supervision and organisation to the team, has been identified as important in improving staff performance. To date this finding is based only on self-report measures. This paper describes and tests an observational measure of practice leadership based on an interview with the front-line manager, a review of paperwork and observations in 58 disability services in Australia. The measure showed good internal consistency and acceptable inter-rater reliability. Practice leadership was associated with staff practice and outcomes for service users. The observed measure of practice leadership appears to be a useful tool for assessing whether leadership within a service promotes enabling and empowering support by staff. It was found to discriminate higher and lower performing services in terms of active support. The measure had good reliability and validity although some further testing is required to give a complete picture of the possible uses and reliability of the measure. The measure is potentially useful in contexts of both research and service development. The confirmation of previous findings from self-report measures that practice leadership is related to the quality of staff practice and outcomes for service users has implications for policy and practice in terms of the training of managers and structures for organisational management. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

The Harvard Medical School Academic Innovations Collaborative: transforming primary care practice and education.

PubMed

Bitton, Asaf; Ellner, Andrew; Pabo, Erika; Stout, Somava; Sugarman, Jonathan R; Sevin, Cory; Goodell, Kristen; Bassett, Jill S; Phillips, Russell S

2014-09-01

Academic medical centers (AMCs) need new approaches to delivering higher-quality care at lower costs, and engaging trainees in the work of high-functioning primary care practices. In 2012, the Harvard Medical School Center for Primary Care, in partnership with with local AMCs, established an Academic Innovations Collaborative (AIC) with the goal of transforming primary care education and practice. This novel two-year learning collaborative consisted of hospital- and community-based primary care teaching practices, committed to building highly functional teams, managing populations, and engaging patients. The AIC built on models developed by Qualis Health and the Institute for Healthcare Improvement, optimized for the local AMC context. Foundational elements included leadership engagement and development, application of rapid-cycle process improvement, and the creation of teams to care for defined patient populations. Nineteen practices across six AMCs participated, with nearly 260,000 patients and 450 resident learners. The collaborative offered three 1.5-day learning sessions each year featuring shared learning, practice coaches, and improvement measures, along with monthly data reporting, webinars, and site visits. Validated self-reports by transformation teams showed that practices made substantial improvement across all areas of change. Important factors for success included leadership development, practice-level resources, and engaging patients and trainees. The AIC model shows promise as a path for AMCs to catalyze health system transformation through primary care improvement. In addition to further evaluating the impact of practice transformation, expansion will require support from AMCs and payers, and the application of similar approaches on a broader scale.

Effects of Personal Protective Equipment Use and Good Workplace Hygiene on Symptoms of Neurotoxicity in Solvent-Exposed Vehicle Spray Painters.

PubMed

Keer, Sam; McLean, Dave; Glass, Bill; Douwes, Jeroen

2018-03-12

To assess the association between the use of personal protective equipment (PPE) and good workplace hygiene and symptoms of neurotoxicity in solvent-exposed vehicle spray painters. Exposure control measures including PPE-use and workplace hygiene practices and symptoms of neurotoxicity were assessed in 267 vehicle repair spray painters. Symptoms were assessed using an adapted version of the EUROQUEST Questionnaire. Frequent respirator and glove use was inversely and significantly associated with symptoms of neurotoxicity in a dose-dependent manner (P < 0.05 for trend) with the strongest protective effect found for consistent glove use (odds ratios [OR] 0.1-0.2, P < 0.01, for reporting ≥10 and ≥5 symptoms). A clear dose-response trend was also observed when combining frequency of respirator and glove use (P < 0.05 for reporting ≥5 and ≥10 symptoms), with an overall reduction in risk of 90% (OR, 0.1, P < 0.01) for those who consistently used both types of PPE. Protective effects were most pronounced for the symptom domains of psychosomatic (P < 0.05 for trend, for combined PPE use), mood (P < 0.05), and memory and concentration symptoms combined (P < 0.05), with reductions in risk of >80%. Poor hygiene workplace practices, such as solvent exposure to multiple body parts (OR 3.4, P = 0.11 for reporting ≥10 symptoms), were associated with an increased risk of symptoms. When using a general workplace hygiene score derived from a combination of PPE-use and (good) workplace practice factors an inverse and significant dose-response trend was observed for reporting ≥5 (P < 0.01) and ≥10 symptoms (P < 0.01). This study has shown that PPE-use and good workplace hygiene are associated with a strongly reduced risk of symptoms of neurotoxicity in solvent-exposed vehicle spray painters.

Measuring teacher self-report on classroom practices: Construct validity and reliability of the Classroom Strategies Scale-Teacher Form.

PubMed

Reddy, Linda A; Dudek, Christopher M; Fabiano, Gregory A; Peters, Stephanie

2015-12-01

This article presents information about the construct validity and reliability of a new teacher self-report measure of classroom instructional and behavioral practices (the Classroom Strategies Scales-Teacher Form; CSS-T). The theoretical underpinnings and empirical basis for the instructional and behavioral management scales are presented. Information is provided about the construct validity, internal consistency, test-retest reliability, and freedom from item-bias of the scales. Given previous investigations with the CSS Observer Form, it was hypothesized that internal consistency would be adequate and that confirmatory factor analyses (CFA) of CSS-T data from 293 classrooms would offer empirical support for the CSS-T's Total, Composite and subscales, and yield a similar factor structure to that of the CSS Observer Form. Goodness-of-fit indices of χ2/df, Root Mean Square Error of Approximation, Goodness of Fit Index, and Adjusted Goodness of Fit Index suggested satisfactory fit of proposed CFA models whereas the Comparative Fit Index did not. Internal consistency estimates of .93 and .94 were obtained for the Instructional Strategies and Behavioral Strategies Total scales respectively. Adequate test-retest reliability was found for instructional and behavioral total scales (r = .79, r = .84, percent agreement 93% and 93%). The CSS-T evidences freedom from item bias on important teacher demographics (age, educational degree, and years of teaching experience). Implications of results are discussed. (c) 2015 APA, all rights reserved).

Implementation in action: how Australian Exercise Physiologists approach exercise prescription for people with mental illness.

PubMed

Stanton, Robert; Rosenbaum, Simon; Lederman, Oscar; Happell, Brenda

2018-04-01

Accredited Exercise Physiologists (AEPs) are trained to deliver exercise and physical activity interventions for people with chronic and complex health conditions including those with mental illness. However, their views on exercise for mental illness, their exercise prescription practices, and need for further training are unknown. To examine the way in which Australian AEPs prescribe exercise for people with mental illness. Eighty-one AEPs (33.3 ± 10.4 years) completed an online version of the Exercise in Mental Illness Questionnaire. Findings are reported using descriptive statistics. AEPs report a high level of knowledge and confidence in prescribing exercise for people with mental illness. AEPs rate exercise to be at least of equal value to many established treatments for mental illness, and frequently prescribe exercise based on current best-practice principles. A need for additional training was identified. The response rate was low (2.4%) making generalisations from the findings difficult. Exercise prescription practices utilised by AEPs are consistent with current best-practice guidelines and there is frequent consultation with consumers to individualise exercise based on their preferences and available resources. Further training is deemed important.

Rivaroxaban in patients with atrial fibrillation: from ROCKET AF to everyday practice.

PubMed

Barón-Esquivias, Gonzalo; Marín, Francisco; Sanmartín Fernandez, Marcelo

2017-05-01

Registries and non-interventional studies offer relevant and complementary information to clinical trials, since they have a high external validity. Areas covered: The information regarding the efficacy and safety of rivaroxaban compared with warfarin, or rivaroxaban alone in clinical practice was reviewed in this manuscript. For this purpose, a search on MEDLINE and EMBASE databases was performed. The MEDLINE and EMBASE search included both medical subject headings (MeSH) and keywords including: atrial fibrillation (AF) OR warfarin OR clinical practice OR ROCKET AF AND rivaroxaban. Case reports were not considered. Expert commentary: In ROCKET AF, rivaroxaban was at least as effective as warfarin for the prevention of stroke in patients with nonvalvular AF at high risk of stroke, but, importantly, with a lesser risk of intracranial, critical and fatal bleedings. A number of observational comparative and non-comparative studies, with more than 60,000 patients included treated with rivaroxaban, have analyzed the efficacy and safety of rivaroxaban in real-life patients with AF in different clinical settings. These studies have shown that in clinical practice, rates of stroke and major bleeding were consistently lower than those reported in ROCKET AF, likely due to the lower thromboembolic and bleeding risk observed in these patients.

Vaginal health and hygiene practices and product use in Canada: a national cross-sectional survey.

PubMed

Crann, Sara E; Cunningham, Shannon; Albert, Arianne; Money, Deborah M; O'Doherty, Kieran C

2018-03-23

The vaginal microbiome influences quality of life and health. The composition of vaginal microbiota can be affected by various health behaviors, such as vaginal douching. The purpose of this study was to examine the types and prevalence of diverse vaginal/genital health and hygiene behaviors among participants living in Canada and to examine associations between behavioral practices and adverse gynecological health conditions. An anonymous online survey, available in English and French, was distributed across Canada. The sample consisted of 1435 respondents, 18 years or older, living in Canada. Respondents reported engaging in diverse vaginal/genital health and hygiene behavioral practices, including the use of commercially manufactured products and homemade and naturopathic products and practices. Over 95% of respondents reported using at least one product in or around the vaginal area. Common products and practices included vaginal/genital moisturizers, anti-itch creams, feminine wipes, washes, suppositories, sprays, powders, and waxing and shaving pubic hair. The majority of the sample (80%) reported experiencing one or more adverse vaginal/genital symptom in their lifetime. Participants who had used any vaginal/genital product(s) had approximately three times higher odds of reporting an adverse health condition. Several notable associations between specific vaginal/genital health and hygiene products and adverse health conditions were identified. This study is the first of its kind to identify the range and prevalence of vaginal/genital health and hygiene behaviors in Canada. Despite a lack of credible information about the impact of these behaviors on women's health, the use of commercially manufactured and homemade products for vaginal/genital health and hygiene is common. Future research can extend the current exploratory study by identifying causal relationships between vaginal/genital health and hygiene behaviors and changes to the vaginal microbiome.

Factors that influence delivery of tobacco cessation support in general dental practice: a narrative review.

PubMed

Lala, Rizwana; Csikar, Julia; Douglas, Gail; Muarry, Jenni

2017-12-01

To review the literature reporting factors that are associated with the delivery of lifestyle support in general dental practice. A systematic review of the quantitative observational studies describing activities to promote the general health of adults in primary care general dental practice. Behavior change included tobacco cessation, alcohol reduction, diet, weight management, and physical activity. Tooth brushing and oral hygiene behaviors were excluded as the focus of this review was on the common risk factors that affect general health as well as oral health. Six cross sectional studies met the inclusion criteria. Five studies only reported activities to support tobacco cessation. As well as tobacco cessation one study also reported activities related to alcohol usage, physical activity, and Body Mass Index. Perceptions of time availability consistently correlated with activities and beliefs about tobacco cessation, alongside the smoking status of the dental professional. Dentists who perceive having more available time were more likely to discuss smoking with patients, prescribe smoking cessation treatments and direct patients toward (signpost to) lifestyle support services. Dental professionals who smoke were less likely to give smoking cessation advice and counselling than nonsmokers. Finally, the data showed that professional support may be relevant. Professionals who work in solo practices or those who felt a lack of support from the wider professional team (peer support) were more likely to report barriers to delivering lifestyle support. Organizational changes in dental practices to encourage more team working and professional time for lifestyle support may influence delivery. Dental professionals who are smokers may require training to develop their beliefs about the effectiveness of smoking cessation interventions. © 2016 American Association of Public Health Dentistry.

A survey on knowledge and self-reported formula handling practices of parents and child care workers in Palermo, Italy

PubMed Central

2009-01-01

Background Powdered infant formula (PIF) is not a sterile product, but this information appears to be poorly diffused among child caregivers. Parents and child care workers may behave in an unsafe manner when handling PIF. Methods This study involved parents and child care workers in the 24 municipal child care centres of Palermo. Knowledge and self-reported practices about PIF handling were investigated by a structured questionnaire. A Likert scale was used to measure the strength of the respondent's feelings. Association of knowledge and self-reported practices with demographic variables was also evaluated. Results 42.4% of parents and 71.0% of child care workers filled in the questionnaire. Significant differences were found between parents and child care workers for age and education. 73.2% of parents and 84.4% of child care workers were confident in sterility of PIF. Generally, adherence to safe procedures when reconstituting and handling PIF was more frequently reported by child care workers who, according to the existing legislation, are regularly subjected to a periodic training on food safety principles and practices. Age and education significantly influenced the answers to the questionnaire of both parents and child care workers. Conclusion The results of the study reveal that parents and child care workers are generally unaware that powdered formulas may contain viable microorganisms. However, child care workers consistently chose safer options than parents when answering the questions about adherence to hygienic practices. At present it seems unfeasible to produce sterile PIF, but the risk of growth of hazardous organisms in formula at the time of administration should be minimized by promoting safer behaviours among caregivers to infants in both institutional settings and home. PMID:20003304

A REGIONAL INSTITUTE TO AID IMPROVEMENT OF INSTRUCTIONAL PRACTICES, MATERIALS AND STUDENT EXPERIENCES FOR COORDINATORS AND INSTRUCTORS OF VOCATIONAL ORIENTATION PROGRAMS. FINAL REPORT.

ERIC Educational Resources Information Center

BLAIR, MARGARET; AND OTHERS

APPROXIMATELY 100 EDUCATORS FROM FIVE STATES AND THE VIRGIN ISLANDS PARTICIPATED IN AN INSTITUTE TO HELP INSTRUCTIONAL AND GUIDANCE PERSONNEL IMPROVE THE VOCATIONAL ORIENTATION OF HIGH SCHOOL STUDENTS WHO ARE PREPARING TO ENTER THE WORLD OF WORK. THE AGENDA CONSISTED OF SPEECHES ON VOCATIONS, GROUP SESSIONS TO DISCUSS VOCATIONAL PROGRAM…

Apollo 11 impact on the occupational medicine program, NASA Manned Spacecraft Center

NASA Technical Reports Server (NTRS)

Wright, P. E.

1969-01-01

Requirements and development of standards for occupational medicine support of personnel in the Lunar Receiving Laboratory (LRL) are outlined. Considered are proper personnel performance and exclusion of people prone to develop a serious illness within the quarantine area. Occupational medicine report for the LRL consists of examination procedures covering laboratory work, periodic examinations, immunizations, health maintenance, preventive practices, medical standards, and waiver authority.

The Contribution of Parenting Practices and Parent Emotion Factors in Children at Risk for Disruptive Behavior Disorders

ERIC Educational Resources Information Center

Duncombe, Melissa E.; Havighurst, Sophie S.; Holland, Kerry A.; Frankling, Emma J.

2012-01-01

The goal of this study was to examine the impact of different parenting characteristics on child disruptive behavior and emotional regulation among a sample of at-risk children. The sample consisted of 373 Australian 5- to 9-year-old children who were screened for serious behavior problems. Seven parenting variables based on self-report were…

Guidelines for Developing and Reporting Machine Learning Predictive Models in Biomedical Research: A Multidisciplinary View

PubMed Central

2016-01-01

Background As more and more researchers are turning to big data for new opportunities of biomedical discoveries, machine learning models, as the backbone of big data analysis, are mentioned more often in biomedical journals. However, owing to the inherent complexity of machine learning methods, they are prone to misuse. Because of the flexibility in specifying machine learning models, the results are often insufficiently reported in research articles, hindering reliable assessment of model validity and consistent interpretation of model outputs. Objective To attain a set of guidelines on the use of machine learning predictive models within clinical settings to make sure the models are correctly applied and sufficiently reported so that true discoveries can be distinguished from random coincidence. Methods A multidisciplinary panel of machine learning experts, clinicians, and traditional statisticians were interviewed, using an iterative process in accordance with the Delphi method. Results The process produced a set of guidelines that consists of (1) a list of reporting items to be included in a research article and (2) a set of practical sequential steps for developing predictive models. Conclusions A set of guidelines was generated to enable correct application of machine learning models and consistent reporting of model specifications and results in biomedical research. We believe that such guidelines will accelerate the adoption of big data analysis, particularly with machine learning methods, in the biomedical research community. PMID:27986644

Error detection and reduction in blood banking.

PubMed

Motschman, T L; Moore, S B

1996-12-01

Error management plays a major role in facility process improvement efforts. By detecting and reducing errors, quality and, therefore, patient care improve. It begins with a strong organizational foundation of management attitude with clear, consistent employee direction and appropriate physical facilities. Clearly defined critical processes, critical activities, and SOPs act as the framework for operations as well as active quality monitoring. To assure that personnel can detect an report errors they must be trained in both operational duties and error management practices. Use of simulated/intentional errors and incorporation of error detection into competency assessment keeps employees practiced, confident, and diminishes fear of the unknown. Personnel can clearly see that errors are indeed used as opportunities for process improvement and not for punishment. The facility must have a clearly defined and consistently used definition for reportable errors. Reportable errors should include those errors with potentially harmful outcomes as well as those errors that are "upstream," and thus further away from the outcome. A well-written error report consists of who, what, when, where, why/how, and follow-up to the error. Before correction can occur, an investigation to determine the underlying cause of the error should be undertaken. Obviously, the best corrective action is prevention. Correction can occur at five different levels; however, only three of these levels are directed at prevention. Prevention requires a method to collect and analyze data concerning errors. In the authors' facility a functional error classification method and a quality system-based classification have been useful. An active method to search for problems uncovers them further upstream, before they can have disastrous outcomes. In the continual quest for improving processes, an error management program is itself a process that needs improvement, and we must strive to always close the circle of quality assurance. Ultimately, the goal of better patient care will be the reward.

A practical implementation for a data dictionary in an environment of diverse data sets

USGS Publications Warehouse

Sprenger, Karla K.; Larsen, Dana M.

1993-01-01

The need for a data dictionary database at the U.S. Geological Survey's EROS Data Center (EDC) was reinforced with the Earth Observing System Data and Information System (EOSDIS) requirement for consistent field definitions of data sets residing at more than one archive center. The EDC requirement addresses the existence of multiple sets with identical field definitions using various naming conventions. The EDC is developing a data dictionary database to accomplish the following foals: to standardize field names for ease in software development; to facilitate querying and updating of the date; and to generate ad hoc reports. The structure of the EDC electronic data dictionary database supports different metadata systems as well as many different data sets. A series of reports is used to keep consistency among data sets and various metadata systems.

Preceptors’ Self-Assessment of Their Ability to Perform the Learning Objectives of an Experiential Program

PubMed Central

2012-01-01

Objective. To evaluate preceptors’ perception of their ability to perform the Structured Practical Experiences in Pharmacy (SPEP) learning objectives through a self-assessment activity. Methods. A self-assessment instrument consisting of 28 learning objectives associated with clinic, community, and hospital pharmacy practice experiences were developed. Preceptors rated their performance ability for each of the learning objectives using a 3-point Likert scale. Results. Of the 116 preceptors, 89 (77%) completed the self-assessment survey instrument. The overall preceptor responses to the items on performance of the 28 SPEP learning objectives ranged from good to excellent. Years of experience, practice experience setting, and involvement as a SPEP or SPEP and PharmD preceptor had no influence on their self-reported capabilities. Conclusion. Most preceptors rated their ability to perform the learning objectives for the structured practical experiences in pharmacy as high. Competency areas requiring further preceptor development were identified. PMID:23193333

Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey.

PubMed

Delaney, Kathleen R; Drew, Barbara L; Rushton, Amy

2018-06-01

Further exploration of the practice roles of psychiatric mental health (PMH) advanced practice registered nurses (APRNs) is warranted. In March of 2016, the American Psychiatric Nurses Association (APNA) conducted a national survey to gather data on the demographics, practice roles, and activities of certified PMH APRNs. The e-mail survey contained 46 questions consistent with minimum data set requirements of the Forum of State Nursing Workforce Centers. The data indicate that PMH APRNs are a clinically active workforce; the majority deliver a wide variety of mental health services including diagnosis and management of both acute and chronic mental illness, prescribing, and providing psychotherapy. PMH APRNs are delivering care to clients dealing with a range of serious mental illnesses across the life span in a variety of roles. It will be critical to monitor the activities and outcomes of this expanding behavioral health care workforce.

Multiracial competence in social work: recommendations for culturally attuned work with multiracial people.

PubMed

Jackson, Kelly E; Samuels, Gina M

2011-07-01

According to the 2010 U.S. census, approximately 9 million individuals report multiracial identities. By the year 2050, as many as one in five Americans could claim a multiracial background. Despite this population growth, a review of recent empirical and theoretical literature in social work suggests a disproportionate lack of attention to issues ofmultiraciality. Instead, social work practice models remain embedded in traditional societal discourses of race and culture that often exclude or marginalize the experiences of multiracial individuals and families.This article summarizes recommendations following the domains of awareness, knowledge, and skills in the NASW Standards for Cultural Competence in Social Work Practice to support culturally attuned social work practice with multiracial people. The authors argue that a culturally attuned practice approach--one that is inclusive of multiraciality--is not only timely, but also consistent with the profession's ethical obligation to provide culturally relevant services to all consumers and clients.

Antimicrobial susceptibility testing by Australian veterinary diagnostic laboratories.

PubMed

Hardefeldt, L Y; Marenda, M; Crabb, H; Stevenson, M A; Gilkerson, J R; Billman-Jacobe, H; Browning, G F

2018-04-01

The national strategy for tackling antimicrobial resistance highlights the need for antimicrobial stewardship in veterinary practice and for surveillance of antimicrobial susceptibility in veterinary pathogens. Diagnostic laboratories have an important role in facilitating both of these processes, but it is unclear whether data from veterinary diagnostic laboratories are similar enough to allow for compilation and if there is consistent promotion of appropriate antimicrobial use embedded in the approaches of different laboratories to susceptibility testing. A cross-sectional study of antimicrobial susceptibility testing and reporting procedures by Australian veterinary diagnostic laboratories was conducted in 2017 using an online questionnaire. All 18 veterinary diagnostic laboratories in Australia completed the questionnaire. Kirby-Bauer disc diffusion was the method predominantly used for antimicrobial susceptibility testing and was used to evaluate 86% of all isolates, although two different protocols were used across the 18 laboratories (CLSI 15/18, CDS 3/18). Minimum inhibitory concentrations were never reported by 61% of laboratories. Common isolates were consistently reported on across all species, except for gram-negative isolates in pigs, for which there was some variation in the approach to reporting. There was considerable diversity in the panels of antimicrobials used for susceptibility testing on common isolates and no consistency was apparent between laboratories for any bacterial species. We recommend that nationally agreed and consistent antimicrobial panels for routine susceptibility testing should be developed and a uniform set of guidelines should be adopted by veterinary diagnostic laboratories in Australia. © 2018 Australian Veterinary Association.

Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project.

PubMed

2003-02-01

International interest in clinical practice guidelines has never been greater but many published guidelines do not meet the basic quality requirements. There have been renewed calls for validated criteria to assess the quality of guidelines. To develop and validate an international instrument for assessing the quality of the process and reporting of clinical practice guideline development. The instrument was developed through a multi-staged process of item generation, selection and scaling, field testing, and refinement procedures. 100 guidelines selected from 11 participating countries were evaluated independently by 194 appraisers with the instrument. Following refinement the instrument was further field tested on three guidelines per country by a new set of 70 appraisers. The final version of the instrument contained 23 items grouped into six quality domains with a 4 point Likert scale to score each item (scope and purpose, stakeholder involvement, rigour of development, clarity and presentation, applicability, editorial independence). 95% of appraisers found the instrument useful for assessing guidelines. Reliability was acceptable for most domains (Cronbach's alpha 0.64-0.88). Guidelines produced as part of an established guideline programme had significantly higher scores on editorial independence and, after the publication of a national policy, had significantly higher quality scores on rigour of development (p<0.005). Guidelines with technical documentation had higher scores on that domain (p<0.0001). This is the first time an appraisal instrument for clinical practice guidelines has been developed and tested internationally. The instrument is sensitive to differences in important aspects of guidelines and can be used consistently and easily by a wide range of professionals from different backgrounds. The adoption of common standards should improve the consistency and quality of the reporting of guideline development worldwide and provide a framework to encourage international comparison of clinical practice guidelines.

Meaninglessness in terminally ill cancer patients: a validation study and nurse education intervention trial.

PubMed

Morita, Tatsuya; Murata, Hisayuki; Hirai, Kei; Tamura, Keiko; Kataoka, Jun; Ohnishi, Hideki; Akizuki, Nobuya; Kurihara, Yukie; Akechi, Tatsuo; Uchitomi, Yosuke

2007-08-01

Recent empirical studies revealed that fostering patients' perception of meaning in their life is an essential task for palliative care clinicians. However, few studies have reported the effects of training programs for nurses specifically aimed at improving skills to relieve the meaninglessness of terminally ill cancer patients, and we have had no specific measurement instruments. The primary aims of this study were 1) to validate measurement tools to quantify nurses' self-reported practice and attitudes toward caring for terminally ill cancer patients feeling meaninglessness and 2) to explore the effects of the five-hour educational workshop focusing on meaninglessness on nurses' self-reported practice, attitudes toward caring for such patients, confidence, burnout, death anxiety, and meaning of life. A quasi-experimental pre-post questionnaire survey was performed on 147 nurses. The questionnaire was distributed before the intervention workshop and one and six months after. The workshop consisted of lecture, role-play, and the exercise of assessment and care planning based on two vignette verbatim records. First, using the first questionnaire sample and an additional sample of 20 nurses for the test-retest examination, we validated a six-item Self-Reported Practice scale, and an eight-item Attitudes Toward Caring for Patients Feeling Meaninglessness scale with three subscales (Willingness to Help, Positive Appraisal, and Helplessness). The nurses also completed a scale to assess confidence in caring for terminally ill patients with meaninglessness, the Maslach Burnout Inventory, the Death Attitude Inventory, the Frommelt Attitudes Toward Care of the Dying scale, the Self-Reported Practice Score in General Communication, and the three pain-related items from the Palliative Care Quiz for Nursing. For the Self-Reported Practice scale and the subscales of the Attitudes Toward Caring for Patients Feeling Meaninglessness scale, the Cronbach's alpha coefficients were 0.63-0.91, and the intra-class correlations were 0.89-0.94. The Self-Reported Practice scale significantly, but moderately, correlated with the Self-Reported Practice Score in General Communication (P=0.41). The Willingness to Help and Helplessness subscales significantly but weakly correlated with the Frommelt scale (P=-0.27, 0.21). Both scales did not correlate or minimally correlated with the Palliative Care Quiz for Nursing (P<0.20). The construct validity was confirmed using factor analysis. At the follow-up, of 147 nurses who participated in this workshop, 91 (62%) and 80 (54%) nurses responded. Self-reported practice and confidence significantly improved, whereas helplessness, emotional exhaustion, and death anxiety significantly decreased. The percentages of nurses who evaluated this program as "useful" or "very useful" were 79% (to understand the conceptual framework in caring for terminally ill patients with meaninglessness), 73% (to help in self-disclosing nurses' personal beliefs, values, and life goals), and 80% (to help in learning how to provide care for patients with meaninglessness). The Self-Reported Practice scale and the Attitudes Toward Caring for Patients Feeling Meaninglessness scale are reliable and valid tools to specifically quantify nurses' self-reported practice and attitudes toward caring for terminally ill cancer patients feeling meaninglessness of life. The five-hour workshop appeared to have a modest but significant beneficial effect on nurse-reported practice, attitudes, and confidence in providing care for terminally ill cancer patients feeling meaninglessness. Further educational intervention trials with control groups are promising.

Health beliefs and practices related to cancer screening among Arab Muslim women in an urban community.

PubMed

Salman, Khlood Faik

2012-01-01

In this exploratory study I investigated the participation status in breast and cervical cancer screening of a group of American immigrant Arab Muslim women (AMW). Perceived knowledge of and barriers to screening participation, relationships among demographic variables, health practice and beliefs, and self-reports of traditionalism and acculturation also are studied. Factors including religious and cultural beliefs, economic concerns, and modesty and embarrassment were considered. To reach the goals of Healthy People 2010 (HP 2010), an effective and meaningful educational initiative to raise awareness about breast and cervical cancer of AMW will require specific interventions consistent with their cultural and religious traditions.

Factors affecting the innovative practice of nurse managers in health organisations.

PubMed

Williams, Lindy; McMurray, Adela J

This exploratory study reports on two surveys conducted in metropolitan and rural health organisations. Two questionnaires consisting of open and closed questions were distributed to a total of 340 respondents resulting in 176 usable responses, yielding a response rate of 53%. The findings revealed that nurse managers require fairness, trust, recognition, supervisory encouragement, organisational support, and reward for efforts. These are key aspects of organisational climate, which support innovative practice. Experience and innovation were significantly related and other factors such as, management structures and management styles, also had an impact on nurse managers' ability to exhibit innovative behaviour in the 21st Century workplace.

Establishing a Core Outcome Measure for Graft Health: a Standardized Outcomes in Nephrology - Kidney Transplantation (SONG-Tx) Consensus Workshop Report.

PubMed

Tong, Allison; Sautenet, Benedicte; Poggio, Emilio D; Lentine, Krista L; Oberbauer, Rainer; Mannon, Roslyn; Murphy, Barbara; Padilla, Benita; Chow, Kai Ming; Marson, Lorna; Chadban, Steve; Craig, Jonathan C; Ju, Angela; Manera, Karine E; Hanson, Camilla S; Josephson, Michelle A; Knoll, Greg

2018-02-22

Graft loss, a critically important outcome for transplant recipients, is variably defined and measured, and incompletely reported in trials. We convened a consensus workshop on establishing a core outcome measure for graft loss for all trials in kidney transplantation. Twenty-five kidney transplant recipients/caregivers and 33 health professionals from eight countries participated. Transcripts were analyzed thematically. Five themes were identified. "Graft loss as a continuum" conceptualizes graft loss as a process, but requiring an endpoint defined as a discrete event. In "defining an event with precision and accuracy," loss of graft function requiring chronic dialysis (minimum 90 days) provided an objective and practical definition; re-transplant would capture preemptive transplantation; relisting was readily measured but would overestimate graft loss; and allograft nephrectomy was redundant in being preceded by dialysis. However, the thresholds for renal replacement therapy varied. Conservative management was regarded as too ambiguous and complex to use routinely. "Distinguishing death-censored graft loss" would ensure clarity and meaningfulness in interpreting results. "Consistent reporting for decision-making" by specifying time points and metrics (ie time to event) was suggested. "Ease of ascertainment and data collection" of the outcome from registries could support use of registry data to efficiently extend follow-up of trial participants. A practical and meaningful core outcome measure for graft loss may be defined as chronic dialysis or re-transplant, and distinguished from loss due to death. Consistent reporting of graft loss using standardized metrics and time points may improve the contribution of trials to decision-making in kidney transplantation.

Registered Dietitian Nutritionists' Perspectives on Integrating Food and Water System Issues into Professional Practice.

PubMed

Heidelberger, Lindsay; Smith, Chery; Robinson-O'Brien, Ramona; Earthman, Carrie; Robien, Kim

2017-02-01

Sustainable agriculture encompasses economic, environmental, and social aspects of the food system. Members of the Academy of Nutrition and Dietetics (Academy) play an important role in promoting sustainable agriculture because they work in areas where they can influence the food purchasing decisions of foodservice operations and the public. To investigate behavior of registered dietitian nutritionists (RDNs) toward incorporating sustainable agriculture principles into professional practice using the Theory of Planned Behavior. This cross-sectional study surveyed RDNs nationwide about their perspectives on incorporating sustainable agriculture issues into practice. The survey questions were based on a survey originally administered to Minnesota RDNs during 2002. The sample (N=626) was drawn from a randomly selected, national sample of Academy members. Data were analyzed using descriptive statistics, independent t tests, Pearson correlations, and stepwise regression. The sample was mostly white, female, and the average age was 45.4±12.2 years. Almost half of Academy RDNs (47%) reported incorporating environmental issues into their practice. All four Theory of Planned Behavior variables (intention, attitude, perceived behavior control, and subjective norm) were predictive of behavior to include sustainable agriculture issues into practice. Barriers to incorporating this topic into practice included lack of knowledge, ability, time, and employer support. This study found that most of the RDN respondents had heard of sustainable agriculture and nearly half reported including this topic in their professional practice. To integrate this topic into practice more consistently, RDNs need more knowledge, time, and employer support. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Misreporting signs of child abuse: the role of decision-making and outcome information.

PubMed

Lindholm, Torun; Sjöberg, Rickard L; Memon, Amina

2014-02-01

Two studies provided evidence that a decision to report an ambiguous case of child abuse affected subsequent memory of the case information, such that participants falsely recognized details that were not presented in the original information, but that are schematically associated with child abuse. Moreover, post-decision information that the child had later died from abuse influenced the memory reports of participants who had chosen not to report the case, increasing their reports of false schema-consistent details. This suggests that false decision-consistent memories are primarily due to sense-making, schematic processing rather than the motivation to justify the decision. The present findings points to an important mechanism by which decision information can become distorted in retrospect, and emphasize the difficulties of improving future decision-making by contemplating past decisions. The results also indicate that decisions may generate false memories in the apparent absence of external suggestion or misleading information. Implications for decision-making theory, and applied practices are discussed. © 2013 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Effects of social support and conflict on parenting among homeless mothers.

PubMed

Marra, Jaime V; McCarthy, Elissa; Lin, Hsiu-Ju; Ford, Julian; Rodis, Eleni; Frisman, Linda K

2009-07-01

Research has shown that having a supportive social network is generally beneficial for individuals, particularly those who are homeless or at risk of homelessness. However, conflict within these networks may diminish the positive effects of social support on well-being, and these effects may be felt acutely within a vulnerable population with multiple needs. This study examined the impact of conflict and social support on parenting behaviors in a sample of mothers who are homeless and were involved in a study of case management interventions of varying intensity. We found that women who reported high emotional and instrumental social support self-reported greater improvements in parenting consistency over time than those who reported lower levels of support. However, three-way interactions showed that conflict in support networks was a risk factor for harsh parenting practices among participants who reported lower levels of instrumental social support. Results suggest that social support may enhance homeless mothers' ability to provide consistent parenting, but that these benefits may be undermined if conflict occurs in combination with limited levels of instrumental social support.

Reliability of self-reported childhood physical abuse by adults and factors predictive of inconsistent reporting.

PubMed

McKinney, Christy M; Harris, T Robert; Caetano, Raul

2009-01-01

Little is known about the reliability of self-reported child physical abuse (CPA) or CPA reporting practices. We estimated reliability and prevalence of self-reported CPA and identified factors predictive of inconsistent CPA reporting among 2,256 participants using surveys administered in 1995 and 2000. Reliability of CPA was fair to moderate (kappa = 0.41). Using a positive report from either survey, the prevalence of moderate (61.8%) and severe (12.0%) CPA was higher than at either survey alone. Compared to consistent reporters of having experienced CPA, inconsistent reporters were less likely to be > or = 30 years old (vs. 18-29) or Black (vs. White) and more likely to have < 12 years of education (vs. 12), have no alcohol-related problems (vs. having problems), or report one type (vs. > or = 2) of CPA. These findings may assist researchers conducting and interpreting studies of CPA.

Evidence-based algorithm for heparin dosing before cardiopulmonary bypass. Part 1: Development of the algorithm.

PubMed

McKinney, Mark C; Riley, Jeffrey B

2007-12-01

The incidence of heparin resistance during adult cardiac surgery with cardiopulmonary bypass has been reported at 15%-20%. The consistent use of a clinical decision-making algorithm may increase the consistency of patient care and likely reduce the total required heparin dose and other problems associated with heparin dosing. After a directed survey of practicing perfusionists regarding treatment of heparin resistance and a literature search for high-level evidence regarding the diagnosis and treatment of heparin resistance, an evidence-based decision-making algorithm was constructed. The face validity of the algorithm decisive steps and logic was confirmed by a second survey of practicing perfusionists. The algorithm begins with review of the patient history to identify predictors for heparin resistance. The definition for heparin resistance contained in the algorithm is an activated clotting time < 450 seconds with > 450 IU/kg heparin loading dose. Based on the literature, the treatment for heparin resistance used in the algorithm is anti-thrombin III supplement. The algorithm seems to be valid and is supported by high-level evidence and clinician opinion. The next step is a human randomized clinical trial to test the clinical procedure guideline algorithm vs. current standard clinical practice.

Measuring safety culture in Dutch primary care: psychometric characteristics of the SCOPE-PC questionnaire.

PubMed

Verbakel, Natasha J; Zwart, Dorien L M; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula

2013-09-17

Patient safety has been a priority in primary healthcare in the last years. The prevailing culture is seen as an important condition for patient safety in practice and several tools to measure patient safety culture have therefore been developed. Although Dutch primary care consists of different professions, such as general practice, dental care, dietetics, physiotherapy and midwifery, a safety culture questionnaire was only available for general practices. The purpose of this study was to modify and validate this existing questionnaire to a generic questionnaire for all professions in Dutch primary care. A validated Dutch questionnaire for general practices was modified to make it usable for all Dutch primary care professions. Subsequently, this questionnaire was administered to a random sample of 2400 practices from eleven primary care professions. The instrument's factor structure, reliability and validity were examined using confirmatory and explorative factor analyses. 921 questionnaires were returned. Of these, 615 were eligible for factor analysis. The resulting SCOPE-PC questionnaire consisted of seven dimensions: 'open communication and learning from errors', 'handover and teamwork', 'adequate procedures and working conditions', 'patient safety management', 'support and fellowship', 'intention to report events' and 'organisational learning' with a total of 41 items. All dimensions had good reliability with Cronbach's alphas ranging from 0.70-0.90, and the questionnaire had a good construct validity. The SCOPE-PC questionnaire has sound psychometric characteristics for use by the different professions in Dutch primary care to gain insight in their safety culture.

Building Consensus: Development of Best Practice Guidelines on Wrong Level Surgery in Spinal Deformity.

PubMed

Vitale, Michael; Minkara, Anas; Matsumoto, Hiroko; Albert, Todd; Anderson, Richard; Angevine, Peter; Buckland, Aaron; Cho, Samuel; Cunningham, Matthew; Errico, Thomas; Fischer, Charla; Kim, Han Jo; Lehman, Ronald; Lonner, Baron; Passias, Peter; Protopsaltis, Themistocles; Schwab, Frank; Lenke, Lawrence

Consensus-building using the Delphi and nominal group technique. To establish best practice guidelines using formal techniques of consensus building among a group of experienced spinal deformity surgeons to avert wrong-level spinal deformity surgery. Numerous previous studies have demonstrated that wrong-level spinal deformity occurs at a substantial rate, with more than half of all spine surgeons reporting direct or indirect experience operating on the wrong levels. Nevertheless, currently, guidelines to avert wrong-level spinal deformity surgery have not been developed. The Delphi process and nominal group technique were used to formally derive consensus among 16 fellowship-trained spine surgeons. Surgeons were surveyed for current practices, presented with the results of a systematic review, and asked to vote anonymously for or against item inclusion during three iterative rounds. Agreement of 80% or higher was considered consensus. Items near consensus (70% to 80% agreement) were probed in detail using the nominal group technique in a facilitated group meeting. Participants had a mean of 13.4 years of practice (range: 2-32 years) and 103.1 (range: 50-250) annual spinal deformity surgeries, with a combined total of 24,200 procedures. Consensus was reached for the creation of best practice guidelines (BPGs) consisting of 17 interventions to avert wrong-level surgery. A final checklist consisting of preoperative and intraoperative methods, including standardized vertebral-level counting and optimal imaging criteria, was supported by 100% of participants. We developed consensus-based best practice guidelines for the prevention of wrong-vertebral-level surgery. This can serve as a tool to reduce the variability in preoperative and intraoperative practices and guide research regarding the effectiveness of such interventions on the incidence of wrong-level surgery. Level V. Copyright © 2017 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

Optoelectronic Reservoir Computing

PubMed Central

Paquot, Y.; Duport, F.; Smerieri, A.; Dambre, J.; Schrauwen, B.; Haelterman, M.; Massar, S.

2012-01-01

Reservoir computing is a recently introduced, highly efficient bio-inspired approach for processing time dependent data. The basic scheme of reservoir computing consists of a non linear recurrent dynamical system coupled to a single input layer and a single output layer. Within these constraints many implementations are possible. Here we report an optoelectronic implementation of reservoir computing based on a recently proposed architecture consisting of a single non linear node and a delay line. Our implementation is sufficiently fast for real time information processing. We illustrate its performance on tasks of practical importance such as nonlinear channel equalization and speech recognition, and obtain results comparable to state of the art digital implementations. PMID:22371825

[Factor analysis and internal consistency of pedagogical practices questionnaire among health care teachers].

PubMed

Pérez V, Cristhian; Vaccarezza G, Giulietta; Aguilar A, César; Coloma N, Katherine; Salgado F, Horacio; Baquedano R, Marjorie; Chavarría R, Carla; Bastías V, Nancy

2016-06-01

Teaching practice is one of the most complex topics of the training process in medicine and other health care careers. The Teaching Practices Questionnaire (TPQ) evaluates teaching skills. To assess the factor structure and internal consistency of the Spanish version of the TPP among health care teachers. The TPQ was answered by 315 university teachers from 13 of the 15 administrative Chilean regions, who were selected through a non-probabilistic volunteer sampling. The internal consistency of TPP factors was calculated and the correlation between them was analyzed. Six factors were identified: Student-centered teaching, Teaching planning, Assessment process, Dialogue relationship, Teacher-centered teaching and Use of technological resources. They had Cronbach alphas ranging from 0.60 to 0.85. The factorial structure of TPQ differentiates the most important functions of teaching. It also shows a theoretical consistency and a practical relevance to perform a diagnosis and continuous evaluation of teaching practices. Additionally, it has an adequate internal consistency. Thus, TPQ is valid and reliable to evaluate pedagogical practices in health care careers.

Protective practices against zoonotic infections among rural and slum communities from South Central Chile.

PubMed

Mason, Meghan R; Gonzalez, Marcelo; Hodges, James S; Muñoz-Zanzi, Claudia

2015-07-28

Despite well-recognized recommendations to reduce human exposure to zoonotic pathogens, the use of personal and herd-level protective practices is inconsistent in communities where human interactions with animals are common. This study assessed household-level participation in rodent- (extermination, proper food storage, trash disposal), occupational- (preventive veterinary care, boot-wearing, glove-wearing), and garden-associated (restricting animal access, boot-wearing, glove-wearing) protective practices in farms, villages, and slums in the Los Rios region, Chile, where zoonotic pathogens are endemic. Questionnaires administered at 422 households across 12 communities recorded household-level socio-demographic characteristics and participation in nine protective practices. Household inclusion in the analysis of occupational practices required having livestock and a household member with occupational exposure to livestock (n = 127), and inclusion in analysis of garden practices required having a garden and at least one animal (n = 233). The proportion of households participating in each protective practice was compared across community types through chi-square analyses. Mixed effects logistic regression assessed household-level associations between socio-demographic characteristics and participation in each protective practice. Most households (95.3 %) reported participation in rodent control, and a positive association between the number of rodent signs in a household and rodent extermination was observed (OR: 1.75, 95 % CI: 1.41, 2.16). Occupational protective practices were reported in 61.8 % of eligible households; household size (OR: 1.63, 95 % CI: 1.17, 5.84) and having children (OR: 0.22, 95 % CI: 0.06, 0.78) were associated with preventive veterinary care. Among eligible households, 73.8 % engaged in protective practices when gardening, and species diversity was positively associated with wearing boots (OR: 1.27, 95 % CI: 1.03, 1.56). Household-level participation in all three protective practices within any exposure category was limited (<10.4 %) and participation in any individual protective practice varied considerably within and across community types. The levels of participation in protective practices reported in this study are consistent with descriptions in the literature of imperfect use of methods that reduce human exposure to zoonotic pathogens. The wide differences across communities in the proportion of households participating in protective practices against human exposure to zoonotic pathogens, suggests that future research should identify community-level characteristics that influence household participation in such practices.

Systematic review of the design, implementation and effectiveness of mass media and nutrition education interventions for infant and young child feeding.

PubMed

Graziose, Matthew M; Downs, Shauna M; O'Brien, Quentin; Fanzo, Jessica

2018-02-01

To systematically review the design, implementation and effectiveness of mass media and nutrition education interventions for improving infant and young child feeding (IYCF) practices and related psychosocial factors. A search of PubMed, Embase and PsycINFO databases, a Google search, and a consultation with experts in the field of IYCF performed in July 2016. Low- and middle-income countries, as defined by the World Bank Group. Eligible studies: included a mass media component (with or without nutrition education); conducted a pre-post evaluation (with or without a control group); assessed IYCF knowledge, attitudes, beliefs and/or practices; and were published in English between 2000 and present. Eighteen unique studies were identified that examined the effect of mass media (types included: television; print; voice and/or SMS (text) messages; radio; megaphones/loudspeakers; videos; social media; songs/dramas) and nutrition education interventions on IYCF practices within thirteen countries. Of these, fifteen studies reported improvements in breast- and/or complementary feeding practices, using indicators recommended by the WHO, and six studies reported improvements in related psychosocial factors. However, little detail was provided on the use of formative research, a formal behaviour change theory and behaviour change techniques. Few studies reported both dose delivered and participants' exposure to the intervention. Despite evidence of effectiveness, few common elements in the design of interventions were identified. Future research should consistently report these details to open the 'black box' of IYCF interventions, identify effective design components and ensure replicability.

Knowledge, attitudes and practices (KAP) of hygiene among school children in Angolela, Ethiopia.

PubMed

Vivas, A P; Gelaye, B; Aboset, N; Kumie, A; Berhane, Y; Williams, M A

2010-06-01

Poor hygiene practices and inadequate sanitary conditions play major roles in the increased burden of communicable diseases within developing countries. This study evaluated the KAP of hygiene among rural school children in Ethiopia and assessed the extent to which proper knowledge of hygiene was associated with personal hygiene characteristics. This cross-sectional study was comprised of 669 students who were interviewed by trained staff Participants were in grades 1-6 at Angolela Primary School, located in rural Ethiopia. Data consisted of hygiene and hand washing practices, knowledge about sanitation, personal hygiene characteristics, and presence of gastrointestinal parasitic infection. Results. Approximately 52% of students were classified as having adequate knowledge of proper hygiene. Most students reported hand washing before meals (99.0%), but only 36.2% reported using soap. Although 76.7% of students reported that washing hands after defecation was important, only 14.8% reported actually following this practice. Students with adequate knowledge of proper hygiene were more likely to have clean clothes (AOR 1.62, CI 1.14-2.29) and to have a lower risk of parasitic infection (AOR 0.78, CI 0.56-1.09) although statistical significance was not achieved for the latter Study findings underscore the need for more hand washing and hygiene education in schools; and provide objective evidence that may guide the development of comprehensive health and hygiene intervention programs in rural Ethiopian schools. Successful implementation of these programs is likely to substantially attenuate the transmissible disease burden borne by school children in rural settings.

Patient Navigators and Parent Use of Quality Data: A Randomized Trial.

PubMed

Goff, Sarah L; Mazor, Kathleen M; Pekow, Penelope S; White, Katharine O; Priya, Aruna; Lagu, Tara; Guhn-Knight, Haley; Murphy, Lorna; Youssef Budway, Yara; Lindenauer, Peter K

2016-10-01

Consumers rarely use publicly reported health care quality data. Despite known barriers to use, few studies have explored the effectiveness of strategies to overcome barriers in vulnerable populations. This randomized controlled trial tested the impact of a patient navigator intervention to increase consumer use of publicly reported quality data. Patients attending an urban prenatal clinic serving a vulnerable population enrolled between May 2013 and January 2015. The intervention consisted of 2 in-person sessions in which women learned about quality performance and viewed scores for local practices on the Massachusetts Health Quality Partners Web site. Women in both the intervention and control arms received a pamphlet about health care quality. Primary study outcomes were mean clinical quality and patient experience scores of the practices women selected (range 1-4 stars). Nearly all (726/746; 97.3%) women completed the study, 59.7% were Hispanic, and 65.1% had a high school education or less. In both unadjusted and adjusted models, women in the intervention group chose practices with modestly higher mean clinical quality (3.2 vs 3.0 stars; P = .001) and patient experience (3.0 vs 2.9 stars; P = .05) scores. When asked to rate what factors mattered the most in their decision, few cited quality scores. An intervention to reduce barriers to using publicly reported health care quality data had a modest effect on patient choice. These findings suggest that factors other than performance on common publicly reported quality metrics have a stronger influence on which pediatric practices women choose. Copyright © 2016 by the American Academy of Pediatrics.

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

PubMed

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

2016-07-01

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

Faculty application of the American Psychological Association style.

PubMed

Morse, Gwen Goetz

2009-10-01

This article explores current faculty methods with the application and evaluation of the American Psychological Association (APA) style. Specific aims were to determine concerns related to APA style, review faculty grading practices, identify institutional resources, and report potential solutions for improving application of APA style. A survey with an exploratory descriptive research design was developed and distributed online to academic chairs and deans, requesting their support in distributing the survey to their faculty. Responses (N = 704) were grouped into five categories: departmental and personal concerns; faculty grading practices; institutional resources; format, writing style, and grammar; and suggestions and potential solutions. Sixty percent reported that application and evaluation of APA style is a concern in their department. Content analysis identified four categories as proposed solutions: consistency, education, resources, and dialogue. On the basis of the feedback of the participants, the CRED program is proposed for the issues that were identified. Copyright 2009, SLACK Incorporated.

The contribution of parenting practices and parent emotion factors in children at risk for disruptive behavior disorders.

PubMed

Duncombe, Melissa E; Havighurst, Sophie S; Holland, Kerry A; Frankling, Emma J

2012-10-01

The goal of this study was to examine the impact of different parenting characteristics on child disruptive behavior and emotional regulation among a sample of at-risk children. The sample consisted of 373 Australian 5- to 9-year-old children who were screened for serious behavior problems. Seven parenting variables based on self-report were evaluated, involving parenting practices, emotion beliefs and behaviors, emotion expressiveness, and mental health. Outcome variables based on parent/teacher report were child disruptive behavior problems and emotion regulatory ability. When entered simultaneously in a multiple regression analysis, inconsistent discipline, negative parental emotional expressiveness, and parent mental health demonstrated the strongest relationship to disruptive behavior problems and problems with emotion regulation. The data presented here elucidate multiple risk pathways to disruptive behavior disorders and can inform the design of prevention and early intervention programs.

A listening skill educational intervention for pediatric rehabilitation clinicians: A mixed-methods pilot study.

PubMed

King, Gillian; Servais, Michelle; Shepherd, Tracy A; Willoughby, Colleen; Bolack, Linda; Moodie, Sheila; Baldwin, Patricia; Strachan, Deborah; Knickle, Kerry; Pinto, Madhu; Parker, Kathryn; McNaughton, Nancy

2017-01-01

To prepare for an RCT by examining the effects of an educational intervention on the listening skills of pediatric rehabilitation clinicians, piloting study procedures, and investigating participants' learning experiences. Six experienced clinicians received the intervention, consisting of video simulations and solution-focused coaching regarding personal listening goals. Self- and observer-rated measures of listening skill were completed and qualitative information was gathered in interviews and a member checking session. Significant change on self-reported listening skills was found from pre- to post-test and/or follow-up. The pilot provided useful information to improve the study protocol, including the addition of an initial orientation to listening skills. Participants found the intervention to be a highly valuable and intense learning experience, and reported immediate changes to their clinical and interprofessional practice. The educational intervention has the potential to be an effective means to enhance the listening skills of practicing pediatric rehabilitation clinicians.

Tracking and Reporting Outcomes Of Procedural Sedation (TROOPS): Standardized Quality Improvement and Research Tools from the International Committee for the Advancement of Procedural Sedation.

PubMed

Roback, M G; Green, S M; Andolfatto, G; Leroy, P L; Mason, K P

2018-01-01

Many hospitals, and medical and dental clinics and offices, routinely monitor their procedural-sedation practices-tracking adverse events, outcomes, and efficacy in order to optimize the sedation delivery and practice. Currently, there exist substantial differences between settings in the content, collection, definition, and interpretation of such sedation outcomes, with resulting widespread reporting variation. With the objective of reducing such disparities, the International Committee for the Advancement of Procedural Sedation has herein developed a multidisciplinary, consensus-based, standardized tool intended to be applicable for all types of sedation providers in all locations worldwide. This tool is amenable for inclusion in either a paper or an electronic medical record. An additional, parallel research tool is presented to promote consistency and standardized data collection for procedural-sedation investigations. Copyright © 2017. Published by Elsevier Ltd.

Defining a Progress Metric for CERT RMM Improvement

DTIC Science & Technology

2017-09-14

Table 1) should be used along with clear guidance on what is to be measured, to avoid subjective interpretations by different project managers . In some...products for each CERT-RMM practice. Project managers should be trained to help the organization improve the accuracy and consistency of its reporting...and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. 1. AGENCY USE ONLY (Leave Blank) 2

48 CFR 52.230-3 - Disclosure and Consistency of Cost Accounting Practices.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Text of Provisions and Clauses 52.230-3 Disclosure and Consistency of Cost Accounting Practices. As prescribed in 30.201-4(b)(1), insert the following clause: Disclosure and Consistency of Cost Accounting... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Disclosure and Consistency...

The young adult Strengths and Difficulties Questionnaire (SDQ) in routine clinical practice.

PubMed

Brann, Peter; Lethbridge, Melissa J; Mildred, Helen

2018-06-01

Expansion of the youth mental health sector has exposed a need for an outcome measure for young adults accessing services. The Strengths and Difficulties Questionnaire (SDQ) is a widely used consumer and carer outcome measure for children and adolescents. The aim of this study was to evaluate the psychometric properties of a young adult SDQ. The young adult SDQ was introduced for routine clinical practice at Eastern Health Child and Youth Mental Health Service (EH-CYMHS), complementing the well-established adolescent and child versions. Data for adolescents (aged 12-17) and young adults (aged 18-25) where both self-report and parent SDQs had been completed at entry point to the service were extracted from a two-year period. Overall, paired cases involved 532 adolescents and 125 young adults. Across both self-report and parent SDQs, a similar pattern of results was found between adolescents and young adults on mean scores, inter-scale correlations, internal consistency, and inter-rater agreement. The findings of the current study support the use of the young adult SDQ in public mental health as an instrument whose psychometric properties, to date, appear consistent with those of the adolescent version. Further investigation is warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

The Kubler-Ross model, physician distress, and performance reporting.

PubMed

Smaldone, Marc C; Uzzo, Robert G

2013-07-01

Physician performance reporting has been proposed as an essential component of health-care reform, with the aim of improving quality by providing transparency and accountability. Despite strong evidence demonstrating regional variation in practice patterns and lack of evidence-based care, public outcomes reporting has been met with resistance from medical professionals. Application of the Kubler-Ross 'five stages of grief' model--a conceptual framework consisting of a series of emotional stages (denial, anger, bargaining, depression, and acceptance) inspired by work with terminally ill patients--could provide some insight into why physicians are reluctant to accept emerging quality-reporting mechanisms. Physician-led quality-improvement initiatives are vital to contemporary health-care reform efforts and applications in urology, as well as other medical disciplines, are currently being explored.

Comprehensive Coach Education and Practice Contact Restriction Guidelines Result in Lower Injury Rates in Youth American Football

PubMed Central

Kerr, Zachary Y.; Yeargin, Susan; Valovich McLeod, Tamara C.; Nittoli, Vincent C.; Mensch, James; Dodge, Thomas; Hayden, Ross; Dompier, Thomas P.

2015-01-01

Background: Research evaluating the effect of comprehensive coach education and practice contact restriction in youth football injury rates is sparse. In 2012, USA Football released their Heads Up Football coaching education program (HUF), and Pop Warner Football (PW) instituted guidelines to restrict contact during practice. Purpose: To compare injury rates among youth football players aged 5 to 15 years by whether their leagues implemented HUF and/or were PW-affiliated. Study Design: Cohort study; Level of evidence, 2. Methods: Athletic trainers (ATs) evaluated and tracked injuries at each practice and game during the 2014 youth football season. Players were drawn from 10 leagues across 4 states. The non–Heads Up Football (NHUF) group consisted of 704 players (none of whom were PW-affiliated) from 29 teams within 4 leagues. The HUF+PW group consisted of 741 players from 27 teams within 2 leagues. The HUF-only group consisted of 663 players from 44 teams within 4 leagues. Injury rates and injury rate ratios (IRRs) were reported with 95% CIs. Results: A total of 370 injuries were reported during 71,262 athlete-exposures (AEs) (rate, 5.19/1000 AEs). Compared with the NHUF group (7.32/1000 AEs), the practice injury rates were lower for the HUF+PW group (0.97/1000 AEs; IRR, 0.13; 95% CI, 0.08-0.21) and the HUF-only group (2.73/1000 AEs; IRR, 0.37; 95% CI, 0.26-0.53). Compared with the NHUF group (13.42/1000 AEs), the game injury rate was lower for the HUF+PW group (3.42/1000 AEs; IRR, 0.25; 95% CI, 0.15-0.44) but not for the HUF-only group (13.76/1000 AEs; IRR, 1.02; 95% CI, 0.73-1.43). Also, the HUF+PW game injury rate was lower than that of HUF-only (IRR, 0.20; 95% CI, 0.12-0.36). Higher injury rates were typically found in those aged 11 to 15 years compared with those aged 5 to 10 years. However, stronger effects related to HUF implementation and PW affiliation were seen among 11- to 15-year-olds. When restricted to concussions only, the sole difference was found between the practice concussion rates among 11- to 15-year-olds in the HUF+PW (0.14/1000 AEs) and NHUF groups (0.79/1000 AEs) (IRR, 0.18; 95% CI, 0.04-0.85). Conclusion: These findings support comprehensive coach education and practice contact restrictions as effective methods of injury mitigation. Future research should continue evaluating similar programming within other levels of competition and sports. PMID:26674011

A Framework for Enhancing the Value of Research for Dissemination and Implementation

PubMed Central

Glasgow, Russell E.; Carpenter, Christopher R.; Grimshaw, Jeremy M.; Rabin, Borsika A.; Fernandez, Maria E.; Brownson, Ross C.

2015-01-01

A comprehensive guide that identifies critical evaluation and reporting elements necessary to move research into practice is needed. We propose a framework that highlights the domains required to enhance the value of dissemination and implementation research for end users. We emphasize the importance of transparent reporting on the planning phase of research in addition to delivery, evaluation, and long-term outcomes. We highlight key topics for which well-established reporting and assessment tools are underused (e.g., cost of intervention, implementation strategy, adoption) and where such tools are inadequate or lacking (e.g., context, sustainability, evolution) within the context of existing reporting guidelines. Consistent evaluation of and reporting on these issues with standardized approaches would enhance the value of research for practitioners and decision-makers. PMID:25393182

A survey of physics and dosimetry practice of permanent prostate brachytherapy in the United States.

PubMed

Prete, J J; Prestidge, B R; Bice, W S; Friedland, J L; Stock, R G; Grimm, P D

1998-03-01

To obtain data with regard to current physics and dosimetry practice in transperineal interstitial permanent prostate brachytherapy (TIPPB) in the U.S. by conducting a survey of institutions performing this procedure with the greatest frequency. Seventy brachytherapists with the greatest volume of TIPPB cases in 1995 in the U.S. were surveyed. The four-page comprehensive questionnaire included questions on both clinical and physics and dosimetry practice. Individuals not responding initially were sent additional mailings and telephoned. Physics and dosimetry practice summary statistics are reported. Clinical practice data is reported separately. Thirty-five (50%) surveys were returned. Participants included 29 (83%) from the private sector and 6 (17%) from academic programs. Among responding clinicians, 125I (89%) is used with greater frequency than 103Pd (83%). Many use both (71%). Most brachytherapists perform preplans (86%), predominately employing ultrasound imaging (85%). Commercial treatment planning systems are used more frequently (75%) than in-house systems (25%). Preplans take 2.5 h (avg.) to perform and are most commonly performed by a physicist (69%). A wide range of apparent activities (mCi) is used for both 125I (0.16-1.00, avg. 0.41) and 103Pd (0.50-1.90, avg. 1.32). Of those assaying sources (71%), the range in number assayed (1 to all) and maximum accepted difference from vendor stated activity (2-20%) varies greatly. Most respondents feel that the manufacturers criteria for source activity are sufficiently stringent (88%); however, some report that vendors do not always meet their criteria (44%). Most postimplant dosimetry imaging occurs on day 1 (41%) and consists of conventional x-rays (83%), CT (63%), or both (46%). Postimplant dosimetry is usually performed by a physicist (72%), taking 2 h (avg.) to complete. Calculational formalisms and parameters vary substantially. At the time of the survey, few institutions have adopted AAPM TG-43 recommendations (21%). Only half (50%) of those not using TG-43 indicated an intent to do so in the future. Calculated doses at 1 cm from a single 1 mCi apparent activity source permanently implanted varied significantly. For 125I, doses calculated ranged from 13.08-40.00 Gy and for 103Pd, from 3.10 to 8.70 Gy. While several areas of current physics and dosimetry practice are consistent among institutions, treatment planning and dose calculation techniques vary considerably. These data demonstrate a relative lack of consensus with regard to these practices. Furthermore, the wide variety of calculational techniques and benchmark data lead to calculated doses which vary by clinically significant amounts. It is apparent that the lack of standardization with regard to treatment planning and dose calculation practice in TIPPB must be addressed prior to performing any meaningful comparison of clinical results between institutions.

Improving the implementation of responsible alcohol management practices by community sporting clubs: A randomised controlled trial.

PubMed

Kingsland, Melanie; Wolfenden, Luke; Tindall, Jennifer; Rowland, Bosco; Sidey, Maree; McElduff, Patrick; Wiggers, John H

2015-07-01

Despite an increased prevalence of risky alcohol consumption and alcohol-related harm among members of sporting groups and at sporting venues, sporting clubs frequently fail to implement alcohol management practices consistent with liquor legislation and best practice guidelines. The aim of this study was to assess the impact of a multi-strategy intervention in improving the implementation of responsible alcohol management practices by sports clubs. A randomised controlled trial was conducted with 87 football clubs, with half randomised to receive a multi-strategy intervention to support clubs to implement responsible alcohol management practices. The 2-year intervention, which was based on implementation and capacity building theory and frameworks, included project officer support, funding, accreditation rewards, printed resources, observational audit feedback, newsletters, training and support from state sporting organisations. Interviews were undertaken with club presidents at baseline and post-intervention to assess alcohol management practice implementation. Post-intervention, 88% of intervention clubs reported implementing '13 or more' of 16 responsible alcohol management practices, which was significantly greater than the proportion of control groups reporting this level of implementation (65%) [odds ratio: 3.7 (95% confidence interval: 1.1-13.2); P = 0.04]. All intervention components were considered highly useful and three-quarters or more of clubs rated the amount of implementation support to be sufficient. The multi-strategy intervention was successful in improving alcohol management practices in community sports clubs. Further research is required to better understand implementation barriers and to assess the long-term sustainability of the change in club alcohol management practices. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Factors influencing professional life satisfaction among neurologists.

PubMed

Teixeira-Poit, Stephanie M; Halpern, Michael T; Kane, Heather L; Keating, Michael; Olmsted, Murrey

2017-06-19

Predicted shortages in the supply of neurologists may limit patients' access to and quality of care for neurological disorders. Retaining neurologists already in practice provides one opportunity to support the overall supply of practicing neurologists. Understanding factors associated with professional life satisfaction (and dissatisfaction) and implementing policies to enhance satisfaction may encourage neurologists to remain in clinical practice. In this paper, we present results from the first study examining factors associated with professional life satisfaction among a large sample of U.S, neurologists. We collaborated with the AAN to survey a sample of U.S. neurologists about their professional life satisfaction. Analyses examined the association of physician and practice characteristics with aspects of professional life satisfaction, including satisfaction with their career in medicine, medical specialty, current position, relationship with colleagues, relationship with patients, work/life balance, and pay. The study population consisted of 625 neurologists. In multivariate regression analyses, no single group or population stratum indicated high (or low) responses to all aspects of satisfaction. Older neurologists reported higher satisfaction with career, specialty, and relationship with patients than younger neurologists. Female neurologists had significantly lower satisfaction with pay than male neurologists. Neurologists who spent more time in research and teaching had greater satisfaction with specialty, relationship with colleagues, and relationship with patients than those spending no time in research. Neurologists who practiced in small cities/rural areas reported lower satisfaction across multiple dimensions than those practicing in large urban areas. Neurologists in solo practice had greater satisfaction with the relationship with their patients, but lower satisfaction with pay. Satisfaction is a multidimensional construct that is associated with physician and practice characteristics. Enhancing professional life satisfaction among neurologists requires multiple strategies, such as promoting comparable wages for men and women, providing collaboration and research opportunities, and providing resources for small and rural practices.

What Affects Authors’ and Editors’ Use of Reporting Guidelines? Findings from an Online Survey and Qualitative Interviews

PubMed Central

Fuller, Thomas; Pearson, Mark; Peters, Jaime; Anderson, Rob

2015-01-01

Objectives To identify and understand, through data from multiple sources, some of the factors that affect authors’ and editors’ decisions to use reporting guidelines in the publication of health research. Design Mixed methods study comprising an online survey and semi-structured interviews with a sample of authors (online survey: n = 56; response rate = 32%; semi-structured interviews: n = 5) and journal editors (online survey: n = 43; response rate = 27%; semi-structured interviews: n = 6) involved in publishing health and medical research. Participants were recruited from an earlier study examining the effectiveness of the TREND reporting guideline. Results Four types of factors interacted to affect authors’ and editors’ likelihood of reporting guideline use; individual (e.g. having multiple reasons for use of reporting guidelines); the professional culture in which people work; environmental (e.g. policies of journals); and, practical (e.g. having time to use reporting guidelines). Having multiple reasons for using reporting guidelines was a particularly salient factor in facilitating reporting guidelines use for both groups of participants. Conclusions Improving the completeness and consistency of reporting of research studies is critical to the integrity and synthesis of health research. The use of reporting guidelines offers one potentially efficient and effective means for achieving this, but decisions to use (or not use) reporting guidelines take many factors into account. These findings could be used to inform future studies that might, for example, test the factors that we have identified within a wider theoretical framework for understanding changes in professional practices. The use of reporting guidelines by senior professionals appears to shape the expectations of what constitutes best practice and can be assimilated into the culture of a field or discipline. Without evidence of effectiveness of reporting guidelines, and sustained, multifaceted efforts to improve reporting, little progress seems likely to be made. PMID:25875918

Primary Palliative Care for the General Internist: Integrating Goals of Care Discussions into the Outpatient Setting

PubMed Central

Ahia, Chad L.; Blais, Christopher M.

2014-01-01

Background Primary palliative care consists of the palliative care competencies required of all primary care clinicians. Included in these competencies is the ability to assist patients and their families in establishing appropriate goals of care. Goals of care help patients and their families understand the patient's illness and its trajectory and facilitate medical care decisions consistent with the patient's values and goals. General internists and family medicine physicians in primary care are central to getting patients to articulate their goals of care and to have these documented in the medical record. Case Report Here we present the case of a 71-year-old male patient with chronic obstructive pulmonary disorder, congestive heart failure, and newly diagnosed Alzheimer dementia to model pertinent end-of-life care communication and discuss practical tips on how to incorporate it into practice. Conclusion General internists and family medicine practitioners in primary care are central to eliciting patients' goals of care and achieving optimal end-of-life outcomes for their patients. PMID:25598737

Environmental resources of selected areas of Hawaii: Cultural environment and aesthetic resources

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

Trettin, L.D.; Petrich, C.H.; Saulsbury, J.W.

This report has been prepared to make available and archive the background scientific data and related information collected on the cultural environment and aesthetic resources during the preparation of the environmental impact statement (EIS) for Phases 3 and 4 of the Hawaii Geothermal Project (HGP) as defined by the state of Hawaii in its April 1989 proposal to Congress. The cultural environment in the Geothermal Resource Zone (GRZ) and associated study area consists of Native Hawaiian cultural and religious practices and both Native Hawaiian and non-Native Hawaiian cultural resources. This report consists of three sections: (1) a description of Nativemore » Hawaiian cultural and religious rights, practices, and values; (2) a description of historic, prehistoric, and traditional Native Hawaiian sites; and (3) a description of other (non-native) sites that could be affected by development in the study area. Within each section, the level of descriptive detail varies according to the information currently available. The description of the cultural environment is most specific in its coverage of the Geothermal Resource Subzones in the Puna District of the island of Hawaii and the study area of South Maui. Ethnographic and archaeological reports by Cultural Advocacy Network Developing Options and International Archaeological Research Institute, Inc., respectively, supplement the descriptions of these two areas with new information collected specifically for this study. Less detailed descriptions of additional study areas on Oahu, Maui, Molokai, and the island of Hawaii are based on existing archaeological surveys.« less

[Case report - a dangerous intoxication after ingestion of alkyl nitrite ("poppers")].

PubMed

Bernasconi, Barbara; Konrad, Christoph; Fischer, Simon

2014-12-01

This case report describes the inadvertent poisoning of a young man with "poppers" after having ingested an unknown amout of the drug. "Poppers" (alkyl nitrite) were made famous in the 1960s as a party drug, and during certain sexual practices, and are still in use today. The drug's inhalation leads to a short-lived rush, vasodilation and relaxtion of smooth muscles. An accidental ingestion can lead to a significant build-up of methemoglobin with dire consequences. The therapy consists of the intravenous administration of methylene blue. © Georg Thieme Verlag Stuttgart · New York.

Assessment of state-of-the-art of in-service inspection methods for graphite epoxy composite structures on commercial transport aircraft

NASA Technical Reports Server (NTRS)

Phelps, M. L.

1979-01-01

A survey was conducted to determine current in-service inspection practices for all types of aircraft structure and particularly for advanced composite structures. The survey consisted of written questionnaires to commercial airlines, visits to airlines, aircraft manufacturers, and government agencies, and a literature search. Details of the survey including visits, questions asked, a bibliography of reviewed literature and details of the results are reported. From the results, a current in-service inspection baseline and a preliminary inspection program for advanced composite structures is documented as appendices to the report.

Context matters: the experience of 14 research teams in systematically reporting contextual factors important for practice change.

PubMed

Tomoaia-Cotisel, Andrada; Scammon, Debra L; Waitzman, Norman J; Cronholm, Peter F; Halladay, Jacqueline R; Driscoll, David L; Solberg, Leif I; Hsu, Clarissa; Tai-Seale, Ming; Hiratsuka, Vanessa; Shih, Sarah C; Fetters, Michael D; Wise, Christopher G; Alexander, Jeffrey A; Hauser, Diane; McMullen, Carmit K; Scholle, Sarah Hudson; Tirodkar, Manasi A; Schmidt, Laura; Donahue, Katrina E; Parchman, Michael L; Stange, Kurt C

2013-01-01

We aimed to advance the internal and external validity of research by sharing our empirical experience and recommendations for systematically reporting contextual factors. Fourteen teams conducting research on primary care practice transformation retrospectively considered contextual factors important to interpreting their findings (internal validity) and transporting or reinventing their findings in other settings/situations (external validity). Each team provided a table or list of important contextual factors and interpretive text included as appendices to the articles in this supplement. Team members identified the most important contextual factors for their studies. We grouped the findings thematically and developed recommendations for reporting context. The most important contextual factors sorted into 5 domains: (1) the practice setting, (2) the larger organization, (3) the external environment, (4) implementation pathway, and (5) the motivation for implementation. To understand context, investigators recommend (1) engaging diverse perspectives and data sources, (2) considering multiple levels, (3) evaluating history and evolution over time, (4) looking at formal and informal systems and culture, and (5) assessing the (often nonlinear) interactions between contextual factors and both the process and outcome of studies. We include a template with tabular and interpretive elements to help study teams engage research participants in reporting relevant context. These findings demonstrate the feasibility and potential utility of identifying and reporting contextual factors. Involving diverse stakeholders in assessing context at multiple stages of the research process, examining their association with outcomes, and consistently reporting critical contextual factors are important challenges for a field interested in improving the internal and external validity and impact of health care research.

Rural disparities in the distribution of policies that support healthy eating in US secondary schools.

PubMed

Nanney, Marilyn S; Davey, Cynthia S; Kubik, Martha Y

2013-08-01

The distribution of food and nutrition policies and practices from 28 US states representing 6,732 secondary schools was evaluated using data from the 2008 School Health Profiles principal survey. School policies and practices evaluated were: availability of low-nutrient, energy-dense (LNED) snacks/drinks; use of healthy eating strategies; banning food marketing; availability of fruits and vegetables; and food package sizes. For each school, school-level demographic characteristics (percentage of students enrolled in free/reduced-price meals, minority enrollment, and geographic location) were also evaluated. Schools in small town/rural locations had significantly fewer policies that support healthy eating strategies and ban food marketing, and were less likely to serve fruits and vegetables at school celebrations, have fruits and vegetables available in vending or school stores, and limit serving-size packages. Schools serving the highest percentage of minority students consistently reported the same or better school food environments. However, schools serving the highest percentage of low-income students had varied results: vending and LNED vending policies were consistently better and fruit and vegetable availability-related policies were consistently worse. Disparities in the distribution of policies and practices that promote healthy school food environments seem most pronounced in small town/rural schools. The data also support the need for continued reinforcement and the potential for expansion of these efforts in urban and suburban areas and schools with highest minority enrollment. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

How item banks and their application can influence measurement practice in rehabilitation medicine: a PROMIS fatigue item bank example.

PubMed

Lai, Jin-Shei; Cella, David; Choi, Seung; Junghaenel, Doerte U; Christodoulou, Christopher; Gershon, Richard; Stone, Arthur

2011-10-01

To illustrate how measurement practices can be advanced by using as an example the fatigue item bank (FIB) and its applications (short forms and computerized adaptive testing [CAT]) that were developed through the National Institutes of Health Patient Reported Outcomes Measurement Information System (PROMIS) Cooperative Group. Psychometric analysis of data collected by an Internet survey company using item response theory-related techniques. A U.S. general population representative sample collected through the Internet. Respondents used for dimensionality evaluation of the PROMIS FIB (N=603) and item calibrations (N=14,931). Not applicable. Fatigue items (112) developed by the PROMIS fatigue domain working group, 13-item Functional Assessment of Chronic Illness Therapy-Fatigue, and 4-item Medical Outcomes Study 36-Item Short Form Health Survey Vitality scale. The PROMIS FIB version 1, which consists of 95 items, showed acceptable psychometric properties. CAT showed consistently better precision than short forms. However, all 3 short forms showed good precision for most participants in that more than 95% of the sample could be measured precisely with reliability greater than 0.9. Measurement practice can be advanced by using a psychometrically sound measurement tool and its applications. This example shows that CAT and short forms derived from the PROMIS FIB can reliably estimate fatigue reported by the U.S. general population. Evaluation in clinical populations is warranted before the item bank can be used for clinical trials. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Evaluating a standardised clinical assessment tool for pre-registration midwifery students: A cross-sectional survey of midwifery students and midwives in Australia.

PubMed

Morrow, Jane; Biggs, Laura; Stelfox, Sara; Phillips, Diane; McKellar, Lois; McLachlan, Helen

2016-02-01

Assessment of clinical competence is a core component of midwifery education. Clinical assessment tools have been developed to help increase consistency and overcome subjectivity of assessment. The study had two main aims. The first was to explore midwifery students and educators/clinical midwives' views and experiences of a common clinical assessment tool used for all preregistration midwifery programmes in Victoria and the University of South Australia. The second was to assess the need for changes to the tool to align with developments in clinical practice and evidence-based care. A cross-sectional, web-based survey including Likert-type scales and open-ended questions was utilised. Students enrolled in all four entry pathways to midwifery at seven Victorian and one South Australian university and educators/clinical midwives across both states. One hundred and ninety-one midwifery students' and 86 educators/clinical midwives responded. Overall, students and educators/clinical midwives were positive about the Clinical Assessment Tool with over 90% reporting that it covered the necessary midwifery skills. Students and educators/clinical midwives reported high levels of satisfaction with the content of the learning tools. Only 4% of educators/clinical midwives and 6% of students rated the Clinical Assessment Tool as poor overall. Changes to some learning tools were necessary in order to reflect recent practice and evidence. A common clinical assessment tool for evaluating midwifery students' clinical practice may facilitate the provision of consistent, reliable and objective assessment of student skills and competency. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Proposal of a New Adverse Event Classification by the Society of Interventional Radiology Standards of Practice Committee.

PubMed

Khalilzadeh, Omid; Baerlocher, Mark O; Shyn, Paul B; Connolly, Bairbre L; Devane, A Michael; Morris, Christopher S; Cohen, Alan M; Midia, Mehran; Thornton, Raymond H; Gross, Kathleen; Caplin, Drew M; Aeron, Gunjan; Misra, Sanjay; Patel, Nilesh H; Walker, T Gregory; Martinez-Salazar, Gloria; Silberzweig, James E; Nikolic, Boris

2017-10-01

To develop a new adverse event (AE) classification for the interventional radiology (IR) procedures and evaluate its clinical, research, and educational value compared with the existing Society of Interventional Radiology (SIR) classification via an SIR member survey. A new AE classification was developed by members of the Standards of Practice Committee of the SIR. Subsequently, a survey was created by a group of 18 members from the SIR Standards of Practice Committee and Service Lines. Twelve clinical AE case scenarios were generated that encompassed a broad spectrum of IR procedures and potential AEs. Survey questions were designed to evaluate the following domains: educational and research values, accountability for intraprocedural challenges, consistency of AE reporting, unambiguity, and potential for incorporation into existing quality-assurance framework. For each AE scenario, the survey participants were instructed to answer questions about the proposed and existing SIR classifications. SIR members were invited via online survey links, and 68 members participated among 140 surveyed. Answers on new and existing classifications were evaluated and compared statistically. Overall comparison between the two surveys was performed by generalized linear modeling. The proposed AE classification received superior evaluations in terms of consistency of reporting (P < .05) and potential for incorporation into existing quality-assurance framework (P < .05). Respondents gave a higher overall rating to the educational and research value of the new compared with the existing classification (P < .05). This study proposed an AE classification system that outperformed the existing SIR classification in the studied domains. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

Positive health practices and temporal perspective in low-income adults.

PubMed

Thompson, Cheryl W; Fitzpatrick, Joyce J

2008-07-01

The purpose of this study was to describe health-promoting behaviours and temporal perspective in low-income adults. Positive health practices represent a broad range of health-promoting behaviours. The ability to adopt positive health practices may be influenced by many factors, one of which is temporal perspective, the perceived relationship between past, present and future times. This exploratory study was conducted in a south central Pennsylvania community with a convenience sample of individuals who were eligible for a subsidized low-income housing programme. Positive health practices were measured using the Personal Lifestyle Questionnaire. Temporal perspective was measured with the Circles Test. The sample consisted of 75 subjects, 61 women (81%) and 14 men (19%). Positive health practices were relatively high (mean = 70 out of a possible score of 96). Forty three per cent of the subjects expressed future temporal dominance and 80% of the subjects in this study expressed non-continuous temporal relatedness. Health-promoting behaviours in this low-income sample were similar to those reported in other samples in middle-class adult samples. The percentage of subjects who expressed future dominance was similar to findings in other samples. The percentage of subjects who expressed non-continuous temporal relatedness was different from findings reported in other samples, suggesting that perception of the relationship of past, present and future times is different in this low-income sample compared with other samples. The temporal relatedness findings suggest that low-income individuals may not believe that adopting positive health practices will influence future health.

The management of menstrual suppression and uterine bleeding: a survey of current practices in the Pediatric Blood and Marrow Transplant Consortium.

PubMed

Adegite, Enitan A; Goyal, Rakesh K; Murray, Pamela J; Marshal, Mike; Sucato, Gina S

2012-09-01

Current guidelines recommend the use of combined hormonal contraceptive pills for menstrual suppression in pediatric blood and marrow transplant (BMT) recipients but recent research reveals that provider practice varies. This study was designed to describe the current practice for managing menstrual issues, that is, menstrual suppression and uterine bleeding, in pediatric BMT patients and to better understand health care providers' practices in the use of gonadotropin-releasing hormone agonists (GnRHa). A cross sectional survey consisting of 53 questions was distributed via email to principal investigators in the Pediatric Blood and Marrow Transplant Consortium (PBMTC). Responses were collected using www.surveymonkey.com. Menstrual suppression and uterine bleeding in pediatric BMT patients are primarily managed by pediatric oncologists (97%). The most frequently reported hormonal method used for induction of therapeutic amenorrhea was GnRHa (41%). The top three reasons for choosing a method were greater likelihood of amenorrhea, concerns about side effects, and possible gonadal protection. Continuous combined hormonal contraceptive pills were the most commonly used method for the management of clinically significant uterine bleeding regardless of primary method used for menstrual suppression. Despite the 2002 PBMTC guidelines, wide variation in menstrual suppression management practices still exists. Our data show that use of GnRHa is more common than previously reported. Additional research is needed to develop evidence-based practice guidelines in pediatric BMT patients. Copyright © 2012 Wiley Periodicals, Inc.

Gay and Bisexual Adolescent Boys' Perspectives on Parent-Adolescent Relationships and Parenting Practices Related to Teen Sex and Dating.

PubMed

Feinstein, Brian A; Thomann, Matthew; Coventry, Ryan; Macapagal, Kathryn; Mustanski, Brian; Newcomb, Michael E

2017-12-26

Close parent-adolescent relationships and specific parenting practices (e.g., communication about sex, monitoring) are associated with reduced sexual risk behavior among heterosexual youth. Despite gay/bisexual male youth being at increased risk of HIV, little is known about parental influences on their sexual behavior. As such, the goal of the current study was to examine parent-adolescent relationships and parenting practices related to teen sex and dating from the perspective of gay/bisexual adolescent boys. Online focus groups were conducted with 52 gay/bisexual male youth ages 14-17 years. Most gay/bisexual adolescent boys felt that their sexual orientation had an influence on their relationships with their parents and discussions about sex/dating. Although some felt that their relationships improved after coming out, a larger percentage reported that it put strain on their relationships. Discussions about sex/dating generally decreased after coming out, but some youth described positive conversations with their parents. Many reported that their parents struggled with whether or not to adapt parenting practices (e.g., rules about dating) after they came out. Youth consistently noted that parent-adolescent relationships and parenting practices depended on the adolescent's level of outness. Findings have important implications for refining HIV prevention programs for gay/bisexual adolescent boys, especially interventions that include parents.

Promoting physical therapists' of research evidence to inform clinical practice: part 1--theoretical foundation, evidence, and description of the PEAK program.

PubMed

Tilson, Julie K; Mickan, Sharon

2014-06-25

There is a need for theoretically grounded and evidence-based interventions that enhance the use of research evidence in physical therapist practice. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists' integration of research evidence into clinical decision-making. The pedagogical foundations for the PEAK educational program include Albert Bandura's social cognitive theory and Malcolm Knowles's adult learning theory. Additionally, two complementary frameworks of knowledge translation, the Promoting Action on Research Implementation in Health Services (PARiHS) and Knowledge to Action (KTA) Cycle, were used to inform the organizational elements of the program. Finally, the program design was influenced by evidence from previous attempts to facilitate the use of research in practice at the individual and organizational levels. The 6-month PEAK program consisted of four consecutive and interdependent components. First, leadership support was secured and electronic resources were acquired and distributed to participants. Next, a two-day training workshop consisting of didactic and small group activities was conducted that addressed the five steps of evidence based practice. For five months following the workshop, participants worked in small groups to review and synthesize literature around a group-selected area of common clinical interest. Each group contributed to the generation of a "Best Practices List" - a list of locally generated, evidence-based, actionable behaviors relevant to the groups' clinical practice. Ultimately, participants agreed to implement the Best Practices List in their clinical practice. This, first of two companion papers, describes the underlying pedagogical theories, knowledge translation frameworks, and research evidence used to derive the PEAK program - an educational program designed to promote the use of research evidence to inform physical therapist practice. The four components of the program are described in detail. The companion paper reports the results of a mixed methods feasibility analysis of this complex educational intervention.

Standardized synoptic cancer pathology reports - so what and who cares? A population-based satisfaction survey of 970 pathologists, surgeons, and oncologists.

PubMed

Lankshear, Sara; Srigley, John; McGowan, Thomas; Yurcan, Marta; Sawka, Carol

2013-11-01

Cancer Care Ontario implemented synoptic pathology reporting across Ontario, impacting the practice of pathologists, surgeons, and medical and radiation oncologists. The benefits of standardized synoptic pathology reporting include enhanced completeness and improved consistency in comparison with narrative reports, with reported challenges including increased workload and report turnaround time. To determine the impact of synoptic pathology reporting on physician satisfaction specific to practice and process. A descriptive, cross-sectional design was utilized involving 970 clinicians across 27 hospitals. An 11-item survey was developed to obtain information regarding timeliness, completeness, clarity, and usability. Open-ended questions were also employed to obtain qualitative comments. A 51% response rate was obtained, with descriptive statistics reporting that physicians perceive synoptic reports as significantly better than narrative reports. Correlation analysis revealed a moderately strong, positive relationship between respondents' perceptions of overall satisfaction with the level of information provided and perceptions of completeness for clinical decision making (r = 0.750, P < .001) and ease of finding information for clinical decision making (r = 0.663, P < .001). Dependent t tests showed a statistically significant difference in the satisfaction scores of pathologists and oncologists (t169 = 3.044, P = .003). Qualitative comments revealed technology-related issues as the most frequently cited factor impacting timeliness of report completion. This study provides evidence of strong physician satisfaction with synoptic cancer pathology reporting as a clinical decision support tool in the diagnosis, prognosis, and treatment of cancer patients.

Practice of breast self-examination among women in Malaysia.

PubMed

Al-Naggar, Redhwan Ahmed; Bobryshev, Yuri V; Al-Jashamy, Karim

2012-01-01

The objective of this study was to examine the practice and associated factors of breast self- examination (BSE) among Malaysian women. For this cross-sectional study 250 women were selected by a simple random sampling technique. The questionnaire was consisted of three parts: socio-demographic characteristics, knowledge about BSE, and practice of BSE. Obtained data was analyzed using SPSS version 13. T-test and ANOVA test were used to explore the relation between socio-demographic characteristics and the practice of BSE. About 32% of the participants reported that they have had family history of cancer and about 20% of the participants reported that they have had family history of breast cancer. The majority of the participants (88.8%) have heard about breast cancer and 78.4% of the participants have heard about BSE. Race, marital status, residency, regular exercise, awareness about breast cancer, belief that breast cancer can be detected early, belief that early detection improves the chance of survival, family history of cancer, family history of breast cancer, awareness about BSE, and belief that BSE is necessary, significantly influenced the practice of BSE among women. Practice of BSE on monthly basis was found to be 47.2% among the study participants. The socio-demographic characteristics significantly influence the practice of BSA among women in Malaysia. The findings of this study might not only influence the planning of specific screening interventions and strategies in Malaysia but might also be important for the relevant international communities, interested in the peculiarities of BSE incidence in different countries.

Psychometric properties of the Kids' Child Feeding Questionnaire-Restriction.

PubMed

Stromberg, Sarah E; Minski, Samantha; Wheeler, Paris B; Chardon, Marie L; Janicke, David M

Research exploring parental restrictive feeding is mixed and shows that it both negatively and positively affects children's dietary intake. One hypothesis for these inconsistent findings is the use of parent-report vs. youth-report measures of parental restrictive feeding, but there are limited psychometrically-sound youth-report measures of this construct. Therefore, the current study aims to evaluate the psychometric properties of a measure of parent restrictive feeding practices, the Kids' Child Feeding Questionnaire-Restriction (KCFQ-R), from the youth perspective. The 7-item, youth-report KCFQ-R is composed of the restriction subscale from the Kids' Child Feeding Questionnaire. This measure was completed by 225 youth attending a primary care appointment. Initial exploratory factor analysis and communalities yielded a single factor solution explaining 39.93% of the variability in the data. Internal consistency using the seven items was .73. The KCFQ-R demonstrated external validity through its significant relationship with parent concern about child overweight. Results provide preliminary support that the KCFQ-R is a psychometrically sound and reliable measure of youth-reported parental restrictive feeding practices. Given the mixed research on the effects of parent-reported parental feeding restriction on various child outcomes, this youth-report measure may help clarify these relationships. Future research should examine youth-report measures of other parent feeding domains. Copyright © 2017 Asia Oceania Association for the Study of Obesity. All rights reserved.

Infection control implementations at forensic medicine practice: a national survey in Turkey.

PubMed

Aydin, Berna; Tanyel, Esra; Colak, Basar; Fisgin, Nuriye; Tulek, Necla

2009-06-01

Because forensic medicine workers have a greater occupational risk for infectious diseases, strict rules and measures against infections must be implemented at every stage of forensic medicine practices. In this study, we aim to evaluate the infection control implementations in forensic medicine practices in Turkey.A questionnaire survey was mailed to forensic medicine specialists and residents between April and June 2005. The questionnaire consisted of 36 questions whose designed was based on standard precautions and protective barriers against infectious risks.In all, 111 doctors from 27 different cities responded to the questionnaire. Of those doctors who responded, 43.2% reported performing external examination anywhere. The percentage of doctors performing external examinations who regularly wore gloves, masks, and gowns, and washed hands with a disinfectant were 81.5%, 24.7%, 30.9%, and 81.5%, respectively. The percentage of doctors performing autopsies who regularly wore masks, protective eye-wear, gloves, special gloves, and special boots were 59.6%, 10.6%, 98.9%, 71.3%, and 36.2%, respectively. Only 2 negative pressure rooms were reported.According to these results, precautionary measures against infectious risks in forensic medicine practice in our country are insufficient. Conditions to facilitate and to improve the compliance with infection control procedures must be prepared.

Ergonomics in gynecologists' daily practice: A nationwide survey in The Netherlands.

PubMed

Alleblas, Chantal C J; Formanoy, Margriet A G; Könemann, Reinier; Radder, Celine M; Huirne, Judith A; Nieboer, Theodoor E

2016-01-01

Gynecologists are exposed to multiple risk factors for developing physical complaints. To enhance the workplace ergonomics in gynecological practice, a more detailed insight about job content and associated demands is necessary to subsequently decrease the exposure to risk factors. The aim of this study was to investigate the prevalence of physical complaints and the presence of ergonomic constraints in Dutch gynecological practice. A questionnaire was distributed among the 1200 members of the Dutch Society of Obstetrics and Gynecology. It consisted of 52 Dutch questions derived from the validated Dutch Musculoskeletal Questionnaire. A total of 227 respondents completed the questionnaire (response rate 18.9%). Overall, 99.5% of the respondents rated their health status as reasonable or good. However, the twelve-month prevalence of physical complaints in one or more body part was 89.4%. Sustained adverse body postures were particularly reported for performing abdominal, and endoscopic surgery, and for assisting in vaginal surgery. Limited workspace, instruments, and patient size were reported by more than 60% of the respondents as constraints for adopting a neutral body posture during vaginal, endoscopic and abdominal surgery respectively. The results emphasize the necessity of enhancing ergonomics in gynecological practice. Better ergonomic circumstances will most likely benefit both the health of the gynecologists as well as the quality of surgical care.

Investigating the exercise-prescription practices of nurses working in inpatient mental health settings.

PubMed

Stanton, Robert; Happell, Brenda; Reaburn, Peter

2015-04-01

Nurses working in mental health are well positioned to prescribe exercise to people with mental illness. However, little is known regarding their exercise-prescription practices. We examined the self-reported physical activity and exercise-prescription practices of nurses working in inpatient mental health facilities. Thirty-four nurses completed the Exercise in Mental Illness Questionnaire - Health Practitioner Version. Non-parametric bivariate statistics revealed no relationship between nurses' self-reported physical activity participation and the frequency of exercise prescription for people with mental illness. Exercise-prescription parameters used by nurses are consistent with those recommended for both the general population and for people with mental illness. A substantial number of barriers to effective exercise prescription, including lack of training, systemic issues (such as prioritization and lack of time), and lack of consumer motivation, impact on the prescription of exercise for people with mental illness. Addressing the barriers to exercise prescription could improve the proportion of nurses who routinely prescribe exercise. Collaboration with exercise professionals, such as accredited exercise physiologists or physiotherapists, might improve knowledge of evidence-based exercise-prescription practices for people with mental illness, thereby improving both physical and mental health outcomes for this vulnerable population. © 2015 Australian College of Mental Health Nurses Inc.

An ethnographic exploration of influences on prescribing in general practice: why is there variation in prescribing practices?

PubMed

Grant, Aileen; Sullivan, Frank; Dowell, Jon

2013-06-21

Prescribing is a core activity for general practitioners, yet significant variation in the quality of prescribing has been reported. This suggests there may be room for improvement in the application of the current best research evidence. There has been substantial investment in technologies and interventions to address this issue, but effect sizes so far have been small to moderate. This suggests that prescribing is a decision-making process that is not sufficiently understood. By understanding more about prescribing processes and the implementation of research evidence, variation may more easily be understood and more effective interventions proposed. An ethnographic study in three Scottish general practices with diverse organizational characteristics. Practices were ranked by their performance against Audit Scotland prescribing quality indicators, incorporating established best research evidence. Two practices of high prescribing quality and one practice of low prescribing quality were recruited. Participant observation, formal and informal interviews, and a review of practice documentation were employed. Practices ranked as high prescribing quality consistently made and applied macro and micro prescribing decisions, whereas the low-ranking practice only made micro prescribing decisions. Macro prescribing decisions were collective, policy decisions made considering research evidence in light of the average patient, one disease, condition, or drug. Micro prescribing decisions were made in consultation with the patient considering their views, preferences, circumstances and other conditions (if necessary).Although micro prescribing can operate independently, the implementation of evidence-based, quality prescribing was attributable to an interdependent relationship. Macro prescribing policy enabled prescribing decisions to be based on scientific evidence and applied consistently where possible. Ultimately, this influenced prescribing decisions that occur at the micro level in consultation with patients. General practitioners in the higher prescribing quality practices made two different 'types' of prescribing decision; macro and micro. Macro prescribing informs micro prescribing and without a macro basis to draw upon the low-ranked practice had no effective mechanism to engage with, reflect on and implement relevant evidence. Practices that recognize these two levels of decision making about prescribing are more likely to be able to implement higher quality evidence.

An ethnographic exploration of influences on prescribing in general practice: why is there variation in prescribing practices?

PubMed Central

2013-01-01

Background Prescribing is a core activity for general practitioners, yet significant variation in the quality of prescribing has been reported. This suggests there may be room for improvement in the application of the current best research evidence. There has been substantial investment in technologies and interventions to address this issue, but effect sizes so far have been small to moderate. This suggests that prescribing is a decision-making process that is not sufficiently understood. By understanding more about prescribing processes and the implementation of research evidence, variation may more easily be understood and more effective interventions proposed. Methods An ethnographic study in three Scottish general practices with diverse organizational characteristics. Practices were ranked by their performance against Audit Scotland prescribing quality indicators, incorporating established best research evidence. Two practices of high prescribing quality and one practice of low prescribing quality were recruited. Participant observation, formal and informal interviews, and a review of practice documentation were employed. Results Practices ranked as high prescribing quality consistently made and applied macro and micro prescribing decisions, whereas the low-ranking practice only made micro prescribing decisions. Macro prescribing decisions were collective, policy decisions made considering research evidence in light of the average patient, one disease, condition, or drug. Micro prescribing decisions were made in consultation with the patient considering their views, preferences, circumstances and other conditions (if necessary). Although micro prescribing can operate independently, the implementation of evidence-based, quality prescribing was attributable to an interdependent relationship. Macro prescribing policy enabled prescribing decisions to be based on scientific evidence and applied consistently where possible. Ultimately, this influenced prescribing decisions that occur at the micro level in consultation with patients. Conclusion General practitioners in the higher prescribing quality practices made two different ‘types’ of prescribing decision; macro and micro. Macro prescribing informs micro prescribing and without a macro basis to draw upon the low-ranked practice had no effective mechanism to engage with, reflect on and implement relevant evidence. Practices that recognize these two levels of decision making about prescribing are more likely to be able to implement higher quality evidence. PMID:23799906

Ethical considerations in aesthetic rhinoplasty: a survey, critical analysis, and review.

PubMed

Karimi, Kian; McKneally, Martin F; Adamson, Peter A

2012-11-01

Although the practice of medicine is built on a foundation of ethics, science, and common sense, the increasing complexity of medical interventions, social interactions, and societal norms of behavior challenges the ethical practice of aesthetic surgeons. We report a survey of the opinions, practices, and attitudes of experienced and novice facial plastic surgeons. The survey consisted of 15 clinical vignettes addressing ethical quandaries in aesthetic rhinoplasty. The vignettes are based on the experience and observations of the senior author (P.A.A.) over nearly 30 years of practice and teaching. Fellowship directors and facial plastic surgery fellows of the American Academy of Facial Plastic and Reconstructive Surgery were surveyed anonymously. Five of the 15 vignettes demonstrated significant differences between the responses of the fellowship directors and the fellows. No single vignette had a unanimous consensus in either group. Aesthetic rhinoplasty surgeons encounter ethical issues that should be reflected on by both experienced and inexperienced facial plastic surgeons, preferably before being faced with them in practice. We present a practical approach to ethical issues in clinical practice. Our survey can also be used as a stimulus for further discussion and teaching.

A decade of individual participant data meta-analyses: A review of current practice.

PubMed

Simmonds, Mark; Stewart, Gavin; Stewart, Lesley

2015-11-01

Individual participant data (IPD) systematic reviews and meta-analyses are often considered to be the gold standard for meta-analysis. In the ten years since the first review into the methodology and reporting practice of IPD reviews was published much has changed in the field. This paper investigates current reporting and statistical practice in IPD systematic reviews. A systematic review was performed to identify systematic reviews that collected and analysed IPD. Data were extracted from each included publication on a variety of issues related to the reporting of IPD review process, and the statistical methods used. There has been considerable growth in the use of "one-stage" methods to perform IPD meta-analyses. The majority of reviews consider at least one covariate other than the primary intervention, either using subgroup analysis or including covariates in one-stage regression models. Random-effects analyses, however, are not often used. Reporting of review methods was often limited, with few reviews presenting a risk-of-bias assessment. Details on issues specific to the use of IPD were little reported, including how IPD were obtained; how data was managed and checked for consistency and errors; and for how many studies and participants IPD were sought and obtained. While the last ten years have seen substantial changes in how IPD meta-analyses are performed there remains considerable scope for improving the quality of reporting for both the process of IPD systematic reviews, and the statistical methods employed in them. It is to be hoped that the publication of the PRISMA-IPD guidelines specific to IPD reviews will improve reporting in this area. Copyright © 2015 Elsevier Inc. All rights reserved.

Are larger dental practices more efficient? An analysis of dental services production.

PubMed Central

Lipscomb, J; Douglass, C W

1986-01-01

Whether cost-efficiency in dental services production increases with firm size is investigated through application of an activity analysis production function methodology to data from a national survey of dental practices. Under this approach, service delivery in a dental practice is modeled as a linear programming problem that acknowledges distinct input-output relationships for each service. These service-specific relationships are then combined to yield projections of overall dental practice productivity, subject to technical and organizational constraints. The activity analysis reported here represents arguably the most detailed evaluation yet of the relationship between dental practice size and cost-efficiency, controlling for such confounding factors as fee and service-mix differences across firms. We conclude that cost-efficiency does increase with practice size, over the range from solo to four-dentist practices. Largely because of data limitations, we were unable to test satisfactorily for scale economies in practices with five or more dentists. Within their limits, our findings are generally consistent with results from the neoclassical production function literature. From the standpoint of consumer welfare, the critical question raised (but not resolved) here is whether these apparent production efficiencies of group practice are ultimately translated by the market into lower fees, shorter queues, or other nonprice benefits. PMID:3102404

The effectiveness and feasibility of TREAT (Tailoring Research Evidence and Theory) journal clubs in allied health: a randomised controlled trial.

PubMed

Wenke, Rachel J; Thomas, Rae; Hughes, Ian; Mickan, Sharon

2018-05-09

Journal clubs (JC) may increase clinicians' evidence-based practice (EBP) skills and facilitate evidence uptake in clinical practice, however there is a lack of research into their effectiveness in allied health. We investigated the effectiveness of a structured JC that is Tailored According to Research Evidence And Theory (TREAT) in improving EBP skills and practice compared to a standard JC format for allied health professionals. Concurrently, we explored the feasibility of implementing TREAT JCs in a healthcare setting, by evaluating participating clinicians' perceptions and satisfaction. We conducted an explanatory mixed methods study involving a cluster randomised controlled trial with a nested focus group for the intervention participants. Nine JCs with 126 allied health participants were randomly allocated to receive either the TREAT or standard JC format for 1 h/month for 6 months. We conducted pre-post measures of EBP skills and attitudes using the EBP questionnaire and Assessing Competence in Evidence-Based Medicine tool and a tailored satisfaction and practice change questionnaire. Post-intervention, we also conducted a focus group with TREAT participants to explore their perceptions of the format. There were no significant differences between JC formats in EBP skills, knowledge or attitudes or influence on clinical practice, with participants maintaining intermediate level skills across time points. Participants reported significantly greater satisfaction with the organisation of the TREAT format. Participants in both groups reported positive changes to clinical practice. Perceived outcomes to the TREAT format and facilitating mechanisms were identified including the use of an academic facilitator, group appraisal approach and consistent appraisal tools which assisted skill development and engagement. It is feasible to implement an evidence-based JC for allied health clinicians. While clinicians were more satisfied with the TREAT format, it did not significantly improve their EBP skills, attitudes, knowledge and/or practice, when compared to the standard format. The use of an academic facilitator, group based critical appraisal, and the consistent use of appraisal tools were perceived as useful components of the JC format. A structured JC may maintain EBP skills in allied health clinicians and facilitate engagement, however additional training may be required to further enhance EBP skills. ACTRN12616000811404 Retrospectively registered 21 June 2016.

A qualitative evaluation of the impact of a palliative care course on preregistration nursing students' practice in Cameroon.

PubMed

Bassah, Nahyeni; Cox, Karen; Seymour, Jane

2016-03-31

Current evidence suggests that palliative care education can improve preregistration nursing students' competencies in palliative care. However, it is not known whether these competencies are translated into students' practice in the care of patients who are approaching the end of life. This paper seeks to contribute to the palliative care evidence base by examining how nursing students in receipt of education report transfer of learning to practice, and what the barriers and facilitators may be, in a resource-poor country. We utilised focus groups and individual critical incident interviews to explore nursing students' palliative care learning transfer. Three focus groups, consisting of 23 participants and 10 individual critical incident interviews were conducted with preregistration nursing student who had attended a palliative care course in Cameroon and had experience caring for a patient approaching the end of life. Data was analysed thematically, using the framework approach. The results suggest that nursing students in receipt of palliative care education can transfer their learning to practice. Students reported recognizing patients with palliative care needs, providing patients with physical, psychosocial and spiritual support and communicating patient information to the wider care team. They did however perceive some barriers to this transfer which were either related to themselves, qualified nurses, the practice setting or family caregivers and patients. The findings from this study suggest that nursing student in receipt of palliative care education can use their learning in practice to provide care to patients and their families approaching the end of life. Nevertheless, these findings need to be treated with some caution given the self-reported nature of the data. Demonstrating the link between preregistration palliative care education and patient care is vital to ensuring that newly acquired knowledge and skills are translated and embedded into clinical practice. This study also has implications for advocating for palliative care policies and adequately preparing clinical placement sites for students' learning and transfer of learning.

Perception of early parenting in panic and agoraphobia.

PubMed

Faravelli, C; Panichi, C; Pallanti, S; Paterniti, S; Grecu, L M; Rivelli, S

1991-07-01

Thirty-two patients with a DSM-III-R diagnosis of panic disorder (PD) were administered the Parental Bonding Instrument (PBI), a 25-item self-report questionnaire devised to evaluate parental rearing practices. Compared with 32 matched healthy controls, PD patients scored both their parents as being significantly less caring and more overprotective. Moreover, the consistency of parental attitudes between the 2 parents was significantly lower, indicating lesser uniformity in the rearing patterns.

Teaching Linguistically and Culturally Diverse Learners: Effective Programs and Practices. Proceedings of an Institute Hosted by the National Center for Research on Cultural Diversity and Second Language Learning (Santa Cruz, California, June 28-30, 1994).

ERIC Educational Resources Information Center

Montone, Christopher L., Ed.

The proceedings presented consist of summaries and reports of the presentations given during a summer institute on teaching linguistically and culturally diverse learners. Summaries of the following papers are provided: "Education 2000 and Beyond: The Challenge of Our Culturally Diverse Students" (Eugene Garcia); "Second Language…

Literacy in Development: People, Language and Power. Papers Given at, Relating to and Produced by the International Seminar Held at the Commonwealth Institute for International Literacy Year (London, England, April 6-7, 1990).

ERIC Educational Resources Information Center

Street, Brian, Ed.

This report consists of papers given at, relating to, and produced by an international seminar that emphasized sharing practical experience and analyzing conditions necessary to set up and sustain a literacy program. The first section provides an "Introduction" (James Porter) and "Background to the Seminar" (Alan Rogers).…

Physicians' contact with families after the death of pediatric patients: a survey of pediatric critical care practitioners' beliefs and self-reported practices.

PubMed

Borasino, Santiago; Morrison, Wynne; Silberman, Jordan; Nelson, Robert M; Feudtner, Chris

2008-12-01

Although research with bereaved families has shown that they appreciate contact with clinicians after the child's death, this realm of clinical practice remains empirically uncharted. The objective of this study was to describe pediatric critical care practitioners' attitudes and self-reported practices regarding contacting families after a patient's death. A total of 376 board-certified members of the American Academy of Pediatrics Section of Critical Care received e-mail invitations to complete a Web-based questionnaire; 204 members responded (effective response rate: 54.3%). Most (95%) participants reported 0 to 1 patient deaths per week. A total of 79% of the respondents reported contacting families at least sometimes, 71.9% had attended funerals, and only 2.5% thought that it was inappropriate for clinicians to attend funerals. A total of 75.9% agreed that follow-up contact helps the family, whereas 47.3% agreed that follow-up contact helps the physicians. The most common methods of follow-up contact included the passive measures of providing contact information; active methods such as meeting with the family, calling them by telephone, or writing a letter or note were used less often. In multivariable analysis, respondents were more likely to report contact with a family after the death of a child when they affirmed the belief that such contact was useful to the family or to the physician or when they were female physicians. Regarding reported funeral attendance after the death of a patient, multivariable analysis revealed similar patterns of association but to an attenuated and nonstatistically significant degree. A high proportion of pediatric critical care physicians have contacted bereaved families and attended funerals after the death of a child patient. These practices were consistently associated with the belief that such follow-up contact helps the family or the practitioner.

What practices do parents perceive as effective or ineffective in promoting a healthy diet, physical activity, and less sitting in children: parent focus groups

PubMed Central

2013-01-01

Background To support parents in improving the health of their young children, examples of effective parenting practices for a healthy diet, physical activity (PA) and sedentary behavior (SB) are needed. This study explores perceived effective and ineffective parenting practices in difficult situations concerning raising healthy children and investigates their relationship with Self-Determination Theory (SDT) and Social Cognitive Theory (SCT). The current study is formative work to inform the content of a randomized controlled trial. Methods Four focus groups were conducted between June and October 2012 at worksites during lunch break. A total of 21 unrelated parents of primary schoolchildren (6 fathers, 15 mothers) participated. A short written questionnaire introduced typical difficult situations derived from parental anecdotal reports, concerning healthy diet, PA and SB. These situations formed the backbone for the subsequent focus group discussion. In October 2012, discussions were audio-recorded and analyzed in Nvivo to identify key response items using thematic analysis. Results Parents experienced explaining why the child should behave healthily, monitoring, being consistent, offering alternatives, reacting empathetically, modeling, motivating, increasing intrinsic value and availability, and using time-out as effective practices, whereas anger was considered ineffective. Opinions were mixed about the effectiveness of giving as much freedom as possible, obliging, rewarding and punishing, and setting rules and agreements. Parenting practices were consistent with principles from both SDT and SCT. Conclusions Parents identified numerous perceived effective practices to respond to their child’s health-related behavior. Since many of them coincide with the evidence base and the success of a parenting program depends upon the degree to which parents’ concerns and motivations are integrated into the program design, important opportunities are created for future intervention programs. PMID:24219513

75 FR 34291 - Federal Acquisition Regulation; Federal Acquisition Circular 2005-42; Small Entity Compliance Guide

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

............ Disclosure and Consistency of Cost 2009-025 Chambers. Accounting Practices for Contracts Awarded to Foreign... of Cost Accounting Practices for Contracts Awarded to Foreign Concerns (FAR Case 2009-025) (Interim... Cost Accounting Standards (CAS) Board clause, Disclosure and Consistency of Cost Accounting Practices...

Low-Income Women's Feeding Practices and Perceptions of Dietary Guidance: A Qualitative Study.

PubMed

Savage, Jennifer S; Neshteruk, Cody D; Balantekin, Katherine N; Birch, Leann L

2016-12-01

Objectives Describe themes characterizing feeding behaviors of low-income women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and identify the attitudes, beliefs, and sources of information that inform these practices. Methods Formative research was conducted including focus groups and semi-structured individual phone interviews with a total of 68 low-income women participating in WIC. Qualitative data were recorded, transcribed, imported into NVivo 8.0, and analyzed for common themes. Results Mothers reported feeding behaviors inconsistent with guidance from WIC and the American Academy of Pediatrics. Three main themes were identified. First, mothers reported receiving conflicting messaging/advice from medical professionals, WIC nutritionists, and family members, which was confusing. Mothers also reported dissatisfaction with the "one size fits most" approach. Lastly, mothers reported relying on their "instincts" and that "all babies are different" when deciding and rationalizing what feeding guidance to follow. Conclusions Future interventions targeting this high-risk population should consider developing personalized (individualized) messaging, tailored to the needs of each mother-child dyad. Focused efforts are needed to build partnerships between WIC providers and other health care providers to provide more consistent messages about responsive feeding to prevent early obesity.

Economic organization of medicine and the Committee on the Costs of Medical Care.

PubMed Central

Perkins, B B

1998-01-01

Recent strategies in managed care and managed competition illustrate how health care reforms may reproduce the patterns of economic organization of their times. Such a reform approach is not a new development in the United States. The work of the 1927-1932 Committee on the Costs of Medical Care exemplifies an earlier effort that applied forms of economic organization to medical care. The committee tried to restructure medicine along lines consistent with its economic environment while attributing its models variously to science, profession, and business. Like current approaches, the committee's reports defined costs as the major problem and business models of organization as the major solution. The reports recommended expanded financial management and group medicine, which would include growth in self-supporting middle-class services such as fee clinics and middle-rate hospital units. Identifying these elements as corporate practice of medicine, the American Medical Association-based minority dissented from the final report in favor of conserving individual entrepreneurial practice. This continuum in forms of economic organization has limited structural reform strategies in medicine for the remainder of the century. PMID:9807547

Sexual and prevention practices in men who have sex with men in the era of combination HIV prevention: results from the Presse Gays et Lesbiennes survey, France, 2011.

PubMed

Velter, A; Saboni, L; Sommen, C; Bernillon, P; Bajos, N; Semaille, C

2015-04-09

To better understand the diversity of practices and behaviours to prevent HIV with casual partners, data from a large convenience sample of men who have sex with men (MSM) in France were categorised into different prevention profiles: no anal intercourse, consistent condom use during anal intercourse, risk-reduction practices (serosorting, seropositioning) and no discernible prevention practice (NDPP). Categories were applied to HIV-positive respondents with controlled (CI; n=672) and uncontrolled infection (UI; n=596), HIV-negative (n=4,734) and untested respondents (n=663). Consistent condom use was reported by 22% (n=148) of HIV-positive-CI respondents, 13% (n=79) of HIV-positives UI, 55% (2,603) of HIV-negatives, and 50% (n=329) of untested (p<0.001). Corresponding figures for NDPP were 45% (n=304), 55% (n=327), 21% (n=984) and 34% (n=227) (p<0.001). Logistic regressions showed that, regardless of respondents' serostatus, NDPP was associated with regularly frequenting dating websites, drug use, exposure to sperm during oral sex, and with HIV diagnosis after 2000 for HIV-positive respondents (CI and UI), with age <30 years for HIV-positive-CI, and with low education for HIV-negatives. Risk-taking remains high, despite implementation of risk-reduction practices. A global health approach should be central to prevention programmes for MSM, to include target behavioural intervention, promotion of condom use, and encouragement of regular HIV testing and early initiation of ART.

An Examination of Cultural Values and Pain Management in Foreign-Born Spanish-Speaking Hispanics Seeking Care at a Federally Qualified Health Center.

PubMed

Torres, Calia A; Thorn, Beverly E; Kapoor, Shweta; DeMonte, Colette

2017-11-01

Most studies done with Hispanics illustrate their preference for self-management practices; therefore, examining the factors driving patients to seek medical care for pain management will help elucidate what patients want and need from their doctors for pain management. The aim of the present study was to obtain patients' perspectives and enhance our understanding of the cultural beliefs influencing pain management decisions of foreign-born Spanish-speaking Hispanics with low acculturation. Twenty-four individuals (17 females and 7 males) with self-reported chronic pain completed the study. Participants attended a focus group and shared about pain management practices and their experiences with medical care for pain management. Descriptive data on pain and mood variables were collected to examine how this population compares with the norms reported in the pain literature for Hispanics. Participants reported a preference for pain self-management and noninvasive medical treatments and expressed negative attitudes toward pain medications, although wanting the option of pain medications as a "last resort." Satisfaction with medical care for pain was highly influenced by the participants' expectations and preference for personal, warm, and friendly interactions. Our findings are consistent with previous reports on Hispanics' preference for self-care practices. Perhaps foreign-born Hispanics may rely on self-care practices and delay medical attention for pain management because of their unfamiliarity with the US health care system. Other potential explanations for a reliance on self-care for pain management involve patients having a limited understanding of or access to effective treatment options for chronic pain and negative experiences with US medical providers. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Strong Communities for Children: Results of a multi-year community-based initiative to protect children from harm.

PubMed

McDonell, James R; Ben-Arieh, Asher; Melton, Gary B

2015-03-01

This article reports the evaluation results from Strong Communities for Children, a multi-year comprehensive community-based initiative to prevent child maltreatment and improve children's safety. The outcome study consisted of a survey of a random sample of caregivers of children under age 10 in the Strong Communities service area and a set of comparison communities matched at the block group level on demography. Survey data were collected in two waves 4 years apart. Data were collected on (a) perceptions of the neighborhood and neighbors (e.g., neighboring, collective efficacy), (b) perceptions of neighbors' parenting practices, (c) parental attitudes and beliefs (e.g., parental stress; parental efficacy), and (d) self-reported parenting practices. The survey data were supplemented by data on substantiated reported rates of child abuse and neglect per 1,000 children and ICD-9 coded child injuries suggesting child abuse and neglect per 1,000 children. Compared to the non-intervention sample across time, the Strong Communities samples showed significant changes in the expected direction for social support, collective efficacy, child safety in the home, observed parenting practices, parental stress, parental efficacy, self-reported parenting practices, rates of officially substantiated child maltreatment, and rates of ICD-9 coded child injuries suggesting child maltreatment. These promising results, obtained through multiple methods of evaluation, confirm that a community mobilization strategy can shift norms of parents' care for their children and neighbors' support for one another, so that young children are safer at home and in the community. Replications should be undertaken and evaluated in other communities under diverse auspices. Copyright © 2014 Elsevier Ltd. All rights reserved.

SCOPE of Pain: An Evaluation of an Opioid Risk Evaluation and Mitigation Strategy Continuing Education Program

PubMed Central

Zisblatt, Lara; Ng, Pamela; Hayes, Sean M.; Peloquin, Sophie; Hardesty, Ilana; White, Julie L.

2016-01-01

Objective. Due to the high prevalence of prescription opioid misuse, the US Food and Drug Administration (FDA) mandated a Risk Evaluation and Mitigation Strategy (REMS) requiring manufacturers of extended-release/long-acting (ER/LA) opioid analgesics to fund continuing education based on a FDA Blueprint. This article describes the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) program, an ER/LA opioid analgesic REMS program, and its impact on clinician knowledge, confidence, attitudes, and self-reported clinical practice. Method. Participants of the 3-h SCOPE of Pain training completed pre-, immediate post- and 2-month post-assessments. Subjects. The primary target group (n = 2,850), and a subset (n = 476) who completed a 2-month post-assessment, consisted of clinicians licensed to prescribe ER/LA opioid analgesics, who care for patients with chronic pain and who completed the 3-h training between February 28, 2013 and June 13, 2014. Results. Immediately post-program, there was a significant increase in correct responses to knowledge questions (60% to 84%, P ≤ 0.02) and 87% of participants planned to make practice changes. At 2-months post-program, there continued to be a significant increase in correct responses to knowledge questions (60% to 69%, P ≤ 0.03) and 67% reported increased confidence in applying safe opioid prescribing care and 86% reported implementing practice changes. There was also an improvement in alignment of desired attitudes toward safe opioid prescribing. Conclusions. The SCOPE of Pain program improved knowledge, attitudes, confidence, and self-reported clinical practice in safe opioid prescribing. This national REMS program holds potential to improve the safe use of opioids for the treatment of chronic pain. PMID:26304703

Factitious thyrotoxicosis induced by mesotherapy: a case report.

PubMed

Danilovic, Debora Lucia Seguro; Bloise, Walter; Knobel, Meyer; Marui, Suemi

2008-06-01

Mesotherapy consists of cutaneous injections of a mixture of compounds and has recently been used for cosmetic purposes to reduce local fat and cellulite. To date, several reports have described only local adverse events related to this therapy. We describe the first report of a female patient who developed thyrotoxicosis due to cosmetic mesotherapy with triiodothyroacetic acid in its formulation. Apart from mechanical rupture of the epidermal barrier, a disturbance of type III deiodinase activity or skin fibroblast paracrine function and vascular alterations related to simultaneously injected vasoactive compounds were observed. These findings could be related to thyroid hormone metabolite absorption and systemic consequences in the reported case. We describe factitious thyrotoxicosis induced by mesotherapy, to raise awareness of a systemic adverse effect resulting from this widespread cosmetic practice.

Development of a Self-Report Checklist to Assess Dementia Care by Nurses in Hospital Settings.

PubMed

Ikegami, Chikako; Ota, Katsumasa

2018-03-01

Nurses working at general hospitals face difficulties in providing dementia care. The current study examined aged care nurses' dementia care practices in the hospital setting and developed a dementia care checklist that nurses can use to review their own care practice. A self-administered questionnaire was given to 676 participants; responses were collected from 595 participants. Exploratory factor analysis identified six factors (e.g., patient understanding prompted by concern and interest for the patient, respect for patients' voluntary behavior, early detection of abnormalities) among the questionnaire's 28 items. This analysis provided a framework for the checklist and verified that it had satisfactory internal consistency and construct validity. The frequency of care practices varied with participants' knowledge of dementia care requirements, satisfaction with their own dementia care practice, confidence in their ability to judge patients' physical condition, and cooperation with colleagues. This checklist might improve dementia care in hospital settings. [Res Gerontol Nurs. 2018; 11(2):91-102.]. © 2018 Ikegami and Ota.

Rethinking the architectural design concept in the digital culture (in architecture's practice perspective)

NASA Astrophysics Data System (ADS)

Prawata, Albertus Galih

2017-11-01

The architectural design stages in architectural practices or in architectural design studio consist of many aspects. One of them is during the early phases of the design process, where the architects or designers try to interpret the project brief into the design concept. This paper is a report of the procedure of digital tools in the early design process in an architectural practice in Jakarta. It targets principally the use of BIM and digital modeling to generate information and transform them into conceptual forms, which is not very common in Indonesian architectural practices. Traditionally, the project brief is transformed into conceptual forms by using sketches, drawings, and physical model. The new method using digital tools shows that it is possible to do the same thing during the initial stage of the design process to create early architectural design forms. Architect's traditional tools and methods begin to be replaced effectively by digital tools, which would drive bigger opportunities for innovation.

Relationship among practice change, motivation, and self-efficacy.

PubMed

Williams, Betsy W; Kessler, Harold A; Williams, Michael V

2014-01-01

The relationship between an individual's sense of self-efficacy, motivation to change, and the implementation of improvement programs has been reported. This research reports the relationship among self-efficacy, motivation to change, and intent to implement continuing medical education (CME) activity learnings. The measure of individual sense of self-efficacy was a 4-item scale. The measure of motivation was a 4-item scale following on the work of Johnson, et al. The self-efficacy scale has been confirmed for structure, and together the 2 scales provide indicators of 3 underlying variables-2 self-efficacy constructs and a motivation variable. In addition, a global intent to implement measure was collected. Preliminary analysis demonstrates a significant relationship between a self-efficacy construct, the motivation to change construct, and global intent to change. Specifically, the sense of efficacy in effecting change in the practice environment is predictive of a high level of motivation to change, which, in turn, is predictive of formation of an intent to change practice patterns. Further inspection of the motivation to change construct suggests that it mediates the self-efficacy constructs' effect on intent. This is consistent with an earlier report on the relationship among self-efficacy, barriers to change, and stated intent. This new finding suggests that the proximal construct motivation completely masks an important underlying causal relationship that appears to contribute to practice change following CME: self-efficacy. A focus on the participants' sense of self-agency may provide a path to practice change. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

Feminine hygiene practices among female patients and nurses in Lebanon.

PubMed

Attieh, Elie; Maalouf, Samer; Roumieh, Dina; Abdayem, Pamela; AbiTayeh, Georges; Kesrouani, Assaad

2016-05-23

Inappropriate feminine hygiene practices are related to vulvovaginitis. We investigated the prevalence of personal hygiene habits among Lebanese women as well as their awareness of adequate practices. Consists of a cross-sectional observational study. Female patients and nurses at Hotel-Dieu de France University Hospital in Beirut- Lebanon filled a questionnaire about their intimate hygiene habits and knowledge of proper practices. The study included 249 women. 21.3 % of the 136 nurses and 38.9 % of the 113 patients reported a history of vulvovaginitis. The majority of women took an intimate bath at least twice daily. 14 % of nurses and 17 % of patients douched.20. Seven percent of the nurses and 43.4 % of the patients used wet wipes. 1.5 % of nurses and 4.4 % of patients used feminine deodorant sprays. There was a significant lack of awareness mainly among patients about suitable hygiene practices as well for their adverse effects. Education provided by nurses, and other healthcare providers is essential to promote reproductive health among Lebanese women.

Attitudes and practices of Chinese physicians regarding chronic kidney disease and acute kidney injury management: a questionnaire-based cross-sectional survey in secondary and tertiary hospitals.

PubMed

Wu, Yanhua; Chen, Yuanhan; Chen, Shixin; He, Yani; Liang, Huaban; Dong, Wei; Liang, Xinling

2018-05-10

This questionnaire-based cross-sectional survey reported the attitudes and practices of Chinese doctors regarding chronic kidney disease (CKD) and acute kidney injury (AKI) management. An online questionnaire consisting of general information, awareness of CKD and AKI, education status, renal laboratory items, and clinical practices between February 20, 2017 and August 15, 2017. Among the 1289 respondents from secondary and tertiary hospitals in 30 provinces, 718 (55.7%) were nephrologists, 94.3% had the ability to evaluate glomerular filtration rates, and 98.8% could evaluate urinary protein excretion, indicating that Chinese doctors met the minimum requirements to manage CKD. However, nearly half of all respondents reported that easy methods for spot urine creatinine-adjusted urinary protein assessments were unavailable. Awareness of the CKD risk stratification system and AKI definition was inadequate, and only 54.2% of respondents reported that they had received nutritional education for renal diseases. Although most of the respondents were nephrologists at university hospitals, 66.4% and 76.3% of respondents reported nephrology referrals and nephrology consultations, respectively, after AKI, suggesting an insufficient role for nephrologists. Finally, management models differed significantly, indicating that universal guidelines for CKD and AKI management are required across China. Several considerable challenges remain regarding CKD and AKI management in China, including inadequate knowledge and training systems, an absence of clinical protocols, and insufficient multidisciplinary cooperation.

Comparing the Quality of Ambulatory Surgical Care for Skin Cancer in a Veterans Affairs Clinic and a Fee-For-Service Practice Using Clinical and Patient-Reported Measures.

PubMed

Dizon, Matthew P; Linos, Eleni; Arron, Sarah T; Hills, Nancy K; Chren, Mary-Margaret

2017-01-01

The Institute of Medicine has identified serious deficiencies in the measurement of cancer care quality, including the effects on quality of life and patient experience. Moreover, comparisons of quality in Veterans Affairs Medical Centers (VA) and other sites are timely now that many Veterans can choose where to seek care. To compare quality of ambulatory surgical care for keratinocyte carcinoma (KC) between a VA and fee-for-service (FFS) practice, we used unique clinical and patient-reported data from a comparative effectiveness study. Patients were enrolled in 1999-2000 and followed for a median of 7.2 years. The practices differed in a few process measures (e.g., median time between biopsy and treatment was 7.5 days longer at VA) but there were no substantial or consistent differences in clinical outcomes or a broad range of patient-reported outcomes. For example, 5-year tumor recurrence rates were equally low (3.6% [2.3-5.5] at VA and 3.4% [2.3-5.1] at FFS), and similar proportions of patients reported overall satisfaction at one year (78% at VA and 80% at FFS, P = 0.69). These results suggest that the quality of care for KC can be compared comprehensively in different health care systems, and suggest that quality of care for KC was similar at a VA and FFS setting.

An iPhone Application Intervention to Promote Surveillance Among Women with a BRCA Mutation: Pre-intervention Data.

PubMed

Cohen, Stephanie A; Scherr, Courtney Lynam; Nixon, Dawn M

2018-04-01

Women with BRCA mutations, at significantly increased risk for breast and ovarian cancer, do not consistently adhere to management guidelines due to lack of awareness and challenges tracking appointments. We developed an iPhone application (app) to help BRCA carriers manage their surveillance. We explored baseline awareness and adherence to surveillance guidelines and analytic data from 21 months of app use. Descriptive statistics were calculated on responses (N = 86) to a survey about surveillance awareness and practices. The majority were aware of breast surveillance guidelines, but only one third were aware of ovarian surveillance guidelines. In practice, the majority reported a clinical breast exam within 6 months, just over half reported a mammogram and breast MRI in the last year, and under half reported ovarian surveillance in the last year. Nearly 50% reported difficulty remembering appointments. Although only 69 received access codes, 284 unique users attempted to enter the app, which was visible in the iTunes store but only available to those with a study code. Evaluation of analytic data demonstrated user engagement with study participants accessing the app 427 times over the 21-month time period (range 2-57; mean = 6.28). Results indicate participants were more likely to know screening guidelines than practice them. There was interest in the app and users were engaged, suggesting app value. We will send a follow-up survey after 18 months of app use for additional evaluation and feedback.

Self-Reported Rationing Behavior Among US Physicians: A National Survey.

PubMed

Sheeler, Robert D; Mundell, Tim; Hurst, Samia A; Goold, Susan Dorr; Thorsteinsdottir, Bjorg; Tilburt, Jon C; Danis, Marion

2016-12-01

Rationing is a controversial topic among US physicians. Understanding their attitudes and behaviors around rationing may be essential to a more open and sensible professional discourse on this important but controversial topic. To describe rationing behavior and associated factors among US physicians. Survey mailed to US physicians in 2012 to evaluate self-reported rationing behavior and variables related to this behavior. US physicians across a full spectrum of practice settings. A total of 2541 respondents, representing 65.6 % of the original mailing list of 3872 US addresses. The study was a cross-sectional analysis of physician attitudes and self-reported behaviors, with neutral language representations of the behaviors as well as an embedded experiment to test the influence of the word "ration" on perceived responsibility. Overall percentage of respondents reporting rationing behavior in various contexts and assessment of attitudes toward rationing. In total, 1348 respondents (53.1 %) reported having personally refrained within the past 6 months from using specific clinical services that would have provided the best patient care, because of health system cost. Prescription drugs (n = 1073 [48.3 %]) and magnetic resonance imaging (n = 922 [44.5 %]) were most frequently rationed. Surgical and procedural specialists were less likely to report rationing behavior (adjusted odds ratio [OR] [95 % CI], 0.8 [0.9-0.9] and 0.5 [0.4-0.6], respectively) compared to primary care. Compared with small or solo practices, those in medical school settings reported less rationing (adjusted OR [95 % CI], 0.4 [0.2-0.7]). Physicians who self-identified as very or somewhat liberal were significantly less likely to report rationing (adjusted OR [95 % CI], 0.7 [0.6-0.9]) than those self-reporting being very or somewhat conservative. A more positive opinion about rationing tended to align with greater odds of rationing. More than one-half of respondents engaged in behavior consistent with rationing. Practicing physicians in specific subgroups were more likely to report rationing behavior.

Use of anti-mullerian hormone for testing ovarian reserve: a survey of 796 infertility clinics worldwide.

PubMed

Tobler, Kyle J; Shoham, Gon; Christianson, Mindy S; Zhao, Yulian; Leong, Milton; Shoham, Zeev

2015-10-01

The aim of this study is to assess how anti-mullerian hormone (AMH) is used worldwide to test ovarian reserve and guide in vitro fertilization (IVF) cycle management. An internet-based survey was sent electronically to registered IVF providers within the IVF-Worldwide.com network. This survey consisted of nine questions which assessed the clinics' use of AMH. The questionnaire was completed online through the IVF-Worldwide.com website, and quality assurance tools were used to verify that only one survey was completed per clinical IVF center. Results are reported as the proportion of IVF cycles represented by a particular answer choice. Survey responses were completed from 796 globally distributed IVF clinics, representing 593,200 IVF cycles worldwide. Sixty percent of the respondent-IVF cycles reported to use AMH as a first line test, and 54 % reported it as the best test for evaluating ovarian reserve. Eighty-nine percent reported that AMH results were extremely relevant or relevant to clinical practice. However in contrast, for predicting live birth rate, 81 % reported age as the best predictor. AMH is currently considered a first line test for evaluating ovarian reserve and is considered relevant to clinical practice by the majority of IVF providers.

Training and Practices of Cannabis Dispensary Staff.

PubMed

Haug, Nancy A; Kieschnick, Dustin; Sottile, James E; Babson, Kimberly A; Vandrey, Ryan; Bonn-Miller, Marcel O

2016-01-01

Introduction: The proliferation of cannabis dispensaries within the United States has emerged from patient demand for the legalization of cannabis as an alternative treatment for a number of conditions and symptoms. Unfortunately, nothing is known about the practices of dispensary staff with respect to recommendation of cannabis strains/concentrations for specific patient ailments. To address this limitation, the present study assessed the training and practices of cannabis dispensary staff. Materials and Methods: Medical and nonmedical dispensary staff ( n =55) were recruited via e-mail and social media to complete an online survey assessing their demographic characteristics, dispensary features, patient characteristics, formal training, and cannabis recommendation practices. Results: Fifty-five percent of dispensary staff reported some formal training for their position, with 20% reporting medical/scientific training. A majority (94%) indicated that they provide specific cannabis advice to patients. In terms of strains, dispensary staff trended toward recommendations of Indica for anxiety, chronic pain, insomnia, nightmares, and Tourette's syndrome. They were more likely to recommend Indica and hybrid plants for post-traumatic stress disorder (PTSD)/trauma and muscle spasms. In contrast, staff were less likely to recommend Indica for depression; hybrid strains were most often recommended for amyotrophic lateral sclerosis (ALS). In terms of cannabinoid concentrations, dispensary staff were most likely to recommend a 1:1 ratio of delta-9-tetrahydrocannabinol (THC):cannabidiol (CBD) for patients suffering from anxiety, Crohn's disease, hepatitis C, and PTSD/trauma, while patients seeking appetite stimulation were most likely to be recommended THC. Staff recommended high CBD for arthritis and Alzheimer's disease and a high CBD or 1:1 ratio for ALS, epilepsy, and muscle spasms. Conclusions: Although many dispensary staff are making recommendations consistent with current evidence, some are recommending cannabis that has either not been shown effective for, or could exacerbate, a patient's condition. Findings underscore the importance of consistent, evidence-based, training of dispensary staff who provide specific recommendations for patient medical conditions.

SPORTS PHYSICAL THERAPY CURRICULA IN PHYSICAL THERAPIST PROFESSIONAL DEGREE PROGRAMS.

PubMed

Mulligan, Edward P; DeVahl, Julie

2017-10-01

The specialty niche of sports physical therapy has grown at a significant rate over the past 40 years. Despite this growth there is little information or direction from the physical therapy education accreditation body or professional association to guide academic programs on the interest or necessity of this type of practice content in physical therapy professional degree programs. The purpose of this survey study is to report on the prevalence, attitudes, barriers, resources, and faculty expertise in providing required or elective sports physical therapy course work. Cross-sectional descriptive survey. A 57-item questionnaire with branching logic was distributed via a web-based electronic data capture tool to survey all Commission on Accreditation for Physical Therapy Education (CAPTE) accredited and candidate schools in the United States. Response data was analyzed to describe typical educational program profiles, faculty demographics, and correlational factors consistent with the presence or absence of specific sports physical therapy curricular content. Thirty one percent of the schools responded to the survey and the program demographics were consistent with all currently accredited schools in regards to their geography, Carnegie classification, and faculty and student size. Forty three percent of programs offered a required or elective course distinct to the practice of sports physical therapy. Descriptive information regarding the sequencing, curricular make-up, resources, and assessment of content competence is reported. The odds of providing this content nearly doubles for programs that have faculty with sports clinical specialist credentials, accredited sports residency curriculums, or state practice acts that allow sports venue coverage. This survey provides an initial overview of sports physical therapy educational efforts in professional physical therapy degree programs. The data can used to spur further discussion on the necessity, structure, and implementation of education content that is inherent to a growing specialty practice in the physical therapy profession. 4, Cross-sectional descriptive survey design.

Training and Practices of Cannabis Dispensary Staff

PubMed Central

Haug, Nancy A.; Kieschnick, Dustin; Sottile, James E.; Babson, Kimberly A.; Vandrey, Ryan; Bonn-Miller, Marcel O.

2016-01-01

Abstract Introduction: The proliferation of cannabis dispensaries within the United States has emerged from patient demand for the legalization of cannabis as an alternative treatment for a number of conditions and symptoms. Unfortunately, nothing is known about the practices of dispensary staff with respect to recommendation of cannabis strains/concentrations for specific patient ailments. To address this limitation, the present study assessed the training and practices of cannabis dispensary staff. Materials and Methods: Medical and nonmedical dispensary staff (n=55) were recruited via e-mail and social media to complete an online survey assessing their demographic characteristics, dispensary features, patient characteristics, formal training, and cannabis recommendation practices. Results: Fifty-five percent of dispensary staff reported some formal training for their position, with 20% reporting medical/scientific training. A majority (94%) indicated that they provide specific cannabis advice to patients. In terms of strains, dispensary staff trended toward recommendations of Indica for anxiety, chronic pain, insomnia, nightmares, and Tourette's syndrome. They were more likely to recommend Indica and hybrid plants for post-traumatic stress disorder (PTSD)/trauma and muscle spasms. In contrast, staff were less likely to recommend Indica for depression; hybrid strains were most often recommended for amyotrophic lateral sclerosis (ALS). In terms of cannabinoid concentrations, dispensary staff were most likely to recommend a 1:1 ratio of delta-9-tetrahydrocannabinol (THC):cannabidiol (CBD) for patients suffering from anxiety, Crohn's disease, hepatitis C, and PTSD/trauma, while patients seeking appetite stimulation were most likely to be recommended THC. Staff recommended high CBD for arthritis and Alzheimer's disease and a high CBD or 1:1 ratio for ALS, epilepsy, and muscle spasms. Conclusions: Although many dispensary staff are making recommendations consistent with current evidence, some are recommending cannabis that has either not been shown effective for, or could exacerbate, a patient's condition. Findings underscore the importance of consistent, evidence-based, training of dispensary staff who provide specific recommendations for patient medical conditions. PMID:28861496

Distinguishing differential susceptibility from diathesis-stress: recommendations for evaluating interaction effects.

PubMed

Roisman, Glenn I; Newman, Daniel A; Fraley, R Chris; Haltigan, John D; Groh, Ashley M; Haydon, Katherine C

2012-05-01

This report describes the state of the art in distinguishing data generated by differential susceptibility from diathesis-stress models. We discuss several limitations of existing practices for probing interaction effects and offer solutions that are designed to better differentiate differential susceptibility from diathesis-stress models and quantify their corresponding implications. In addition, we demonstrate the utility of these methods by revisiting published evidence suggesting that temperamental difficulty serves as a marker of enhanced susceptibility to early maternal caregiving across a range of outcome domains in the NICHD Study of Early Child Care and Youth Development. We find that, with the exception of mother reports of psychopathology, there is consistent evidence in the Study of Early Child Care and Youth Development that the predictive significance of early sensitivity is moderated by difficult temperament over time. However, differential susceptibility effects emerged primarily for teacher reports of academic skills, social competence, and symptomatology. In contrast, effects more consistent with the diathesis-stress model were obtained for mother reports of social skills and objective tests of academic skills. We conclude by discussing the value of the application of this work to the next wave of Gene × Environment studies focused on early caregiving experiences.

Following through: The consistency of survivorship care plan use in United States cancer programs

PubMed Central

Deal, Allison M.; Mayer, Deborah K.; Weiner, Bryan J.

2014-01-01

Background The Institute of Medicine suggests that consistent survivorship care plan (SCP) use involves developing and delivering SCPs to all cancer survivors and their primary care providers (PCPs). We describe the consistency of SCP use in US cancer programs and assess its relationship with cancer program-level determinants. Methods We surveyed employees knowledgeable about survivorship practices in cancer programs reporting current SCP use (n=36; 81% response rate). We operationalized consistent SCP use as whether SCPs were (1) developed for ≥75% survivors; (2) delivered to ≥75% survivors; (3) delivered to ≥75% PCPs; and (4) all of the above. We use descriptive statistics to report SCP use consistency and evaluate associations using Fisher’s Exact and Wilcoxon Rank Sum tests. Results SCPs were developed for ≥75% survivors in five programs (15%); eight (25%) delivered ≥75% SCPs to survivors; seven (23%) delivered ≥75% SCPs to PCPs; only one program (4%) met all three criteria. We found relationships between SCP use consistency and geographic region (p = .05); initiating SCP use in response to survivors’ requests (p = .03); and membership in the National Cancer Institute’s National Community Cancer Centers Program (p = .01). Conclusion SCP use is highly inconsistent. Survivors and cancer care quality improvement organizations may play a key role in improving the consistency of SCP use in US cancer programs. Survivors can initiate SCP use. Cancer care quality improvement organizations can specify how cancer programs’ compliance with SCP guidelines will be assessed. Future research should identify mechanisms underlying the relationships that we found. PMID:24577781

Total joint arthroplasty: practice variation of physiotherapy across the continuum of care in Alberta.

PubMed

Jones, C Allyson; Martin, Ruben San; Westby, Marie D; Beaupre, Lauren A

2016-11-04

Comprehensive and timely rehabilitation for total joint arthroplasty (TJA) is needed to maximize recovery from this elective surgical procedure for hip and knee arthritis. Administrative data do not capture the variation of treatment for rehabilitation across the continuum of care for TJA, so we conducted a survey for physiotherapists to report practice for TJA across the continuum of care. The primary objective was to describe the reported practice of physiotherapy for TJA across the continuum of care within the context of a provincial TJA clinical pathway and highlight possible gaps in care. A cross-sectional on-line survey was accessible to licensed physiotherapists in Alberta, Canada for 11 weeks. Physiotherapists who treated at least five patients with TJA annually were asked to complete the survey. The survey consisted of 58 questions grouped into pre-operative, acute care and post-acute rehabilitation. Variation of practice was described in terms of number, duration and type of visits along with goals of care and program delivery methods. Of the 80 respondents, 26 (33 %) stated they worked in small centres or rural settings in Alberta with the remaining respondents working in two large urban sites. The primary treatment goal differed for each phase across the continuum of care in that pre-operative phase was directed at improving muscle strength, functional activities were commonly reported for acute care, and post-acute phase was directed at improving joint range-of-motion. Proportionally, more physiotherapists from rural areas treated patients in out-patient hospital departments (59 %), whereas a higher proportion in urban physiotherapists saw patients in private clinics (48 %). Across the continuum of care, treatment was primarily delivered on an individual basis rather than in a group format. Variation of practice reported with pre-and post-operative care in the community will stimulate dialogue within the profession as to what is the minimal standard of care to provide patients undergoing TJA.

Energy intake misreporting among children and adolescents: a literature review.

PubMed

Forrestal, Sarah G

2011-04-01

While adults' energy intake misreporting is a well-documented phenomenon, relatively little is known about the nature and extent of misreporting among children and adolescents. Children's and adolescents' dietary reporting patterns are likely to be distinct because of their ongoing cognitive and social development. These developmental differences present unique challenges to aspects of dietary reporting, such as food knowledge, portion size estimation and response editing. This review of 28 articles describes energy intake misreporting among children and adolescents. Like adults, children and adolescents tended to underreport energy, with the largest biases observed with food records. Even when mean reported energy intake was close to its expected value, approximately half of all individuals were classified as misreporters, and overreporting appeared to be more common than it is among adults. Associations between numerous characteristics and misreporting were explored in the literature, with the most consistent findings for age and adiposity. Two predictors for adults, gender and social desirability, were not consistent factors among children and adolescents. The review concludes by highlighting knowledge gaps and recommendations for future research and practice. © 2010 Blackwell Publishing Ltd.

Development of the standards of reporting of neurological disorders (STROND) checklist: a guideline for the reporting of incidence and prevalence studies in neuroepidemiology.

PubMed

Bennett, Derrick A; Brayne, Carol; Feigin, Valery L; Barker-Collo, Suzanne; Brainin, Michael; Davis, Daniel; Gallo, Valentina; Jetté, Nathalie; Karch, André; Kurtzke, John F; Lavados, Pablo M; Logroscino, Giancarlo; Nagel, Gabriele; Preux, Pierre-Marie; Rothwell, Peter M; Svenson, Lawrence W

2015-07-01

Incidence and prevalence studies of neurological disorders play an important role in assessing the burden of disease and planning services. However, the assessment of disease estimates is hindered by problems in reporting for such studies. Despite a growth in published reports, existing guidelines relate to analytical rather than descriptive epidemiological studies. There are also no user-friendly tools (e.g., checklists) available for authors, editors and peer-reviewers to facilitate best practice in reporting of descriptive epidemiological studies for most neurological disorders. The Standards of Reporting of Neurological Disorders (STROND) is a guideline that consists of recommendations and a checklist to facilitate better reporting of published incidence and prevalence studies of neurological disorders. A review of previously developed guidance was used to produce a list of items required for incidence and prevalence studies in neurology. A three-round Delphi technique was used to identify the 'basic minimum items' important for reporting, as well as some additional 'ideal reporting items'. An e-consultation process was then used in order to gauge opinion by external neuroepidemiological experts on the appropriateness of the items included in the checklist. Of 38 candidate items, 15 items and accompanying recommendations were developed along with a user-friendly checklist. The introduction and use of the STROND checklist should lead to more consistent, transparent and contextualised reporting of descriptive neuroepidemiological studies resulting in more applicable and comparable findings and ultimately support better healthcare decisions.

Context Matters: The Experience of 14 Research Teams in Systematically Reporting Contextual Factors Important for Practice Change

PubMed Central

Tomoaia-Cotisel, Andrada; Scammon, Debra L.; Waitzman, Norman J.; Cronholm, Peter F.; Halladay, Jacqueline R.; Driscoll, David L.; Solberg, Leif I.; Hsu, Clarissa; Tai-Seale, Ming; Hiratsuka, Vanessa; Shih, Sarah C.; Fetters, Michael D.; Wise, Christopher G.; Alexander, Jeffrey A.; Hauser, Diane; McMullen, Carmit K.; Scholle, Sarah Hudson; Tirodkar, Manasi A.; Schmidt, Laura; Donahue, Katrina E.; Parchman, Michael L.; Stange, Kurt C.

2013-01-01

PURPOSE We aimed to advance the internal and external validity of research by sharing our empirical experience and recommendations for systematically reporting contextual factors. METHODS Fourteen teams conducting research on primary care practice transformation retrospectively considered contextual factors important to interpreting their findings (internal validity) and transporting or reinventing their findings in other settings/situations (external validity). Each team provided a table or list of important contextual factors and interpretive text included as appendices to the articles in this supplement. Team members identified the most important contextual factors for their studies. We grouped the findings thematically and developed recommendations for reporting context. RESULTS The most important contextual factors sorted into 5 domains: (1) the practice setting, (2) the larger organization, (3) the external environment, (4) implementation pathway, and (5) the motivation for implementation. To understand context, investigators recommend (1) engaging diverse perspectives and data sources, (2) considering multiple levels, (3) evaluating history and evolution over time, (4) looking at formal and informal systems and culture, and (5) assessing the (often nonlinear) interactions between contextual factors and both the process and outcome of studies. We include a template with tabular and interpretive elements to help study teams engage research participants in reporting relevant context. CONCLUSIONS These findings demonstrate the feasibility and potential utility of identifying and reporting contextual factors. Involving diverse stakeholders in assessing context at multiple stages of the research process, examining their association with outcomes, and consistently reporting critical contextual factors are important challenges for a field interested in improving the internal and external validity and impact of health care research. PMID:23690380

Fecal occult blood testing beliefs and practices of U.S. primary care physicians: serious deviations from evidence-based recommendations.

PubMed

Nadel, Marion R; Berkowitz, Zahava; Klabunde, Carrie N; Smith, Robert A; Coughlin, Steven S; White, Mary C

2010-08-01

Fecal occult blood testing (FOBT) is an important option for colorectal cancer screening that should be available in order to achieve high population screening coverage. However, results from a national survey of clinical practice in 1999-2000 indicated that many primary care physicians used inadequate methods to implement FOBT screening and follow-up. To determine whether methods to screen for fecal occult blood have improved, including the use of newer more sensitive stool tests. Cross-sectional national survey of primary care physicians. Participants consisted of 1,134 primary care physicians who reported ordering or performing FOBT in the 2006-2007 National Survey of Primary Care Physicians' Recommendations and Practices for Cancer Screening. Self-reported data on details of FOBT implementation and follow-up of positive results. Most physicians report using standard guaiac tests; higher sensitivity guaiac tests and immunochemical tests were reported by only 22.0% and 8.9%, respectively. In-office testing, that is, testing of a single specimen collected during a digital rectal examination in the office, is still widely used although inappropriate for screening: 24.9% of physicians report using only in-office tests and another 52.9% report using both in-office and home tests. Recommendations improved for follow-up after a positive test: fewer physicians recommend repeating the FOBT (17.8%) or using tests other than colonoscopy for the diagnostic work-up (6.6%). Only 44.3% of physicians who use home tests have reminder systems to ensure test completion and return. Many physicians continue to use inappropriate methods to screen for fecal occult blood. Intensified efforts to inform physicians of recommended technique and promote the use of tracking systems are needed.

48 CFR 52.230-4 - Disclosure and Consistency of Cost Accounting Practices-Foreign Concerns.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONTRACT CLAUSES Text of Provisions and Clauses 52.230-4 Disclosure and Consistency of Cost Accounting... Disclosure Statement, disclose in writing its cost accounting practices as required by 48 CFR 9903.202-1... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Disclosure and Consistency...

Practical design and evaluation methods of omnidirectional vision sensors

NASA Astrophysics Data System (ADS)

Ohte, Akira; Tsuzuki, Osamu

2012-01-01

A practical omnidirectional vision sensor, consisting of a curved mirror, a mirror-supporting structure, and a megapixel digital imaging system, can view a field of 360 deg horizontally and 135 deg vertically. The authors theoretically analyzed and evaluated several curved mirrors, namely, a spherical mirror, an equidistant mirror, and a single viewpoint mirror (hyperboloidal mirror). The focus of their study was mainly on the image-forming characteristics, position of the virtual images, and size of blur spot images. The authors propose here a practical design method that satisfies the required characteristics. They developed image-processing software for converting circular images to images of the desired characteristics in real time. They also developed several prototype vision sensors using spherical mirrors. Reports dealing with virtual images and blur-spot size of curved mirrors are few; therefore, this paper will be very useful for the development of omnidirectional vision sensors.

To Refer or Not to Refer: Exploring Family Therapists' Beliefs and Practices Related to the Referral of Lesbian, Gay, and Bisexual Clients.

PubMed

McGeorge, Christi R; Stone Carlson, Thomas; Farrell, Molly

2016-07-01

This study explored how negative beliefs toward lesbian, gay, and bisexual (LGB) individuals and LGB clinical competence influenced family therapists' beliefs and practices regarding referring based on the sexual orientation of the client. The sample consisted of 741 experienced clinicians. The results of this study indicated that the majority of the participants believe it is ethical to refer LGB clients; however, most had never made such a referral. Furthermore, participants who had referred based solely on the client's sexual orientation reported higher levels of negative beliefs toward LGB individuals and lower levels of LGB clinical competence. Finally, negative beliefs toward LGB persons not only predicted the practice of referring, but also the belief that it is ethical to refer an LGB client. © 2015 American Association for Marriage and Family Therapy.

Occupational stress among Swedish audiologists in clinical practice: Reasons for being stressed.

PubMed

Brännström, K Jonas; Holm, Lucas; Larsson, Josefina; Lood, Sofie; Notsten, Margareta; Turunen Taheri, Satu

2016-08-01

The present study reports on the application of a Swedish translation of the audiologist occupational stress questionnaire (AOSQ) on audiologists working in Sweden. The relations between AOSQ scores and perceived effort, perceived rewards, coping strategies at work, demographic variables such as salary, education length, practise length, and practice type were tested. A cross-sectional e-mail survey using the AOSQ, effort-reward imbalance questionnaire, and demographic questions. Four-hundred and four Swedish licensed audiologists working with clients. The Swedish AOSQ translation demonstrated high inter-item correlations and high internal consistency. Several stress factors were identified: time spent at work, accountability, leadership at the workplace, paperwork and practice demands, equipment and clinical protocols, own health concerns, and job control. The outcome on the complete AOSQ questionnaire was related to perceived effort, perceived rewards, coping strategies at work, and age. The Swedish AOSQ translation seems to provide a valid measure of occupational stress among audiologists.

Continuing professional development of dentists through distant learning: an Indira Gandhi National Open University-Dental Council of India experiment a report.

PubMed

Kuba, Ruchika; Kohli, Anil

2014-01-01

To keep themselves updated with all the advancements in the field of dentistry, dentists should involve themselves in some kind of professional development. Distance learning is the most appropriate way to serve the growing demand due to technological advancements. Indira Gandhi National Open University in collaboration with Dental Council of India (DCI) developed and launched two continuing professional development programs in Endodontics (postgraduate certificate in endodontics) and postgraduate certificate in oral implantology and has trained over 400 and 280 BDS dentists respectively till date. The program package consists of self-instructional material, assignments, videos and practical training. The training is conducted in premiere dental colleges and institutions recognized by DCI. The certificate is awarded after a term end examination, both in theory and practical. The pass percentages of the theory courses ranged from around 63% to 98%, and 90% of the candidates cleared the practical exam.

Microscopic or occult hematuria, when reflex testing is not good laboratory practice.

PubMed

Froom, Paul; Barak, Mira

2010-01-01

Consensus opinion suggests that hematuria found by dipstick and not confirmed on microscopic examination (<2 erythrocytes per high power field) signifies a false-positive reagent strip test result. Standard practice is to repeat the dipstick test several days later and if still positive to confirm by microscopic examination. If discordant results are obtained, experts recommend reflex testing for urinary myoglobin and hemoglobin concentrations. The question is whether or not this approach represents good laboratory practice. These recommendations are not evidence based. We conclude that the reference range for red blood cells on the reagent strip should be increased to 25x10(6) cells/L for young men, and 50x10(6) cells/L for the rest of the adult population, ranges consistent with flow cytometry reports. Confirmation reflex testing using tests that have inferior sensitivity, precision and probably accuracy is not recommended.

Media fill for validation of a good manufacturing practice-compliant cell production process.

PubMed

Serra, Marta; Roseti, Livia; Bassi, Alessandra

2015-01-01

According to the European Regulation EC 1394/2007, the clinical use of Advanced Therapy Medicinal Products, such as Human Bone Marrow Mesenchymal Stem Cells expanded for the regeneration of bone tissue or Chondrocytes for Autologous Implantation, requires the development of a process in compliance with the Good Manufacturing Practices. The Media Fill test, consisting of a simulation of the expansion process by using a microbial growth medium instead of the cells, is considered one of the most effective ways to validate a cell production process. Such simulation, in fact, allows to identify any weakness in production that can lead to microbiological contamination of the final cell product as well as qualifying operators. Here, we report the critical aspects concerning the design of a Media Fill test to be used as a tool for the further validation of the sterility of a cell-based Good Manufacturing Practice-compliant production process.

Educational Testing and Validity of Conclusions in the Scholarship of Teaching and Learning

PubMed Central

Beltyukova, Svetlana A.; Martin, Beth A.

2013-01-01

Validity and its integral evidence of reliability are fundamentals for educational and psychological measurement, and standards of educational testing. Herein, we describe these standards of educational testing, along with their subtypes including internal consistency, inter-rater reliability, and inter-rater agreement. Next, related issues of measurement error and effect size are discussed. This article concludes with a call for future authors to improve reporting of psychometrics and practical significance with educational testing in the pharmacy education literature. By increasing the scientific rigor of educational research and reporting, the overall quality and meaningfulness of SoTL will be improved. PMID:24249848

Cultural Beliefs and Attitudes About Breast Cancer and Screening Practices Among Arabic Women in Australia.

PubMed

Kwok, Cannas; Endrawes, Gihane; Lee, Chun Fan

2016-01-01

Arabic women have been consistently reported as having remarkably low participation rates in breast cancer screening measures in their home countries and after migration to Western countries. Little is known about the screening behaviors of Arabic women in Australia. This study aimed to report breast cancer screening practices among Arabic women in Australia and to examine the relationship between (1) demographic factors and (2) the Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) score and women's breast screening behaviors. A descriptive cross-sectional method was used. Both English and Arabic versions of the BCSBQ were administered to the 251 Arabic Australian women 18 years or older who participated in the study. The majority of participants (62.9%-92%) had heard of breast awareness, clinical breast examination, and mammography. However, only 7.6% practiced breast awareness monthly, 21.4% had undergone clinical breast examination annually, and 40.3% had biannual mammography. Length of stay in Australia, being retired, and being unemployed were positively associated with the recommended performance of breast awareness and mammography. In terms of BCSBQ scores, women who engaged in the 3 screening practices had significantly higher scores on the attitudes to health check-ups and barriers to mammography subscales. Attitudes toward health check-ups and perceived barriers to mammography were important determinants of breast cancer screening practices among Arabic Australian women. To fully understand barriers discouraging Arabic Australian women from participating in breast cancer screening practices, efforts should be focused on specific subgroup (ie, working group) of Arabic Australian women.

Get your science used—Six guidelines to improve your products

USGS Publications Warehouse

Perry, Suzanne C.; Blanpied, Michael L.; Burkett, Erin R.; Campbell, Nnenia M.; Carlson, Anders; Cox, Dale A.; Driedger, Carolyn L.; Eisenman, David P.; Fox-Glassman, Katherine T.; Hoffman, Sherry; Hoffman, Susanna M.; Jaiswal, Kishor S.; Jones, Lucile M.; Luco, Nicolas; Marx, Sabine M.; McGowan, Sean M.; Mileti, Dennis S.; Moschetti, Morgan P.; Ozman, David; Pastor, Elizabeth; Petersen, Mark D.; Porter, Keith A.; Ramsey, David W.; Ritchie, Liesel A.; Fitzpatrick, Jessica K.; Rukstales, Kenneth S.; Sellnow, Timothy L.; Vaughon, Wendy L.; Wald, David J.; Wald, Lisa A.; Wein, Anne; Zarcadoolas, Christina

2016-03-03

On the basis of research and practice into how people think, use tools, make decisions, and understand scientific/technical information, the social and behavioral scientists, marketers, and social-impact designers at the NSHM workshop provided remarkably consistent guidelines to develop successful science products, such as text, maps, and other products. In this report the guidelines are numbered for clarity, but they can be applied repeatedly, piecemeal, or out of order to fit each project and your resources.

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

Gavignet, A.A.; Bradbury, L.J.; Quetier, F.P.

In current practice, the optimization of drilling hydraulics consists of the selection of nozzle sizes that maximize either jet impact or hydraulic power at the nozzle. But what is required for a real optimization is the knowledge of the hydraulic forces available for cleaning at the rock face, not at the nozzle. This paper shows the results of hot-wire anemometry experiments that provide insight into the flow distribution in a jet bit. Direct measurements of the flow field, including turbulence levels, are reported and discussed.

Management of Pediatric Nonalcoholic Fatty Liver Disease by Academic Hepatologists in Canada: A Nationwide Survey.

PubMed

Mouzaki, Marialena; Ling, Simon C; Schreiber, Richard A; Kamath, Binita M

2017-10-01

The literature on the optimal clinical management of pediatric patients with nonalcoholic fatty liver disease (NAFLD) is limited. The objective of this study was to identify discrepancies in the care provided to patients with NAFLD by hepatologists practicing in academic centers across Canada. A nationwide survey was distributed electronically to all pediatric hepatologists practicing in university-affiliated hospitals using the infrastructure of the Canadian Pediatric Hepatology Research Group. The responses were anonymous. The response rate to the survey was 79%. Everyone reported diagnosing NAFLD based on a combination of elevated transaminases and imaging suggestive of steatosis in the context of an otherwise negative workup for other liver diseases. Only 14% use liver biopsy to confirm the diagnosis. There are significant discrepancies in the frequency of screening for other comorbidities (eg, hypertension, sleep apnea, etc) and in the frequency of laboratory investigations (eg, lipid profile, transaminases, international normalized ratio, etc). Frequency of outpatient clinic follow-up varies significantly. Treatment is consistently based on lifestyle modifications; however, reported patient outcomes in terms of body mass index improvements are poor. There are significant discrepancies in the care provided to children with NAFLD by hepatologists practicing in academic centers across Canada.

Factors contributing to the effectiveness of physical activity counselling in primary care: a realist systematic review.

PubMed

Gagliardi, Anna R; Abdallah, Flavia; Faulkner, Guy; Ciliska, Donna; Hicks, Audrey

2015-04-01

Physical activity (PA) counselling in primary care increases PA but is not consistently practiced. This study examined factors that optimise the delivery and impact of PA counselling. A realist systematic review based on the PRECEDE-PROCEED model and RAMESES principles was conducted to identify essential components of PA counselling. MEDLINE, EMBASE, Cochrane Library, PsycINFO, and Physical Education Index were searched from 2000 to 2013 for studies that evaluated family practice PA counselling. Of 1546 articles identified, 10 were eligible for review (3 systematic reviews, 5 randomised controlled trials, 2 observational studies). Counselling provided by clinicians or counsellors alone that explored motivation increased self-reported PA at least 12 months following intervention. Multiple sessions may sustain increased PA beyond 12 months. Given the paucity of eligible studies and limited detail reported about interventions, further research is needed to establish the optimal design and delivery of PA counselling. Research and planning should consider predisposing, reinforcing and enabling design features identified in these studies. Since research shows that PA counselling promotes PA but is not widely practiced, primary care providers will require training and tools to operationalize PA counselling. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Ethnic variations in parental ethnic socialization and adolescent ethnic identity: a longitudinal study.

PubMed

Else-Quest, Nicole M; Morse, Emily

2015-01-01

Achievement of a positive ethnic identity has been linked to positive outcomes for ethnic minority youth and is fostered by parental ethnic socialization practices. In light of findings of variability in developmental trajectories and outcomes, we examined ethnic group variations in parents' ethnic socialization practices and adolescents' ethnic identity. Within a sample of 370 adolescents who self-identified as White, African American, Latino/a, or Asian American, and their parents, parental ethnic socialization practices (including preparation for bias, promotion of mistrust, and cultural socialization) and adolescent ethnic identity development (including identity exploration and commitment) were assessed at 10th and 11th grades. Consistent with predictions, African American youth reported higher levels of ethnic identity exploration and commitment than youth from other ethnic groups, and parents of African American youth tended to report higher levels of ethnic socialization than other parents. Parental cultural socialization significantly predicted adolescent ethnic identity exploration and commitment 1 year later; ethnicity did not moderate this link. Findings are discussed in the context of the schools and urban community from which the sample was recruited, highlighting the importance of sociocultural context in development. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

The role of personality traits and barriers to mental health treatment seeking among college students.

PubMed

Jennings, Kristen S; Goguen, Kandice N; Britt, Thomas W; Jeffirs, Stephanie M; Wilkes, Jack R; Brady, Ashley R; Pittman, Rebecca A; DiMuzio, Danielle J

2017-11-01

Many college students experience a mental health problem yet do not seek treatment from a mental health professional. In the present study, we examined how perceived barriers (stigma perceptions, negative attitudes about treatment, and perceptions of practical barriers), as well as the Big Five personality traits, relate to treatment seeking among college students reporting a current mental health problem. The sample consisted of 261 college students, 115 of which reported experiencing a current problem. Results of a series of logistic regressions revealed that perceived stigma from others (OR = .32), self-stigma (OR = .29), negative attitudes about treatment (OR = .27), and practical barriers (OR = .34) were all associated with a lower likelihood of having sought treatment among students experiencing a problem. Of the five-factor model personality traits, only Neuroticism was associated with a higher likelihood of having sought treatment when experiencing a mental health problem (OR = 2.71). When we considered all significant predictors in a final stepwise conditional model, only self-stigma, practical barriers, and Neuroticism remained significant unique predictors. Implications for addressing barriers to treatment and encouraging treatment seeking among college students are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Certified nurse-midwife and physician collaborative practice. Piloting a survey on the Internet.

PubMed

Miller, S; King, T; Lurie, P; Choitz, P

1997-01-01

This pilot study was designed to describe the clinical areas of collaboration, financial structures, and sources of conflict for certified nurse-midwives (CNMs) involved in nurse-midwife and physician collaborative practice (CP). A questionnaire was posted on an electronic bulletin board maintained by the Community-Based Nurse Midwifery Education Program of the Frontier School of Nursing. The nonrandom, convenience sample consisted of 78 respondents. Their mean age was 42 years; they had been in practice for a mean of 10 years, and 56% had graduate degrees. Eighty-nine percent reported involvement in CP. Eighty-three percent co-managed higher-risk women, and 46% performed vacuum-assisted deliveries or were first assistants at cesarean sections. Forty-eight percent of CNMs did not bill in their own names, and only 12% had full hospital privileges. The most common sources of conflict in CPs were clinical practice issues (100% ever encountered), power inequities (92%), financial issues (66%), and gender relations (58%). Collaborative practice is a common form of practice for CNMs and suggests a model for collaboration in other sectors of the health care system. Future research should explore methods of reducing the potential for conflict between CNMs and physicians.

The reliability and validity of multiple mini interviews (MMIs) in values based recruitment to nursing, midwifery and paramedic practice programmes: Findings from an evaluation study.

PubMed

Callwood, Alison; Cooke, Debbie; Bolger, Sarah; Lemanska, Agnieszka; Allan, Helen

2018-01-01

Universities in the United Kingdom (UK) are required to incorporate values based recruitment (VBR) into their healthcare student selection processes. This reflects an international drive to strengthen the quality of healthcare service provision. This paper presents novel findings in relation to the reliability and predictive validity of multiple mini interviews (MMIs); one approach to VBR widely being employed by universities. To examine the reliability (internal consistency) and predictive validity of MMIs using end of Year One practice outcomes of under-graduate pre-registration adult, child, mental health nursing, midwifery and paramedic practice students. Cross-discipline evaluation study. One university in the United Kingdom. Data were collected in two streams: applicants to A) The September 2014 and 2015 Midwifery Studies programmes; B) September 2015 adult; Child and Mental Health Nursing and Paramedic Practice programmes. Fifty-seven midwifery students commenced their programme in 2014 and 69 in 2015; 47 and 54 agreed to participate and completed Year One respectively. 333 healthcare students commenced their programmes in September 2015. Of these, 281 agreed to participate and completed their first year (180 adult, 33 child and 34 mental health nursing and 34 paramedic practice students). Stream A featured a seven station four-minute model with one interviewer at each station and in Stream B a six station model was employed. Cronbach's alpha was used to assess MMI station internal consistency and Pearson's moment correlation co-efficient to explore associations between participants' admission MMI score and end of Year one clinical practice outcomes (OSCE and mentor grading). Stream A: Significant correlations are reported between midwifery applicant's MMI scores and end of Year One practice outcomes. A multivariate linear regression model demonstrated that MMI score significantly predicted end of Year One practice outcomes controlling for age and academic entry level: coefficients 0.195 (p=0.002) and 0.116 (p=0.002) for OSCE and mentor grading respectively. In Stream B no significant correlations were found between MMI score and practice outcomes measured by mentor grading. Internal consistency for each MMI station was 'excellent' with values ranging from 0.966-0.974 across Streams A and B. This novel, cross-discipline study shows that MMIs are reliable VBR tools which have predictive validity when a seven station model is used. These data are important given the current international use of different MMI models in healthcare student selection processes. Copyright © 2017. Published by Elsevier Ltd.

The importance of family management, closeness with father and family structure in early adolescent alcohol use.

PubMed

Habib, Cherine; Santoro, Joseph; Kremer, Peter; Toumbourou, John; Leslie, Eva; Williams, Joanne

2010-10-01

To examine the importance of family management, family structure and father-adolescent relationships on early adolescent alcohol use. Cross-sectional data was collected across 30 randomly selected Australian communities stratified to represent a range of socio-economic and regional variation. Data were collected during school time from adolescents attending a broad range of schools. The sample consisted of a combined 8256 students (aged 10-14 years). Students completed a web-based survey as part of the Healthy Neighbourhoods project. Family management-which included practices such as parental monitoring and family rules about alcohol use-had the strongest and most consistent relationship with alcohol use in early adolescence. Adolescents reporting higher family management were less likely to have drunk alcohol in their life-time, less likely to drink alcohol in the preceding 30 days and less likely to have had an alcohol binge. Adolescents reporting emotionally close relationships with their fathers were less likely to have drunk alcohol in their life-time and less likely to have had an alcohol binge in the preceding fortnight. Findings indicate that family management practices may contribute to alcohol abstinence in adolescents. Furthermore, emotionally close father-adolescent relationships may also foster abstinence; however, fathers' drinking behaviours need to be considered. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

Construct validity and internal consistency in the Leisure Practices Scale (EPL) for adults.

PubMed

Andrade, Rubian Diego; Schwartz, Gisele Maria; Tavares, Giselle Helena; Pelegrini, Andreia; Teixeira, Clarissa Stefani; Felden, Érico Pereira Gomes

2018-02-01

This study proposes and analyzes the construct validity and internal consistency of the Leisure Practices Scale (EPL). This survey seeks to identify the preferences and involvement in in different leisure practices in adults. The instrument was formed based on the cultural leisure content (artistic, manual, physical, sports, intellectual, social, tourist, virtual and contemplation/leisure). The validation process was conducted with: a) content analysis by leisure experts, who evaluated the instrument for clarity of language and practical relevance, which allowed the calculation of the content validity coefficient (CVC); b) reproducibility test-retest with 51 subjects to calculate the temporal variation coefficient; c) internal consistency analysis with 885 participants. The evaluation presented appropriate coefficients, both with respect to language clarity (CVCt = 0.883) and practical relevance (CVCt = 0.879). The reproducibility coefficients were moderate to excellent. The scale showed adequate internal consistency (0.72). The EPL has psychometric quality and acceptable values in its structure, and can be used to investigate adult involvement in leisure activities.

No evidence that polygynous marriage is a harmful cultural practice in northern Tanzania

PubMed Central

Lawson, David W.; James, Susan; Ngadaya, Esther; Ngowi, Bernard; Mfinanga, Sayoki G. M.; Borgerhoff Mulder, Monique

2015-01-01

Polygyny is cross-culturally common and a topic of considerable academic and policy interest, often deemed a harmful cultural practice serving the interests of men contrary to those of women and children. Supporting this view, large-scale studies of national African demographic surveys consistently demonstrate that poor child health outcomes are concentrated in polygynous households. Negative population-level associations between polygyny and well-being have also been reported, consistent with the hypothesis that modern transitions to socially imposed monogamy are driven by cultural group selection. We challenge the consensus view that polygyny is harmful, drawing on multilevel data from 56 ethnically diverse Tanzanian villages. We first demonstrate the vulnerability of aggregated data to confounding between ecological and individual determinants of health; while across villages polygyny is associated with poor child health and low food security, such relationships are absent or reversed within villages, particularly when children and fathers are coresident. We then provide data indicating that the costs of sharing a husband are offset by greater wealth (land and livestock) of polygynous households. These results are consistent with models of polygyny based on female choice. Finally, we show that village-level negative associations between polygyny prevalence, food security, and child health are fully accounted for by underlying differences in ecological vulnerability (rainfall) and socioeconomic marginalization (access to education). We highlight the need for improved, culturally sensitive measurement tools and appropriate scales of analysis in studies of polygyny and other purportedly harmful practices and discuss the relevance of our results to theoretical accounts of marriage and contemporary population policy. PMID:26504213

Changing dietary behaviour: the role and development of practitioner communication.

PubMed

Whitehead, Kirsten

2015-05-01

The need to support people to change diet-related behaviour is widely advocated and how to do this effectively in practice is an expanding area of research. Important factors to consider are how healthcare practitioners communicate with their patients and how that communication may affect diet-related behaviour change and subsequent outcomes. The aim of the present paper is to discuss communication skills for behaviour change (CSBC), focusing predominantly on registered dietitians who are required to communicate effectively and have an important role in supporting patients to change diet-related behaviour. The views of dietitians in relation to CSBC have been investigated and respondents have consistently reported that they perceive these skills to be of vital importance in practice. Patient views have reiterated the importance of good CSBC in one-to-one consultations. However, pre-qualification training of dietitians is thought to deliver practitioners who are competent at a minimum level. The need for ongoing continuous professional development (CPD) in relation to CSBC has been recognised but currently most CPD focuses on updating knowledge rather than improving these essential skills. Measuring CSBC in a consistent and objective manner is difficult and an assessment tool, DIET-COMMS, has been developed and validated for this purpose. DIET-COMMS can be used to support CSBC development, but concerns about logistical challenges and acceptability of implementing this in practice have been raised. Although a suitable assessment tool now exists there is a need to develop ways to facilitate assessment of CSBC in practice.

Burnout and Psychological Distress Among Pediatric Critical Care Physicians in the United States.

PubMed

Shenoi, Asha N; Kalyanaraman, Meena; Pillai, Aravind; Raghava, Preethi S; Day, Scottie

2018-01-01

To estimate the prevalence of physician burnout, psychological distress, and its association with selected personal and practice characteristics among pediatric critical care physicians and to evaluate the relationship between burnout and psychological distress. Cross-sectional, online survey. Pediatric critical care practices in the United States. Pediatric critical care physicians. None. A nonrandom sample of 253 physicians completed an online survey consisting of personal and practice characteristics, the Maslach Burnout Inventory, and the General Health Questionnaire. Nearly half of the participants (49%; 95% CI, 43-55%; n = 124) scored high burnout in at least one of the three subscales of the Maslach Burnout Inventory and 21% reported severe burnout. The risk of any burnout was about two times more in women physicians (odds ratio, 1.97; 95% CI, 1.2-3.4). Association between other personal or practice characteristics and burnout was not evident in this study, while regular physical exercise appeared to be protective. One third of all participants (30.5%) and 69% of those who experienced severe burnout screened positive for psychological distress. About 90% of the physicians reporting severe burnout have considered leaving their practice. Burnout is high among pediatric critical care physicians in the United States. About two thirds of the physicians with severe burnout met the screening criteria for psychological distress that suggests possible common mental disorders. Significant percentages of physicians experiencing burnout and considering to leave the profession has major implications for the critical care workforce.

Elaborating on theory with middle managers' experience implementing healthcare innovations in practice.

PubMed

Birken, Sarah A; DiMartino, Lisa D; Kirk, Meredith A; Lee, Shoou-Yih D; McClelland, Mark; Albert, Nancy M

2016-01-04

The theory of middle managers' role in implementing healthcare innovations hypothesized that middle managers influence implementation effectiveness by fulfilling the following four roles: diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation. The theory also suggested several activities in which middle managers might engage to fulfill the four roles. The extent to which the theory aligns with middle managers' experience in practice is unclear. We surveyed middle managers (n = 63) who attended a nursing innovation summit to (1) assess alignment between the theory and middle managers' experience in practice and (2) elaborate on the theory with examples from middle managers' experience overseeing innovation implementation in practice. Middle managers rated all of the theory's hypothesized four roles as "extremely important" but ranked diffusing and synthesizing information as the most important and selling innovation implementation as the least important. They reported engaging in several activities that were consistent with the theory's hypothesized roles and activities such as diffusing information via meetings and training. They also reported engaging in activities not described in the theory such as appraising employee performance. Middle managers' experience aligned well with the theory and expanded definitions of the roles and activities that it hypothesized. Future studies should assess the relationship between hypothesized roles and the effectiveness with which innovations are implemented in practice. If evidence supports the theory, the theory should be leveraged to promote the fulfillment of hypothesized roles among middle managers, doing so may promote innovation implementation.

Cancer screening and Haitian immigrants: the primary care provider factor.

PubMed

Gany, Francesca; Trinh-Shevrin, Chau; Aragones, Abraham

2008-06-01

Haitian immigrants, among the fastest growing immigrant communities in the United States, have low cancer screening rates. Several patient barriers have been identified and associated with low screening rates but little is known on provider barriers for cancer screening. To address this gap, we assessed the cancer screening practices, attitudes, and beliefs of primary care providers serving the Haitian community. We surveyed a random sample of physicians serving first generation Haitian immigrants in New York City, identified through their zip codes of practice. Participants completed a questionnaire to assess their beliefs, attitudes and practices surrounding cancer screening, and their perceptions of patient barriers to screening. 50 of 87 physicians (58%) consented to participate in the study. Cancer site-specific and overall cancer screening scores were created for breast, cervical, and colorectal cancer screening. 75% of providers followed breast cancer screening guidelines, 16% for cervical cancer, and 30% for colorectal cancer. None of the providers in the sample were following guidelines for all three cancer sites. Additionally, 97% reported recommending digital rectal exam and PSA annually to patients 50 years or older with no family history, and 100% to patients over 50 years old with family history. The reported practices of providers serving the Haitian immigrant community in New York City are not fully consistent with practice guidelines. Efforts should be made to reinforce screening guideline knowledge in physicians serving the Haitian immigrant community, to increase the utilization of systems that increase cancer screening, and to implement strategies to overcome patient barriers.

Current Ketamine Practice: Results of the 2016 American Society of Pain Management Nursing Survey on Ketamine.

PubMed

Klaess, Cynthia C; Jungquist, Carla R

2018-06-01

Ketamine is increasingly utilized for a variety of pain management challenges. Audience comments from a ketamine presentation at the 2015 American Society of Pain Management Nursing (ASPMN) Conference reflected wide variation in ketamine practices as well as barriers to use. The goal was to gain a greater understanding of ASPMN member practice patterns and barriers related to ketamine as adjunctive therapy for pain management. A questionnaire survey design was used. Respondents represented 35 states and 2 countries. The participants were 146 respondents from ASPMN membership (1,485 members). The survey was distributed by ASPMN on SurveyMonkey. Practice setting and ketamine administration practices were assessed with areas for comments. Results were reviewed using frequencies to describe responses and formatted into tables. Comments were individually reviewed and grouped into common themes. Administration of ketamine as an analgesic was reported by 63% of respondents. Continuous intravenous ketamine infusions were the most common route of administration (65%); however, wide variability in dosing and length of therapy was reported. A wide variety of practices and challenges related to ketamine utilization were noted. Numerous studies have indicated the analgesic benefits of ketamine in pain management. The lack of practice standardization has created challenges to its consistent use and outcome measurement. Additionally, the off-label use of ketamine for pain management creates its own unique challenges. However, given the current national climate with intense focus on pain management, interdisciplinary practitioners have an ideal opportunity to evaluate ketamine's use in a comprehensive approach to pain management. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

The BLISS cluster randomised controlled trial of the effect of 'active dissemination of information' on standards of care for premature babies in England (BEADI) study protocol [ISRCTN89683698].

PubMed

Acolet, Dominique; Jelphs, Kim; Davidson, Deborah; Peck, Edward; Clemens, Felicity; Houston, Rosie; Weindling, Michael; Lavis, John; Elbourne, Diana

2007-10-08

Gaps between research knowledge and practice have been consistently reported. Traditional ways of communicating information have limited impact on practice changes. Strategies to disseminate information need to be more interactive and based on techniques reported in systematic reviews of implementation of changes. There is a need for clarification as to which dissemination strategies work best to translate evidence into practice in neonatal units across England. The objective of this trial is to assess whether an innovative active strategy for the dissemination of neonatal research findings, recommendations, and national neonatal guidelines is more likely to lead to changes in policy and practice than the traditional (more passive) forms of dissemination in England. Cluster randomised controlled trial of all neonatal units in England (randomised by hospital, n = 182 and stratified by neonatal regional networks and neonatal units level of care) to assess the relative effectiveness of active dissemination strategies on changes in local policies and practices. Participants will be mainly consultant lead clinicians in each unit. The intervention will be multifaceted using: audit and feedback; educational meetings for local staff (evidence-based lectures on selected topics, interactive workshop to examine current practice and draw up plans for change); and quality improvement and organisational changes methods. Policies and practice outcomes for the babies involved will be collected before and after the intervention. Outcomes will assess all premature babies born in England during a three month period for timing of surfactant administration at birth, temperature control at birth, and resuscitation team (qualification and numbers) present at birth.

Becoming a good doctor: perceived need for ethics training focused on practical and professional development topics.

PubMed

Roberts, Laura W; Warner, Teddy D; Hammond, Katherine A Green; Geppert, Cynthia M A; Heinrich, Thomas

2005-01-01

Ethics training has become a core component of medical student and resident education. Curricula have been developed without the benefit of data regarding the views of physicians-in-training on the need for ethics instruction that focuses on practical issues and professional development topics. A written survey was sent to all medical students and PGY1-3 residents at the University of New Mexico School of Medicine. The survey consisted of eight demographic questions and 124 content questions in 10 domains. Responses to a set of 24 items related to ethically important dilemmas, which may occur in the training period and subsequent professional practice, are reported. Items were each rated on a 9-point scale addressing the level of educational attention needed compared to the amount currently provided. Survey respondents included 200 medical students (65% response) and 136 residents (58% response). Trainees, regardless of level of training or clinical discipline, perceived a need for more academic attention directed at practical ethical and professional dilemmas present during training and the practice of medicine. Women expressed a desire for more education directed at both training-based and practice-based ethical dilemmas when compared to men. A simple progression of interest in ethics topics related to level of medical training was not found. Residents in diverse clinical specialties differed in perceived ethics educational needs. Psychiatry residents reported a need for enhanced education directed toward training-stage ethics problems. This study documents the importance placed on ethics education directed at practical real-world dilemmas and ethically important professional developmental issues by physicians-in-training. Academic medicine may be better able to fulfill its responsibilities in teaching ethics and professionalism and in serving its trainees by paying greater attention to these topics in undergraduate and graduate medical curricula.

Meta-narrative analysis of sports injury reporting practices based on the Injury Definitions Concept Framework (IDCF): A review of consensus statements and epidemiological studies in athletics (track and field).

PubMed

Timpka, Toomas; Jacobsson, Jenny; Ekberg, Joakim; Finch, Caroline F; Bichenbach, Jerome; Edouard, Pascal; Bargoria, Victor; Branco, Pedro; Alonso, Juan Manuel

2015-11-01

Consistency in routines for reporting injury has been a focus of development efforts in sports epidemiology for a long time. To gain an improved understanding of current reporting practices, we applied the Injury Definitions Concept Framework (IDCF) in a review of injury reporting in a subset of the field. Meta-narrative review. An analysis of injury definitions reported in consensus statements for different sports and studies of injury epidemiology in athletics (track and field) published in PubMed between 1980 and 2013 was performed. Separate narratives for each of the three reporting contexts in the IDCF were constructed from the data. Six consensus statements and 14 studies reporting on athletics injury epidemiology fulfilled the selection criteria. The narratives on sports performance, clinical examination, and athlete self-report contexts were evenly represented in the eligible studies. The sports performance and athlete self-report narratives covered both professional and community athletes as well as training and competition settings. In the clinical examination narrative, data collection by health service professionals was linked to studies of professional athletes at international championships. From an application of the IDCF in a review of injury reporting in sports epidemiology we observed a parallel usage of reporting contexts in this field of research. The co-existence of reporting methodologies does not necessarily reflect a problematic situation, but only provided that firm precautions are taken when comparing studies performed in the different contexts. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Consistent Condom Use with Paying and Nonpaying Partners among Female Sex Workers in Iran: Findings of a National Biobehavioral Survey.

PubMed

Karamouzian, Mohammad; Sadeghirad, Behnam; Sharifi, Hamid; Sedaghat, Abbas; Haghdoost, Ali Akbar; Mirzazadeh, Ali

Little is known about the dynamics of condom use among female sex workers (FSWs) in Iran. We investigated the correlates of consistent condom use (CCU) among FSWs, using data from a national biobehavioral surveillance survey in 2010. A total of 872 FSWs were recruited using a facility-based sampling strategy from 21 sites in 13 cities in Iran. Data were collected through face-to-face interviews using a standardized questionnaire. Overall, 33.6% and 17.3% of FSWs reported CCU with paying and nonpaying sex partners, respectively. Consistent condom use with paying partners was significantly associated with temporary marriage, accessing family planning services and history of working in brothels. Conversely, temporary marriage or married status, condom rupture/slippage, and HIV seropositivity remained independently significantly associated with CCU with nonpaying sex partners. Our findings indicated the urgent need for scaling up condom promotion interventions catered toward FSWs and their sex partners to practice safe sex consistently.

Reporting of Telehealth-Delivered Dietary Intervention Trials in Chronic Disease: Systematic Review.

PubMed

Warner, Molly M; Kelly, Jaimon T; Reidlinger, Dianne P; Hoffmann, Tammy C; Campbell, Katrina L

2017-12-11

Telehealth-delivered dietary interventions are effective for chronic disease management and are an emerging area of clinical practice. However, to apply interventions from the research setting in clinical practice, health professionals need details of each intervention component. The aim of this study was to evaluate the completeness of intervention reporting in published dietary chronic disease management trials that used telehealth delivery methods. Eligible randomized controlled trial publications were identified through a systematic review. The completeness of reporting of experimental and comparison interventions was assessed by two independent assessors using the Template for Intervention Description and Replication (TIDieR) checklist that consists of 12 items including intervention rationale, materials used, procedures, providers, delivery mode, location, when and how much intervention delivered, intervention tailoring, intervention modifications, and fidelity. Where reporting was incomplete, further information was sought from additional published material and through email correspondence with trial authors. Within the 37 eligible trials, there were 49 experimental interventions and 37 comparison interventions. One trial reported every TIDieR item for their experimental intervention. No publications reported every item for the comparison intervention. For the experimental interventions, the most commonly reported items were location (96%), mode of delivery (98%), and rationale for the essential intervention elements (96%). Least reported items for experimental interventions were modifications (2%) and intervention material descriptions (39%) and where to access them (20%). Of the 37 authors, 14 responded with further information, and 8 could not be contacted. Many details of the experimental and comparison interventions in telehealth-delivered dietary chronic disease management trials are incompletely reported. This prevents accurate interpretation of trial results and implementation of effective interventions in clinical practice. ©Molly M Warner, Jaimon T Kelly, Dianne P Reidlinger, Tammy C Hoffmann, Katrina L Campbell. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.12.2017.

An assessment of health sector guidelines and services for treatment of sexual violence in El Salvador, Guatemala, Honduras and Nicaragua.

PubMed

McNaughton Reyes, H Luz; Billings, Deborah L; Paredes-Gaitan, Yolanda; Padilla Zuniga, Karen

2012-12-01

In Central America, approximately 12% of women report ever having been forced to have sex by an intimate male partner, and sexual violence by others is also a frequent experience. All Central American countries are signatories to human rights agreements that oblige States to ensure access to comprehensive health services for victims of sexual violence, but there is limited information as to whether these agreements have been translated into policy and practice. This article critically examines health sector guidelines for the treatment of sexual violence in El Salvador, Guatemala, Honduras and Nicaragua, and reports on an assessment of services in 34 private- and public-sector facilities in the four countries. Overall, policies were consistent with international agreements and included guidance on detection and documentation of violence, forensic examination, treatment, referral and follow-up care. However, only a small proportion of women who experience sexual violence actually seek care. The challenge facing all four countries is to turn policy into practice. Screening practices were inconsistent, and policies needed to indicate more clearly the roles and responsibilities of health care providers and forensic specialists. Finally, women's right to privacy and confidentiality in reports of cases to legal authorities needed further consideration, as well as the importance of providing all services at a single location. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Intimate Partner Violence Experienced by Physicians: A Review.

PubMed

Hernandez, Barbara Couden; Reibling, Ellen T; Maddux, Charles; Kahn, Michael

2016-03-01

Physicians play a significant role in screening for domestic violence. However, little information is available about the prevalence of physicians who experience intimate partner violence (IPV) or the implications for their clinical practice. National surveys indicate a potential prevalence of 16% for sexual abuse and 32% for abuse by an intimate partner. This extrapolates to more than 395,000 potential physician victims, the majority of which are women. We conducted a systematic review of IPV and physician victims from 1990 to 2014 that included peer-reviewed journals, trade books, and dissertations that referenced physician victims. We identified 17 publications; nine quantitative studies, four first-person accounts, one qualitative study, and a qualitative dissertation that included two physician subjects. Two case studies of victimized physicians were identified in trade books. Quantitative results noted that women reported higher prevalence for all experiences of violence [childhood exposure (6%-32%), adult IPV exposure (7%-24%)] than men (6%-10%). This review highlights the need for improved understanding of physician experience with IPV, and development of physician-sensitive resources and treatment approaches. Contributions and limitations are provided for each publication. IPV exposure impacts clinical practice, including reticence to consistently screen patients. Lower reported prevalence may be related to extreme stigma among physicians that may prevent their reporting and help seeking, but more research is needed. We provide recommendations for clinical practice, education, and future research.

Guidelines for Developing and Reporting Machine Learning Predictive Models in Biomedical Research: A Multidisciplinary View.

PubMed

Luo, Wei; Phung, Dinh; Tran, Truyen; Gupta, Sunil; Rana, Santu; Karmakar, Chandan; Shilton, Alistair; Yearwood, John; Dimitrova, Nevenka; Ho, Tu Bao; Venkatesh, Svetha; Berk, Michael

2016-12-16

As more and more researchers are turning to big data for new opportunities of biomedical discoveries, machine learning models, as the backbone of big data analysis, are mentioned more often in biomedical journals. However, owing to the inherent complexity of machine learning methods, they are prone to misuse. Because of the flexibility in specifying machine learning models, the results are often insufficiently reported in research articles, hindering reliable assessment of model validity and consistent interpretation of model outputs. To attain a set of guidelines on the use of machine learning predictive models within clinical settings to make sure the models are correctly applied and sufficiently reported so that true discoveries can be distinguished from random coincidence. A multidisciplinary panel of machine learning experts, clinicians, and traditional statisticians were interviewed, using an iterative process in accordance with the Delphi method. The process produced a set of guidelines that consists of (1) a list of reporting items to be included in a research article and (2) a set of practical sequential steps for developing predictive models. A set of guidelines was generated to enable correct application of machine learning models and consistent reporting of model specifications and results in biomedical research. We believe that such guidelines will accelerate the adoption of big data analysis, particularly with machine learning methods, in the biomedical research community. ©Wei Luo, Dinh Phung, Truyen Tran, Sunil Gupta, Santu Rana, Chandan Karmakar, Alistair Shilton, John Yearwood, Nevenka Dimitrova, Tu Bao Ho, Svetha Venkatesh, Michael Berk. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.12.2016.

Doctors' Perceptions and Practices of Breaking Bad News: A Qualitative Study From Greece.

PubMed

Oikonomidou, Despoina; Anagnostopoulos, Fotios; Dimitrakaki, Christine; Ploumpidis, Dimitrios; Stylianidis, Stylianos; Tountas, Yannis

2017-06-01

There is limited information about doctors' communication behaviors and their salient beliefs with regard to bad news disclosure in Greece. In this qualitative study we investigated the self-reported practices of doctors on breaking bad news, their perceptions about the factors affecting the delivery of such news, and their beliefs about the most appropriate disclosure manner. A focus group discussion and individual interviews were conducted. Twenty-five resident and specialist doctors from primary health care and hospital settings participated. We analyzed the collected data with content analysis techniques. Participants were found to acknowledge the importance of appropriate and effective delivery of bad news; however, none of them reported the implementation of empirically informed communication practices. They described communication patterns mainly formed by their work experience and often guided by the patient's family requests. Doctor, patient, and family characteristics and organizational features and resources were reported to affect the delivery of bad news. Participants perceived the most appropriate disclosure manner as an individualized approach to each patient's unique needs. They suggested an interdisciplinary, collaborative management of the delivery process and the establishment of formal supportive services. These findings may provide useful information for the development of tailored, empirically informed curriculum interventions and educational programs in order to address several barriers to communication. Sociocultural characteristics that influence the disclosure practice, as well as physicians' perceptions that are consistent with the optimal information delivery, should be taken into account. System-level strategies that focus on the development of patient-centered communication also need to be prioritized.

Readiness of Primary Care Practices for Medical Home Certification

PubMed Central

Clark, Sarah J.; Sakshaug, Joseph W.; Chen, Lena M.; Hollingsworth, John M.

2013-01-01

OBJECTIVES: To assess the prevalence of medical home infrastructure among primary care practices for children and identify practice characteristics associated with medical home infrastructure. METHODS: Cross-sectional analysis of restricted data files from 2007 and 2008 of the National Ambulatory Medical Care Survey. We mapped survey items to the 2011 National Committee on Quality Assurance’s Patient-Centered Medical home standards. Points were awarded for each “passed” element based on National Committee for Quality Assurance scoring, and we then calculated the percentage of the total possible points met for each practice. We used multivariate linear regression to assess associations between practice characteristics and the percentage of medical home infrastructure points attained. RESULTS: On average, pediatric practices attained 38% (95% confidence interval 34%–41%) of medical home infrastructure points, and family/general practices attained 36% (95% confidence interval 33%–38%). Practices scored higher on medical home elements related to direct patient care (eg, providing comprehensive health assessments) and lower in areas highly dependent on health information technology (eg, computerized prescriptions, test ordering, laboratory result viewing, or quality of care measurement and reporting). In multivariate analyses, smaller practice size was significantly associated with lower infrastructure scores. Practice ownership, urban versus rural location, and proportion of visits covered by public insurers were not consistently associated with a practice’s infrastructure score. CONCLUSIONS: Medical home programs need effective approaches to support practice transformation in the small practices that provide the vast majority of the primary care for children in the United States. PMID:23382438

Australian and New Zealand Perfusion Survey: Management and Procedure

PubMed Central

Tuble, Sigrid C.; Willcox, Timothy W.; Baker, Robert A.

2009-01-01

Abstract: In this report, we will discuss management and procedural aspects of perfusion practice. This report allows us to compare and contrast recent trends and changes in perfusion with historic practices. A survey comprised of 233 single-answer and 12 open-ended questions was sent by e-mail to senior perfusionists or individuals in charge of perfusion in 40 hospital groups. The survey encompasses a review of the perfusion practices for the calendar year of 2003, and respondents were required to answer the survey based on the predominant practice in their institutions. Standard management of routine adult cardiopulmonary bypass (CPB) in 2003 consisted of perfusion strategies that achieved a target temperature of 32.0°C (range, 28.0–35.0°C), a flow index of 2.4 L/min/m2 (range, 1.6–3.0 L/min/m2) during normothermia and 1.8 L/min/m2 (range, 1.2–3.0 L/min/m2) during hypothermia, and a pressure during CPB between 50 (range, 30–65 mmHg) and 70 mmHg (range, 60–95 mmHg). Myocardial protection with blood cardioplegia was used in 77% of the 20,688 CPB cases, whereas in 53% cases, cardiotomy blood was never processed. Pre-operatively, 76% of perfusion groups assessed their patients (21% directly with the patient), and 85% responded that perfusionists performed or participated in a formal pre-bypass checklist. The majority of the perfusion groups used a handwritten perfusion record (62%), 12% used an electronic perfusion record, and 26% used both, whereas more than one half of the groups were involved in quality assurance (79%), incident reporting (74%), audits (62%), research (53%), participating in interdisciplinary meetings (53%), and morbidity and mortality meetings (65%). Only 26% conducted formal perfusion team meetings. This report outlines the status of clinical management and procedural performance for perfusion practices in Australia and New Zealand in 2003. Awareness of these trends will allow perfusionists to assess both individual practices and unit performance. PMID:19681302

Poikilodermatous changes on the forearms of a woman practicing aroma-therapy: extracervical poikiloderma of Civatte?*

PubMed Central

Katoulis, Alexandros; Makris, Michalis; Gregoriou, Stamatis; Rallis, Eustathios; Kanelleas, Antonis; Stavrianeas, Nicolaos; Rigopoulos, Dimitris

2014-01-01

We report the case of a 48-year-old, Caucasian female who presented with slowly progressing asymptomatic poikilodermatous changes of the extensor aspects of the forearms. She also had typical Poikiloderma of Civatte on the V of the neck and erythemato-telangiectatic rosacea of the central face. The patient had been practicing aroma-therapy for many years. Histologic examination revealed findings consistent with PC. Patch-testing revealed positive reactions to Fragrance mix and Nickel sulphate. Based on clinical and histological findings, a diagnosis of extracervical PC was suggested. PC with extra-cervical or extra-facial involvement is rare. In addition, this case supports the theory that contact sensitization to fragrances may contribute to the development of PC. PMID:25054757

The congruence of perceptions and behaviors exhibited by twelve successful middle school teachers in implementingScience/Technology/Society/Constructivist practices in Iowa Scope, Sequence, and Coordination schools

NASA Astrophysics Data System (ADS)

Yutakom, Naruemon

1997-11-01

The purposes of this study were (1) to investigate teacher perceptions about teaching and the strategies they use in teaching for successful middle school teachers purporting to use Science/Technology/Society and Constructivist practices in Iowa Scope, Sequence, and Coordination (SS&C) schools and (2) to note the congruence between these perceptions and the actual behaviors exhibited by these teachers. Multiple methods of data collection used to discern the actual behaviors included observation by means of classroom videotapes, a teacher perception survey, teacher interviews, instructional documents, teacher stories, demographic information concerning teachers from the Iowa-SS&C database, and a student survey. Findings include: (1) Successful SS&C teachers report that they use STS/Constructivist teaching practices; further, interviews indicated that they also have knowledge and understanding of the science content and pedagogy which are consistent with the STS/Constructivist philosophy. These perceptions and this knowledge influence their stated goals, rationale for teaching, understanding of the teaching and learning processes, and ideas about needed professional development. (2) Successful SS&C teachers exhibit a wide range of STS/Constructivist teaching behaviors. The five most common of these are: (a) acceptance of a variety of student responses, (b) students apply their knowledge in meeting everyday challenges, (c) student-student verbal interactions encouraged, (d) students encouraged to use higher order thinking skills, (e) a variety of assessment tools were used. Over 31% of the questions the teachers ask are higher order level questions; the average wait-time for the teachers is 3.4 seconds following each question. (3) Students report that SS&C teachers provide learning environments that are relevant and meaningful to them and that student-student interaction is encouraged. They do not report involvement with planning, conducting lessons, and assessing their own learning. (4) Teacher beliefs and knowledge about STS/Constructivist philosophy influence their teaching behaviors. The practices of seven of the teachers match their perceptions. One teacher exhibited fewer STS/Constructivist strategies than he reported to be the situation while four practiced more STS/Constructivist strategies than they reported.

Breast Cancer Screening Beliefs Questionnaire: Psychometric properties assessment of the Arabic version.

PubMed

Kwok, Cannas; Endrawes, Gihane; Lee, Chun Fan

2016-02-01

The aim of the study was to report the psychometric properties of the Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). A convenience sample of 251 Arabic-Australian women was recruited from a number of Arabic community organizations. Construct validity was examined by Cuzick's non-parametric test while Cronbach α was used to assess internal consistency reliability. Explanatory factor analysis was conducted to study the factor structure. The results indicated that the Arabic version of the BCSBQ had satisfactory validity and internal consistency. The Cronbach's alpha of the three subscales ranged between 0.810 and 0.93. The frequency of breast cancer screening practices (breast awareness, clinical breast-examination and mammography) were significantly associated with attitudes towards general health check-up and perceived barriers to mammographic screening. Exploratory factor analysis showed a similar fit for the hypothesized three-factor structure with our data set. The Arabic version of the BCBSQ is a culturally appropriate, valid and reliable instrument for assessing the beliefs, knowledge and attitudes to breast cancer and breast cancer screening practices among Arabic-Australian women. Copyright © 2015 Elsevier Ltd. All rights reserved.

Experience-dependent induction of hypnagogic images during daytime naps: a combined behavioural and EEG study.

PubMed

Kusse, Caroline; Shaffii-LE Bourdiec, Anahita; Schrouff, Jessica; Matarazzo, Luca; Maquet, Pierre

2012-02-01

This study characterizes hypnagogic hallucinations reported during a polygraphically recorded 90-min daytime nap following or preceding practice of the computer game Tetris. In the experimental group (N = 16), participants played Tetris in the morning for 2 h during three consecutive days, while in a first control group (N = 13, controlling the effect of experience) participants did not play any game, and in a second control group (N = 14, controlling the effect of anticipation) participants played Tetris after the nap. During afternoon naps, participants were repetitively awakened 15, 45, 75, 120 or 180 s after the onset of S1, and were asked to report their mental content. Reports content was scored by three judges (inter-rater reliability 85%). In the experimental group, 48 out of 485 (10%) sleep-onset reports were Tetris-related. They mostly consisted of images and sounds with very little emotional content. They exactly reproduced Tetris elements or mixed them with other mnemonic components. By contrast, in the first control group, only one report out of 107 was scored as Tetris-related (1%), and in the second control group only three reports out of 112 were scored as Tetris-related (3%; between-groups comparison; P = 0.006). Hypnagogic hallucinations were more consistently induced by experience than by anticipation (P = 0.039), and they were predominantly observed during the transition of wakefulness to sleep. The observed attributes of experience-related hypnagogic hallucinations are consistent with the particular organization of regional brain activity at sleep onset, characterized by high activity in sensory cortices and in the default-mode network. © 2011 European Sleep Research Society.

Companies' contribution to sustainability through global supply chains.

PubMed

Thorlakson, Tannis; de Zegher, Joann F; Lambin, Eric F

2018-02-27

Global supply chains play a critical role in many of the most pressing environmental stresses and social struggles identified by the United Nations' Sustainable Development Goals (SDGs). Responding to calls from the global community, companies are adopting a variety of voluntary practices to improve the environmental and/or social management of their suppliers' activities. We develop a global survey of 449 publicly listed companies in the food, textile, and wood-products sectors with annual reports in English to provide insight into how the private sector contributes to advancing the SDGs via such sustainable-sourcing practices. We find that while 52% of companies use at least one sustainable-sourcing practice, these practices are limited in scope; 71% relates to only one or a few input materials and 60.5% apply to only first-tier suppliers. We also find that sustainable-sourcing practices typically address a small subset of the sustainability challenges laid out by the SDGs, primarily focusing on labor rights and compliance with national laws. Consistent with existing hypotheses, companies that face consumer and civil society pressure are associated with a significantly higher probability of adopting sustainable-sourcing practices. Our findings highlight the opportunities and limitations of corporate sustainable-sourcing practices in addressing the myriad sustainability challenges facing our world today. Copyright © 2018 the Author(s). Published by PNAS.

Companies’ contribution to sustainability through global supply chains

PubMed Central

Thorlakson, Tannis; de Zegher, Joann F.; Lambin, Eric F.

2018-01-01

Global supply chains play a critical role in many of the most pressing environmental stresses and social struggles identified by the United Nations’ Sustainable Development Goals (SDGs). Responding to calls from the global community, companies are adopting a variety of voluntary practices to improve the environmental and/or social management of their suppliers’ activities. We develop a global survey of 449 publicly listed companies in the food, textile, and wood-products sectors with annual reports in English to provide insight into how the private sector contributes to advancing the SDGs via such sustainable-sourcing practices. We find that while 52% of companies use at least one sustainable-sourcing practice, these practices are limited in scope; 71% relates to only one or a few input materials and 60.5% apply to only first-tier suppliers. We also find that sustainable-sourcing practices typically address a small subset of the sustainability challenges laid out by the SDGs, primarily focusing on labor rights and compliance with national laws. Consistent with existing hypotheses, companies that face consumer and civil society pressure are associated with a significantly higher probability of adopting sustainable-sourcing practices. Our findings highlight the opportunities and limitations of corporate sustainable-sourcing practices in addressing the myriad sustainability challenges facing our world today. PMID:29440420

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

PubMed Central

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

2013-01-01

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

Prevalence and Predictors of Self-Reported Consistent Condom Usage among Male Clients of Female Sex Workers in Tamil Nadu, India

PubMed Central

Charles, Bimal; Sam, Asirvatham Edwin

2014-01-01

Clients of female sex workers (FSWs) possess a high potential of transmitting HIV and other sexually transmitted infections from high risk FSWs to the general population. Promotion of safer sex practices among the clients is essential to limit the spread of HIV/AIDS epidemic. The aim of this study is to estimate the prevalence of consistent condom use (CCU) among clients of FSWs and to assess the factors associated with CCU in Tamil Nadu. 146 male respondents were recruited from the hotspots who reportedly had sex with FSWs in exchange for cash at least once in the past one month. Data were analyzed using bivariate and multivariate methods. Overall, 48.6 and 0.8 percent clients consistently used condoms in the past 12 months with FSWs and regular partners, respectively. Logistic regression showed that factors such as education, peers' use of condoms, and alcohol consumption significantly influenced clients' CCU with FSWs. Strategies for safe sex-behaviour are needed among clients of FSWs in order to limit the spread of HIV/AIDS epidemic in the general population. The role of peer-educators in experience sharing and awareness generation must also be emphasized. PMID:26316978

Are nutrition messages lost in transmission? Assessing the quality and consistency of diabetes guideline recommendations on the delivery of nutrition therapy.

PubMed

Hale, Kelli; Capra, Sandra; Bauer, Judy

2016-12-01

To provide an overview of (1) the consistency of Type 2 Diabetes Clinical Practice Guidelines recommendations on the delivery of nutrition therapy and (2) Clinical Practice Guideline quality. Large international clinical practice guideline repositories, diabetes organisation websites, and electronic databases (Pubmed, Scopus), were searched to identify Clinical Practice Guidelines for adults with type 2 diabetes published 2005 to August 2014. Recommendations on the delivery of nutrition therapy were extracted and inductive content analysis was used to analyse consistency. Two researchers independently assessed guideline quality using the AGREE II tool. Nine topics were identified from the recommendations. Overall the consistency of the recommendations was related to guideline type. Compared with nutrition-specific guidelines, the broad ones had a broader focus and included more patient-focused recommendations. The ten Clinical Practice Guidelines assessed included six broad guidelines and four nutrition specific guidelines. Based on AGREE II analysis, the broad guidelines were higher quality than nutrition-specific ones. Broad Clinical Practice Guidelines were higher quality and included more patient-focused recommendations than nutrition-specific ones. Our findings suggest a need for nutrition-specific guidelines to be modified to include greater patient-focus, or for practitioners delivering nutrition therapy to adopt broad Clinical Practice Guidelines. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

TEST–RETEST RELIABILITY OF CAPABILITY MEASUREMENT IN THE UK GENERAL POPULATION

PubMed Central

Al-Janabi, Hareth; Flynn, Terry N; Peters, Tim J; Bryan, Stirling; Coast, Joanna

2015-01-01

Although philosophically attractive, it may be difficult, in practice, to measure individuals' capabilities (what they are able to do in their lives) as opposed to their functionings (what they actually do). To examine whether capability information could be reliably self-reported, we administered a measure of self-reported capability (the Investigating Choice Experiments Capability Measure for Adults, ICECAP-A) on two occasions, 2 weeks apart, alongside a self-reported health measure (the EuroQol Five Dimensional Questionnaire with 3 levels, EQ-5D-3L). We found that respondents were able to report capabilities with a moderate level of consistency, although somewhat less reliably than their health status. The more socially orientated nature of some of the capability questions may account for the difference. © 2014 The Authors Health Economics Published by John Wiley & Sons Ltd. PMID:25204621

Australian and New Zealand Perfusion Survey: Equipment and Monitoring

PubMed Central

Baker, Robert A.; Willcox, Timothy W.

2006-01-01

Abstract: The current practice of perfusion in Australia and New Zealand continues to adopt new techniques and procedures into clinical practice. Our aims were to report current practice in 2003 and to compare and contrast current practice with historic practice. A total of 62 centers (40 perfusion groups) performing procedures using cardiopulmonary bypass (CPB) were identified and were e-mailed a detailed electronic survey. The survey was comprised of an excel worksheet that contained 233 single answer questions (either dropdown lists, yes/no, true/false, or numeric) and 12 questions that allowed the respondent to provide a commentary. Respondents were instructed to answer all questions based on what represented the predominant practice of perfusion in their institutions during 2003. We report an 89% response rate representing a caseload of 20,688 adult cases. These data allowed us to profile the following. A standard adult CPB setup in 2003 consisted of a membrane oxygenator (100% of cases), a roller pump (70%) as the main arterial pump, although a centrifugal pump would be considered for selected procedures (30%), a circuit incorporating a hard-shell venous reservoir (86%), and a mixture of biocompatible and nonbiocompatible circuit components (66%). The circuit would include a pre-bypass filter (88%), an arterial line filter (94%), and would allow monitoring of the following: hard-shell venous reservoir low level (100%) with servo-regulation of the arterial pump (85%), microbubble alarm (94%) with servo-regulation of the arterial pump (79.5%), arterial line pressures (100%) with servo-regulation of the arterial pump (79%), inline venous O2 saturation (100%), and inline hematocrit (58%). Perfusion practice in Australia and New Zealand has adopted changes over the last decade; however, some areas of practice show wide variation. This survey provides a baseline of contemporary practice for Australian and New Zealand perfusionists. PMID:17089508

Nurses' readiness for evidence-based practice at Finnish university hospitals: a national survey.

PubMed

Saunders, Hannele; Stevens, Kathleen R; Vehviläinen-Julkunen, Katri

2016-08-01

The aim of this study was to determine nurses' readiness for evidence-based practice at Finnish university hospitals. Although systematic implementation of evidence-based practice is essential to effectively improving patient outcomes and value of care, nurses do not consistently use evidence in practice. Uptake is hampered by lack of nurses' individual and organizational readiness for evidence-based practice. Although nurses' evidence-based practice competencies have been widely studied in countries leading the evidence-based practice movement, less is known about nurses' readiness for evidence-based practice in the non-English-speaking world. A cross-sectional descriptive survey design. The study was conducted in November-December 2014 in every university hospital in Finland with a convenience sample (n = 943) of practicing nurses. The electronic survey data were collected using the Stevens' Evidence-Based Practice Readiness Inventory, which was translated into Finnish according to standardized guidelines for translation of research instruments. The data were analysed using descriptive and inferential statistics. Nurses reported low to moderate levels of self-efficacy and low levels of evidence-based practice knowledge. A statistically significant, direct correlation was found between nurses' self-efficacy in employing evidence-based practice and their actual evidence-based practice knowledge level. Several statistically significant differences were found between nurses' socio-demographic variables and nurses' self-efficacy in employing evidence-based practice, and actual and perceived evidence-based practice knowledge. Finnish nurses at university hospitals are not ready for evidence-based practice. Although nurses are familiar with the concept of evidence-based practice, they lack the evidence-based practice knowledge and self-efficacy in employing evidence-based practice required for integrating best evidence into clinical care delivery. © 2016 John Wiley & Sons Ltd.

What do consistently high-performing in vitro fertilization programs in the U.S. do?

PubMed

Van Voorhis, Bradley J; Thomas, Mika; Surrey, Eric S; Sparks, Amy

2010-09-01

To identify common clinical and laboratory practices among consistently high-performing IVF programs. Questionnaire study of selected IVF programs. Academic and private practice IVF programs. Ten of 12 programs identified as having consistently high singleton delivery rates per cycle. None. Common clinical practices. Common clinical practices identified among these programs included testing all patients for ovarian reserve, endometrial defects, and hydrosalpinges; use of a mixed LH and FSH stimulation protocol with step-down dosing; and use of ultrasound guidance for ET. Common laboratory practices included selective use of intracytoplasmic sperm injection, group culture of embryos in microdrops, and use of blastocyst ET in selected cases. Common laboratory features included good air quality using filtration and heated stages for oocyte and embryo work. Although a number of factors were identified in this best-practices questionnaire, programs often differed in many aspects of care. However, high-performing programs cited experience of physicians, embryologists, and staff members as well as consistency of approach, attention to detail, and good communication as being vital to excellent outcomes. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Processing Mode Causally Influences Emotional Reactivity

PubMed Central

Watkins, Ed; Moberly, Nicholas J.; Moulds, Michelle L.

2008-01-01

Three studies are reported showing that emotional responses to stress can be modified by systematic prior practice in adopting particular processing modes. Participants were induced to think about positive and negative scenarios in a mode either characteristic of or inconsistent with the abstract-evaluative mind-set observed in depressive rumination, via explicit instructions (Experiments 1 and 2) and via implicit induction of interpretative biases (Experiment 3), before being exposed to a failure experience. In all three studies, participants trained into the mode antithetical to depressive rumination demonstrated less emotional reactivity following failure than participants trained into the mode consistent with depressive rumination. These findings provide evidence consistent with the hypothesis that processing mode modifies emotional reactivity and support the processing-mode theory of rumination. PMID:18540752

Comparison of Kt/V and urea reduction ratio in measuring dialysis adequacy in paediatric haemodialysis in England.

PubMed

Dunne, Nina; Campbell, Malcolm; Fitzpatrick, Maggie; Callery, Peter

2014-06-01

The National Kidney Foundation-Dialysis Outcomes Quality Initiative (KDOQI) guidelines and the Renal Association recommend the use of either Kt/V or urea reduction ratio (URR) to measure haemodialysis adequacy. To determine the methods used to measure paediatric haemodialysis adequacy and to assess consistency between calculations of single pool Kt/V (spKt/V) and URR. A service evaluation was conducted to establish current practices in measuring dialysis adequacy. A prospective longitudinal study was conducted to compare spKt/V and URR. Thirty-two children were recruited consisting of 13 males and 19 females in five paediatric dialysis centres. Inconsistencies were reported of the method of post-urea sampling with 4 of the 10 centres using the KDOQI recommended sampling method. Five dialysis centres reported using URR and five reported using spKt/V. There were substantial differences between the two measures. Using URR suggested that up to 44% of children did not receive adequate dialysis, whereas measurement by spKt/V suggested no more than 6% of the same dialysis sessions were not adequate. One standard measure should be used to assess dialysis adequacy in paediatric centres in England. KDOQI guidelines were not consistently followed in obtaining a post-urea blood sample and this procedure should be standardised. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Promoting physical therapists’ of research evidence to inform clinical practice: part 1 - theoretical foundation, evidence, and description of the PEAK program

PubMed Central

2014-01-01

Background There is a need for theoretically grounded and evidence-based interventions that enhance the use of research evidence in physical therapist practice. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists’ integration of research evidence into clinical decision-making. The pedagogical foundations for the PEAK educational program include Albert Bandura’s social cognitive theory and Malcolm Knowles’s adult learning theory. Additionally, two complementary frameworks of knowledge translation, the Promoting Action on Research Implementation in Health Services (PARiHS) and Knowledge to Action (KTA) Cycle, were used to inform the organizational elements of the program. Finally, the program design was influenced by evidence from previous attempts to facilitate the use of research in practice at the individual and organizational levels. Discussion The 6-month PEAK program consisted of four consecutive and interdependent components. First, leadership support was secured and electronic resources were acquired and distributed to participants. Next, a two-day training workshop consisting of didactic and small group activities was conducted that addressed the five steps of evidence based practice. For five months following the workshop, participants worked in small groups to review and synthesize literature around a group-selected area of common clinical interest. Each group contributed to the generation of a “Best Practices List” - a list of locally generated, evidence-based, actionable behaviors relevant to the groups’ clinical practice. Ultimately, participants agreed to implement the Best Practices List in their clinical practice. Summary This, first of two companion papers, describes the underlying pedagogical theories, knowledge translation frameworks, and research evidence used to derive the PEAK program – an educational program designed to promote the use of research evidence to inform physical therapist practice. The four components of the program are described in detail. The companion paper reports the results of a mixed methods feasibility analysis of this complex educational intervention. PMID:24965501

Socio-demographic predictors of health and environmental co-benefit behaviours for climate change mitigation in urban China.

PubMed

Chan, Emily Ying Yang; Wang, Susan Shuxin; Ho, Janice Ying-En; Huang, Zhe; Liu, Sida; Guo, Chunlan

2017-01-01

This study aims to examine the patterns and socio-demographic predictors of health and environmental co-benefit behaviours that support climate change mitigation in a densely populated Asian metropolis-Hong Kong. A population-based, stratified and cross-sectional random digit dialling telephone survey study was conducted between January and February 2016, among the Cantonese-speaking population aged 15 and above in Hong Kong. Socio-demographic data and the self-reported practice of 10 different co-benefit behaviours were solicited. Ethics approval and participant's verbal consent were sought. The study sample consisted of 1,017 respondents (response rate: 63.6%) were comparable to the age, gender and geographical distributions of the Hong Kong population found in the latest 2011 Hong Kong Population Census. Among the co-benefit behaviours, using less packaging and disposable shopping bags were practiced in the highest frequency (70.1%). However, four behaviours were found to have never been practiced by more than half of the respondents, including bringing personal eating utensils when dining in restaurants or small eateries, showering less than five minutes, having one vegetarian meal a week, and buying more organic food. Results of multivariable logistic regression showed that frequency of practicing co-benefit behaviours were consistently associated with gender and age. Urban residents in Hong Kong do not engage in the practice of co-benefit behaviours in a uniform way. In general, females and older people are more likely to adopt co-benefit behaviours in their daily lives. Further research to assess the knowledge and attitudes of the population towards these co-benefit behaviours will provide support to relevant climate change mitigation policies and education programmes.

Interest and satisfaction of dentists in practicing periodontics: A survey based on treatment of gingival recession

PubMed Central

Grover, Vishakha; Kapoor, Anoop; Malhotra, Ranjan; Sachdeva, Sonia

2012-01-01

Background: Gingival recession is a common occurrence and patients often report to dental clinic with associated problems such as root surface hypersensitivity, esthetic concerns, cervical root abrasions, and root caries that make it a concern for patients. Based upon the fact that gingival recession is an enigma for clinicians because of multitude of etiological factors and plethora of treatment modalities present for its treatment, a survey was conducted to assess knowledge as well as opinion about most common etiology, classification, and preferred treatment of gingival recession and to evaluate the interest and satisfaction of dentists in practicing periodontics. Materials and Methods: Study design consisted of a cross-sectional online survey, conducted among dentists practicing in state of Punjab, India, in the month of April 2011. A structured online questionnaire consisting of 17 questions evaluating the interest of dentists in periodontics based on knowledge about gingival recession (most of them giving the possibility of multiple choices of answers) was sent to about 300 dentists. Pearson Chi-Square and Mann-Whitney U tests were used for statistical analysis of data collected. P ≤ 0.05 was considered as statistically significant and P ≤ 0.01 considered as highly significant. Results: A greater proportion of periodontists had better knowledge about etiology (P = 0.07), classification (P = 0.000), and treatment of gingival recession (P = 0.000). A greater number of periodontists opted for the surgical modalities to correct the defects produced by gingival recession as compared to non-periodontists and had better interest (P = 0.000) and satisfaction (P = 0.000) in practicing periodontics. Conclusion: The results elucidated that periodontists had better interest and satisfaction in practicing periodontics, and were more inclined towards surgical correction of gingival recession as compared to non-periodontists. PMID:23162580

Socio-demographic predictors of health and environmental co-benefit behaviours for climate change mitigation in urban China

PubMed Central

Wang, Susan Shuxin; Ho, Janice Ying-en; Huang, Zhe; Liu, Sida; Guo, Chunlan

2017-01-01

Objective This study aims to examine the patterns and socio-demographic predictors of health and environmental co-benefit behaviours that support climate change mitigation in a densely populated Asian metropolis—Hong Kong. Methods A population-based, stratified and cross-sectional random digit dialling telephone survey study was conducted between January and February 2016, among the Cantonese-speaking population aged 15 and above in Hong Kong. Socio-demographic data and the self-reported practice of 10 different co-benefit behaviours were solicited. Ethics approval and participant’s verbal consent were sought. Findings The study sample consisted of 1,017 respondents (response rate: 63.6%) were comparable to the age, gender and geographical distributions of the Hong Kong population found in the latest 2011 Hong Kong Population Census. Among the co-benefit behaviours, using less packaging and disposable shopping bags were practiced in the highest frequency (70.1%). However, four behaviours were found to have never been practiced by more than half of the respondents, including bringing personal eating utensils when dining in restaurants or small eateries, showering less than five minutes, having one vegetarian meal a week, and buying more organic food. Results of multivariable logistic regression showed that frequency of practicing co-benefit behaviours were consistently associated with gender and age. Conclusion Urban residents in Hong Kong do not engage in the practice of co-benefit behaviours in a uniform way. In general, females and older people are more likely to adopt co-benefit behaviours in their daily lives. Further research to assess the knowledge and attitudes of the population towards these co-benefit behaviours will provide support to relevant climate change mitigation policies and education programmes. PMID:29176879

Interest and satisfaction of dentists in practicing periodontics: A survey based on treatment of gingival recession.

PubMed

Grover, Vishakha; Kapoor, Anoop; Malhotra, Ranjan; Sachdeva, Sonia

2012-07-01

Gingival recession is a common occurrence and patients often report to dental clinic with associated problems such as root surface hypersensitivity, esthetic concerns, cervical root abrasions, and root caries that make it a concern for patients. Based upon the fact that gingival recession is an enigma for clinicians because of multitude of etiological factors and plethora of treatment modalities present for its treatment, a survey was conducted to assess knowledge as well as opinion about most common etiology, classification, and preferred treatment of gingival recession and to evaluate the interest and satisfaction of dentists in practicing periodontics. Study design consisted of a cross-sectional online survey, conducted among dentists practicing in state of Punjab, India, in the month of April 2011. A structured online questionnaire consisting of 17 questions evaluating the interest of dentists in periodontics based on knowledge about gingival recession (most of them giving the possibility of multiple choices of answers) was sent to about 300 dentists. Pearson Chi-Square and Mann-Whitney U tests were used for statistical analysis of data collected. P ≤ 0.05 was considered as statistically significant and P ≤ 0.01 considered as highly significant. A greater proportion of periodontists had better knowledge about etiology (P = 0.07), classification (P = 0.000), and treatment of gingival recession (P = 0.000). A greater number of periodontists opted for the surgical modalities to correct the defects produced by gingival recession as compared to non-periodontists and had better interest (P = 0.000) and satisfaction (P = 0.000) in practicing periodontics. The results elucidated that periodontists had better interest and satisfaction in practicing periodontics, and were more inclined towards surgical correction of gingival recession as compared to non-periodontists.

Technology Integration Barriers: Urban School Mathematics Teachers Perspectives

NASA Astrophysics Data System (ADS)

Wachira, Patrick; Keengwe, Jared

2011-02-01

Despite the promise of technology in education, many practicing teachers face several challenges when trying to effectively integrate technology into their classroom instruction. Additionally, while national statistics cite a remarkable improvement in access to computer technology tools in schools, teacher surveys show consistent declines in the use and integration of computer technology to enhance student learning. This article reports on primary technology integration barriers that mathematics teachers identified when using technology in their classrooms. Suggestions to overcome some of these barriers are also provided.

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

Buchanan, J.R.; Keilholtz, G.W.

This report discusses the current status of liquid-metal fast breeder (LMFBR) development and one of the principal safety issues, a hypothetical core-disruptive accident (HCDA). Bibliographic information on worldwide LMFBRs relative to the development of the breeder reactor as a safe source of nuclear power is presented for the period 1960 through 1969. The bibliography consists of 1560 abstracts covering early research and development and operating experiences leading up to the present design practices that are necessary for the licensing of breeder reactors. Key-word, author, and permuted-title indexes are included for completeness.

A Hydrodynamic Model of Transport in the Wheat Ear

NASA Technical Reports Server (NTRS)

Stieber, Joseph; Stieber, Joli; Bubenheim, David L.; Kliss, Mark (Technical Monitor)

1996-01-01

The vascular arrangement in the main axis (rachis) of the wheat ear, studied and reported in a previous paper by the same, described a circuit-cascade system consisting of capacitance and resistance passages (so-called RC-circuits). Some hydromechanic aspects (e.g., resonance, impulse control) of this asymmetric transport system and their possible role and importance in the fluid supply are discussed. A theoretical analysis of how this system works, as well as samples of practical application are presented.

40 CFR 63.11223 - How do I demonstrate continuous compliance with the work practice and management practice standards?

Code of Federal Regulations, 2011 CFR

2011-07-01

... should be consistent with the manufacturer's specifications, if available. (3) Inspect the system... properly. (4) Optimize total emissions of carbon monoxide. This optimization should be consistent with the...

48 CFR 52.230-4 - Disclosure and Consistency of Cost Accounting Practices-Foreign Concerns.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Consistency of Cost Accounting Practices —Foreign Concerns (JUN 2010) (a) The Contractor, in connection with.... Government to examine and make copies of any documents, papers, and records relating to compliance with the...

Consistent assignment of nursing staff to residents in nursing homes: a critical review of conceptual and methodological issues.

PubMed

Roberts, Tonya; Nolet, Kimberly; Bowers, Barbara

2015-06-01

Consistent assignment of nursing staff to residents is promoted by a number of national organizations as a strategy for improving nursing home quality and is included in pay for performance schedules in several states. However, research has shown inconsistent effects of consistent assignment on quality outcomes. In order to advance the state of the science of research on consistent assignment and inform current practice and policy, a literature review was conducted to critique conceptual and methodological understandings of consistent assignment. Twenty original research reports of consistent assignment in nursing homes were found through a variety of search strategies. Consistent assignment was conceptualized and operationalized in multiple ways with little overlap from study to study. There was a lack of established methods to measure consistent assignment. Methodological limitations included a lack of control and statistical analyses of group differences in experimental-level studies, small sample sizes, lack of attention to confounds in multicomponent interventions, and outcomes that were not theoretically linked. Future research should focus on developing a conceptual understanding of consistent assignment focused on definition, measurement, and links to outcomes. To inform current policies, testing consistent assignment should include attention to contexts within and levels at which it is most effective. Published by Oxford University Press on behalf of the Gerontological Society of America 2013.

An educational approach to improve outcomes in acute kidney injury (AKI): report of a quality improvement project.

PubMed

Xu, Gang; Baines, Richard; Westacott, Rachel; Selby, Nick; Carr, Susan

2014-03-20

To assess the impact of a quality improvement project that used a multifaceted educational intervention on how to improve clinician's knowledge, confidence and awareness of acute kidney injury (AKI). 2 large acute teaching hospitals in England, serving a combined population of over 1.5 million people. All secondary care clinicians working in the clinical areas were targeted, with a specific focus on clinicians working in acute admission areas. A multifaceted educational intervention consisting of traditional didactic lectures, case-based teaching in small groups and an interactive web-based learning resource. We assessed clinicians' knowledge of AKI and their self-reported clinical behaviour using an interactive questionnaire before and after the educational intervention. Secondary outcome measures included clinical audit of patient notes before and after the intervention. 26% of clinicians reported that they were aware of local AKI guidelines in the preintervention questionnaire compared to 64% in the follow-up questionnaire (χ²=60.2, p<0.001). There was an improvement in the number of clinicians reporting satisfactory practice when diagnosing AKI, 50% vs 68% (χ²=12.1, p<0.001) and investigating patients with AKI, 48% vs 64% (χ²=9.5, p=0.002). Clinical audit makers showed a trend towards better clinical practice. This quality improvement project utilising a multifaceted educational intervention improved awareness of AKI as demonstrated by changes in the clinician's self-reported management of patients with AKI. Elements of the project have been sustained beyond the project period, and demonstrate the power of quality improvement projects to help initiate changes in practice. Our findings are limited by confounding factors and highlight the need to carry out formal randomised studies to determine the impact of educational initiatives in the clinical setting.

Evaluating best educational practices, student satisfaction, and self-confidence in simulation: A descriptive study.

PubMed

Zapko, Karen A; Ferranto, Mary Lou Gemma; Blasiman, Rachael; Shelestak, Debra

2018-01-01

The National League for Nursing (NLN) has endorsed simulation as a necessary teaching approach to prepare students for the demanding role of professional nursing. Questions arise about the suitability of simulation experiences to educate students. Empirical support for the effect of simulation on patient outcomes is sparse. Most studies on simulation report only anecdotal results rather than data obtained using evaluative tools. The aim of this study was to examine student perception of best educational practices in simulation and to evaluate their satisfaction and self-confidence in simulation. This study was a descriptive study designed to explore students' perceptions of the simulation experience over a two-year period. Using the Jeffries framework, a Simulation Day was designed consisting of serial patient simulations using high and medium fidelity simulators and live patient actors. The setting for the study was a regional campus of a large Midwestern Research 2 university. The convenience sample consisted of 199 participants and included sophomore, junior, and senior nursing students enrolled in the baccalaureate nursing program. The Simulation Days consisted of serial patient simulations using high and medium fidelity simulators and live patient actors. Participants rotated through four scenarios that corresponded to their level in the nursing program. Data was collected in two consecutive years. Participants completed both the Educational Practices Questionnaire (Student Version) and the Student Satisfaction and Self-Confidence in Learning Scale. Results provide strong support for using serial simulation as a learning tool. Students were satisfied with the experience, felt confident in their performance, and felt the simulations were based on sound educational practices and were important for learning. Serial simulations and having students experience simulations more than once in consecutive years is a valuable method of clinical instruction. When conducted well, simulations can lead to increased student satisfaction and self-confidence. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Role of Qualitative Research Methods in Discrete Choice Experiments

PubMed Central

Vass, Caroline; Rigby, Dan; Payne, Katherine

2017-01-01

Background. The use of qualitative research (QR) methods is recommended as good practice in discrete choice experiments (DCEs). This study investigated the use and reporting of QR to inform the design and/or interpretation of healthcare-related DCEs and explored the perceived usefulness of such methods. Methods. DCEs were identified from a systematic search of the MEDLINE database. Studies were classified by the quantity of QR reported (none, basic, or extensive). Authors (n = 91) of papers reporting the use of QR were invited to complete an online survey eliciting their views about using the methods. Results. A total of 254 healthcare DCEs were included in the review; of these, 111 (44%) did not report using any qualitative methods; 114 (45%) reported “basic” information; and 29 (11%) reported or cited “extensive” use of qualitative methods. Studies reporting the use of qualitative methods used them to select attributes and/or levels (n = 95; 66%) and/or pilot the DCE survey (n = 26; 18%). Popular qualitative methods included focus groups (n = 63; 44%) and interviews (n = 109; 76%). Forty-four studies (31%) reported the analytical approach, with content (n = 10; 7%) and framework analysis (n = 5; 4%) most commonly reported. The survey identified that all responding authors (n = 50; 100%) found that qualitative methods added value to their DCE study, but many (n = 22; 44%) reported that journals were uninterested in the reporting of QR results. Conclusions. Despite recommendations that QR methods be used alongside DCEs, the use of QR methods is not consistently reported. The lack of reporting risks the inference that QR methods are of little use in DCE research, contradicting practitioners’ assessments. Explicit guidelines would enable more clarity and consistency in reporting, and journals should facilitate such reporting via online supplementary materials. PMID:28061040

The Role of Qualitative Research Methods in Discrete Choice Experiments.

PubMed

Vass, Caroline; Rigby, Dan; Payne, Katherine

2017-04-01

The use of qualitative research (QR) methods is recommended as good practice in discrete choice experiments (DCEs). This study investigated the use and reporting of QR to inform the design and/or interpretation of healthcare-related DCEs and explored the perceived usefulness of such methods. DCEs were identified from a systematic search of the MEDLINE database. Studies were classified by the quantity of QR reported (none, basic, or extensive). Authors ( n = 91) of papers reporting the use of QR were invited to complete an online survey eliciting their views about using the methods. A total of 254 healthcare DCEs were included in the review; of these, 111 (44%) did not report using any qualitative methods; 114 (45%) reported "basic" information; and 29 (11%) reported or cited "extensive" use of qualitative methods. Studies reporting the use of qualitative methods used them to select attributes and/or levels ( n = 95; 66%) and/or pilot the DCE survey ( n = 26; 18%). Popular qualitative methods included focus groups ( n = 63; 44%) and interviews ( n = 109; 76%). Forty-four studies (31%) reported the analytical approach, with content ( n = 10; 7%) and framework analysis ( n = 5; 4%) most commonly reported. The survey identified that all responding authors ( n = 50; 100%) found that qualitative methods added value to their DCE study, but many ( n = 22; 44%) reported that journals were uninterested in the reporting of QR results. Despite recommendations that QR methods be used alongside DCEs, the use of QR methods is not consistently reported. The lack of reporting risks the inference that QR methods are of little use in DCE research, contradicting practitioners' assessments. Explicit guidelines would enable more clarity and consistency in reporting, and journals should facilitate such reporting via online supplementary materials.

Radiology reports for incidental thyroid nodules on CT and MRI: high variability across subspecialties.

PubMed

Grady, A T; Sosa, J A; Tanpitukpongse, T P; Choudhury, K R; Gupta, R T; Hoang, J K

2015-02-01

Variability in radiologists' reporting styles and recommendations for incidental thyroid nodules can lead to confusion among clinicians and may contribute to inconsistent patient care. Our aim was to describe reporting practices of radiologists for incidental thyroid nodules seen on CT and MR imaging and to determine factors that influence reporting styles. This is a retrospective study of patients with incidental thyroid nodules reported on CT and MR imaging between January and December 2011, identified by text search for "thyroid nodule" in all CT and MR imaging reports. The studies included CT and MR imaging scans of the neck, spine, and chest. Radiology reports were divided into those that mentioned the incidental thyroid nodules only in the "Findings" section versus those that reported the incidental thyroid nodules in the "Impression" section as well, because this latter reporting style gives more emphasis to the finding. Univariate and multivariate analyses were performed to identify radiologist, patient, and nodule characteristics that influenced reporting styles. Three hundred seventy-five patients met the criterion of having incidental thyroid nodules. One hundred thirty-eight (37%) patients had incidental thyroid nodules reported in the "Impression" section. On multivariate analysis, only radiologists' divisions and nodule size were associated with reporting in "Impression." Chest radiologists and neuroradiologists were more likely to report incidental thyroid nodules in the "Impression" section than their abdominal imaging colleagues, and larger incidental thyroid nodules were more likely to be reported in "Impression" (P ≤ .03). Seventy-three percent of patients with incidental thyroid nodules of ≥20 mm were reported in the "Impression" section, but higher variability in reporting was seen for incidental thyroid nodules measuring 10-14 mm and 15-19 mm, which were reported in "Impression" for 61% and 50% of patients, respectively. Reporting practices for incidental thyroid nodules detected on CT and MR imaging are predominantly influenced by nodule size and the radiologist's subspecialty. Reporting was highly variable for nodules measuring 10-19 mm; this finding can be partially attributed to different reporting styles among radiology subspecialty divisions. The variability demonstrated in this study further underscores the need to develop CT and MR imaging practice guidelines with the goal of standardizing reporting of incidental thyroid nodules and thereby potentially improving the consistency and quality of patient care. © 2015 by American Journal of Neuroradiology.

Vegetable parenting practices scale. Item response modeling analyses

PubMed Central

Chen, Tzu-An; O’Connor, Teresia; Hughes, Sheryl; Beltran, Alicia; Baranowski, Janice; Diep, Cassandra; Baranowski, Tom

2015-01-01

Objective To evaluate the psychometric properties of a vegetable parenting practices scale using multidimensional polytomous item response modeling which enables assessing item fit to latent variables and the distributional characteristics of the items in comparison to the respondents. We also tested for differences in the ways item function (called differential item functioning) across child’s gender, ethnicity, age, and household income groups. Method Parents of 3–5 year old children completed a self-reported vegetable parenting practices scale online. Vegetable parenting practices consisted of 14 effective vegetable parenting practices and 12 ineffective vegetable parenting practices items, each with three subscales (responsiveness, structure, and control). Multidimensional polytomous item response modeling was conducted separately on effective vegetable parenting practices and ineffective vegetable parenting practices. Results One effective vegetable parenting practice item did not fit the model well in the full sample or across demographic groups, and another was a misfit in differential item functioning analyses across child’s gender. Significant differential item functioning was detected across children’s age and ethnicity groups, and more among effective vegetable parenting practices than ineffective vegetable parenting practices items. Wright maps showed items only covered parts of the latent trait distribution. The harder- and easier-to-respond ends of the construct were not covered by items for effective vegetable parenting practices and ineffective vegetable parenting practices, respectively. Conclusions Several effective vegetable parenting practices and ineffective vegetable parenting practices scale items functioned differently on the basis of child’s demographic characteristics; therefore, researchers should use these vegetable parenting practices scales with caution. Item response modeling should be incorporated in analyses of parenting practice questionnaires to better assess differences across demographic characteristics. PMID:25895694

Use of spiritual coping strategies by gender, race/ethnicity, and religion at 1 and 3 months after infant's/child's intensive care unit death.

PubMed

Hawthorne, Dawn M; Youngblut, JoAnne M; Brooten, Dorothy

2017-10-01

In the United States, 57,000 children (newborn to 18 years) die annually. Bereaved parents may rely on religious or spiritual beliefs in their grief. The study's purpose was to examine differences in parents' use of spiritual and religious coping practices by gender, race/ethnicity, and religion at 1 and 3 months after infant/ICU death. The sample consisted of 165 bereaved parents, 78% minority. The Spiritual Coping Strategies Scale was used to measure religious and spiritual coping practices, separately. One-way ANOVAs indicated that Black non-Hispanic mothers used significantly more religious coping practices at 3 months than White non-Hispanic mothers. Protestant and Catholic parents used more religious coping practices than the "no" and "other" religion groups at 1 and 3 months. Within the 30 mother-father dyads (paired t-tests), mothers reported significantly greater use of religious coping practices at 1 and 3 months and spiritual coping practices at 3 months than fathers. Religious coping practices were most commonly used by Black mothers and Protestant and Catholic parents. Within dyads, mothers used more spiritual and religious coping practices than fathers. These findings are beneficial for healthcare personnel in providing support to bereaved parents of diverse races/ethnicities and religions. ©2017 American Association of Nurse Practitioners.

Development of the Standards of Reporting of Neurological Disorders (STROND) checklist: A guideline for the reporting of incidence and prevalence studies in neuroepidemiology.

PubMed

Bennett, Derrick A; Brayne, Carol; Feigin, Valery L; Barker-Collo, Suzanne; Brainin, Michael; Davis, Daniel; Gallo, Valentina; Jetté, Nathalie; Karch, André; Kurtzke, John F; Lavados, Pablo M; Logroscino, Giancarlo; Nagel, Gabriele; Preux, Pierre-Marie; Rothwell, Peter M; Svenson, Lawrence W

2015-09-01

Incidence and prevalence studies of neurologic disorders play an important role in assessing the burden of disease and planning services. However, the assessment of disease estimates is hindered by problems in reporting for such studies. Despite a growth in published reports, existing guidelines relate to analytical rather than descriptive epidemiologic studies. There are also no user-friendly tools (e.g., checklists) available for authors, editors, and peer reviewers to facilitate best practice in reporting of descriptive epidemiologic studies for most neurologic disorders. The Standards of Reporting of Neurological Disorders (STROND) is a guideline that consists of recommendations and a checklist to facilitate better reporting of published incidence and prevalence studies of neurologic disorders. A review of previously developed guidance was used to produce a list of items required for incidence and prevalence studies in neurology. A 3-round Delphi technique was used to identify the "basic minimum items" important for reporting, as well as some additional "ideal reporting items." An e-consultation process was then used in order to gauge opinion by external neuroepidemiologic experts on the appropriateness of the items included in the checklist. Of 38 candidate items, 15 items and accompanying recommendations were developed along with a user-friendly checklist. The introduction and use of the STROND checklist should lead to more consistent, transparent, and contextualized reporting of descriptive neuroepidemiologic studies resulting in more applicable and comparable findings and ultimately support better health care decisions. © 2015 American Academy of Neurology.

Horizontal alignment design consistency for rural two-lane highways.

DOT National Transportation Integrated Search

1995-01-01

The state of the practice in highway geometric design consistency was determined through a review of U.S. and foreign geometric design policy, practice, and research. Models, and a menu-driven microcomputer procedure for their use, were developed for...

Evaluation of autopsy and police reports in the investigation of sudden unexplained death in the young.

PubMed

Wilms, Heath R; Midgley, David J; Morrow, Paul; Stables, Simon; Crawford, Jackie; Skinner, Jonathan R

2012-12-01

To evaluate police and autopsy reports in sudden unexplained deaths in 0-40 year olds. A structured, blind review of police and autopsy reports send to a cardiac genetic service from before (February 2006-December 2007) and after (January-December 2009) new best practice guidelines were introduced in Australia and New Zealand was performed. The reviews focused on reporting on: (1) presentation and clinical history, (2) cardiac autopsy, (3) histological tests and toxicology, and (4) detailed examination of coronary arteries. 110 reports were evaluated against the guidelines. 100 % reported location, 95 % activity at time of death, and 84 % some clinical history. Less than 25 % reported on family history, presence/absence of illicit drugs or alcohol, recorded a possible arrhythmic trigger, or history of fits/faints or collapses. Over 95 % listed heart weight, valvular examinations, pulmonary and some myocardial histology. Less than 50 % commented on septal, LV (left ventricle) and RV (right ventricle) wall thickness. Less than 50 % mentioned site of histology samples, or gave specific description of LV or RV histology or conduction system. Toxicology was not mentioned in a third. Histology of coronary arteries was described in only 18 %. Post guidelines reporting increased in some areas, e.g. in 1-40 year olds: antecedent symptoms (22-61 %), number and location of histology samples (0-47 %), and histology of coronary arteries (6-50 %). Most police and autopsy reports fall short of best practice guidelines. They have improved somewhat after the new guidelines were introduced, but need to be more consistent and particularly need to include significant negative findings.

A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation.

PubMed

Sand-Jecklin, Kari; Sherman, Jay

2014-10-01

To quantify quantitative outcomes of a practice change to a blended form of bedside nursing report. The literature identifies several benefits of bedside nursing shift report. However, published studies have not adequately quantified outcomes related to this process change, having either small or unreported sample sizes or not testing for statistical significance. Quasi-experimental pre- and postimplementation design. Seven medical-surgical units in a large university hospital implemented a blend of recorded and bedside nursing report. Outcomes monitored included patient and nursing satisfaction, patient falls, nursing overtime and medication errors. We found statistically significant improvements postimplementation in four patient survey items specifically impacted by the change to bedside report. Nursing perceptions of report were significantly improved in the areas of patient safety and involvement in care and nurse accountability postimplementation. However, there was a decline in nurse perception that report took a reasonable amount of time after bedside report implementation; contrary to these perceptions, there was no significant increase in nurse overtime. Patient falls at shift change decreased substantially after the implementation of bedside report. An intervening variable during the study period invalidated the comparison of medication errors pre- and postintervention. There was some indication from both patients and nurses that bedside report was not always consistently implemented. Several positive outcomes were documented in relation to the implementation of a blended bedside shift report, with few drawbacks. Nurse attitudes about report at the final data collection were more positive than at the initial postimplementation data collection. If properly implemented, nursing bedside report can result in improved patient and nursing satisfaction and patient safety outcomes. However, managers should involve staff nurses in the implementation process and continue to monitor consistency in report format as well as satisfaction with the process. © 2014 John Wiley & Sons Ltd.

Social Impact Assessment: The lesser sibling in the South African EIA process?

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

Hildebrandt, L., E-mail: Leandri.hildebrandt@nwu.ac.za; Sandham, L.A., E-mail: luke.sandham@nwu.ac.za

2014-09-15

Social Impact Assessment has developed as an integral but neglected component of EIA in South Africa since it became mandatory in 1997, and has therefore been referred to as the “orphan” or “lesser sibling” of EIA, as has SIA in the UK and the US. The aim of this paper is to test this claim by reviewing the quality of a sample of SIA reports, and also to establish whether there has been any improvement in quality following the introduction of revised EIA regulations in 2006. The results confirm that SIA can be called “the lesser sibling” due to themore » weak grades achieved in the quality review, but also reveal that there has been a slight and consistent improvement in quality, most likely driven by best practice considerations in the absence of prescriptive regulations for SIA. Suggestions and recommendations for addressing observed weakness in SIA performance are advanced. - Highlights: • The quality of a sample of SIA reports was evaluated using a review package. • SIA reports received mostly weak grades. • Limited improvement observed from first to second regulatory regime. • Improvements most likely due to best practice considerations.« less

Patient-Reported Outcomes in Cancer Drug Development and US Regulatory Review: Perspectives From Industry, the Food and Drug Administration, and the Patient.

PubMed

Basch, Ethan; Geoghegan, Cindy; Coons, Stephen Joel; Gnanasakthy, Ari; Slagle, Ashley F; Papadopoulos, Elektra J; Kluetz, Paul G

2015-06-01

Data reported directly by patients about how they feel and function are rarely included in oncology drug labeling in the United States, in contrast to Europe and to nononcology labeling in the United States, where this practice is more common. Multiple barriers exist, including challenges unique to oncology trials, and industry's concerns regarding cost, logistical complexities, and the Food and Drug Administration's (FDA's) rigorous application of its 2009 guidance on the use of patient-reported outcome (PRO) measures. A panel consisting of representatives of industry, FDA, the PRO Consortium, clinicians, and patients was assembled at a 2014 workshop cosponsored by FDA to identify practical recommendations for overcoming these barriers. Key recommendations included increasing proactive encouragement by FDA to clinical trial sponsors for including PROs in drug development programs; provision of comprehensive PRO plans by sponsors to FDA early in drug development; promotion of an oncology-specific PRO research agenda; development of an approach to existing ("legacy") PRO measures, when appropriate (focused initially on symptoms and functional status); and increased FDA and industry training in PRO methodology. FDA has begun implementing several of these recommendations.

Health professionals responding to men for safety (HERMES): feasibility of a general practice training intervention to improve the response to male patients who have experienced or perpetrated domestic violence and abuse.

PubMed

Williamson, Emma; Jones, Sue K; Ferrari, Giulia; Debbonaire, Thangam; Feder, Gene; Hester, Marianne

2015-05-01

To evaluate a training intervention for general practice-based doctors and nurses in terms of the identification, documentation, and referral of male patients experiencing or perpetrating domestic violence and abuse (DVA) in four general practices in the south west of England. Research suggests that male victims and perpetrators of DVA present to primary care clinicians to seek support for their experiences. We know that the response of primary care clinicians to women patients experiencing DVA improves from training and the establishment of referral pathways to specialist DVA services. The intervention consisted of a 2-h practice-based training. Outcome measures included: a pre-post, self-reported survey of staff practice; disclosures of DVA as documented in medical records pre-post (six months) intervention; semi-structured interviews with clinicians; and practice-level contact data collected by DVA specialist agencies. Results show a significant increase in clinicians' self-reported preparedness to meet the needs of male patients experiencing or perpetrating DVA. There was a small increase in male patients identified within the medical records (6 pre- to 17 post-intervention) but only five of those patients made contact with a specialist DVA agency identified within the referral pathway. The training increased clinicians' confidence in responding to male patients affected by DVA. The increase in recorded identification of DVA male patients experiencing or perpetrating DVA was small and contact of those patients with a specialist DVA support service was negligible. We need to better understand male help seeking in relation to DVA, further develop interventions to increase identification of male patients experiencing or perpetrating DVA behaviours, and facilitate access to support services.

A comparison of the self-reported dry eye practices of New Zealand optometrists and ophthalmologists.

PubMed

Xue, Ally L; Downie, Laura E; Ormonde, Susan E; Craig, Jennifer P

2017-03-01

The aim of this cross-sectional survey was to evaluate the self-reported clinical practices of New Zealand optometrists and ophthalmologists with respect to the diagnosis and management of dry eye disease. It also sought to compare these behaviours with the current research evidence base. An anonymous survey was distributed electronically to New Zealand eye care clinicians (optometrists n = 614, ophthalmologists n = 113) to determine practitioner interest in dry eye disease, practice experience, practice modality, preferred diagnostic and management strategies, and information used to guide patient care. Respondents from both professions (response rates, optometrists: 26%, ophthalmologists: 26%) demonstrated similarly strong knowledge of tear film assessment. Ninety percent of respondents ranked patient symptoms and meibomian gland evaluation as the most valuable and common diagnostic approaches. Conversely, standardised grading scales and validated dry eye questionnaires were infrequently adopted. Both professions tailored dry eye management according to severity, indicating eyelid hygiene and non-preserved lubricants as mainstay therapies. Ophthalmologists prescribed systemic tetracyclines significantly more often than optometrists for moderate (48% vs 11%) and severe (72% vs 32%) dry eye (p < 0.05). Continuing education conferences were acknowledged as the primary information source used to guide dry eye management practices by both professions. Consistent with evidence-based guidelines, New Zealand eye care professionals combine subjective and objective techniques to diagnose and stratify dry eye management according to disease severity. There is potential to improve dissemination of research evidence into clinical practice, with continuing education via professional conferences the favoured mode of delivery. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

Development of an item bank for food parenting practices based on published instruments and reports from Canadian and US parents.

PubMed

O'Connor, Teresia M; Pham, Truc; Watts, Allison W; Tu, Andrew W; Hughes, Sheryl O; Beauchamp, Mark R; Baranowski, Tom; Mâsse, Louise C

2016-08-01

Research to understand how parents influence their children's dietary intake and eating behaviors has expanded in the past decades and a growing number of instruments are available to assess food parenting practices. Unfortunately, there is no consensus on how constructs should be defined or operationalized, making comparison of results across studies difficult. The aim of this study was to develop a food parenting practice item bank with items from published scales and supplement with parenting practices that parents report using. Items from published scales were identified from two published systematic reviews along with an additional systematic review conducted for this study. Parents (n = 135) with children 5-12 years old from the US and Canada, stratified to represent the demographic distribution of each country, were recruited to participate in an online semi-qualitative survey on food parenting. Published items and parent responses were coded using the same framework to reduce the number of items into representative concepts using a binning and winnowing process. The literature contributed 1392 items and parents contributed 1985 items, which were reduced to 262 different food parenting concepts (26% exclusive from literature, 12% exclusive from parents, and 62% represented in both). Food parenting practices related to 'Structure of Food Environment' and 'Behavioral and Educational' were emphasized more by parent responses, while practices related to 'Consistency of Feeding Environment' and 'Emotional Regulation' were more represented among published items. The resulting food parenting item bank should next be calibrated with item response modeling for scientists to use in the future. Copyright © 2016 Elsevier Ltd. All rights reserved.

Success under duress: policies and practices managers view as keys to profitability in five California hospitals with challenging payer mix.

PubMed

Rundall, Thomas; Oberlin, Shelley; Thygesen, Brian; Janus, Katharina

2012-01-01

Hospitals with a challenging payer mix (CPM)-high proportions of uninsured and Medicaid patients and a low proportion of commercially insured patients-are an important source of care for low-income, uninsured people. Achieving profitability is difficult for CPM hospitals. From 2005 through 2008, only one-third of 67 CPM hospitals in California reported positive total margins. In-depth group interviews were completed with the management leadership teams of a diverse group of five profitable CPM hospitals to identify the management strategies and practices that the hospitals' leadership teams credited for their financial success. Twelve management policy and practice topics were identified. Four of the policies and practices that managers identified involve organizational actions to increase hospital revenue or operational efficiency. These factors are consistent with those identified in previous research. However, managers also identified eight factors not previously revealed in research on hospital profitability, including management policies and practices that establish the organizational culture, workforce, relationships, monitoring systems, and governance necessary to ensure that hospital employees and affiliated physicians support and successfully implement organizational actions necessary to achieve profitability.

Do Providers Know What They Do Not Know? A Correlational Study of Knowledge Acquisition and Person-Centered Care.

PubMed

Matthews, Elizabeth B; Stanhope, Victoria; Choy-Brown, Mimi; Doherty, Meredith

2018-07-01

Person-centered care (PCC) is a central feature of health care reform, yet the tools needed to deliver this practice have not been implemented consistently. Person-centered care planning (PCCP) is a treatment planning approach operationalizing the values of recovery. To better understand PCCP implementation, this study examined the relationship between recovery knowledge and self-reported PCCP behaviors among 224 community mental health center staff. Results indicated that increased knowledge decreased the likelihood of endorsing non-recovery implementation barriers and self-reporting a high level of PCCP implementation. Findings suggest that individuals have difficulty assessing their performance, and point to the importance of objective fidelity measures.

Plant-Wide Assessment Report for Shaw Industries, Plant #78; Aiken, SC

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

Michael Brown PE, CEM; Matt Soderlund; Bill Meffert PE

A plant-wide energy assessment sponsored by the U.S. Department of Energy was conducted at Shaw Industries Group, plant #78 in Aiken, SC. The assessment team consisted of Georgia Tech faculty from the Energy & Environmental Management Center and Shaw personnel from plant #78 and the corporate energy group. The purpose of this assessment was to uncover as many opportunities for saving energy usage and costs using techniques that have been established as best practices in the energy engineering field. In addition, these findings are to be shared with similar plants in Shaw Industries Group to multiply the lessons learned. Themore » findings from this assessment are included in this report.« less

Logistical considerations for establishing reliable surgical telementoring programs: a report of the SAGES Project 6 Logistics Working Group.

PubMed

Camacho, Diego R; Schlachta, Christopher M; Serrano, Oscar K; Nguyen, Ninh T

2018-03-30

Surgical telementoring programs (STMPs) as educational tools have consistently demonstrated success in the training of surgeons in a variety of surgical disciplines. The goal of an STMP is to train and educate practicing surgeons by improving or remediating surgical skills or assisting in the safe adoption of new procedures. STMPs may even have a role in assisting with recertification. In 2015, the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) launched the SAGES Telementoring Initiative at the Project 6 Summit. Herein, we provide a report on the SAGES Project 6 Logistics working group and lay out a plan for the recommended logistical framework to carry out an STMP.

Sharing Research Models: Using Software Engineering Practices for Facilitation

PubMed Central

Bryant, Stephanie P.; Solano, Eric; Cantor, Susanna; Cooley, Philip C.; Wagener, Diane K.

2011-01-01

Increasingly, researchers are turning to computational models to understand the interplay of important variables on systems’ behaviors. Although researchers may develop models that meet the needs of their investigation, application limitations—such as nonintuitive user interface features and data input specifications—may limit the sharing of these tools with other research groups. By removing these barriers, other research groups that perform related work can leverage these work products to expedite their own investigations. The use of software engineering practices can enable managed application production and shared research artifacts among multiple research groups by promoting consistent models, reducing redundant effort, encouraging rigorous peer review, and facilitating research collaborations that are supported by a common toolset. This report discusses three established software engineering practices— the iterative software development process, object-oriented methodology, and Unified Modeling Language—and the applicability of these practices to computational model development. Our efforts to modify the MIDAS TranStat application to make it more user-friendly are presented as an example of how computational models that are based on research and developed using software engineering practices can benefit a broader audience of researchers. PMID:21687780

An ethnographic study of nurses' experience with nursing research and its integration in practice.

PubMed

Dupin, Cécile Marie; Borglin, Gunilla; Debout, Christophe; Rothan-Tondeur, Monique

2014-09-01

To report from a study aimed at illuminating how French Registered Nurses experience and engage in nursing research in clinical practice. Nursing research in France is mainly conducted by nurses working at clinical research units rather than by dedicated nurse researchers. Education, i.e. advanced degrees, in the field of nursing research is still in its infancy and not yet consistent with the international context. Outside France, the general perception is that nursing research is a unified part of professional nursing. Consequently, in-depth knowledge about how nurses in a French clinical context might experience and engage in nursing research is still lacking. The design of this study was influenced by an ethnographic approach as described by the French anthropologists Beaud and Weber. Data, participatory observations, field notes and interviews (n = 6) were collected in a teaching hospital between April-August 2012. The field consisted of a wound-care unit and clinical research units. Collected data were analysed based on Beaud and Weber's description of analysis. Three beliefs were identified: being a unified part of a research team, being an integral part of 'crosswise - across' activities and being part of research activities. Commitment to nursing research was strengthened by patient-related issues. Based on this context, nursing research would likely benefit from the support of a naturalized reciprocity between clinical practice and research. © 2014 John Wiley & Sons Ltd.

Raccoon roundworm (Baylisascaris procyonis) as an occupational hazard: 2. Use of personal protective equipment and infection control practices among raccoon rehabilitators.

PubMed

Sapp, S G H; Murray, B; Hoover, E R; Green, G T; Yabsley, M J

2018-03-30

Baylisascaris procyonis, the raccoon roundworm, is a zoonotic ascarid of importance to human and animal health. Wildlife rehabilitators who care for raccoons may be at an increased risk for exposure to the parasite, especially if proper precautions are not taken. In a wider effort to evaluate awareness regarding B. procyonis in the wildlife rehabilitation community, an online survey (38-39 questions) including questions about B. procyonis knowledge and attitudes was developed and administered to wildlife rehabilitators. To assess precautions taken among raccoon rehabilitators, participants who rehabilitated raccoons (n = 447) answered additional questions about use of personal protective equipment (PPE) and infection control practices (ICPs). Reported use of gloves was variable, but hand hygiene was generally consistent. Masks and gowns were seldom used. Part-time or infrequent volunteers and rehabilitators located in the Central, Midwest and Southeast were significantly less likely to report consistent use of PPE. A total knowledge score from the survey was used to predict the likelihood of reporting the use of particular ICPs/PPE. Knowledge score had a highly significant but small effect on the likelihood of prophylactic use of anthelmintics, anthelmintics use for B. procyonis specifically, cleaning appropriately, and using species-dedicated housing. Risk factor analysis was performed on data from a prior serologic survey to evaluate factors associated with exposure to B. procyonis and inconsistent handwashing after contact with live raccoons and their faeces; practising rehabilitation in B. procyonis hyperendemic regions and practising rehabilitation in the western region were significant risk factors for being seropositive. These data further demonstrate that correct PPE/ICPs are critical in mitigating the risk of B. procyonis exposure among raccoon rehabilitators and among other captive species. © 2018 Blackwell Verlag GmbH.

Preventive care in general practice among healthy older New South Wales residents.

PubMed

Harris, Mark F; Islam, Fakhrul Md; Jalaludin, Bin; Chen, Jack; Bauman, Adrian E; Comino, Elizabeth J

2013-06-16

Despite being at high risk, disadvantaged patients may be less likely to receive preventive care in general practice. This study aimed to explore self-reported preventive care received from general practitioners and the factors associated with this by healthy New South Wales (NSW) residents aged 45-74 years. A self-completed questionnaire was sent to 100,000 NSW residents in the 45 and Up cohort study. There was a 60% response rate. After exclusions there were 39,964 participants aged 45-74 years who did not report cardiovascular disease or diabetes. Dichotomised outcome variables were participant report of having had a clinical assessment of their blood pressure (BP), blood cholesterol (BC) or blood glucose (BG), or received advice to eat less high fat food, eat more fruit and vegetables or be more physically active from their GP in the last 12 months. Independent variables included socio-demographic, lifestyle risk factors, health status, access to health care and confidence in self-management. Most respondents reported having had their BP (90.6%), BC (73.9%) or BG (69.4%) assessed. Fewer reported being given health advice to (a)eat less high fat food (26.6%), (b) eat more fruit and vegetables (15.5%) or (c) do more physical activity (19.9%). The patterns of association were consistent with recognised need: participants who were older, less well educated or overweight were more likely to report clinical assessments; participants who were overseas born, of lower educational attainment, less confident in their own self-management, reported insufficient physical activity or were overweight were more likely to report receiving advice. However current smokers were less likely to report clinical assessments; and rural and older participants were less likely to receive diet or physical activity advice. This study demonstrated a gap between reported clinical assessments and preventive advice. There was evidence for inverse care for rural participants and smokers, who despite being at higher risk of health problems, were less likely to report receiving preventive care. This suggests the need for greater effort to promote preventive care for these groups in Australian general practice.

Correlates of risky sexual behaviors in recently traditionally circumcised men from initiation lodges in the Eastern Cape, South Africa.

PubMed

Nyembezi, Anam; Sifunda, Sibusiso; Funani, Itumeleng; Ruiter, Robert A C; Van Den Borne, Bart; Reddy, Priscilla S

This exploratory quantitative study examines past risky sexual behaviors among young men who were circumcised as part of a rite of passage to adulthood embedded within a cultural and traditional belief system in the Eastern Cape Province in South Africa. Following permission from the Eastern Cape House of Traditional Leaders (ECHOTL), individual face-to-face interviews using a structured questionnaire were conducted among 114 initiates. The mean age of the participants was 18.9 years, ranging from 15 to 32 years old. About 79.8% reported already having had sex with a woman prior to initiation. Of those, 89% reported that they ever used condoms when having sex, and 61% reported consistent use. Logistic regression analysis showed that consistent condom use increased with higher educational levels. Those involved in other risky health behaviors (specifically, smoking) were also more likely to report inconsistent condom use. Most participants had positive beliefs about male circumcision and STI/HIV transmission. This study provides a first look at the sexual behaviors of young men at the time of their initiation in adulthood, a process that is intended to make it socially acceptable to initiate sexual relations and highlights a major public health challenge in integrating the protective health benefits of circumcision with indigenous cultural practices.

Syringe Access, Syringe Sharing, and Police Encounters among People Who Inject Drugs in New York City: A Community-Level Perspective

PubMed Central

Beletsky, Leo; Heller, Daliah; Jenness, Samuel M.; Neaigus, Alan; Gelpi-Acosta, Camila; Hagan, Holly

2013-01-01

Background Injection drug user (IDU) experience and perceptions of police practices may alter syringe exchange program (SEP) use or influence risky behaviour. Previously, no community-level data had been collected to identify the prevalence or correlates of police encounters reported by IDUs in the United States. Methods New York City IDUs recruited through respondent-driven sampling were asked about past-year police encounters and risk behaviours, as part of the National HIV Behavioural Surveillance study. Data were analysed using multiple logistic regression. Results A majority (52%) of respondents (n=514) reported being stopped by police officers; 10% reported syringe confiscation. In multivariate modelling, IDUs reporting police stops were less likely to use SEPs consistently (adjusted odds ratio [AOR]=0.59; 95% confidence interval [CI]=0.40–0.89), and IDUs who had syringes confiscated may have been more likely to share syringes (AOR=1.76; 95% CI=0.90–3.44), though the finding did not reach statistical significance. Conclusions Findings suggest that police encounters may influence consistent SEP use. The frequency of IDU-police encounters highlights the importance of including contextual and structural measures in infectious disease risk surveillance, and the need to develop approaches harmonizing structural policing and public health. PMID:23916801

Private provider participation in statewide immunization registries

PubMed Central

Clark, Sarah J; Cowan, Anne E; Bartlett, Diana L

2006-01-01

Background Population-based registries have been promoted as an effective method to improve childhood immunization rates, yet rates of registry participation in the private sector are low. We sought to describe, through a national overview, the perspectives of childhood immunization providers in private practice regarding factors associated with participation or non-participation in immunization registries. Methods Two mailed surveys, one for 264 private practices identified as registry non-participants and the other for 971 identified as registry participants, from 15 of the 31 states with population-based statewide immunization registries. Frequency distributions were calculated separately for non-participants and participants regarding the physician-reported factors that influenced decisions related to registry participation. Pearson chi-square tests of independence were used to assess associations among categorical variables. Results Overall response rate was 62% (N = 756). Among non-participants, easy access to records of vaccines provided at other sites (N = 101, 68%) and printable immunization records (N = 82, 55%) were most often cited as "very important" potential benefits of a registry, while the most commonly cited barriers to participation were too much cost/staff time (N = 36, 38%) and that the practice has its own system for recording and monitoring immunizations (N = 35, 37%). Among registry participants, most reported using the registry to input data on vaccines administered (N = 326, 87%) and to review immunization records of individual patients (N = 302, 81%). A minority reported using it to assess their practice's immunization coverage (N = 110, 29%) or generate reminder/recall notices (N = 54, 14%). Few participants reported experiencing "significant" problems with the registry; the most often cited was cost/staff time to use the registry (N = 71, 20%). Conclusion Most registry participants report active participation with few problems. The problems they report are generally consistent with the barriers anticipated by non-participants, but did not impede participation. Recruitment efforts should focus on demonstrating the benefits of the registry to providers. In addition, many participants are not utilizing the full range of registry features; further study is needed to determine how best to increase use of these features. PMID:16480494

Euthanasia for people with psychiatric disorders or dementia in Belgium: analysis of officially reported cases.

PubMed

Dierickx, Sigrid; Deliens, Luc; Cohen, Joachim; Chambaere, Kenneth

2017-06-23

Euthanasia for people who are not terminally ill, such as those suffering from psychiatric disorders or dementia, is legal in Belgium under strict conditions but remains a controversial practice. As yet, the prevalence of euthanasia for people with psychiatric disorders or dementia has not been studied and little is known about the characteristics of the practice. This study aims to report on the trends in prevalence and number of euthanasia cases with a psychiatric disorder or dementia diagnosis in Belgium and demographic, clinical and decision-making characteristics of these cases. We analysed the anonymous databases of euthanasia cases reported to the Federal Control and Evaluation Committee Euthanasia from the implementation of the euthanasia law in Belgium in 2002 until the end of 2013. The databases we received provided the information on all euthanasia cases as registered by the Committee from the official registration forms. Only those with one or more psychiatric disorders or dementia and no physical disease were included in the analysis. We identified 179 reported euthanasia cases with a psychiatric disorder or dementia as the sole diagnosis. These consisted of mood disorders (N = 83), dementia (N = 62), other psychiatric disorders (N = 22) and mood disorders accompanied by another psychiatric disorder (N = 12). The proportion of euthanasia cases with a psychiatric disorder or dementia diagnosis was 0.5% of all cases reported in the period 2002-2007, increasing from 2008 onwards to 3.0% of all cases reported in 2013. The increase in the absolute number of cases is particularly evident in cases with a mood disorder diagnosis. The majority of cases concerned women (58.1% in dementia to 77.1% in mood disorders). All cases were judged to have met the legal requirements by the Committee. While euthanasia on the grounds of unbearable suffering caused by a psychiatric disorder or dementia remains a comparatively limited practice in Belgium, its prevalence has risen since 2008. If, as this study suggests, people with psychiatric conditions or dementia are increasingly seeking access to euthanasia, the development of practice guidelines is all the more desirable if physicians are to respond adequately to these highly delicate requests.

Meditation Breath Attention Scores (MBAS): Development and investigation of an internet-based assessment of focused attention during meditation practice.

PubMed

Frewen, Paul; Hargraves, Heather; DePierro, Jonathan; D'Andrea, Wendy; Flodrowski, Les

2016-07-01

Meditation Breath Attention Scores (MBAS) represent a self-report, state measure of focused attention (FA) during the practice of meditation. The MBAS assessment procedure involves sounding a bell at periodic intervals during meditation practice, at which times participants indicate if they were attending toward breathing (scored 1) or if instead they had become distracted (e.g., by mind wandering; scored 0); scores are then tallied to yield participants' MBAS for that meditation. The current study developed and evaluated a fully automated and Internet-based version of MBAS in 1,101 volunteers. Results suggested that: (a) MBAS are internally consistent across bell rings; (b) MBAS total scores exhibit a non-normal distribution identifying subgroups of participants with particularly poor or robust FA during meditation; (c) MBAS decrease linearly with the duration of meditation practices, indicating that participants tend to experience less FA later as opposed to earlier in the meditation; (d) in the case of eyes-open meditation, MBAS are higher when the amount of time between bells is shorter; (e) MBAS correlate with various self-reported subjective experiences occurring during meditation; and (f) MBAS are weakly associated with higher trait mindful "acting with awareness," lesser ADHD-related symptoms of inattentiveness, and estimated minutes of meditation practiced in the past month. In sum, results provide further support for the construct validity of MBAS and serve to further characterize the dynamics of individual differences in FA during meditation. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Self-Care in Palliative Care Nursing and Medical Professionals: A Cross-Sectional Survey.

PubMed

Mills, Jason; Wand, Timothy; Fraser, Jennifer A

2017-06-01

Self-care is an important consideration for palliative care professionals. To date, few details have been recorded about the nature or uptake of self-care practices in the palliative care workforce. As part of a broader mixed methods study, this article reports findings from a national survey of nurses and doctors. The objective of this study was to examine perceptions, education, and practices relating to self-care among palliative care nursing and medical professionals. A cross-sectional survey using REDCap software was conducted between April and May 2015. Perceived importance of self-care, self-care education and planning, and self-care strategies most utilized were explored. Descriptive statistics were calculated and content analysis used to identify domains of self-care. Three hundred seventy-two palliative care nursing and medical professionals practicing in Australia. Most respondents regarded self-care as very important (86%). Some rarely practised self-care and less than half (39%) had received training in self-care. Physical self-care strategies were most commonly reported, followed closely by social self-care and inner self-care. Self-care plans had been used by a small proportion of respondents (6%) and over two-thirds (70%) would consider using self-care plans if training could be provided. Self-care is practised across multiple health related domains, with physical self-care strategies used most frequently. Australian palliative care nurses and doctors recognize the importance of self-care practice, but further education and training are needed to increase their understanding of, and consistency in, using effective self-care strategies. These findings carry implications for professional practice and future research.

Doctors' and nurses' perceptions of interdisciplinary collaboration in the NICU, and the impact of a neonatal nurse practitioner model of practice.

PubMed

Copnell, Beverley; Johnston, Linda; Harrison, Denise; Wilson, Anita; Robson, Anne; Mulcahy, Caroline; Ramudu, Louisa; McDonnell, Geraldine; Best, Christine

2004-01-01

The importance of interdisciplinary collaboration has been attested to by a number of authors. Some have suggested that Nurse Practitioners (NPs) may be able to improve collaboration between doctors and nurses, but this assertion does not appear to have been researched. To investigate doctors' and nurses' perceptions of interdisciplinary collaboration in two neonatal intensive care units, and to assess the impact of a Neonatal Nurse Practitioner (NNP) practice model on these perceptions. The study was conducted as part of a larger project to develop a NNP model of practice. Survey, pre- and post-intervention. Medical and nursing staff in both units were surveyed before and after introduction of the NP model of practice. The instrument consisted of 25 statements relating to nurse-doctor interactions, with which respondents indicated their level of agreement on a five-point Likert scale. The Mann-Whitney U-test was used to compare scores for individual items and for overall collaboration between various groups of staff, and between the first and second surveys. Significant differences between the responses of nurses and doctors were found on both surveys. Areas of disagreement chiefly concerned doctors' behaviour and their attitudes towards nurses, rather than nurses' behaviour or environmental factors. Doctors consistently reported a higher degree of collaboration than did nurses. Few differences were found between first and second surveys. Results suggest that problems in nurse-physician interactions exist in both units. No impact of the NNP role, as established in this project, on interdisciplinary collaboration could be demonstrated. Further research in this area is warranted.

Translating knowledge into best practice care bundles: a pragmatic strategy for EBP implementation via moving postprocedural pain management nursing guidelines into clinical practice.

PubMed

Saunders, Hannele

2015-07-01

To describe quantitative and qualitative best evidence as sources for practical interventions usable in daily care delivery in order to integrate best evidence into clinical decision-making at local practice settings. To illustrate the development, implementation and evaluation of a pain management nursing care bundle based on a clinical practice guideline via a real-world clinical exemplar. Successful implementation of evidence-based practice requires consistent integration of best evidence into daily clinical decision-making. Best evidence comprises high-quality knowledge summarised in systematic reviews and translated into guidelines. However, consistent integration of guidelines into care delivery remains challenging, partly due to guidelines not being in a usable form for daily practice or relevant for the local context. A position paper with a clinical exemplar of a nurse-led, evidence-based quality improvement project to design, implement and evaluate a pain management care bundle translated from a national nursing guideline. A pragmatic approach to integrating guidelines into daily practice is presented. Best evidence from a national nursing guideline was translated into a pain management care bundle and integrated into daily practice in 15 medical-surgical (med-surg) units of nine hospitals of a large university hospital system in Finland. Translation of best evidence from guidelines into usable form as care bundles adapted to the local setting may increase implementation and uptake of guidelines and improve quality and consistency of care delivery. A pragmatic approach to translating a nursing guideline into a pain management care bundle to incorporate best evidence into daily practice may help achieve more consistent and equitable integration of guidelines into care delivery, and better quality of pain management and patient outcomes. © 2015 John Wiley & Sons Ltd.

A systematic review of the psychometric properties of self-report research utilization measures used in healthcare

PubMed Central

2011-01-01

Background In healthcare, a gap exists between what is known from research and what is practiced. Understanding this gap depends upon our ability to robustly measure research utilization. Objectives The objectives of this systematic review were: to identify self-report measures of research utilization used in healthcare, and to assess the psychometric properties (acceptability, reliability, and validity) of these measures. Methods We conducted a systematic review of literature reporting use or development of self-report research utilization measures. Our search included: multiple databases, ancestry searches, and a hand search. Acceptability was assessed by examining time to complete the measure and missing data rates. Our approach to reliability and validity assessment followed that outlined in the Standards for Educational and Psychological Testing. Results Of 42,770 titles screened, 97 original studies (108 articles) were included in this review. The 97 studies reported on the use or development of 60 unique self-report research utilization measures. Seven of the measures were assessed in more than one study. Study samples consisted of healthcare providers (92 studies) and healthcare decision makers (5 studies). No studies reported data on acceptability of the measures. Reliability was reported in 32 (33%) of the studies, representing 13 of the 60 measures. Internal consistency (Cronbach's Alpha) reliability was reported in 31 studies; values exceeded 0.70 in 29 studies. Test-retest reliability was reported in 3 studies with Pearson's r coefficients > 0.80. No validity information was reported for 12 of the 60 measures. The remaining 48 measures were classified into a three-level validity hierarchy according to the number of validity sources reported in 50% or more of the studies using the measure. Level one measures (n = 6) reported evidence from any three (out of four possible) Standards validity sources (which, in the case of single item measures, was all applicable validity sources). Level two measures (n = 16) had evidence from any two validity sources, and level three measures (n = 26) from only one validity source. Conclusions This review reveals significant underdevelopment in the measurement of research utilization. Substantial methodological advances with respect to construct clarity, use of research utilization and related theory, use of measurement theory, and psychometric assessment are required. Also needed are improved reporting practices and the adoption of a more contemporary view of validity (i.e., the Standards) in future research utilization measurement studies. PMID:21794144

Clinical terminology support for a national ambulatory practice outcomes research network.

PubMed

Ricciardi, Thomas N; Lieberman, Michael I; Kahn, Michael G; Masarie, F E

2005-01-01

The Medical Quality Improvement Consortium (MQIC) is a nationwide collaboration of 74 healthcare delivery systems, consisting of 3755 clinicians, who contribute de-identified clinical data from the same commercial electronic medical record (EMR) for quality reporting, outcomes research and clinical research in public health and practice benchmarking. Despite the existence of a common, centrally-managed, shared terminology for core concepts (medications, problem lists, observation names), a substantial "back-end" information management process is required to ensure terminology and data harmonization for creating multi-facility clinically-acceptable queries and comparable results. We describe the information architecture created to support terminology harmonization across this data-sharing consortium and discuss the implications for large scale data sharing envisioned by proponents for the national adoption of ambulatory EMR systems.

Clinical Terminology Support for a National Ambulatory Practice Outcomes Research Network

PubMed Central

Ricciardi, Thomas N.; Lieberman, Michael I.; Kahn, Michael G.; Masarie, F.E. “Chip”

2005-01-01

The Medical Quality Improvement Consortium (MQIC) is a nationwide collaboration of 74 healthcare delivery systems, consisting of 3755 clinicians, who contribute de-identified clinical data from the same commercial electronic medical record (EMR) for quality reporting, outcomes research and clinical research in public health and practice benchmarking. Despite the existence of a common, centrally-managed, shared terminology for core concepts (medications, problem lists, observation names), a substantial “back-end” information management process is required to ensure terminology and data harmonization for creating multi-facility clinically-acceptable queries and comparable results. We describe the information architecture created to support terminology harmonization across this data-sharing consortium and discuss the implications for large scale data sharing envisioned by proponents for the national adoption of ambulatory EMR systems. PMID:16779116

Exploring perceptions and experiences of Bolivian health researchers with research ethics.

PubMed

Sullivan, Sarah; Aalborg, Annette; Basagoitia, Armando; Cortes, Jacqueline; Lanza, Oscar; Schwind, Jessica S

2015-04-01

In Bolivia, there is increasing interest in incorporating research ethics into study procedures, but there have been inconsistent application of research ethics practices. Minimal data exist regarding the experiences of researchers concerning the ethical conduct of research. A cross-sectional study was administered to Bolivian health leaders with research experience (n = 82) to document their knowledge, perceptions, and experiences of research ethics committees and infrastructure support for research ethics. Results showed that 16% of respondents reported not using ethical guidelines to conduct their research and 66% indicated their institutions did not consistently require ethics approval for research. Barriers and facilitators to incorporate research ethics into practice were outlined. These findings will help inform a comprehensive rights-based research ethics education program in Bolivia. © The Author(s) 2015.

Diagnosis and management practices for gestational diabetes mellitus in Australia: Cross-sectional survey of the multidisciplinary team.

PubMed

Meloncelli, Nina; Barnett, Adrian; Pelly, Fiona; de Jersey, Susan

2018-04-18

Gestational diabetes mellitus (GDM) is one of the most common pregnancy disorders; however, if well managed, women with GDM experience similar pregnancy outcomes to those without. Currently, there is limited evidence on actual management practices across Australia or how multidisciplinary teams interact to optimise care. To examine the current screening, diagnostic, task and role perceptions and management practices, as reported by members of the GDM multidisciplinary team. A 64-item electronic survey containing multiple choice, Likert scale and open-ended questions was developed for this cross-sectional observational study and advertised through health professional organisations and Queensland Health facilities in May and June, 2017. The 183 survey respondents included 45 diabetes educators, 43 dietitians, 21 endocrinologists/diabetes specialists, 14 obstetricians and 21 midwives. Although almost 90% reported using updated diagnostic guidelines, less than two-thirds used GDM management guidelines. While 68% reported using the same blood glucose targets for GDM management, there was variation to what criteria prompted the commencement of medication to control blood glucose levels. There was a good consensus concerning the health professional responsible for tasks such as medical nutrition therapy, gestational weight gain and self-blood glucose monitoring education and ultrasound use. Other tasks appeared to be the role of almost any member of the GDM multidisciplinary team. The survey results indicate there is a need for consistent evidence on how to best manage GDM and that role identity, access to specialist knowledge and best practice need to be clearly defined within GDM models of care. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Personality, gender and medico-legal matters in medical practice.

PubMed

Nash, Louise; Daly, Michele; Johnson, Maree; Coulston, Carissa; Tennant, Chris; van Ekert, Elizabeth; Walter, Garry; Willcock, Simon; Walton, Merrilyn

2009-02-01

The aim of this paper was to explore the relationship between the personality traits of Australian General Practitioners (GPs) and their gender, work practice arrangements, and history of medico-legal matters. A cross-sectional self report survey was mailed to 1239 GPs. There were 566 respondents (45.7% response rate to survey). The survey assessed personality traits (using the Eysenck Personality Questionnaire), demographic and practice information, and history of medico-legal matters with any medical defence organization. The number and type of medico-legal matters was also extracted from the UNITED Medical Protection database. Male respondents had significantly higher psychoticism scores than females (p<0.001), and females had significantly higher neuroticism scores than males (p<0.01), as in community samples. However, for GPs who worked more than 48 hours per week, there were no gender differences in personality trait scores. Solo practitioners and non-solo practitioners did not differ on personality scores. Proceduralists and non-proceduralists did not differ on personality scores. However, a higher proportion of proceduralists experienced a medico-legal matter than non-proceduralists (p<0.001). There was a positive correlation between extraversion scores and doctors who attended peer review (p<0.001). There was no difference in the numbers of medico-legal matters for doctors who attended peer review. Males who self reported a medico-legal matter had higher neuroticism scores than the males who did not report medico-legal matters. This was not the case for females. For males, this pattern was not replicated when considering data from UNITED. The known demographic and practice factors that differ for doctors having a medico-legal matter are replicated here--being male, a proceduralist and working longer hours. There is not a consistent pattern regarding personality traits and medico-legal matters.

Sugar-Fat Seesaw: A Systematic Review of the Evidence

PubMed Central

Sadler, Michele Jeanne; McNulty, Helene; Gibson, Sigrid

2015-01-01

Further to reports of a reciprocal relationship between sugar and fat intakes, this review aimed to provide an in-depth analysis and to determine the likely influence of this relationship on the achievement of population dietary guidelines. Using systematic methods, relevant literature was selected according to preset criteria. A strong and consistent inverse association was found between total sugars and total fat intakes expressed as percentage energy. Fewer studies considered absolute intakes and these reported a positive relationship, which may be influenced by confounding with energy intakes. Evidence for an inverse relationship between percentage energy from fat and extrinsic sugars was weaker and less consistent than for fat and total sugars. Reciprocal relationships were also observed for sugar-saturated fat, sugar−protein, sugar−alcohol, and sugar−starch expressed as percentage energy. Under-reporting of dietary intakes had no major influence on the findings. This review confirms the existence of the sugar−fat seesaw on a percentage energy basis and concludes that it is most likely explained by a combination of mathematical and food compositional effects. This finding is relevant because dietary guidelines are expressed as percentage energy and implies that at the population level multiple guidelines may be difficult to achieve in practice. PMID:24915391

The effect of improving primary care depression management on employee absenteeism and productivity. A randomized trial.

PubMed

Rost, Kathryn; Smith, Jeffrey L; Dickinson, Miriam

2004-12-01

To test whether an intervention to improve primary care depression management significantly improves productivity at work and absenteeism over 2 years. Twelve community primary care practices recruiting depressed primary care patients identified in a previsit screening. Practices were stratified by depression treatment patterns before randomization to enhanced or usual care. After delivering brief training, enhanced care clinicians provided improved depression management over 24 months. The research team evaluated productivity and absenteeism at baseline, 6, 12, 18, and 24 months in 326 patients who reported full-or part-time work at one or more completed waves. Employed patients in the enhanced care condition reported 6.1% greater productivity and 22.8% less absenteeism over 2 years. Consistent with its impact on depression severity and emotional role functioning, intervention effects were more observable in consistently employed subjects where the intervention improved productivity by 8.2% over 2 years at an estimated annual value of US 1982 dollars per depressed full-time equivalent and reduced absenteeism by 28.4% or 12.3 days over 2 years at an estimated annual value of US 619 dollars per depressed full-time equivalent. This trial, which is the first to our knowledge to demonstrate that improving the quality of care for any chronic disease has positive consequences for productivity and absenteeism, encourages formal cost-benefit research to assess the potential return-on-investment employers of stable workforces can realize from using their purchasing power to encourage better depression treatment for their employees.

Determinants of Behavior Change Intention Among Heterosexual Thai Males Diagnosed with Sexually Transmitted Diseases.

PubMed

Thato, Ratsiri; Daengsaard, Ekkachai

2016-11-01

This study sought to identify factors associated with intention to change sexual practices among heterosexual Thai males diagnosed with sexually transmitted infections (STIs). STI clinic patients (n = 247) reported their sexual behaviors and condom use during the previous 3 months. STI and HIV knowledge, motivation to change sexual practices, and behavioral skills were assessed. Then, self-reported behavior change intention, including consistent condom use, reducing number of sexual partners, not using drugs and alcohol when having sex, and refusal of condomless sex, was examined. Consistent condom use in the past 3 months by Thai males diagnosed with STIs was low across all types of sexual partners (lover 13.8%, casual partner 14.9%, and sex worker 2.5%). Risk reduction self-efficacy (p < 0.001), perceived benefits from condom use (p < 0.001), perceived barriers to condom use (p < 0.001), perceived risk for HIV (p < 0.05), and STI and HIV knowledge (p < 0.05) were significantly correlated with behavior change intention. Significant predictors of behavior change intention were risk reduction self-efficacy (p < 0.001), perceived benefits of condom use (p = 0.016), and perceived risk for HIV (p = 0.033). They explained 36% of behavior change intention variance. Intervention aimed at enhancing motivation and behavioral skills to adopt preventive behaviors should be developed to prevent recurrent STIs, including HIV infection, among heterosexual Thai males diagnosed with STIs.

Impact of a dedicated cancer-associated thrombosis service on clinical outcomes: a mixed-methods evaluation of a clinical improvement exercise

PubMed Central

Noble, Simon; Pease, Nikki; Sui, Jessica; Davies, James; Lewis, Sarah; Malik, Usman; Alikhan, Raza; Prout, Hayley; Nelson, Annmarie

2016-01-01

Objectives Cancer-associated thrombosis (CAT) complex condition, which may present to any healthcare professional and at any point during the cancer journey. As such, patients may be managed by a number of specialties, resulting in inconsistent practice and suboptimal care. We describe the development of a dedicated CAT service and its evaluation. Setting Specialist cancer centre, district general hospital and primary care. Participants Patients with CAT and their referring clinicians. Intervention A cross specialty team developed a dedicated CAT service , including clear referral pathways, consistent access to medicines, patient's information and a specialist clinic. Primary and secondary outcome measures The service was evaluated using a mixed-methods evaluation , including audits of clinical practice, clinical outcomes, staff surveys and qualitative interviewing of patients and healthcare professionals. Results Data from 457 consecutive referrals over an 18-month period were evaluated. The CAT service has led to an 88% increase in safe and consistent community prescribing of low-molecular-weight heparin, with improved access to specialist advice and information. Patients reported improved understanding of their condition, enabling better self-management as well as better access to support and information. Referring clinicians reported better care standards for their patients with improved access to expertise and appropriate management. Conclusions A dedicated CAT service improves overall standards of care and is viewed positively by patients and clinicians alike. Further health economic evaluation would enhance the case for establishing this as the standard model of care. PMID:27895068

Geology of Wisconsin: Survey of 1873-1879, Volume I

USGS Publications Warehouse

Chamberlin, T.C.

1883-01-01

The leading purpose df this volume was determined by the following enactment, being section 1, chapter 121, of the Laws of 1876. "The people of the State of Wisconsin, represented in Senate and Assembly, do enact as follows: Section 1. That in the preparation of his final report, the chief geologist be, and he is hereby authorized to collate the general geology and the leading facts and principles relating to the material resources of the State, together with practical suggestions as to the methods of detecting and utilizing the same, so as to constitute the material for a volume suited to the wants of explorers, miners, land owners, and manufacturers, who use crude native products, and to the needs of the schools of the State, and the masses of intelligent people who are not familiar with the principles of geology; said volume to be written in clear, plain language, with explanations of technical terms, and to be properly illustrated with maps and diagrams, and to be so arranged as to constitute a key to the more perfect understanding of the whole report." To subserve the purposes thus legally defined, the volume will be found to consist of three distinct portions; Part I, embracing the General Geology of the State, with explanatory matter; Part II, consisting of lists of the minerals, rocks and life-products of the State, with descriptions and auxiliary discussions; and Part III, embracing industrial descriptions and practical suggestions with reference to the leading natural resources of the State.

Verification of adolescent self-reported smoking.

PubMed

Kentala, Jukka; Utriainen, Pekka; Pahkala, Kimmo; Mattila, Kari

2004-02-01

Smoking and the validity of information obtained on it is often questioned in view of the widespread belief that adolescents tend to under- or over-report the habit. The aim here was to verify smoking habits as reported in a questionnaire given in conjunction with dental examinations by asking participants directly whether they smoked or not and performing biochemical measurements of thiocyanate in the saliva and carbon monoxide in the expired air. The series consisted of 150 pupils in the ninth grade (age 15 years). The reports in the questionnaires seemed to provide a reliable estimate of adolescent smoking, the sensitivity of the method being 81-96%, specificity 77-95%. Biochemical verification or control of smoking proved needless in normal dental practice. Accepting information offered by the patient provides a good starting point for health education and work motivating and supporting of self-directed breaking of the habit.

Towards good dementia care: Awareness and uptake of an online Dementia Pathways tool for rural and regional primary health practitioners.

PubMed

Ollerenshaw, Alison; Wong Shee, Anna; Yates, Mark

2018-04-01

To explore the awareness and usage of an online dementia pathways tool (including decision tree and region-specific dementia services) for primary health practitioners (GPs and nurses) in regional Victoria. Quantitative pilot study using surveys and Google Analytics. A large regional area (48 000 square kilometres, population 220 000) in Victoria. Two hundred and sixty-three GPs and 160 practice nurses were invited to participate, with 42 respondents (GPs, n = 21; practice nurses, n = 21). Primary care practitioners' awareness and usage of the dementia pathways tool. Survey respondents that had used the tool (n = 14) reported accessing information about diagnosis, management and referral. Practitioners reported improvements in knowledge, skills and confidence about core dementia topics. There were 9683 page views between August 2013 and February 2015 (monthly average: 509 page views). The average time spent on page was 2.03 min, with many visitors (68%) spending more than 4 min at the site. This research demonstrates that the tool has been well received by practitioners and has been consistently used since its launch. Health practitioners' valued the content and the availability of local resources. Primary health practitioners reported that the dementia pathways tool provided access to region-specific referral and management resources for all stages of dementia. Such tools have broad transferability in other health areas with further research needed to determine their contribution to learning in the practice setting and over time. © 2017 National Rural Health Alliance Inc.

Self-Regulation of Driving Behavior in People with Parkinson Disease.

PubMed

Stolwyk, Renerus J; Scally, Karen A; Charlton, Judith L; Bradshaw, John L; Iansek, Robert; Georgiou-Karistianis, Nellie

2015-06-01

To determine the extent and nature of driving self-regulation in drivers with Parkinson disease (PD) and factors associated with self-regulatory practices. Although people with PD have consistently been shown to have driving impairments, few studies have examined self-regulatory driving practices and their relationship to driving performance. We used a self-report driving questionnaire to examine driving self-regulation in 37 drivers with PD and 37 healthy age-matched controls. We also analyzed factors associated with self-regulatory practices, primarily demographic, disease-related, psychological, and simulated driving performance variables. The drivers with PD reported significantly higher rates of self-perceived decline in their driving ability (P=0.008) and driving significantly shorter distances per week (P=0.004) than controls. Unfamiliar situations (P=0.009), in-car distractions (P<0.001), low visibility conditions (P=0.004), and long journeys (P=0.003) were particularly challenging for the drivers with PD, and their pattern of driving avoidance mirrored these difficulties. The use of self-regulatory strategies among drivers with PD was associated with female sex (rho=0.42, P=0.009) and perceived decline in driving ability (rho=-0.55, P<0.001), but not with age or objective measures of disease severity, cognition, or simulated driving performance. Drivers with PD reported driving less overall and restricting their driving to avoid particularly difficult circumstances. Further research is warranted on effective use of self-regulation strategies to improve driving performance in people with PD.

The knowledge and attitude of the Turkish community pharmacists toward pharmacovigilance in the Kadikoy district of Istanbul.

PubMed

Toklu, Hale Zerrin; Uysal, Meral Keyer

2008-10-01

We investigated the knowledge and attitudes of community pharmacists towards pharmacovigilance and adverse drug reactions (ADRs) in Kadiköy district of Istanbul (Turkey). The community pharmacies in Kadikoy. Kadikoy is one of the biggest districts of Istanbul and has the largest number of pharmacies. Kadikoy district was divided into two regions, the central and the peripheral. Between December 2005 and June 2006 we conducted a survey about the knowledge and attitude of community pharmacists (n = 219) using a face-to-face questionnaire. The questionnaire consisted of questions about the sociodemographic characteristics of the pharmacists, their knowledge of pharmacovigilance and their attitudes towards ADR reporting. The knowledge of pharmacovigilance practice, ADR reporting compliance rates, reasons for not reporting ADR and perceptions of the Turkish community pharmacists on pharmacovigilance practice were evaluated. Although all 411 pharmacies in the Kadikoy district were visited, only 53% of the community pharmacists (n = 219) consented to participate in the study. Of those that did respond, only 17.2% of the pharmacists had any knowledge about 'pharmacovigilance'. Sixty-five percent of the pharmacists stated that patients reported an ADR to them during the previous 12 months, and 21% of pharmacists reported to the concerned organizations. Our survey showed that only 7% actually reported an ADR to the national pharmacovigilance center. On the other hand, 89% of the pharmacists believed that the role of the pharmacist in ADR reporting was essential. The results show that Turkish community pharmacists have poor knowledge about pharmacovigilance. There is an urgent need for educational programs to train them about pharmacovigilance and ADR reporting.