Making Meaning with Friends: Exploring the Function, Direction and Tone of Small Group Discussions of Literature in Elementary School Classrooms

ERIC Educational Resources Information Center

Peterson, Katie

2016-01-01

The merits of decentralized small groups has been questioned in literature and by practicing teachers; thus this study shows the academic and identity work children do as they attempt to make meaning in these spaces. This study explores the affordances and drawbacks of decentralized small group discussion contexts in a multiage (3rd/4th) grade…

Group practice--trend for the future.

PubMed

Furumoto, H H

1983-11-01

Group practices in various forms and combinations appear to set the trend for small animal practice management. By pooling their financial resources, energies, and talents, veterinarians can share the burden of increasing overhead costs and enjoy the benefits of specialization, new technologies, continuing education, consultations and referrals, peer review, applied research and publication, and fringe benefits such as paid vacation and sick leave, profit sharing, and pension. Group practices preserve ownership continuity at fair market value and afford opportunities for the utilization of expert business consultants. There are prerequisites to establishing a successful group practice: An adequate personal income base, a sufficient pet population, and business associates with compatible practice philosophy. Special considerations must be given to the social, economic, and psychological forces at work in a group practice environment. Professional and personal interactions can make or break a group practice. The group concept, MIP treatment of clients and their pets, and personalized appointments are important features which must be emphasized. The law of supply and demand and the law of diminishing returns must be kept in focus at all times. In tandem, they dictate the fortunes of all business enterprises and group practices can be particularly vulnerable to them. Long-term business commitment is a condition of group practice ownership and may pose a conflict with other interests. A predetermined buy-sell agreement and deferred compensation plan may provide the answer in case of dissolution, termination, or early retirement. A system of animal and material transport and transfer of business transactions and medical records must be set up between satellite clinics and the base hospital. A hospital-owned-and-operated shuttle service appears to offer the greatest flexibility and convenience. Cost-effectiveness of a shuttle service depends on the volume of referral cases generated for the base hospital. Computers may provide the answer to rapid and reliable transfer of data between satellite clinics and central or base hospitals in the near future. New approaches to small animal medicine and practice management must be explored and adopted. Prepaid pet medical insurance seems to be the answer to rapidly growing sophistication and escalating cost of small animal patient care. Human and companion animal interactions have been given a fresh impetus by veterinary educators, clinical psychologists, psychiatrists, humane societies, organizations for the mentally and physically handicapped, gerontologic centers, and others.(ABSTRACT TRUNCATED AT 400 WORDS)

Managed Care, Time Pressure, and Physician Job Satisfaction: Results from the Physician Worklife Study

PubMed Central

Linzer, Mark; Konrad, Thomas R; Douglas, Jeffrey; McMurray, Julia E; Pathman, Donald E; Williams, Eric S; Schwartz, Mark D; Gerrity, Martha; Scheckler, William; Bigby, JudyAnn; Rhodes, Elnora

2000-01-01

OBJECTIVE To assess the association between HMO practice, time pressure, and physician job satisfaction. DESIGN National random stratified sample of 5,704 primary care and specialty physicians in the United States. Surveys contained 150 items reflecting 10 facets (components) of satisfaction in addition to global satisfaction with current job, one's career and one's specialty. Linear regression–modeled satisfaction (on 1–5 scale) as a function of specialty, practice setting (solo, small group, large group, academic, or HMO), gender, ethnicity, full-time versus part-time status, and time pressure during office visits. “HMO physicians” (9% of total) were those in group or staff model HMOs with>50% of patients capitated or in managed care. RESULTS Of the 2,326 respondents, 735 (32%) were female, 607 (26%) were minority (adjusted response rate 52%). HMO physicians reported significantly higher satisfaction with autonomy and administrative issues when compared with other practice types (moderate to large effect sizes). However, physicians in many other practice settings averaged higher satisfaction than HMO physicians with resources and relationships with staff and community (small to moderate effect sizes). Small and large group practice and academic physicians had higher global job satisfaction scores than HMO physicians (P < .05), and private practice physicians had quarter to half the odds of HMO physicians of intending to leave their current practice within 2 years (P < .05). Time pressure detracted from satisfaction in 7 of 10 satisfaction facets (P < .05) and from job, career, and specialty satisfaction (P < .01). Time allotted for new patients in HMOs (31 min) was less than that allotted in solo (39 min) and academic practices (44 min), while 83% of family physicians in HMOs felt they needed more time than allotted for new patients versus 54% of family physicians in small group practices (P < .05 after Bonferroni's correction). CONCLUSIONS HMO physicians are generally less satisfied with their jobs and more likely to intend to leave their practices than physicians in many other practice settings. Our data suggest that HMO physicians' satisfaction with staff, community, resources, and the duration of new patient visits should be assessed and optimized. Whether providing more time for patient encounters would improve job satisfaction in HMOs or other practice settings remains to be determined. PMID:10940129

Scottish pharmacists' perceptions and experiences of a practice-based small group learning pilot: a qualitative study.

PubMed

Cunningham, David E; Zlotos, Leon; Power, Ailsa

2014-05-01

CPD is an important feature of healthcare professions and regulatory bodies consider it mandatory. Studies of CPD activity of pharmacists showed that 10% were undertaking no CPD. Practice-based small group learning (PBSGL) is a well-received and popular learning resource for GPs in Scotland. From 2011, a pharmacy pilot was undertaken: pharmacists were trained as peer-facilitators and existing PBSGL modules were adapted. Four NHS boards took part and this study aimed to explore the perceptions and experiences of pharmacists. A qualitative research approach was adopted using focus groups and in-depth interviews. Interviews were audio-recorded and transcriptions made. Transcripts were coded and themes developed using grounded theory methods. Participants welcomed PBSGL: it was a feasible learning method, acceptable and had educational impact. They appreciated its interactive nature and discussions founded on their experiences in practice. Participants liked the self-reliance of PBSGL in that they were not dependent on specialist practitioners. There were logistical challenges that impacted on the success of group discussion; some pharmacists were less familiar with small group work. Pharmacists felt isolated during work and appreciated peer discussion. There was a tentative welcome to inter-professional learning but group composition and module topics might impact on the success of this. Pharmacists were able to change their learning practice in uni-professional PBSGL groups and were able to learn from each other. There may be further learning opportunities if pharmacists participate in inter-professional groups.

Effects of Lecture, Teacher Demonstrations, Discussion and Practical Work on 10th Graders' Attitudes to Chemistry and Understanding of Electrolysis.

ERIC Educational Resources Information Center

Thompson, Jerome; Soyibo, Kola

2002-01-01

Investigates whether the use of the combination of lecture, teacher demonstrations, class discussion, and student practical work in small groups significantly improved experimental subjects' attitudes to chemistry and understanding of electrolysis more than their control group counterparts who were not exposed to practical work. Examines whether…

Sense of Community in Academic Communities of Practice: Predictors and Effects

ERIC Educational Resources Information Center

Nistor, Nicolae; Daxecker, Irene; Stanciu, Dorin; Diekamp, Oliver

2015-01-01

Sense of community (SoC) in communities of practice (CoP) seems to play a similar role to that of group cohesion in small groups: Both sustain participants' knowledge sharing, which in turn substantiates the socio-cognitive structures that make up the CoP such as scholar identities, practical repertoires in research and teaching or relationships…

Developing leadership: management skills for small group practices.

PubMed

Brechbill, D D

1998-01-01

The role of group administrators is changing as quickly as is the group practice environment. The results of a survey of physicians and administrators in physician-owned group practices with fewer than 15 physicians offers some guidance. Physicians and administrators, the results show, have similar expectations for administrators. They also agree that physician-administrator teamwork has become more professional. The results also suggest that administrators need the tools to be proactive planners for their organizations, rather than passively responding to change.

Small-Group Standardized Patient Encounter Improves Athletic Training Students' Psychosocial Intervention and Referral Skills

ERIC Educational Resources Information Center

Walker, Stacy E.; Weidner, Thomas G.; Thrasher, Ashley B.

2016-01-01

Context: Athletic trainers provide psychological support, counseling, intervention, and referral to patients during clinical practice. However, students are rarely exposed to real-life opportunities to develop these skills. Objective: To determine if a small-group standardized patient (SP) encounter improved athletic training students'…

Biotechnology Apprenticeship for Secondary-Level Students: Teaching Advanced Cell Culture Techniques for Research.

ERIC Educational Resources Information Center

Lewis, Jennifer R.; Kotur, Mark S.; Butt, Omar; Kulcarni, Sumant; Riley, Alyssa A.; Ferrell, Nick; Sullivan, Kathryn D.; Ferrari, Mauro

2002-01-01

Discusses small-group apprenticeships (SGAs) as a method for introducing cell culture techniques to high school participants. Teaches cell culture practices and introduces advance imaging techniques to solve various biomedical engineering problems. Clarifies and illuminates the value of small-group laboratory apprenticeships. (Author/KHR)

Occupational Choice Strategy: A Small Group Vocational Counseling Program. Participant's Workbook.

ERIC Educational Resources Information Center

Schriner, Kay Fletcher; Roessler, Richard T.

The student workbook is part of the Occupational Choice Strategy (OCS) small group vocational counseling program. OCS incorporates: (1) concise occupational information easily accessed by the participants, (2) assessment methods that clarify a client's self-picture and vocational potential, (3) opportunities to practice decision-making and…

Children as Playtime Monitors: What It Means for the Monitor

ERIC Educational Resources Information Center

Sharma-Stray, Leela; Creasy, Rob

2013-01-01

Although many schools within the United Kingdom adopt practices, such as the use of prefects or playtime monitors, there is very little research that explores how such practices are experienced by children who take on these roles. This small-scale study explores the experiences of a small group of children who volunteered to be playtime monitors…

Deming, quality and the small medical group administrator.

PubMed

Noll, D C

1992-01-01

As administrators, writes Douglas Noll, we can coordinate and implement quality measures affecting our practices and which impact the patient's total medical experience. Unfortunately, many smaller groups cannot hire an outside consultant or single employee whose sole purpose would be to monitor quality. Noll offers several simple practices that administrators can use to improve the quality of service in their groups.

Workplace relational factors and physicians' intention to withdraw from practice.

PubMed

Masselink, Leah E; Lee, Shoou-Yih D; Konrad, Thomas R

2008-01-01

Physician turnover threatens continuity of care for patients and is a huge expense for health care organizations. Health care organizations have been advised to help physicians build positive relations with colleagues, staff, and patients as a strategy to socially integrate physicians in the workplace and to increase physician retention. Although these recommendations are touted as "evidence-based" practices, the importance of workplace relationships for physician retention has not been established empirically. The purpose of this study is to examine two questions: Are physicians who report better relationships with colleagues, staff, and patients less likely to intend to withdraw from practice? Do the effects of these relational factors differ for large-group and solo/small-group practice physicians? Using data from the Physician Worklife Survey, we analyzed the associations between physicians' reported relationships with colleagues, staff, and patients and intention to withdraw from practice within 2 years using logistic regression. : Relationships with colleagues had a significant and negative association with intended withdrawal from practice for large-group practice physicians. The joint effect of relationships with colleagues, staff, and patients was significant for large-group practice physicians, but it only approached significance for solo/small-group practice physicians. This study suggests that workplace relationships may influence physicians' intention to withdraw from practice, but the mechanisms by which they do so are unclear. Possible interventions to improve physician retention include promotion of informal mentoring and efforts to support community involvement of physicians and their families. Further research examining the role of these and other programs in promoting physician retention can help employers to foster positive workplace relationships and improve retention.

Developing Statistical Physics Course Handout on Distribution Function Materials Based on Science, Technology, Engineering, and Mathematics

NASA Astrophysics Data System (ADS)

Riandry, M. A.; Ismet, I.; Akhsan, H.

2017-09-01

This study aims to produce a valid and practical statistical physics course handout on distribution function materials based on STEM. Rowntree development model is used to produce this handout. The model consists of three stages: planning, development and evaluation stages. In this study, the evaluation stage used Tessmer formative evaluation. It consists of 5 stages: self-evaluation, expert review, one-to-one evaluation, small group evaluation and field test stages. However, the handout is limited to be tested on validity and practicality aspects, so the field test stage is not implemented. The data collection technique used walkthroughs and questionnaires. Subjects of this study are students of 6th and 8th semester of academic year 2016/2017 Physics Education Study Program of Sriwijaya University. The average result of expert review is 87.31% (very valid category). One-to-one evaluation obtained the average result is 89.42%. The result of small group evaluation is 85.92%. From one-to-one and small group evaluation stages, averagestudent response to this handout is 87,67% (very practical category). Based on the results of the study, it can be concluded that the handout is valid and practical.

Defending the solo and small practice neurologist.

PubMed

Jones, Elaine C; Evans, David A

2015-04-01

Changes in health care are having a dramatic effect on the practice of medicine. In 2005, a National Center for Health Statistics survey showed that 55%-70% of physicians are in small/solo practices. These data also demonstrated that 70% of physicians identified themselves as owners. Since passage of the Affordable Care Act (ACA) in 2010, neurologists report an 8% increase in academic practice settings, a 2% decrease in private practice settings, and a 5% decrease in solo practice settings. Surveys of family physicians showed that 60% are now employees of hospitals or larger groups. A survey by The Physicians Foundation showed that 89% of physicians believed that the traditional model of independent private practice is either "on shaky ground" or "a dinosaur soon to go extinct." With the changes expected from the ACA, solo/small practices will continue to face challenges and therefore must pay close attention to business and clinical metrics.

Small group effectiveness during pharmacology learning sessions in a Nepalese medical school.

PubMed

Shankar, Pr; Gurung, Sb; Jha, N; Bajracharya, O; Karki, Bms; Thapa, Tp

2011-01-01

Small group learning sessions are used in pharmacology at the KIST Medical College, Lalitpur, Nepal. Feedback about student behaviours that enhance and hinder small group effectiveness was obtained. This will help us improve the small group sessions and will also be useful to educators using small groups in other medical schools. The small groups were self-managing with a group leader, time-keeper, recorder and presenter. Small group effectiveness was measured using the Tutorial Group Effectiveness Instrument (TGEI) developed by Singaram and co-authors. The instrument was administered in June 2010 and key findings obtained were shared with students and facilitators. The instrument was administered again in August. The mean cognitive, motivational, demotivational and overall scores were compared among different categories of respondents in June and August. Scores were also compared between June and August 2010. A total of 89 students participated in the study in June and 88 in August 2010. In June, females rated overall group productivity higher compared to males. The cognitive and motivational scores were higher in August 2010 while the demotivational score was lower. The small group effectiveness was higher in August after the educational intervention which utilised feedback about problems observed, theoretical considerations of effective small groups and how this information can be applied in practice.

Teaching Softly in Hard Environments: Meanings of Small-Group Reflective Teaching to Clinical Faculty

ERIC Educational Resources Information Center

Whiting, Ellen; Wear, Delese; Aultman, Julie M.; Zupp, Laurie

2012-01-01

A vast literature exists on teaching reflection and reflective practice to trainees in small groups, yet with few exceptions the literature does not address the benefits of these interactions to faculty. Like multiculturalism or cultural competency, the literature assumes that faculty have themselves "achieved" these propensities and…

Assessing and Predicting Small-Group Literacy Instruction in Early Childhood Classrooms

ERIC Educational Resources Information Center

Farley, Kristin Sue; Piasta, Shayne; Dogucu, Mine; O'Connell, Ann

2017-01-01

Research Findings: The present study assessed the extent to which early childhood educators utilized small-group literacy instruction and explored factors potentially associated with the use of this evidence-based practice. The classroom activities of 83 early childhood educators were observed in the fall and spring, and videos were coded to…

Oregon department of transportation small business group twice-monthly payments pilot project : summary report.

DOT National Transportation Integrated Search

2008-07-01

Oregon Department of Transportation (ODOT) recently completed a pilot study on small business payment practices. In the study, three pilot projects were tested where payments to small business contractors were changed from a monthly payment to twice-...

Whole-Class Scaffolding for Learning to Solve Mathematics Problems Together in a Computer-Supported Environment

ERIC Educational Resources Information Center

Abdu, Rotem; Schwarz, Baruch; Mavrikis, Manolis

2015-01-01

We investigate teachers' practices in a whole-class context when they scaffold students' learning in situations where students use technologies that facilitate group learning to solve mathematical problems in small groups. We describe teachers' practices in order to evaluate their contribution to "Whole-Class Scaffolding" in the context…

Teachers' Responses to Using a Small-Group Delivery Method during Reading Instruction: A Qualitative Approach

ERIC Educational Resources Information Center

Reynolds, Dorothy M. Valentine

2010-01-01

The purpose of this research was to examine teachers' perspectives on transitioning from a predominately whole to small-group delivery method during reading instruction. This study used a qualitative approach and nested itself in an epistemology of constructivism. The research operated under the umbrella of practice ethnography as it closely…

Defense Cybersecurity: Opportunities Exist for DOD to Share Cybersecurity Resources with Small Businesses

DTIC Science & Technology

2015-09-01

risk self- Communications identified by small businesses . The guidance Commission includes links to addit ional cybersecurity resources...Working Group 4: Final Report. The report’s appendix provides cybersecurity risk management and best practice recommendations for small and medium...including small businesses . Cybersecurity education for risk assessment and planning. These programs provide education and training that small

Using Cooperative Small Groups in Introductory Accounting Classes: A Practical Approach.

ERIC Educational Resources Information Center

Miglietti, Cynthia

2002-01-01

Effective use of cooperative learning groups requires the following: attention to group formation, orientation that sets clear expectations and guidelines, activities to develop teamwork skills, peer evaluation, and other assessments that recognize and measure individual effort on group projects. (SK)

STORMWATER BEST MANAGEMENT PRACTICES DESIGN GUIDE VOLUME 3 - BASIN BEST MANAGEMENT PRACTICES

EPA Science Inventory

This manual provides design guidelines for a group of stormwater management (SWM) best management practices (BMPs) broadly referred to as basin or pond BMPs. Basin BMPs are the mainstay of stormwater management. Water resources engineers have designed small and large ponds for ma...

Meditation

MedlinePlus

... of anxiety in the meditation groups compared to control groups. In a small, NCCIH-funded study, 54 adults ... Practice . 2003;17(6):309–319. Cardoso R, de Souza E, Camano L, et al. Meditation in ...

Prescribing Data in General Practice Demonstration (PDGPD) project--a cluster randomised controlled trial of a quality improvement intervention to achieve better prescribing for chronic heart failure and hypertension.

PubMed

Williamson, Margaret; Cardona-Morrell, Magnolia; Elliott, Jeffrey D; Reeve, James F; Stocks, Nigel P; Emery, Jon; Mackson, Judith M; Gunn, Jane M

2012-08-23

Research literature consistently documents that scientifically based therapeutic recommendations are not always followed in the hospital or in the primary care setting. Currently, there is evidence that some general practitioners in Australia are not prescribing appropriately for patients diagnosed with 1) hypertension (HT) and 2) chronic heart failure (CHF). The objectives of this study were to improve general practitioner's drug treatment management of these patients through feedback on their own prescribing and small group discussions with peers and a trained group facilitator. The impact evaluation includes quantitative assessment of prescribing changes at 6, 9, 12 and 18 months after the intervention. A pragmatic multi site cluster RCT began recruiting practices in October 2009 to evaluate the effects of a multi-faceted quality improvement (QI) intervention on prescribing practice among Australian general practitioners (GP) in relation to patients with CHF and HT. General practices were recruited nationally through General Practice Networks across Australia. Participating practices were randomly allocated to one of three groups: two groups received the QI intervention (the prescribing indicator feedback reports and small group discussion) with each group undertaking the clinical topics (CHF and HT) in reverse order to the other. The third group was waitlisted to receive the intervention 6 months later and acted as a "control" for the other two groups.De-identified data on practice, doctor and patient characteristics and their treatment for CHF and HT are extracted at six-monthly intervals before and after the intervention. Post-test comparisons will be conducted between the intervention and control arms using intention to treat analysis and models that account for clustering of practices in a Network and clustering of patients within practices and GPs. This paper describes the study protocol for a project that will contribute to the development of acceptable and sustainable methods to promote QI activities within routine general practice, enhance prescribing practices and improve patient outcomes in the context of CHF and HT. Australian New Zealand Clinical Trials Registry (ANZCTR), Trial # 320870.

Prescribing Data in General Practice Demonstration (PDGPD) project - a cluster randomised controlled trial of a quality improvement intervention to achieve better prescribing for chronic heart failure and hypertension

PubMed Central

2012-01-01

Background Research literature consistently documents that scientifically based therapeutic recommendations are not always followed in the hospital or in the primary care setting. Currently, there is evidence that some general practitioners in Australia are not prescribing appropriately for patients diagnosed with 1) hypertension (HT) and 2) chronic heart failure (CHF). The objectives of this study were to improve general practitioner’s drug treatment management of these patients through feedback on their own prescribing and small group discussions with peers and a trained group facilitator. The impact evaluation includes quantitative assessment of prescribing changes at 6, 9, 12 and 18 months after the intervention. Methods A pragmatic multi site cluster RCT began recruiting practices in October 2009 to evaluate the effects of a multi-faceted quality improvement (QI) intervention on prescribing practice among Australian general practitioners (GP) in relation to patients with CHF and HT. General practices were recruited nationally through General Practice Networks across Australia. Participating practices were randomly allocated to one of three groups: two groups received the QI intervention (the prescribing indicator feedback reports and small group discussion) with each group undertaking the clinical topics (CHF and HT) in reverse order to the other. The third group was waitlisted to receive the intervention 6 months later and acted as a “control” for the other two groups. De-identified data on practice, doctor and patient characteristics and their treatment for CHF and HT are extracted at six-monthly intervals before and after the intervention. Post-test comparisons will be conducted between the intervention and control arms using intention to treat analysis and models that account for clustering of practices in a Network and clustering of patients within practices and GPs. Discussion This paper describes the study protocol for a project that will contribute to the development of acceptable and sustainable methods to promote QI activities within routine general practice, enhance prescribing practices and improve patient outcomes in the context of CHF and HT. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), Trial # 320870. PMID:22913571

Using benchmarking techniques and the 2011 maternity practices infant nutrition and care (mPINC) survey to improve performance among peer groups across the United States.

PubMed

Edwards, Roger A; Dee, Deborah; Umer, Amna; Perrine, Cria G; Shealy, Katherine R; Grummer-Strawn, Laurence M

2014-02-01

A substantial proportion of US maternity care facilities engage in practices that are not evidence-based and that interfere with breastfeeding. The CDC Survey of Maternity Practices in Infant Nutrition and Care (mPINC) showed significant variation in maternity practices among US states. The purpose of this article is to use benchmarking techniques to identify states within relevant peer groups that were top performers on mPINC survey indicators related to breastfeeding support. We used 11 indicators of breastfeeding-related maternity care from the 2011 mPINC survey and benchmarking techniques to organize and compare hospital-based maternity practices across the 50 states and Washington, DC. We created peer categories for benchmarking first by region (grouping states by West, Midwest, South, and Northeast) and then by size (grouping states by the number of maternity facilities and dividing each region into approximately equal halves based on the number of facilities). Thirty-four states had scores high enough to serve as benchmarks, and 32 states had scores low enough to reflect the lowest score gap from the benchmark on at least 1 indicator. No state served as the benchmark on more than 5 indicators and no state was furthest from the benchmark on more than 7 indicators. The small peer group benchmarks in the South, West, and Midwest were better than the large peer group benchmarks on 91%, 82%, and 36% of the indicators, respectively. In the West large, the Midwest large, the Midwest small, and the South large peer groups, 4-6 benchmarks showed that less than 50% of hospitals have ideal practice in all states. The evaluation presents benchmarks for peer group state comparisons that provide potential and feasible targets for improvement.

Small Groups, Big Change: Preliminary Findings from the Sparks for Change Institute

NASA Astrophysics Data System (ADS)

Kirsch, R.; Batchelor, R. L.; Habtes, S. Y.; King, B.; Crockett, J.

2017-12-01

The geoscience professoriate continues to under represent women and minorities, yet the value of diversity, both for science as well as recruiting and retaining diverse students, is well known. While there are growing numbers of early career tenure-track minority faculty, low retention rates pose a challenge for sustained diversity in the professoriate. Part of this challenge is the lack of institutional support and recognition in tenure and promotion pathways for faculty who undertake broadening participation efforts. Sparks for Change is a NSF Geoscience Opportunities for Leadership in Diversity (GOLD)-funded project that aims to change departmental culture to better value and reward inclusion and broadening participation efforts. By encouraging, recognizing, and rewarding diversity, equity, and inclusion (DEI) efforts at the department level, we aim to support and retain underrepresented minority (URM) faculty, who often disproportionately undertake these efforts, and to build more inclusive environments for faculty, staff and students alike. Sparks for Change utilizes a small group theory of change, arguing that the effort of a small group of committed individuals inside the organization is the best way to overcome the institutional inertia of academic departments that makes them resistant to change. For this effort, we propose that the ideal composition of these small groups is a junior faculty URM who is interested in DEI in the geosciences, a senior member of that same department who can lend weight to efforts and is positioned to help enact department policy, and an external broadening participation expert who can share best practices and provide accountability for the group. Eleven of these small groups, representing a range of institutions, will be brought together at the Sparks for Change Institute in Boulder, CO, in September. There they will receive leadership training on adaptive, transformative, and solidarity practices, share DEI experiences and best practices, build a community of "change agents", and develop department-specific action plans for their own institution. In this talk we will discuss our findings from the institute and highlight some of the action plans the small groups developed for changing their department.

[Nutrition consultation in small animal practice - a field for specialized veterinarians].

PubMed

Bergler, R; Wechsung, S; Kienzle, E; Hoff, T; Dobenecker, B

2016-01-01

The study aimed to identify barriers to the implementation of nutrition consultation in veterinary practice. Differences between individual veterinarians in their problem-solving strategies in nutrition consultation were investigated. Representative online survey of 214 veterinarians (female/male) using a standardized questionnaire. Statistical analysis by correlations, t-test, analysis of variance and factor analysis as well as cluster analysis of types of veterinarians. Over 90% of vets had seen an increase in owners' questions on feeding pets. Forty-one percent estimated the percentage of patients suffering from nutrition-related diseases in their practice to be 20-30%. At the same time, 70% of vets agreed that nutrition consultation was neglected in every-day practice. Vets estimated that only 30% of owners complied with recommendations on nutrition. Over 80% of vets presumed that pet owners gave false information on feeding. For other sensitive questions, including domestic and financial situations, the percentage of presumed false information was below 60%. Approximately 50% of the vets did not feel sufficiently competent with regard to nutrition consultation. Less than 50% asked for payment of nutrition consultation. Only 18% had taken part in continuing education in animal nutrition. The cluster analysis identified five different strategies to cope with nutrition consultation, four of which were based on a low priority for nutrition in their own practice. Some vets referred nutrition problems to specialized colleagues (7.2%), others consulted with representatives of pet food companies (28.2%), another group offered free, quick tips (23.4%), and a small percentage ignored nutrition (13.4%). There was one group with a strong interest in nutrition (27.8%). It is remarkable that this group felt the least competent in small-animal nutrition. Conclusion and practical relevance: The study demonstrates that sound nutrition consultation in small-animal practice requires a high degree of specialization. In addition, special coping strategies to obtain a sound nutrition history and a fair payment are necessary. Vets fulfilling these conditions may find a wide field of work.

Implementing Primary Social and Emotional Aspects of Learning (SEAL) Small Group Interventions: Recommendations for Practitioners

ERIC Educational Resources Information Center

Lendrum, Ann; Humphrey, Neil; Kalambouka, Afroditi; Wigelsworth, Michael

2009-01-01

This article presents an extended vignette describing a good practice model for implementing SEAL small group work at "Mellington Primary", a fictional school. The vignette/model was developed from in-depth case studies at five primary schools in the north-west of England during a national evaluation of primary SEAL by the authors. The…

Pre-Service Teachers: An Analysis of Reading Instruction in High Needs Districts Dual Language Classrooms

ERIC Educational Resources Information Center

Whitacre, Michael; Diaz, Zulmaris; Esquierdo, Joy

2013-01-01

Pre-service teachers need opportunities to apply theory and connect to best practices as they teach in classroom settings be it, whole or small group. For many pre-service teachers often times their experience is limited to simply watching instruction or working with small groups of students (Pryor & Kuhn, 2004). The student teaching…

Evaluating a Small-Group Counseling Program--A Model for Program Planning and Improvement in the Elementary Setting

ERIC Educational Resources Information Center

Bostick, Dee; Anderson, Ron

2009-01-01

School counselors are under increasing pressure to evaluate their programs in a manner consistent with teachers and other educators. A small-group counseling intervention was used by a school counselor as part of a three-level program planning initiative that illustrated best research practices to evaluate program outcomes. Forty-nine third-grade…

Use of Modified SOAP Notes and Peer-Led Small-Group Discussion in a Medical Physiology Course: Addressing the Hidden Curriculum

ERIC Educational Resources Information Center

Kibble, Jonathan; Hansen, Penelope A.; Nelson, Loren

2006-01-01

Peer leading of small-group discussion of cases; use of modified subjective, objective, assessment of physiology (SOAP) notes; and opportunities for self-assessment were introduced into a Medical Physiology course to increase students' awareness and practice of professional behaviors. These changes arose from faculty members' understanding of the…

A Model of Small-Group Problem-Based Learning in Pharmacy Education: Teaching in the Clinical Environment

ERIC Educational Resources Information Center

Khumsikiew, Jeerisuda; Donsamak, Sisira; Saeteaw, Manit

2015-01-01

Problem-based Learning (PBL) is an alternate method of instruction that incorporates basic elements of cognitive learning theory. Colleges of pharmacy use PBL to aid anticipated learning outcomes and practice competencies for pharmacy student. The purpose of this study were to implement and evaluate a model of small group PBL for 5th year pharmacy…

Improving coding accuracy in an academic practice.

PubMed

Nguyen, Dana; O'Mara, Heather; Powell, Robert

2017-01-01

Practice management has become an increasingly important component of graduate medical education. This applies to every practice environment; private, academic, and military. One of the most critical aspects of practice management is documentation and coding for physician services, as they directly affect the financial success of any practice. Our quality improvement project aimed to implement a new and innovative method for teaching billing and coding in a longitudinal fashion in a family medicine residency. We hypothesized that implementation of a new teaching strategy would increase coding accuracy rates among residents and faculty. Design: single group, pretest-posttest. military family medicine residency clinic. Study populations: 7 faculty physicians and 18 resident physicians participated as learners in the project. Educational intervention: monthly structured coding learning sessions in the academic curriculum that involved learner-presented cases, small group case review, and large group discussion. overall coding accuracy (compliance) percentage and coding accuracy per year group for the subjects that were able to participate longitudinally. Statistical tests used: average coding accuracy for population; paired t test to assess improvement between 2 intervention periods, both aggregate and by year group. Overall coding accuracy rates remained stable over the course of time regardless of the modality of the educational intervention. A paired t test was conducted to compare coding accuracy rates at baseline (mean (M)=26.4%, SD=10%) to accuracy rates after all educational interventions were complete (M=26.8%, SD=12%); t24=-0.127, P=.90. Didactic teaching and small group discussion sessions did not improve overall coding accuracy in a residency practice. Future interventions could focus on educating providers at the individual level.

Reflections on Beliefs and Practices from a Group of New Zealand Outdoor Educators: Consistencies and Conflicts

ERIC Educational Resources Information Center

Hill, Allen

2010-01-01

This article draws from a research project in 2007 with a small group of New Zealand outdoor educators. The purpose of the project was to examine teacher beliefs about outdoor education and explore the complex relationships between beliefs, values, and self-perceptions of pedagogical practice. Of specific interest was how theories of consistency…

Activist Literacies: An Analysis of the Literacy Practices of a School-Based Human Rights Club

ERIC Educational Resources Information Center

Collin, Ross

2012-01-01

In this article, I examine the literacy practices of a high school-based human rights club. I investigate how the group engages in certain kinds of textual production to sponsor and arrange advisory sessions (school-wide meetings between teachers and small groups of students). More specifically, I consider how the club adapts school genres to…

Group Process as Drama.

ERIC Educational Resources Information Center

McLeod, John

1984-01-01

Suggests that drama, as well as training or therapy, may be employed as a useful research and practice paradigm in working with small groups. The implications of this view for group development as a whole, and for member and leader participation, are explored. (JAC)

Improved satisfaction of preoperative patients after group video-teaching during interview at preanesthetic evaluation clinic: the experience of a medical center in Taiwan.

PubMed

Yang, Ya-Ling; Wang, Kuan-Jen; Chen, Wei-Hao; Chuang, Kuan-Chih; Tseng, Chia-Chih; Liu, Chien-Cheng

2007-09-01

Anesthesiologist-directed anesthetic preoperative evaluation clinic (APEC) is used to prepare patients to receive anesthesia for surgery. Studies have shown that APEC can reduce preoperative tests, consultations, surgery delays and cancellations. APEC with video-teaching has been purposed as a medium to provide comprehensive information about the process of anesthesia but it has not been practiced in small groups of patients. It is rational to assume that video-teaching in a small group patients can provide better information to patients to understand the process of anesthesia and in turn improve their satisfaction in anesthesia practice. This study was designed to evaluate the difference of satisfaction between patients who joined in small group video-teaching at APEC and patients who paid a traditional preoperative visit in the waiting area, using questionnaire for evaluation. Totally, 237 eligible patients were included in the study in a space of two months. Patients were divided in two groups; 145 patients joined the small group video-teaching designated as study group and 92 patients who were paid traditional preoperative visit at the waiting area served as control. All patients were requested to fill a special questionnaire after postoperative visit entrusted to two non-medical persons. There were significantly higher scores of satisfaction in anesthesia inclusive of waiting time for surgery in the operation room, attitude towards anesthetic staffs during postoperative visit and management of complications in patients who were offered small group video-teaching in comparison with patients of traditional preoperative visit. The results indicated that APEC with group video-teaching could not only make patients more satisfied with process of anesthesia in elective surgery but also reduce the expenditure of hospitalization and anesthetic manpower.

Implementing the patient-centered medical home model for chronic disease care in small medical practices: practice group characteristics and physician understanding.

PubMed

Baxter, Louisa; Nash, David B

2013-01-01

Strengthening primary care may improve health outcomes and restrain spending. The patient-centered medical home (PCMH) model is endorsed as a tool to achieve this. Early evaluations in large group practices demonstrate improvements in some health outcomes. Evidence is lacking from small medical practices that deliver the majority of primary health care. This was a national survey of 200 physicians that explored perceptions of PCMH. There was considerable interest in adoption of the model; however, providing PCMH care was seen as an extension of traditional roles that requires additional reimbursement. No differentiation was made among a variety of payment models to do this. All joint principle components of the model were identified as important: extending access and information technology were the most contentious. There was consensus that PCMH might improve the quality of primary care; however, tension between wider societal benefits and rising costs for individual practices was a challenge to implementation.

How do Small Groups Promote Behaviour Change? An Integrative Conceptual Review of Explanatory Mechanisms.

PubMed

Borek, Aleksandra J; Abraham, Charles

2018-03-01

Small groups are used to promote health, well-being, and personal change by altering members' perceptions, beliefs, expectations, and behaviour patterns. An extensive cross-disciplinary literature has articulated and tested theories explaining how such groups develop, function, and facilitate change. Yet these theoretical understandings are rarely applied in the development, description, and evaluation of health-promotion, group-based, behaviour-change interventions. Medline database, library catalogues, search engines, specific journals and reference lists were searched for relevant texts. Texts were reviewed for explanatory concepts or theories describing change processes in groups, which were integrated into the developing conceptual structure. This was designed to be a parsimonious conceptual framework that could be applied to design and delivery. Five categories of interacting processes and concepts were identified and defined: (1) group development processes, (2) dynamic group processes, (3) social change processes, (4) personal change processes, and (5) group design and operating parameters. Each of these categories encompasses a variety of theorised mechanisms explaining individual change in small groups. The final conceptual model, together with the design issues and practical recommendations derived from it, provides a practical basis for linking research and theory explaining group functioning to optimal design of group-based, behaviour-change interventions. © 2018 The Authors. Applied Psychology: Health and Well-Being published by John Wiley & Sons Ltd on behalf of International Association of Applied Psychology.

An Examination of a Small-Group Decoding Intervention for Struggling Readers: Comparing Accuracy and Automaticity Criteria

ERIC Educational Resources Information Center

Hudson, Roxanne F.; Isakson, Carole; Richman, Taylor; Lane, Holly B.; Arriaza-Allen, Stephanie

2011-01-01

In this study, we compared methods to improve the decoding and reading fluency of struggling readers. Second-grade poor readers were randomly assigned to one of the two practice conditions within a repeated reading intervention. Both interventions were in small groups, were 20-28 min long, took place 2-4 days per week, and consisted of phonemic…

Emotions in Group Work: Insights from an Appraisal-Oriented Perspective

ERIC Educational Resources Information Center

Zschocke, Karen; Wosnitza, Marold; Bürger, Kathrin

2016-01-01

Small group work is common practice in higher education. However, empirical research on students' emotions related to group work is still relatively scarce. Particularly, little is known about students' appraisals of a group task as antecedents of emotions arising in the context of group work. This paper provides a first attempt to systematically…

Journal Clubs and Case Conferences: From Academic Tradition to Communities of Practice

ERIC Educational Resources Information Center

Price, David W.; Felix, Kate G.

2008-01-01

Introduction: As small group learning sessions, Journal Clubs (JCs) and Case Conferences (CCs), if structured interactively, have potential as educational formats that can change practice. However, the degree to which these formats, as currently typically structured, lead to practice change is unknown. Methods: We used concepts of communities of…

The recruitment of new members to existing PBSGL small groups: a qualitative study.

PubMed

Park, Julia; Cunningham, David E

2018-04-23

Introduction Practice-Based Small Group Learning (PBSGL) is a learning programme widely adopted by primary healthcare professions (general practitioners, general practice nurses and pharmacists) in Scotland and other countries in the UK. PBSGL groups recruit members and decide on meeting dates and venues. Study aims To determine how groups recruit new members and discern what are the important attributes of the new members. Method A grounded theory approach was used with purposive sampling to recruit PBSGL groups to the study. Focus groups drawn from established PBSGL groups were conducted by two researchers following an iterative process, with interviews audio-recorded and transcribed, and codes and themes constructed. Data saturation was achieved. Results and conclusions Four themes were identified that affected group recruitment: group formation and purpose; group culture and ethos; experience and seniority range of group members; professional socialisation and cross-fertilisation. Groups whose main purpose was learning encouraged diverse membership, while groups that were stricter with recruitment often prioritised friendship, group safety, trust and peer support over learning. The variation in group's openness to recruitment may make it difficult for potential members to find a group and this may affect the development and expansion of the PBSGL programme.

Testing an empirically derived mental health training model featuring small groups, distributed practice and patient discussion.

PubMed

Murrihy, Rachael C; Byrne, Mitchell K; Gonsalvez, Craig J

2009-02-01

Internationally, family doctors seeking to enhance their skills in evidence-based mental health treatment are attending brief training workshops, despite clear evidence in the literature that short-term, massed formats are not likely to improve skills in this complex area. Reviews of the educational literature suggest that an optimal model of training would incorporate distributed practice techniques; repeated practice over a lengthy time period, small-group interactive learning, mentoring relationships, skills-based training and an ongoing discussion of actual patients. This study investigates the potential role of group-based training incorporating multiple aspects of good pedagogy for training doctors in basic competencies in brief cognitive behaviour therapy (BCBT). Six groups of family doctors (n = 32) completed eight 2-hour sessions of BCBT group training over a 6-month period. A baseline control design was utilised with pre- and post-training measures of doctors' BCBT skills, knowledge and engagement in BCBT treatment. Family doctors' knowledge, skills in and actual use of BCBT with patients improved significantly over the course of training compared with the control period. This research demonstrates preliminary support for the efficacy of an empirically derived group training model for family doctors. Brief CBT group-based training could prove to be an effective and viable model for future doctor training.

Rural Renaissance. Revitalizing Small High Schools.

ERIC Educational Resources Information Center

Ford, Edmund A.

Written in 1961, this document presents the rationales and applications of what were and still are, in most instances, considered innovative practices. Subjects discussed are building designs, teaching machines, educational television, flexible scheduling, multiple classes and small-group techniques, teacher assistants, shared services, and…

Use and effect of clinical photographic records on the motivation and oral hygiene practices of a group of mentally handicapped adults.

PubMed

Bickley, S R; Shaw, L; Shaw, M J

1990-01-01

A study was undertaken to test the hypothesis that clinical photographic records can be used to motivate oral hygiene performance in mentally handicapped adults. Plaque reduction over the period of the study was shown to be higher in the test group than the control group but differences between the test and control groups were not statistically significant. The small numbers involved (29) and the difficulties in matching subjects may have mitigated against demonstrating a statistically significant difference between the two groups. All participants demonstrated high levels of toothbrushing ability during the practical aspects of the study but this was not maintained through daily oral hygiene practices in the majority of subjects.

Merit-Based Incentive Payment System Participation: Radiologists Can Run but Cannot Hide.

PubMed

Rosenkrantz, Andrew B; Goldberg, Julia E; Duszak, Richard; Nicola, Gregory N

2018-04-01

To optimize the flexibility and relevancy of its Merit-Based Incentive Payment System (MIPS), CMS exempts selected physicians and groups from participation and grants others relaxed reporting requirements. We assess the practical implications of such special status determinations. For a random sample of 1,000 Medicare-participating radiologists, the CMS MIPS Participation Lookup Tool was manually searched. Individual radiologists' and associated groups' participation requirements and special statuses were assessed. Although only 55% of radiologists were required to participate in MIPS as individuals when considering only one associated taxpayer identification number (TIN), 83% were required to participate as individuals when considering all associated TINs. When using the group reporting option, 97% of radiology groups were required to participate. High participation requirements persisted across generalist and subspecialist radiologists, small and rural, and both academic and nonacademic practices. Non-patient-facing and hospital-based statuses were assigned to high fractions of individual radiologists (91% and 71%, respectively), but much lower fractions of group practices (72% and 25%). Rural and health professional shortage area statuses were assigned to higher percentages of groups (27% and 39%) than individuals (13% and 23%). Small practice status was assigned to 22% of individuals versus 16% of groups. Although not apparent if only considering individual radiologist-TIN combinations, the overwhelming majority of radiologists will be required to participate in MIPS, at the individual or group level. Radiology groups are strongly encouraged to review their physicians' MIPS participation requirements and special statuses to ensure optimal performance scores and payment bonuses. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A Kindergarten Number-Sense Intervention With Contrasting Practice Conditions for Low-Achieving Children

PubMed Central

Dyson, Nancy; Jordan, Nancy C.; Beliakoff, Amber; Hassinger-Das, Brenna

2015-01-01

The efficacy of a research-based number-sense intervention for low-achieving kinder-gartners was examined. Children (N = 126) were randomly assigned to 1 of 3 conditions: a number-sense intervention followed by a number-fact practice session, an identical number-sense intervention followed by a number-list practice session, or a business-as-usual control group. The interventions were delivered in a small-group setting over 24 half-hour lessons. Both intervention groups performed better than controls on measures of number sense, arithmetic fluency, and general mathematics calculation achievement at immediate posttest. However, the number-fact practice condition gave children an additional advantage over the number-list practice condition on the outcomes at delayed posttest 8 weeks later. The number-fact practice condition was especially effective for producing gains in English learners. PMID:26388651

Practical Educational Prescriptions for Students in the Mainstream.

ERIC Educational Resources Information Center

Choate, Joyce S., Ed.; Young, Larry S., Ed.

Activity suggestions developed by experienced teachers are presented for mainstreamed students with difficulties in specific instructional areas of reading, mathematics, spelling, writing, and behavior. Activity descriptions are grouped according to instructional area, and are classified as large group, small group, or one to one exercises.…

Focus Group Meets Nominal Group Technique: An Effective Combination for Student Evaluation?

ERIC Educational Resources Information Center

Varga-Atkins, Tünde; McIsaac, Jaye; Willis, Ian

2017-01-01

In Higher Education Focus Groups and Nominal Group Technique are two well-established methods for obtaining student feedback about their learning experience. These methods are regularly used for the enhancement and quality assurance. Based on small-scale research of educational developers' practice in curriculum development, this study presents…

Effective Online Lectures: Improving Practice through Design and Pedagogy

ERIC Educational Resources Information Center

Bese, Terry Lane

2016-01-01

The purpose of this research project was to improve the practice of using online lectures at a small private university. Using action research methodology, the researcher worked with a group of five university instructors to refine the use of online lectures through design and pedagogical practice. Beginning with a template or guide based on the…

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.

Using Benchmarking Techniques and the 2011 Maternity Practices Infant Nutrition and Care (mPINC) Survey to Improve Performance among Peer Groups across the United States

PubMed Central

Edwards, Roger A.; Dee, Deborah; Umer, Amna; Perrine, Cria G.; Shealy, Katherine R.; Grummer-Strawn, Laurence M.

2015-01-01

Background A substantial proportion of US maternity care facilities engage in practices that are not evidence-based and that interfere with breastfeeding. The CDC Survey of Maternity Practices in Infant Nutrition and Care (mPINC) showed significant variation in maternity practices among US states. Objective The purpose of this article is to use benchmarking techniques to identify states within relevant peer groups that were top performers on mPINC survey indicators related to breastfeeding support. Methods We used 11 indicators of breastfeeding-related maternity care from the 2011 mPINC survey and benchmarking techniques to organize and compare hospital-based maternity practices across the 50 states and Washington, DC. We created peer categories for benchmarking first by region (grouping states by West, Midwest, South, and Northeast) and then by size (grouping states by the number of maternity facilities and dividing each region into approximately equal halves based on the number of facilities). Results Thirty-four states had scores high enough to serve as benchmarks, and 32 states had scores low enough to reflect the lowest score gap from the benchmark on at least 1 indicator. No state served as the benchmark on more than 5 indicators and no state was furthest from the benchmark on more than 7 indicators. The small peer group benchmarks in the South, West, and Midwest were better than the large peer group benchmarks on 91%, 82%, and 36% of the indicators, respectively. In the West large, the Midwest large, the Midwest small, and the South large peer groups, 4–6 benchmarks showed that less than 50% of hospitals have ideal practice in all states. Conclusion The evaluation presents benchmarks for peer group state comparisons that provide potential and feasible targets for improvement. PMID:24394963

An Innovative Pharmaceutical Care Practical Course

ERIC Educational Resources Information Center

Bulatova, N. R.; Aburuz, S.; Yousef, A. M.

2007-01-01

The innovative practical course was developed to improve the students' ability to acquire pharmaceutical care skills. The primary components of the course were in-school training using small group discussions and hospital experience including identification, analysis, prevention and resolution of drug-therapy problems, patient counseling on their…

Effects of group-selection timber harvest in bottomland hardwoods on fall migrant birds

Treesearch

John C. Kilgo; Karl V. Miller; Winston P. Smith

1999-01-01

Due to projected demands for hardwood timber, development of silvicultural practices that provide for adequate regeneration in southeastern bottomland hardwoods without causing undue harm to wildlife resources is critical. Group-selection silviculture involves harvesting a small group of trees, which creates a canopy gap (usually

Grouping for Inequity

ERIC Educational Resources Information Center

Macqueen, Suzanne Elizabeth

2013-01-01

The inequity of streaming as a method of organising classes was established by research conducted in the 1960s and 1970s. While the practice produces small advantages for limited groups of students, it hinders the academic and social advancement of the majority. Although streaming has declined, new forms of achievement grouping have emerged, with…

Patient experience of access to primary care: identification of predictors in a national patient survey.

PubMed

Kontopantelis, Evangelos; Roland, Martin; Reeves, David

2010-08-28

The 2007/8 GP Access Survey in England measured experience with five dimensions of access: getting through on the phone to a practice, getting an early appointment, getting an advance appointment, making an appointment with a particular doctor, and surgery opening hours. Our aim was to identify predictors of patient satisfaction and experience with access to English primary care. 8,307 English general practices were included in the survey (of 8,403 identified). 4,922,080 patients were randomly selected and contacted by post and 1,999,523 usable questionnaires were returned, a response rate of 40.6%. We used multi-level logistic regressions to identify patient, practice and regional predictors of patient satisfaction and experience. After controlling for all other factors, younger people, and people of Asian ethnicity, working full time, or with long commuting times to work, reported the lowest levels of satisfaction and experience of access. For people in work, the ability to take time off work to visit the GP effectively eliminated the disadvantage in access. The ethnic mix of the local area had an impact on a patient's reported satisfaction and experience over and above the patient's own ethnic identity. However, area deprivation had only low associations with patient ratings. Responses from patients in small practices were more positive for all aspects of access with the exception of satisfaction with practice opening hours. Positive reports of access to care were associated with higher scores on the Quality and Outcomes Framework and with slightly lower rates of emergency admission. Respondents in London were the least satisfied and had the worst experiences on almost all dimensions of access. This study identifies a number of patient groups with lower satisfaction, and poorer experience, of gaining access to primary care. The finding that access is better in small practices is important given the increasing tendency for small practices to combine into larger units. Consideration needs to be given to ways of retaining these and other benefits of small practice size when primary care services are reconfigured. Differences between population groups (e.g. younger people, ethnic minorities) may be due to differences in actual care received or different response tendencies of different groups. Further analysis is needed to determine whether case-mix adjustment is required when comparing practices serving different populations.

Cross-Cultural Pedagogy: Practical Strategies for a Successful Interprofessional Study Abroad Course

ERIC Educational Resources Information Center

Bai, Jieru; Larimer, Susan; Riner, Mary Beth

2016-01-01

This article discusses some practical strategies for designing and implementing a cross-cultural interprofessional study abroad course, including pre-departure preparation, facilitating small groups with local students, establishing a weekly theme, utilizing role-play and reflective assignments, and implementing meaningful evaluation strategies.…

Effectiveness of a quality management program in dental care practices.

PubMed

Goetz, Katja; Campbell, Stephen M; Broge, Björn; Brodowski, Marc; Wensing, Michel; Szecsenyi, Joachim

2014-04-28

Structured quality management is an important aspect for improving patient dental care outcomes, but reliable evidence to validate effects is lacking. We aimed to examine the effectiveness of a quality management program in primary dental care settings in Germany. This was an exploratory study with a before-after-design. 45 dental care practices that had completed the European Practice Assessment (EPA) accreditation scheme twice (intervention group) were selected for the study. The mean interval between the before and after assessment was 36 months. The comparison group comprised of 56 dental practices that had undergone their first assessment simultaneously with follow-up assessment in the intervention group. Aggregated scores for five EPA domains: 'infrastructure', 'information', 'finance', 'quality and safety' and 'people' were calculated. In the intervention group, small non-significant improvements were found in the EPA domains. At follow-up, the intervention group had higher scores on EPA domains as compared with the comparison group (range of differences was 4.2 to 10.8 across domains). These differences were all significant in regression analyses, which controlled for relevant dental practice characteristics. Dental care practices that implemented a quality management program had better organizational quality in contrast to a comparison group. This may reflect both improvements in the intervention group and a selection effect of dental practices volunteering for the first round of EPA practice assessment.

Differential impact of student behaviours on group interaction and collaborative learning: medical students' and tutors' perspectives.

PubMed

Iqbal, Maha; Velan, Gary M; O'Sullivan, Anthony J; Balasooriya, Chinthaka

2016-08-22

Collaboration is of increasing importance in medical education and medical practice. Students' and tutors' perceptions about small group learning are valuable to inform the development of strategies to promote group dynamics and collaborative learning. This study investigated medical students' and tutors' views on competencies and behaviours which promote effective learning and interaction in small group settings. This study was conducted at UNSW Australia. Five focus group discussions were conducted with first and second year medical students and eight small group tutors were interviewed. Data were transcribed verbatim and thematic analysis was conducted. Students and tutors identified a range of behaviours that influenced collaborative learning. The main themes that emerged included: respectfulness; dominance, strong opinions and openness; constructiveness of feedback; active listening and contribution; goal orientation; acceptance of roles and responsibilities; engagement and enthusiasm; preparedness; self- awareness and positive personal attributes. An important finding was that some of these student behaviours were found to have a differential impact on group interaction compared with collaborative learning. This information could be used to promote higher quality learning in small groups. This study has identified medical students' and tutors' perceptions regarding interactional behaviours in small groups, as well as behaviours which lead to more effective learning in those settings. This information could be used to promote learning in small groups.

Support groups: an empowering, experiential strategy.

PubMed

Heinrich, K T; Robinson, C M; Scales, M E

1998-01-01

The authors describe a student-facilitated support group experience initiated at student request and designed for RN-BSN students. Students report they emerged enlightened about group theory, empowered to share their knowledge of groups, and energized to initiate groups in their work settings. If educators make the learning experience safe, practice letting go and being vigilant, and celebrate group successes, students learn how to initiate, facilitate, and terminate small groups.

Development of Innovative Group Work Practice Using the Intervention Research Paradigm

ERIC Educational Resources Information Center

Comer, Edna; Meier, Andrea; Galinsky, Maeda J.

2004-01-01

Rothman and Thomas' intervention research (IR) paradigm provides an alternative, developmental research method that is appropriate for practice research, especially at the early stages. It is more flexible than conventional experimental designs, capitalizes on the availability of small samples, accommodates the dynamism and variation in practice…

Perspective Taking and Synchronous Argumentation for Learning the Day/Night Cycle

ERIC Educational Resources Information Center

Schwarz, Baruch B.; Schur, Yaron; Pensso, Haim; Tayer, Naama

2011-01-01

Changing practices in schools is a very complex endeavor. This paper is about new practices we prompted to foster collaboration and critical reasoning in science classrooms: the presentation of pictures representing different perspectives, small group synchronous argumentation, and moderation of synchronous argumentation. A CSCL tool helped in…

Extreme, Collaborative Curriculum Invention in Hawai'i

ERIC Educational Resources Information Center

Kelin, Daniel A., II; Jaffe, Nick; Bangerter, Neida; Wong, Randy; Kealoha; Penney-Rohner, Vicki

2013-01-01

This article describes ideas that came out of two workshops from a statewide Institute in Hawaii, comprised of sixty-five teaching artists, that focused on analyzing best practices. These were collaborative curriculum design workshops that yielded provocative and inspiring theoretical and practical ideas. In the first workshop, small groups of…

Understanding School Counseling Internships from a Communities of Practice Framework

ERIC Educational Resources Information Center

Woodside, Marianne; Ziegler, Mary; Paulus, Trena M.

2009-01-01

School counseling interns are on the boundary of communities of practice. This study explored how school counselors develop competence during internship experiences by analyzing an online dialogue taking place among a small group of interns. Feelings of being on the boundary intensified with unsatisfactory supervisor-intern relationships (lack of…

Enhancing the Student Experience of Laboratory Practicals through Digital Video Guides

ERIC Educational Resources Information Center

Croker, Karen; Andersson, Holger; Lush, David; Prince, Rob; Gomez, Stephen

2010-01-01

Laboratory-based learning allows students to experience bioscience principles first hand. In our experience, practical content and equipment may have changed over time, but teaching methods largely remain the same, typically involving; whole class introduction with a demonstration, students emulating the demonstration in small groups, gathering…

Advances in participatory occupational health aimed at good practices in small enterprises and the informal sector.

PubMed

Kogi, Kazutaka

2006-01-01

Participatory programmes for occupational risk reduction are gaining importance particularly in small workplaces in both industrially developing and developed countries. To discuss the types of effective support, participatory steps commonly seen in our "work improvement-Asia" network are reviewed. The review covered training programmes for small enterprises, farmers, home workers and trade union members. Participatory steps commonly focusing on low-cost good practices locally achieved have led to concrete improvements in multiple technical areas including materials handling, workstation ergonomics, physical environment and work organization. These steps take advantage of positive features of small workplaces in two distinct ways. First, local key persons are ready to accept local good practices conveyed through personal, informal approaches. Second, workers and farmers are capable of understanding technical problems affecting routine work and taking flexible actions leading to solving them. This process is facilitated by the use of locally adjusted training tools such as local good examples, action checklists and group work methods. It is suggested that participatory occupational health programmes can work in small workplaces when they utilize low-cost good practices in a flexible manner. Networking of these positive experiences is essential.

Evaluating effectiveness of small group information literacy instruction for Undergraduate Medical Education students using a pre- and post-survey study design.

PubMed

McClurg, Caitlin; Powelson, Susan; Lang, Eddy; Aghajafari, Fariba; Edworthy, Steven

2015-06-01

The Undergraduate Medical Education (UME) programme at the University of Calgary is a three-year programme with a strong emphasis on small group learning. The purpose of our study was to determine whether librarian led small group information literacy instruction, closely integrated with course content and faculty participation, but without a hands on component, was an effective means to convey EBM literacy skills. Five 15-minute EBM information literacy sessions were delivered by three librarians to 12 practicing physician led small groups of 15 students. Students were asked to complete an online survey before and after the sessions. Data analysis was performed through simple descriptive statistics. A total of 144 of 160 students responded to the pre-survey, and 112 students answered the post-survey. Instruction in a small group environment without a mandatory hands on component had a positive impact on student's evidence-based information literacy skills. Students were more likely to consult a librarian and had increased confidence in their abilities to search and find relevant information. Our study demonstrates that student engagement and faculty involvement are effective tools for delivering information literacy skills when working with students in a small group setting outside of a computer classroom. © 2015 Health Libraries Group.

Evaluating practice-based learning specific to the community matron role.

PubMed

Banning, Maggi

2009-02-01

Since the inception of the community matron role in 2004 there has been much debate about the exact nature of the role in primary and secondary care. How to effectively skill-up and educate a diverse group of clinicians has been a hot topic. This study involved a small focus group of community matrons in training. The qualitative themes extracted from this work are reported on and suggest that practice-based learning is both valuable and efficacious.

Proceedings of the Annual Midwest Research-to-Practice Conference in Adult and Continuing Education (4th, Ann Arbor, Michigan, October 10-11, 1985).

ERIC Educational Resources Information Center

Berlin, L. S., Ed.

This document contains the following papers on practical applications of research on adult and continuing education: "Elderly Criminal Behavior: Linking Research to Practice," by Donald J. Bachand and Carl I. Brahce; "Father? Teacher? Friend? Instructor-Student Relationships in a Refugee Class," by Gary J. Bekker; "The Small Group: Understanding…

Can small group education and peer review improve care for patients with asthma/chronic obstructive pulmonary disease?

PubMed Central

Smeele, I. J.; Grol, R. P.; van Schayck, C. P.; van den Bosch, W. J.; van den Hoogen, H. J.; Muris, J. W.

1999-01-01

OBJECTIVE: To study the effectiveness of an intensive small group education and peer review programme aimed at implementing national guidelines on asthma/chronic obstructive pulmonary disease (COPD) on care provision by general practitioners (GPs) and on patient outcomes. DESIGN: A randomised experimental study with pre-measurement and post- measurement (after one year) in an experimental group and a control group in Dutch general practice. SUBJECTS AND INTERVENTION: Two groups of GPs were formed and randomised. The education and peer review group (17 GPs with 210 patients) had an intervention consisting of an interactive group education and peer review programme (four sessions each lasting two hours). The control group consisted of 17 GPs with 223 patients (no intervention). MAIN OUTCOME MEASURES: Knowledge, skills, opinion about asthma and COPD care, presence of equipment in practice; actual performance about peakflow measurement, non-pharmacological and pharmacological treatment; asthma symptoms (Dutch Medical Research Council), smoking habits, exacerbation ratio, and disease specific quality of life (QOL-RIQ). Data were collected by a written questionnaire for GPs, by self recording of consultations by GPs, and by a written self administered questionnaire for adult patients with asthma/COPD. RESULTS: Data from 34 GP questionnaires, 433 patient questionnaires, and recordings from 934 consultations/visits and 350 repeat prescriptions were available. Compared with the control group there were only significant changes for self estimated skills (+16%, 95% confidence interval 4% to 26%) and presence of peakflow meters in practice (+18%, p < 0.05). No significant changes were found for provided care and patient outcomes compared with the control group. In the subgroup of more severe patients, the group of older patients, and in the group of patients not using anti-inflammatory medication at baseline, no significant changes compared with the control group were seen in patient outcomes. CONCLUSION: Except for two aspects, intensive small group education and peer review in asthma and COPD care do not seem to be effective in changing relevant aspects of the provided care by GPs in accordance with guidelines, nor in changing patients' health status. PMID:10557684

75 FR 81274 - Media and Wireless Telecommunications Bureaus Seek Comment on Recommendation of the Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-27

..., similar to its existing practice of establishing the small business definitions on a service-by-service... to disseminate licenses among ``a wide variety of applicants, including small businesses, rural telephone companies, and businesses owned by members of minority groups and women'' and to ``ensure that...

Technology Mentors: Enablers of ICT Uptake in Australian Small Business

ERIC Educational Resources Information Center

Woodley, Carolyn J.; Burgess, Stephen; Paguio, Rafael; Bingley, Scott

2015-01-01

Purpose: The purpose of this paper is to report on the innovative employment of students as technology mentors as part of a Blended Learning Program (BLP) that supported a group of owner-managers of small businesses to adopt appropriate information and communication technologies (ICT) to enhance their work practices. Design/methodology/approach:…

Autonomy and interdependence: beliefs of Brazilian mothers from state capitals and small towns.

PubMed

Vieira, Mauro Luis; Seidl-de-Moura, Maria Lucia; Macarini, Samira Mafioletti; Martins, Gabriela Dal Forno; Lordelo, Eulina da Rocha; Tokumaru, Rosana Suemi; Oliva, Angela Donate

2010-11-01

This study aimed to investigate characteristics of Brazilian mothers' beliefs system, in the dimensions of autonomy and interdependence. A group of 600 women, half from state capitals and half from small towns, participated in the study. They were individually interviewed with Scales of Allocentrism, Beliefs about Parental Practices and Socialization Goals. Paired and Independent samples t tests and Multivariate GLM were performed. The results indicate that although mothers from both contexts value autonomy, mothers inhabiting small towns considered the relational dimension as the most important; whereas mothers inhabiting capitals valued equally both dimensions, either in their beliefs about practices or in the socialization goals for their children. Mothers from small towns have a higher mean score for allocentrism than mothers living in capitals. Thus, place of residence proved to be a relevant variable in the modulation of maternal beliefs. Educational level was not a significant factor in the variables considered and with this group of mothers. The study results are discussed in terms of their contribution to the understanding of the complex relationship between dimensions of autonomy and interdependence in mothers' beliefs system.

The use of quality circles as a support tool in the taking over of practices by young general practitioners

PubMed Central

Král, Norbert; Seifert, Bohumil; Kovář, Jan; Mucha, Cyril; Vojtíšková, Jana; Bednár, Jáchym; Martin, Seifert

2018-01-01

Introduction: Although informal meetings of healthcare professionals in smaller groups are common in the area of primary care in the Czech Republic, the method of quality circles is not in wide use. The aim of our project is to use this method to help new general practitioners (GPs) when they take over a medical practice and to suggest measures to improve the organization and overall attractiveness of new practices, as well as patient satisfaction. Materials and Methods: For the purposes of this observation, an already existing informal group formed by healthcare professionals and their trainees was used. The group met a total of four times in a 6-month period. In the first meeting, problematic areas were identified. In the second, specific issues of newly starting to practice were discussed, with time to consider suggestions for improvements. The third meeting consisted of an analysis of the suggested measures and their implementation, and in the fourth, these measures and their effects were evaluated. Results: On the basis of the discussion in the first and second meetings, suggestions were made, and then, during the third meeting, structured into three dimensions: (1) The organization of work, including clinical activities, (2) the attractiveness of the practice and the satisfaction levels of the patients, (3) the satisfaction levels of the employees. In each area, specific measures were proposed. The new doctors' feedback in the fourth phase of the project was positive. The main problems the new doctors faced were related to their lack of knowledge and experience with buying or starting their own practice, as well as being an effective team leader. Conclusion: Despite the application of small groups being significantly larger, it was demonstrated that if GPs are given direction and clear goals in their meetings, these meetings can be very constructive. Small groups thus offer a good platform for young GPs in starting their own practice, giving them the capacity to do so.

"Explain to Your Partner": Teachers' Instructional Practices and Students' Dialogue in Small Groups

ERIC Educational Resources Information Center

Webb, Noreen M.; Franke, Megan L.; De, Tondra; Chan, Angela G.; Freund, Deanna; Shein, Pat; Melkonian, Doris K.

2009-01-01

Collaborative group work has great potential to promote student learning, and increasing evidence exists about the kinds of interaction among students that are necessary to achieve this potential. Less often studied is the role of the teacher in promoting effective group collaboration. This article investigates the extent to which teachers'…

Does It Say That? Tensions in Teacher Questions When the Text Has the Final Say

ERIC Educational Resources Information Center

Boelé, Amy L.

2017-01-01

Using sociocultural concepts of authoritative and dialogic discourse, I sought to examine 5th-grade teachers' questioning practices during small-group reading instruction to understand the differences between groups reading text on grade level and groups reading texts below grade level. The purpose was also to examine how questions functioned for…

Social Work Practice with Groups: A Clinical Perspective. Second Edition.

ERIC Educational Resources Information Center

Reid, Kenneth E.

This guide is written for beginning and advanced social work students, as well as battle-weary social workers. It instructs practitioners in how to do social work with groups and how to integrate small-group theory and therapeutic principles in such a way that is therapeutic and life enhancing. The wide-ranging concepts and skills presented here…

Strategic Reading Groups: Guiding Readers in the Middle Grades

ERIC Educational Resources Information Center

Berne, Jennifer; Degener, Sophie C.

2012-01-01

Strategic grouping can transform reading instruction in the middle grades from a hit-or-miss learning experience to a targeted, responsive one. This book features a practical and field-tested model for small-group differentiated reading instruction in Grades 4-8. Jennifer Berne and Sophie C. Degener offer a clear, detailed discussion of how to…

A Case Study Examination of Best Practices of Professional Learning Communities

ERIC Educational Resources Information Center

Akopoff, Tanya M.

2010-01-01

A current trend in education is that small teacher groups, called professional learning communities (PLC), are being advocated as a tool to help teachers reach struggling students. Educators planning to use PLC as an intervention strategy can benefit from research-based information about PLC best practices. This multiple case study addressed the…

Creating High Functioning Schools: Practice and Research.

ERIC Educational Resources Information Center

Cano, Yvonne, Ed.; Wood, Fred H., Ed.; Simmons, Jan C., Ed.

This book contains 17 papers, chosen from those presented within the last 2 years at the annual National Conference on Creating the Quality School, hosted by the Center for the Study of Small/Rural Schools at the University of Oklahoma. The papers are grouped into three sections: leadership for school improvement; classroom practices for school…

Diabetes Care as an Active Learning Model of Postgraduate Education and Training for Pharmaceutical Care.

ERIC Educational Resources Information Center

Koda-Kimble, Mary Anne; Batz, Forrest R.

1994-01-01

In a University of California continuing pharmacy education course in diabetes care, practicing pharmacists lived as patients with diabetes for two days and role-played in small groups. One year later, participants reported making changes in their diabetes care-related practice, suggesting its effectiveness in improving practitioners' skill…

Inclusion Classrooms and Teachers: A Survey of Current Practices

ERIC Educational Resources Information Center

Kilanowski-Press, Lisa; Foote, Chandra J.; Rinaldo, Vince J.

2010-01-01

This study investigates the current state of inclusion practices in general education classrooms via survey of 71 inclusion teachers currently serving as special educators across the state of New York. Specifically, small group instruction, co-teaching, one-to-one instruction, and planning support are explored in relationship to class size, number…

Teacher Education and the Cultural Imagination: Autobiography, Conversation, and Narrative.

ERIC Educational Resources Information Center

Florio-Ruane, Susan

This book argues for the importance of addressing the role of culture in the lives of student teachers. It explains how passionate dialogue in small groups about multicultural literature and autobiography can transform teachers' lives and practice, arguing for a broad and intellectual, yet practical and concrete, vision of teacher development in…

Assessment and Management of the Communication Difficulties of Children with Cerebral Palsy: A UK Survey of SLT Practice

ERIC Educational Resources Information Center

Watson, Rose Mary; Pennington, Lindsay

2015-01-01

Background: Communication difficulties are common in cerebral palsy (CP) and are frequently associated with motor, intellectual and sensory impairments. Speech and language therapy research comprises single-case experimental design and small group studies, limiting evidence-based intervention and possibly exacerbating variation in practice. Aims:…

Promoting Reflective Practice in Continuing Education in France

ERIC Educational Resources Information Center

Ryder, Jane

2012-01-01

Educationalist Fred Korthagen elaborated a model in the 1980s for the relationship between the teacher educator and the teacher which embraces reflective practice as its guiding principle. In the present study, research was carried out into teacher development among a small group of language teachers working in continuing education in France.…

Evaluation of economic efficiencies in clinical retina practice: activity-based cost analysis and modeling to determine impacts of changes in patient management

PubMed Central

Murray, Timothy G; Tornambe, Paul; Dugel, Pravin; Tong, Kuo Bianchini

2011-01-01

Background The purpose of this study is to report the use of activity-based cost analysis to identify areas of practice efficiencies and inefficiencies within a large academic retinal center and a small single-specialty group. This analysis establishes a framework for evaluating rapidly shifting clinical practices (anti-vascular endothelial growth factor therapy, microincisional vitrectomy surgery) and incorporating changing reimbursements for care delivery (intravitreal injections, optical coherence tomography [OCT]) to determine the impact on practice profitability. Pro forma modeling targeted the impact of declining reimbursement for OCT imaging and intravitreal injection using a strategy that incorporates activity-based cost analysis into a direct evaluation schema for clinical operations management. Methods Activity-based costing analyses were performed at two different types of retinal practices in the US, ie, a small single-specialty group practice and an academic hospital-based practice (Bascom Palmer Eye Institute). Retrospective claims data were utilized to identify all procedures performed and billed, submitted charges, allowed charges, and net collections from each of these two practices for the calendar years 2005–2006 and 2007–2008. A pro forma analysis utilizing current reimbursement profiles was performed to determine the impact of altered reimbursement on practice profitability. All analyses were performed by a third party consulting firm. Results The small single-specialty group practice outperformed the academic hospital-based practice on almost all markers of efficiency. In the academic hospital-based practice, only four service lines were profitable, ie, nonlaser surgery, laser surgery, non-OCT diagnostics, and injections. Profit margin varied from 62% for nonlaser surgery to 1% for intravitreal injections. Largest negative profit contributions were associated with office visits and OCT imaging. Conclusion Activity-based cost analysis is a powerful tool to evaluate retinal practice efficiencies. These two distinct practices were able to provide significant increases in clinical care (office visits, ophthalmic imaging, and patient procedures) through maintaining efficiencies of care. Pro forma analysis of 2011 data noted that OCT payments to facilities and physicians continue to decrease dramatically and that this payment decrease further reduced the profitability for the two largest aspects of these retinal practices, ie, intravitreal injections and OCT retinal imaging. Ultimately, all retinal practices are at risk for significant shifts in financial health related to rapidly evolving changes in patterns of care and reimbursement associated with providing outstanding clinical care. PMID:21792278

[Approach to Evidence-based Medicine Exercises Using Flipped Teaching: Introductory Education for Clinical Practice for 4th-Year Pharmacy Students].

PubMed

Onda, Mitsuko; Takagaki, Nobumasa

2018-01-01

　Osaka University of Pharmaceutical Sciences has included an evidence-based medicine (EBM) exercise in the introductory education for clinical practice for 4th-year pharmacy students since 2015. The purpose of this exercise is to learn the process of practice and basic concepts of EBM, especially to cultivate the practical ability to solve patients' problems and answer their questions. Additionally, in 2016, we have attempted flipped teaching. The students are instructed to review the basic knowledge necessary for active learning in this exercise by watching video teaching materials and to bring reports summarizing the contents on the flipped teaching days. The program includes short lectures [overview of EBM, document retrieval, randomized controlled trials (RCTs), and systematic review], exercises [patient, intervention, comparison, outcome (PICO) structuring, critical appraisal of papers in small groups with tutors], and presentations. The program includes: step 1, PICO structuring based on scenarios; step 2, critical appraisal of English-language papers on RCTs using evaluation worksheets; and step 3, reviewing the results of the PICO exercise with patients. The results of the review are shared among groups through general discussion. In this symposium, I discuss students' attitudes, the effectiveness of small group discussions using flipped teaching, and future challenges to be addressed in this program.

Self sufficient world

ERIC Educational Resources Information Center

George, Lynn

1974-01-01

Described the efforts of Sietze Leeflang, a Dutch scientific journalist, and his group of young scientists to take a practical stand on environmental pollution by working their small farm in innovative fashion. (RK)

Classroom Groups in Theory and Practice.

ERIC Educational Resources Information Center

Boydell, Deanne

1979-01-01

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

The Building Blocks of Preschool Success

ERIC Educational Resources Information Center

Beauchat, Katherine A.; Blamey, Katrin L.; Walpole, Sharon

2010-01-01

Written expressly for preschool teachers, this engaging book explains the "whats," "whys," and "how-tos" of implementing best practices for instruction in the preschool classroom. The authors show how to target key areas of language and literacy development across the entire school day, including whole-group and small-group activities, center…

Classroom "Families": Cooperating or Competing--Girls' and Boys' Interactional Styles in a Bilingual Classroom.

ERIC Educational Resources Information Center

Cook-Gumperz, Jenny; Szymanski, Margaret

2001-01-01

Examines how students use gendered discourse practices in small peer group settings to accomplish their school tasks. The analysis contributes to the separate worlds hypothesis by showing how Latino children interactionally orient to their peer group as a gendered context. (Author/VWL)

Teaching with the Case Study Method to Promote Active Learning in a Small Molecule Crystallography Course for Chemistry Students

ERIC Educational Resources Information Center

Campbell, Michael G.; Powers, Tamara M.; Zheng, Shao-Liang

2016-01-01

Implementing the case study method in a practical X-ray crystallography course designed for graduate or upper-level undergraduate chemistry students is described. Compared with a traditional lecture format, assigning small groups of students to examine literature case studies encourages more active engagement with the course material and…

Impact of Sample Size and Variability on the Power and Type I Error Rates of Equivalence Tests: A Simulation Study

ERIC Educational Resources Information Center

Rusticus, Shayna A.; Lovato, Chris Y.

2014-01-01

The question of equivalence between two or more groups is frequently of interest to many applied researchers. Equivalence testing is a statistical method designed to provide evidence that groups are comparable by demonstrating that the mean differences found between groups are small enough that they are considered practically unimportant. Few…

Exploring Secondary Students' Epistemological Features Depending on the Evaluation Levels of the Group Model on Blood Circulation

ERIC Educational Resources Information Center

Lee, Shinyoung; Kim, Heui-Baik

2014-01-01

The purpose of this study is to identify the epistemological features and model qualities depending on model evaluation levels and to explore the reasoning process behind high-level evaluation through small group interaction about blood circulation. Nine groups of three to four students in the eighth grade participated in the modeling practice.…

Sex, pain and cranberries - ideas from the 2006 Registrar Research Workshop.

PubMed

Montgomery, Brett D; McMeniman, Erin; Cameron, Sara Kate; Duncan, Tristram; Prosser, Stuart; Moore, Ray

2007-01-01

The Registrar Research Workshop has been a feature of Australian general practice training since 1994. Twenty five general practice registrars attend the annual 3 day event, which aims to develop registrars' understanding of the research process. Presenters and facilitators are drawn from the academic general practitioner and primary health care research community. Presentations alternate with small group sessions, where groups of five registrars are guided through the process of developing a research question, identifying appropriate research methods, and addressing ethical and funding concerns, before preparing a presentation about their research proposal for their peers. Research questions are developed from unanswered questions that have arisen in registrars' clinical practice.

Assessment Practices of Educational Psychologists in Aotearoa/New Zealand: From Diagnostic to Dialogic Ways of Working

ERIC Educational Resources Information Center

Bourke, Roseanna; Dharan, Vijaya

2015-01-01

Psychologists working in education in Aotearoa/New Zealand work in diverse educational environments making day-to-day decisions informed by evidence-based practice. As a relatively small professional group with a complex work programme, they contribute to the assessments and decision-making processes of children and young people across multiple…

Therapeutic Art Practices with Orphan Children in Bulgaria

ERIC Educational Resources Information Center

Ivanova, Alexandra S.

2004-01-01

This paper presents therapeutic art practices carried out with 60 orphan children in the small town of Ugarchin in northern Bulgaria. In 1999, a group of artists and teachers developed a varied program of art activities for these children. These activities included two 1-week visits and the opening of five art workshops--Art History, Ceramics,…

Chat It Up: Backchanneling to Promote Reflective Practice among In-Service Teachers

ERIC Educational Resources Information Center

Kassner, Laura D.; Cassada, Kate M.

2017-01-01

In a graduate education course geared toward developing reflective teaching practice in in-service teachers, backchannels, in the form of chat rooms, were employed in small groups to facilitate peer feedback during viewings of video recorded instruction. This study examined the nature and quality of peer feedback exchanged in the digital medium…

Lifelong Learning in Ethical Practice: A Challenge for Continuing Medical Education.

ERIC Educational Resources Information Center

Kenny, Nuala; Sargeant, Joan; Allen, Michael

2001-01-01

Questionnaires and small-group discussions with a physician-ethicist revealed that physicians had very little formal ethics training in medical school. They did not feel they needed a very high level of confidence regarding ethical issues in practice, but lacked a systematic approach to identification and analysis of ethical issues. (Contains 24…

A Simple Laboratory Practical to Illustrate RNA Mediated Gene Interference Using Drosophila Cell Culture

ERIC Educational Resources Information Center

Buluwela, Laki; Kamalati, Tahereh; Photiou, Andy; Heathcote, Dean A.; Jones, Michael D.; Ali, Simak

2010-01-01

RNA mediated gene interference (RNAi) is now a key tool in eukaryotic cell and molecular biology research. This article describes a five session laboratory practical, spread over a seven day period, to introduce and illustrate the technique. During the exercise, students working in small groups purify PCR products that encode "in vitro"…

Gender-related differences in general practice preferences: longitudinal evidence from the Netherlands 1982-2001.

PubMed

Mayorova, Tanja; Stevens, Fred; Scherpbier, Albert; van der Velden, Lud; van der Zee, Jouke

2005-04-01

The proportion of female doctors is increasing. Yet, there is little evidence that demonstrates changing career preferences over a long period, nor do we know the long-term impact of changing male-female ratios in medicine. We explored this within the GP profession. By means of a longitudinal cohort study (postal questionnaires) among all graduated GPs in the Netherlands between 1982 and 2001 we explored trends in career preferences and investigated whether practice preferences of men and women differ over the years. Preference of becoming a GP has significantly decreased among men. GPs prefer group practice more than solo practice. Female doctors were more likely to prefer a small practice and to associate. Men prefer to take over an established practice. Main reasons to abstain from practicing as a GP for men were having found another job or not having found a practice according to their preferences. Main reasons for women were having decided for another job and family life. We conclude that male and female GPs select differently on practice setting. Preferences change through the years but tend to converge. Gender differences are likely due to the circumstance that career choices for men are more influenced by fluctuating labour markets, while female choices are more based on family circumstances. We expect that as more women will become a GP the demand for small group practices will increase. Also, as many female GPs abstain from practicing after having finished a vocational GP training program it will be essential to create work facilities to keep them available for the GP labour market.

[Qualitative evaluation of employer requirements associated with occupational health and safety as good practice in small-scale enterprises].

PubMed

Kuroki, Naomi; Miyashita, Nana; Hino, Yoshiyuki; Kayashima, Kotaro; Fujino, Yoshihisa; Takada, Mikio; Nagata, Tomohisa; Yamataki, Hajime; Sakuragi, Sonoko; Kan, Hirohiko; Morita, Tetsuya; Ito, Akiyoshi; Mori, Koji

2009-09-01

The purpose of this study was to identify what motivates employers to promote good occupational health and safety practices in small-scale enterprises. Previous studies have shown that small-scale enterprises generally pay insufficient attention to issues of occupational health and safety. These findings were mainly derived from questionnaire based surveys. Nevertheless, some small-scale enterprises in which employers exercise good leadership do take a progressive approach to occupational health and safety. Although good practices can be identified in small-scale enterprises, it remains unclear what motivates employers in small-scale enterprises to actively implement occupational health and safety practices. We speculated that identifying employer motivations in promoting occupational health would help to spread good practices among small-scale enterprises. Using a qualitative approach based on the KJ methods, we interviewed ten employers who actively promote occupational health and safety in the workplace. The employers were asked to discuss their views of occupational health and safety in their own words. A semi-structured interview format was used, and transcripts were made of the interviews. Each transcript was independently coded by two or more researchers. These transcripts and codes were integrated and then the research group members discussed the heading titles and structural relationships between them according to the KJ method. Qualitative analysis revealed that all the employers expressed a strong interest in a "good company" and "good management". They emphasized four elements of "good management", namely "securing human resources", "trust of business partners", "social responsibility" and "employer's health condition itself", and considered that addressing occupational health and safety was essential to the achievement of these four elements. Consistent with previous findings, the results showed that implementation of occupational health and safety activities depended on "cost", "human resources", "time to perform", and "advisory organization". These results suggest that employer awareness of the relationship between good management and occupational health is essential to the implementation of occupational health and safety practices in small-scale enterprises.

A qualitative evaluation of owner and worker health and safety beliefs in small auto collision repair shops.

PubMed

Parker, David L; Bejan, Anca; Brosseau, Lisa M

2012-05-01

About 223,000 people are employed in approximately 34,500 auto collision repair businesses. In general, employees and owners in these establishments lack knowledge of health and safety practices and do not have the technical expertise to make their place of work safer. Three employee and three owner focus groups were conducted. The goal of these focus groups was to characterize health and safety beliefs of owners and employees and to determine the best methods for motivating safety improvements in collision repair shops. A total of 11 owners and 19 workers participated in these focus groups. Employees and owners were aware of a wide range of hazards. Both groups noted difficulty in staying informed. Employers were hesitant to set and enforce safety and health rules. Employees perceive owners to be unwilling to dedicate the resources to make the workplace safer and provide personal protective equipment. Both groups felt insurance reimbursement practices placed undue pressure on employees. Focus groups provide important insights into intervention development in very small enterprises in general and auto collision shops in specific. Employers were conflicted about allowing employees a certain level of independence while also maintaining a safe workplace. From the employee perspective, owners frequently fail to provide adequate personal protective equipment and make improvements needed to ensure safe work. The unique managerial needs of very small enterprises must be accounted for if health and safety programs are to be implemented in these establishments. Copyright © 2012 Wiley Periodicals, Inc.

Self-insurance and the potential effects of health reform on the small-group market.

PubMed

Linehan, Kathryn

2010-12-21

The Patient Protection and Affordable Care Act (PPACA) as amended by the Health Care Education Reconciliation Act of 2010 makes landmark changes to health insurance markets. Individual and small-group insurance plans and markets will see the biggest changes, but PPACA also affects large employer and self-insured plans by imposing rules for benefit design and health plan practices. Over half of workers--most often those in very large firms--are covered by self-insured health plans in which employers (or employee groups) bear all or some of the risk of providing insurance coverage to a defined population of workers and their dependents. As PPACA provisions become effective, some have argued that smaller firms that offer insurance may opt to self-insure their health benefits because of new small-group market rules. Such a shift could affect risk pooling in the small-group market. This paper examines the definition and prevalence of self-insured health plans, the application of PPACA provisions to these plans, and the possible effects on the broader health insurance market, should many more employers decide to self-insure.

Do clinical practice education groups result in sustained change in GP prescribing?

PubMed

Richards, Dee; Toop, Les; Graham, Patrick

2003-04-01

Concern has been expressed at the poor uptake of evidence into clinical practice. This is despite the fact that continuing education is an embedded feature of quality assurance in general practice. There are a variety of clinical practice education methods available for dissemination of new evidence. Recent systematic reviews indicate that the effectiveness of these different strategies is extremely variable. Our aim was to determine whether a peer-led small group education pilot programme used to promote rational GP prescribing is an effective tool in changing practice when added to prescribing audit and feedback, academic detailing and educational bulletins, and to determine whether any effect seen decays over time. A retrospective analysis of a controlled trial of a small group education strategy with 24 month follow-up was carried out. The setting was an independent GPs association (IPA) of 230 GPs in the Christchurch New Zealand urban area. All intervention and control group GPs were already receiving prescribing audit and feedback, academic detailing and educational bulletins. The intervention group were the first 52 GPs to respond to an invitation to pilot the project. Two control groups were used, one group who joined the pilot later and a second group which included all other GPs in the IPA. The main outcome measures were targeted prescribing data for 12 months before and 24 months after each of four education sessions. An effect in the expected direction was seen in six of the eight key messages studied. This effect was statistically significant for five of the eight messages studied. The effect size varied between 7 and 40%. Where a positive effect was seen, the effect decayed with time but persisted to a significant level for 6-24 months of observation. The results support a positive effect of the education strategy on prescribing behaviour in the intervention group for most outcomes measured. The effect seen is statistically significant, sustained and is in addition to any effect of the other pharmaceutical educational initiatives already undertaken by the IPA.

Educating for Leadership in a Divided Country: Educational Practices for a New Nigeria

ERIC Educational Resources Information Center

Aydin, Hasan

2013-01-01

This study reports on a 2011 qualitative field study conducted at the Nigerian Turkish International Colleges (NTICs) in Abuja, Nigeria. The study uses both in-depth interviews and small focus groups to elicit the lived experience of six identified groups of stakeholders (administrators, teachers, students, parents, Nigerian leaders, and…

Cooperative/Collaborative Learning: Research and Practice (Primarily) at the Collegiate Level, Parts I and II.

ERIC Educational Resources Information Center

Cooper, James L.; And Others

1991-01-01

Cooperative learning may be defined as a structured, systematic instructional strategy in which small groups work together toward a common goal. It differs from collaborative learning in its emphasis on highly structured techniques for ensuring positive interdependence within groups and its insistence on individual accountability rather than…

Reciprocal Peer Tutoring and Repeated Reading: Increasing Practicality Using Student Groups

ERIC Educational Resources Information Center

Oddo, Maria; Barnett, David W.; Hawkins, Renee O.; Musti-Rao, Shobana

2010-01-01

Previous research has investigated the efficacy of peer-mediated repeated reading (RR) interventions carried out by student dyads. This research extends the existing research by investigating the impact of RR on oral reading fluency and comprehension when carried out by a teacher in small groups of fourth-grade students. Outcomes were analyzed…

Engaging Undergraduate Biology Students in Scientific Modeling: Analysis of Group Interactions, Sense-Making, and Justification

ERIC Educational Resources Information Center

Bierema, Andrea M.-K.; Schwarz, Christina V.; Stoltzfus, Jon R.

2017-01-01

National calls for improving science education (e.g., "Vision and Change") emphasize the need to learn disciplinary core ideas through scientific practices. To address this need, we engaged small groups of students in developing diagrammatic models within two (one large-enrollment and one medium-enrollment) undergraduate introductory…

Impact of Student vs Faculty Facilitators on Motivational Interviewing Student Outcomes.

PubMed

Widder-Prewett, Rebecca; Draime, Juanita A; Cameron, Ginger; Anderson, Douglas; Pinkerton, Mark; Chen, Aleda M H

2017-08-01

Objective. To determine the impact of student or faculty facilitation on student self-assessed attitudes, confidence, and competence in motivational interviewing (MI) skills; actual competence; and evaluation of facilitator performance. Methods. Second-year pharmacy (P2) students were randomly assigned to a student or faculty facilitator for a four-hour, small-group practice of MI skills. MI skills were assessed in a simulated patient encounter with the mMITI (modified Motivational Interviewing Treatment Integrity) tool. Students completed a pre-post, 6-point, Likert-type assessment addressing the research objectives. Differences were assessed using a Mann-Whitney U test. Results. Student (N=44) post-test attitudes, confidence, perceived or actual competence, and evaluations of facilitator performance were not different for faculty- and student-facilitated groups. Conclusion. Using pharmacy students as small-group facilitators did not affect student performance and were viewed as equally favorable. Using pharmacy students as facilitators can lessen faculty workload and provide an outlet for students to develop communication and facilitation skills that will be needed in future practice.

Multilevel Grouping, Grades Preschool-5 Small and Rural Schools. Outstanding Teaching Practices Series, Volume 4.

ERIC Educational Resources Information Center

Regional Laboratory for Educational Improvement of the Northeast & Islands, Andover, MA.

This document reports on the 1991-92 Teacher Recognition Program honoring exceptional teachers from rural and small schools in the New England states, New York, Puerto Rico, and the Virgin Islands. The program was intended to enrich the quality of education in the Northeast United States and its Caribbean jurisdictions by sharing information about…

SU-E-T-257: Output Constancy: Reducing Measurement Variations in a Large Practice Group

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

Hedrick, K; Fitzgerald, T; Miller, R

2014-06-01

Purpose: To standardize output constancy check procedures in a large medical physics practice group covering multiple sites, in order to identify and reduce small systematic errors caused by differences in equipment and the procedures of multiple physicists. Methods: A standardized machine output constancy check for both photons and electrons was instituted within the practice group in 2010. After conducting annual TG-51 measurements in water and adjusting the linac to deliver 1.00 cGy/MU at Dmax, an acrylic phantom (comparable at all sites) and PTW farmer ion chamber are used to obtain monthly output constancy reference readings. From the collected charge reading,more » measurements of air pressure and temperature, and chamber Ndw and Pelec, a value we call the Kacrylic factor is determined, relating the chamber reading in acrylic to the dose in water with standard set-up conditions. This procedure easily allows for multiple equipment combinations to be used at any site. The Kacrylic factors and output results from all sites and machines are logged monthly in a central database and used to monitor trends in calibration and output. Results: The practice group consists of 19 sites, currently with 34 Varian and 8 Elekta linacs (24 Varian and 5 Elekta linacs in 2010). Over the past three years, the standard deviation of Kacrylic factors measured on all machines decreased by 20% for photons and high energy electrons as systematic errors were found and reduced. Low energy electrons showed very little change in the distribution of Kacrylic values. Small errors in linac beam data were found by investigating outlier Kacrylic values. Conclusion: While the use of acrylic phantoms introduces an additional source of error through small differences in depth and effective depth, the new standardized procedure eliminates potential sources of error from using many different phantoms and results in more consistent output constancy measurements.« less

Investigation of the working behavior of part-time occupational physicians using practical recording sheets.

PubMed

Ikegami, Kazunori; Nozawa, Hiroki; Michii, Satoshi; Sugano, Ryosuke; Ando, Hajime; Hasegawa, Masayuki; Kitamura, Hiroko; Ogami, Akira

2016-12-03

We investigated the working behavior of part-time occupational physicians using practical recording sheets to clarify issues of occupational physicians' activities according to industrial groups or size of business. We collected 561 recording sheets in 96 industries from 11 part-time occupational physicians as collaborators, who volunteered to be a part of this research. We collected a variety of information from the practical recording sheets, including the industry in which each occupational physician was employed, the annual number of times of work attendance, occupational physician-conducted workplace patrol, and employee health management. We investigated their annual practices regarding work environment management, work management, health management, and general occupational health management. In addition, we analyzed the differences between the secondary and tertiary industry groups and between the group of offices employing 100 people or fewer (≤100 group) and 101 people and above (≥101 group) in each industry group. The median work attendance by all occupational physicians was four times a year; the tertiary industry group had a significantly lower rate of work attendance than the secondary industry group. The occupational physicians' participation in risk assessment, mental health measures or overwork prevention, and the formulation of the occupational health management system and the annual plan were significantly lower in the tertiary industry group than in the secondary industry group. We observed that for the annual number of times of work attendance, occupational physician-conducted workplace patrol was significantly lower in the ≤100 group than in the ≥101 group in each industry group. These findings show that occupational physicians' activities have not been conducted enough in tertiary industries and small-sized offices employing ≤100 people. It would be necessary to evaluate how to provide occupational health service or appropriate occupational physicians' activities for small-sized offices or tertiary industries. Thereafter, it would likely be beneficial to construct a system to support the activities of part-time occupational physicians as well as the activity of occupational health at workplaces.

Managing Astronomy Research Data: Case Studies of Big and Small Research Projects

NASA Astrophysics Data System (ADS)

Sands, Ashley E.

2015-01-01

Astronomy data management refers to all actions taken upon data over the course of the entire research process. It includes activities involving the collection, organization, analysis, release, storage, archiving, preservation, and curation of research data. Astronomers have cultivated data management tools, infrastructures, and local practices to ensure the use and future reuse of their data. However, new sky surveys will soon amass petabytes of data requiring new data management strategies.The goal of this dissertation, to be completed in 2015, is to identify and understand data management practices and the infrastructure and expertise required to support best practices. This will benefit the astronomy community in efforts toward an integrated scholarly communication framework.This dissertation employs qualitative, social science research methods (including interviews, observations, and document analysis) to conduct case studies of data management practices, covering the entire data lifecycle, amongst three populations: Sloan Digital Sky Survey (SDSS) collaboration team members; Individual and small-group users of SDSS data; and Large Synoptic Survey Telescope (LSST) collaboration team members. I have been observing the collection, release, and archiving of data by the SDSS collaboration, the data practices of individuals and small groups using SDSS data in journal articles, and the LSST collaboration's planning and building of infrastructure to produce data.Preliminary results demonstrate that current data management practices in astronomy are complex, situational, and heterogeneous. Astronomers often have different management repertoires for working on sky surveys and for their own data collections, varying their data practices as they move between projects. The multitude of practices complicates coordinated efforts to maintain data.While astronomy expertise proves critical to managing astronomy data in the short, medium, and long term, the larger astronomy data workforce encompasses a greater breadth of educational backgrounds. Results show that teams of individuals with distinct expertise are key to ensuring the long-term preservation and usability of astronomy datasets.

Effect of Long-Term Physical Activity Practice after Cardiac Rehabilitation on Some Risk Factors

ERIC Educational Resources Information Center

Freyssin, Celine, Jr.; Blanc, Philippe; Verkindt, Chantal; Maunier, Sebastien; Prieur, Fabrice

2011-01-01

The objective of this study was to evaluate the effects of long-term physical activity practice after a cardiac rehabilitation program on weight, physical capacity and arterial compliance. The Dijon Physical Activity Score was used to identify two groups: sedentary and active. Weight, distance at the 6-min walk test and the small artery elasticity…

A Community of Practice Model for Introducing Mobile Tablets to University Faculty

ERIC Educational Resources Information Center

Drouin, Michelle; Vartanian, Lesa Rae; Birk, Samantha

2014-01-01

We examined the effectiveness of a community of practice (CoP) model for introducing tablets to 139 faculty members at a higher education institution. Using a CoP within a systems model, we used large- and small-group mentorship to foster collaboration among faculty members. Most faculty members agreed that the project was well organized and…

Preservice Teachers' Professional Development in a Community of Practice Summer Literacy Camp for Children At-Risk: A Sociocultural Perspective

ERIC Educational Resources Information Center

Richards, Janet C.

2006-01-01

This inquiry applied an innovative sociocultural framework to examine transformations in preservice teachers' professional development as they worked with children at-risk in a summer literacy camp. The camp incorporated a community of practice model in which teams of masters and doctoral students mentored small groups of preservice teachers. The…

Interactive large-group teaching in a dermatology course.

PubMed

Ochsendorf, F R; Boehncke, W-H; Sommerlad, M; Kaufmann, R

2006-12-01

This is a prospective study to find out whether an interactive large-group case-based teaching approach combined with small-group bedside teaching improves student satisfaction and learning outcome in a practical dermatology course. During two consecutive terms a rotating system of large-group interactive case-study-method teaching with two tutors (one content expert, one process facilitator) and bedside teaching with randomly appointed tutors was evaluated with a nine-item questionnaire and multiple-choice test performed at the beginning and the end of the course (n = 204/231 students evaluable). The results of three different didactic approaches utilized over the prior year served as a control. The interactive course was rated significantly better (p < 0.0001) than the standard course with regard to all items. The aggregate mark given by the students for the whole course was 1.58-0.61 (mean +/- SD, range 1 (good)-5 (poor)). This was significantly better than the standard course (p < 0.0001) and not different from small-group teaching approaches. The mean test results in the final examination improved significantly (p < 0.01). The combination of large-group interactive teaching and small-group bedside teaching was well accepted, improved the learning outcome, was rated as good as a small-group didactic approach and needed fewer resources in terms of personnel.

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

Using Key Performance Indicators to Do More with Less in Your Practice

PubMed Central

Taylor, Brian

2016-01-01

Key performance indicators (KPIs) are important to managing any sustainable business. This tutorial provides audiologists, especially those with little formal business education, with a working definition of KPIs. A major theme of this article is that a relatively small group of about a dozen KPIs are an essential part of managing a successful audiology practice. The most useful KPIs for managing retail-oriented and medically oriented practices will be provided. Best practice benchmarks and how to use them to hire, coach, and train your staff also is covered. PMID:28028323

Using Key Performance Indicators to Do More with Less in Your Practice.

PubMed

Taylor, Brian

2016-11-01

Key performance indicators (KPIs) are important to managing any sustainable business. This tutorial provides audiologists, especially those with little formal business education, with a working definition of KPIs. A major theme of this article is that a relatively small group of about a dozen KPIs are an essential part of managing a successful audiology practice. The most useful KPIs for managing retail-oriented and medically oriented practices will be provided. Best practice benchmarks and how to use them to hire, coach, and train your staff also is covered.

Effect of pay-for-performance incentives on quality of care in small practices with electronic health records: a randomized trial.

PubMed

Bardach, Naomi S; Wang, Jason J; De Leon, Samantha F; Shih, Sarah C; Boscardin, W John; Goldman, L Elizabeth; Dudley, R Adams

2013-09-11

Most evaluations of pay-for-performance (P4P) incentives have focused on large-group practices. Thus, the effect of P4P in small practices, where many US residents receive care, is largely unknown. Furthermore, whether electronic health records (EHRs) with chronic disease management capabilities support small-practice response to P4P has not been studied. To assess the effect of P4P incentives on quality in EHR-enabled small practices in the context of an established quality improvement initiative. A cluster-randomized trial of small (<10 clinicians) primary care clinics in New York City from April 2009 through March 2010. A city program provided all participating clinics with the same EHR software with decision support and patient registry functionalities and quality improvement specialists offering technical assistance. Incentivized clinics were paid for each patient whose care met the performance criteria, but they received higher payments for patients with comorbidities, who had Medicaid insurance, or who were uninsured (maximum payments: $200/patient; $100,000/clinic). Quality reports were given quarterly to both the intervention and control groups. Comparison of differences in performance improvement, from the beginning to the end of the study, between control and intervention clinics for aspirin or antithrombotic prescription, blood pressure control, cholesterol control, and smoking cessation interventions. Mixed-effects logistic regression was used to account for clustering of patients within clinics, with a treatment by time interaction term assessing the statistical significance of the effect of the intervention. Participating clinics (n = 42 for each group) had similar baseline characteristics, with a mean of 4592 (median, 2500) patients at the intervention group clinics and 3042 (median, 2000) at the control group clinics. Intervention clinics had greater adjusted absolute improvement in rates of appropriate antithrombotic prescription (12.0% vs 6.1%, difference: 6.0% [95% CI, 2.2% to 9.7%], P = .001 for interaction term), blood pressure control (no comorbidities: 9.7% vs 4.3%, difference: 5.5% [95% CI, 1.6% to 9.3%], P = .01 for interaction term; with diabetes mellitus: 9.0% vs 1.2%, difference: 7.8% [95% CI, 3.2% to 12.4%], P = .007 for interaction term; with diabetes mellitus or ischemic vascular disease: 9.5% vs 1.7%, difference: 7.8% [95% CI, 3.0% to 12.6%], P = .01 for interaction term), and in smoking cessation interventions (12.4% vs 7.7%, difference: 4.7% [95% CI, -0.3% to 9.6%], P = .02 for interaction term). Intervention clinics performed better on all measures for Medicaid and uninsured patients except cholesterol control, but no differences were statistically significant. Among small EHR-enabled clinics, a P4P incentive program compared with usual care resulted in modest improvements in cardiovascular care processes and outcomes. Because most proposed P4P programs are intended to remain in place more than a year, further research is needed to determine whether this effect increases or decreases over time. clinicaltrials.gov Identifier: NCT00884013.

Student satisfaction and self-assessment after small group discussion in a medical ethics education program.

PubMed

Joh, Hee-Kyung; Shin, Jwa-Seop

2009-09-01

Small group discussions are useful tools in medical ethics education. We aimed to assess student satisfaction with specific components of a small group discussion and to evaluate student self-assessment of the objectives of education. A structured questionnaire was developed after a literature review and a focus group interview. Components of the small group discussion were categorized by discussion case (self, other), individual activities (self-study, making materials, presentation experience), and group activities (preclass/in-class/postclass/plenary discussion, instructor's comments). The items for student self-assessment were: "To specify ethical issue in actual practice", "To get new knowledge", "To consider doctor's entity", "Empathy to others", "To get multidimensional viewpoint", "Viewpoint change", "To deliver my thought clearly", and "Ability to confront the medical ethics dilemma in the future". After the survey, an in-depth interview was performed to determine the reason behind the students' answers. A total of 121 students responded, for whom overall satisfaction and self-assessment were high. Students reported greater satisfaction with self-case, presentation experience, in-class discussion, and instructor's comments but less satisfaction with self-study before class and postclass discussion. Student self-assessment was highest in the ability to specify an ethical issue and lowest for viewpoint change and self-confidence. After multivariate analysis, higher student self-assessment was associated with greater satisfaction with the small group discussion. To improve the quality of medical ethics education, close investigation and monitoring of each component of the small group discussion and student achievement are essential, as is continuous feedback.

Preschool Daily Patterns of Physical Activity Driven by Location and Social Context

ERIC Educational Resources Information Center

Schlechter, Chelsey R.; Rosenkranz, Richard R.; Fees, Bronwyn S.; Dzewaltowski, David A.

2017-01-01

Background: Preschool children are recommended to spend at least 15 minutes/hour (25% time) in light-to-vigorous physical activity (total physical activity, TPA). Preschool provider practices, such as whether children are put in small group or whole-group activities, are likely to affect children's TPA levels during preschool. The current study…

Attitudes and Language Use in Group Discussions on Socio-Scientific Issues

ERIC Educational Resources Information Center

Lindahl, Mats Gunnar; Folkesson, Anne-Mari

2016-01-01

The school systems of many countries have been pervaded by student-centred pedagogy making students' small group discussion a common feature of the classroom practice.However, there is a lack of studies focussing different modes of discussion for the purpose of finding out whether some modes are more beneficial than others. Hence, the aim of this…

A Connective Ethnography of Peer Knowledge Sharing and Diffusion in a Tween Virtual World

ERIC Educational Resources Information Center

Fields, Deborah A.; Kafai, Yasmin B.

2009-01-01

Prior studies have shown how knowledge diffusion occurs in classrooms and structured small groups around assigned tasks yet have not begun to account for widespread knowledge sharing in more native, unstructured group settings found in online games and virtual worlds. In this paper, we describe and analyze how an insider gaming practice spread…

Small-Sample DIF Estimation Using SIBTEST, Cochran's Z, and Log-Linear Smoothing

ERIC Educational Resources Information Center

Lei, Pui-Wa; Li, Hongli

2013-01-01

Minimum sample sizes of about 200 to 250 per group are often recommended for differential item functioning (DIF) analyses. However, there are times when sample sizes for one or both groups of interest are smaller than 200 due to practical constraints. This study attempts to examine the performance of Simultaneous Item Bias Test (SIBTEST),…

Responses to Different Types of Inquiry Prompts: College Students' Discourse, Performance, and Perceptions of Group Work in an Engineering Class

ERIC Educational Resources Information Center

Balgopal, Meena M.; Casper, Anne Marie A.; Atadero, Rebecca A.; Rambo-Hernandez, Karen E.

2017-01-01

Working in small groups to solve problems is an instructional strategy that allows university students in science, technology, engineering, and mathematics disciplines the opportunity to practice interpersonal and professional skills while gaining and applying discipline-specific content knowledge. Previous research indicates that not all group…

Correct fair market value calculation needed to avoid regulatory challenges.

PubMed

Dietrich, M O

1997-09-01

In valuing a physician practice for acquisition, it is important for buyers and sellers to distinguish between fair market value and strategic value. Although many buyers would willingly pay for the strategic value of a practice, tax-exempt buyers are required by law to consider only the fair market value in setting a bid price. Valuators must adjust group earnings to exclude items that do not apply to any willing seller and include items that do apply to any willing seller to arrive at the fair market value of the practice. In addition, the weighted average cost of capital (WACC), which becomes the discount rate in the valuation model, is critical to the measure of value of the practice. Small medical practices are assumed to have few hard assets and little long-term debt, and the WACC is calculated on the basis of those assumptions. When a small practice has considerable debt, however, this calculated WACC may be inappropriate for valuing the practice. In every case, evidence that shows that a transaction has been negotiated "at arm's length" should stave off any regulatory challenge.

Teaching medical management and operations engineering for systems-based practice to radiology residents.

PubMed

Brandon, Catherine J; Mullan, Patricia B

2013-03-01

To better prepare radiology residents for providing care within the context of the larger health care system, this study evaluated the feasibility and impact of a curriculum to enhance radiology residents' understanding and ability to apply concepts from medical management and industrial and operational engineering to systems-based practice problems in radiology practice. A multiprofessional team including radiology, medical education, and industrial and operational engineering professionals collaborated in developing a seven-module curriculum, including didactic lectures, interactive large-group analysis, and small-group discussions with case-based radiology examples, which illustrated real-life management issues and the roles physicians held. Residents and faculty participated in topic selection. Pre- and post-instruction formative assessments were administered, and results were shared with residents during teaching sessions. Attendance and participation in case-based scenario resolutions indicate the feasibility and impact of the interactive curriculum on residents' interest and ability to apply curricular concepts to systems-based practice in radiology. Paired t test analyses (P < .05) and effect sizes showed residents significantly increased their knowledge and ability to apply concepts to systems-based practice issues in radiology. Our iterative curriculum development and implementation process demonstrated need and support for a multiprofessional team approach to teach management and operational engineering concepts. Curriculum topics are congruent with Accreditation Council for Graduate Medical Education requirements for systems-based practice. The case-based curriculum using a mixed educational format of didactic lectures and small-group discussion and problem analysis could be adopted for other radiology programs, for both residents and continuing medical education applications. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

Will Large DSO-Managed Group Practices Be the Predominant Setting for Oral Health Care by 2025? Two Viewpoints: Viewpoint 1: Large DSO-Managed Group Practices Will Be the Setting in Which the Majority of Oral Health Care Is Delivered by 2025 and Viewpoint 2: Increases in DSO-Managed Group Practices Will Be Offset by Models Allowing Dentists to Retain the Independence and Freedom of a Traditional Practice.

PubMed

Cole, James R; Dodge, William W; Findley, John S; Young, Stephen K; Horn, Bruce D; Kalkwarf, Kenneth L; Martin, Max M; Winder, Ronald L

2015-05-01

This Point/Counterpoint article discusses the transformation of dental practice from the traditional solo/small-group (partnership) model of the 1900s to large Dental Support Organizations (DSO) that support affiliated dental practices by providing nonclinical functions such as, but not limited to, accounting, human resources, marketing, and legal and practice management. Many feel that DSO-managed group practices (DMGPs) with employed providers will become the setting in which the majority of oral health care will be delivered in the future. Viewpoint 1 asserts that the traditional dental practice patterns of the past are shifting as many younger dentists gravitate toward employed positions in large group practices or the public sector. Although educational debt is relevant in predicting graduates' practice choices, other variables such as gender, race, and work-life balance play critical roles as well. Societal characteristics demonstrated by aging Gen Xers and those in the Millennial generation blend seamlessly with the opportunities DMGPs offer their employees. Viewpoint 2 contends the traditional model of dental care delivery-allowing entrepreneurial practitioners to make decisions in an autonomous setting-is changing but not to the degree nor as rapidly as Viewpoint 1 professes. Millennials entering the dental profession, with characteristics universally attributed to their generation, see value in the independence and flexibility that a traditional practice allows. Although DMGPs provide dentists one option for practice, several alternative delivery models offer current dentists and future dental school graduates many of the advantages of DMGPs while allowing them to maintain the independence and freedom a traditional practice provides.

Memory Transmission in Small Groups and Large Networks: An Agent-Based Model.

PubMed

Luhmann, Christian C; Rajaram, Suparna

2015-12-01

The spread of social influence in large social networks has long been an interest of social scientists. In the domain of memory, collaborative memory experiments have illuminated cognitive mechanisms that allow information to be transmitted between interacting individuals, but these experiments have focused on small-scale social contexts. In the current study, we took a computational approach, circumventing the practical constraints of laboratory paradigms and providing novel results at scales unreachable by laboratory methodologies. Our model embodied theoretical knowledge derived from small-group experiments and replicated foundational results regarding collaborative inhibition and memory convergence in small groups. Ultimately, we investigated large-scale, realistic social networks and found that agents are influenced by the agents with which they interact, but we also found that agents are influenced by nonneighbors (i.e., the neighbors of their neighbors). The similarity between these results and the reports of behavioral transmission in large networks offers a major theoretical insight by linking behavioral transmission to the spread of information. © The Author(s) 2015.

Effect of Practicing Soccer Juggling With Different Sized Balls Upon Performance, Retention, and Transfer to Ball Reception.

PubMed

Raastad, Olav; Aune, Tore Kristian; van den Tillaar, Roland

2016-10-01

The aim of this study was to investigate if making the skill acquisition phase more difficult or easier would enhance performance in soccer juggling, and if this practice has a positive intertask transfer effect to ball reception performance. Twenty-two adolescent soccer players were tested in juggling a soccer ball and in the control of an approaching ball at a pre, post and retention test. The participants were randomly divided in a small ball size and bigger ball size training group that both trained four times per week for 6 weeks. At the post and retention test both groups enhanced performance in soccer juggling test with no difference between groups and no increase in ball reception performance at these tests. It was concluded that about intra task transfer and retention of soccer juggling skills, it does not matter if you increase (small balls) or decrease the difficulty (larger balls) when using the same amount of practice time within the skill acquisition phase in soccer juggling. In addition that for ball juggling and ball reception (inter task) these two tasks differ too much in afferent information and movement characteristics that no positive transfer between these two skills no positive intertask transfer can be expected.

Geritalk: communication skills training for geriatric and palliative medicine fellows.

PubMed

Kelley, Amy S; Back, Anthony L; Arnold, Robert M; Goldberg, Gabrielle R; Lim, Betty B; Litrivis, Evgenia; Smith, Cardinale B; O'Neill, Lynn B

2012-02-01

Expert communication is essential to high-quality care for older patients with serious illness. Although the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatric and palliative medicine fellows is often inadequate or unavailable. The current study drew upon the educational principles and format of an evidence-based, interactive teaching method to develop an intensive communication skills training course designed specifically to address the common communication challenges that geriatric and palliative medicine fellows face. The 2-day retreat, held away from the hospital environment, included large-group overview presentations, small-group communication skills practice, and development of future skills practice commitment. Faculty received in-depth training in small-group facilitation techniques before the course. Geriatric and palliative medicine fellows were recruited to participate in the course and 100% (n = 18) enrolled. Overall satisfaction with the course was very high (mean 4.8 on a 5-point scale). After the course, fellows reported an increase in self-assessed preparedness for specific communication challenges (mean increase 1.4 on 5-point scale, P < .001). Two months after the course, fellows reported a high level of sustained skills practice (mean 4.3 on 5-point scale). In sum, the intensive communication skills program, customized for the specific needs of geriatric and palliative medicine fellows, improved fellows' self-assessed preparedness for challenging communication tasks and provided a model for ongoing deliberate practice of communication skills. © 2012, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

Geritalk: Communication Skills Training for Geriatrics and Palliative Medicine Fellows

PubMed Central

Kelley, Amy S.; Back, Anthony L.; Arnold, Robert M.; Goldberg, Gabrielle R.; Lim, Betty B.; Litrivis, Evgenia; Smith, Cardinale B.; O’Neill, Lynn B.

2011-01-01

Expert communication is essential to high quality care for older patients with serious illness. While the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatrics and palliative medicine fellows is often inadequate or unavailable. We drew upon the educational principles and format of an evidence-based, interactive teaching method, to develop an intensive communication skills training course designed specifically to address the common communication challenges faced by geriatrics and palliative medicine fellows. The 2-day retreat, held away from the hospital environment, included large-group overview presentations, small-group communication skills practice, and development of future skills practice commitment. Faculty received in-depth training in small-group facilitation techniques prior to the course. Geriatrics and palliative medicine fellows were recruited to participate in the course and 100% (n=18) enrolled. Overall satisfaction with the course was very high (mean 4.8 on 5-point scale). Compared to before the course, fellows reported an increase in self-assessed preparedness for specific communication challenges (mean increase 1.4 on 5-point scale, p<0.01). Two months after the course, fellows reported a high level of sustained skills practice (mean 4.3 on 5-point scale). In sum, the intensive communication skills program, tailored to the specific needs of geriatrics and palliative medicine fellows, improved fellows’ self-assessed preparedness for challenging communication tasks and provided a model for ongoing deliberate practice of communication skills. PMID:22211768

Basic reference aids for small medical libraries.

PubMed

Blair, E D

1967-04-01

Selected primarily for the small medical library, this list is compiled to serve as a practical guide for the librarian in developing and utilizing an effective reference collection. Arrangement is by broad subject groups; titles chosen are chiefly in English with geographic coverage limited to the United States and Canada. Texts in subject fields have been omitted since these are adequately covered in several comprehensive guides to the literature.

Supporting Students with Autistic Spectrum Disorder (ASD) at Secondary School: A Parent and Student Perspective

ERIC Educational Resources Information Center

Tobias, Adele

2009-01-01

This paper describes a small-scale research project undertaken in July 2007, which focused on a group of students with a diagnosis of autistic spectrum disorder (ASD) currently attending a mainstream secondary school. Three focus groups were held with students in Years 9 and 11 and with their parents in order to explore current practice on…

Developing the learning physical science curriculum: Adapting a small enrollment, laboratory and discussion based physical science course for large enrollments

NASA Astrophysics Data System (ADS)

Goldberg, Fred; Price, Edward; Robinson, Stephen; Boyd-Harlow, Danielle; McKean, Michael

2012-06-01

We report on the adaptation of the small enrollment, lab and discussion based physical science course, Physical Science and Everyday Thinking (PSET), for a large-enrollment, lecture-style setting. Like PSET, the new Learning Physical Science (LEPS) curriculum was designed around specific principles based on research on learning to meet the needs of nonscience students, especially prospective and practicing elementary and middle school teachers. We describe the structure of the two curricula and the adaptation process, including a detailed comparison of similar activities from the two curricula and a case study of a LEPS classroom implementation. In LEPS, short instructor-guided lessons replace lengthier small group activities, and movies, rather than hands-on investigations, provide the evidence used to support and test ideas. LEPS promotes student peer interaction as an important part of sense making via “clicker” questions, rather than small group and whole class discussions typical of PSET. Examples of student dialog indicate that this format is capable of generating substantive student discussion and successfully enacting the design principles. Field-test data show similar student content learning gains with the two curricula. Nevertheless, because of classroom constraints, some important practices of science that were an integral part of PSET were not included in LEPS.

High-Intensity Small-Sided Games versus Repeated Sprint Training in Junior Soccer Players.

PubMed

Eniseler, Niyazi; Şahan, Çağatay; Özcan, Ilker; Dinler, Kıvanç

2017-12-01

The aim of this study was to compare the effects of high-intensity small-sided games training (SSGT) versus repeated-sprint training (RST) on repeated-sprint ability (RSA), soccer specific endurance performance and short passing ability among junior soccer players. The junior soccer players were recruited from of a professional team (age 16.9 ± 1.1 years). The tests included the repeated-shuttle-sprint ability test (RSSAT), Yo-Yo Intermittent Recovery Test level 1 (Yo-Yo IR1) and Loughborough Soccer Passing Test (LSPT). Nineteen participants were randomly assigned to either the small-sided games training (SSGTG) (n = 10) or repeated-sprint training group (RSTG) (n = 9). Small-sided games or repeated-sprint training were added to the regular training sessions for two days of the regular practice week. The Wilcoxon signed-rank and Mann-Whitney U tests were used to examine differences in groups and training effects. A time x training group effect was found in the improvement of short-passing ability for the smallsided games training group which showed significantly better scores than the repeated-sprint training group (p ≤ 0.05). Both groups showed similar improvements in RSAdecrement (p < 0.05). Only the repeated-sprint training group improved in the Yo-Yo IR1 (p < 0.05). This study clearly shows that high-intensity small-sided games training can be used as an effective training mode to enhance both repeated sprint ability and short-passing ability.

High-Intensity Small-Sided Games versus Repeated Sprint Training in Junior Soccer Players

PubMed Central

Şahan, Çağatay; Özcan, Ilker; Dinler, Kıvanç

2017-01-01

Abstract The aim of this study was to compare the effects of high-intensity small-sided games training (SSGT) versus repeated-sprint training (RST) on repeated-sprint ability (RSA), soccer specific endurance performance and short passing ability among junior soccer players. The junior soccer players were recruited from of a professional team (age 16.9 ± 1.1 years). The tests included the repeated-shuttle-sprint ability test (RSSAT), Yo-Yo Intermittent Recovery Test level 1 (Yo-Yo IR1) and Loughborough Soccer Passing Test (LSPT). Nineteen participants were randomly assigned to either the small-sided games training (SSGTG) (n = 10) or repeated-sprint training group (RSTG) (n = 9). Small-sided games or repeated-sprint training were added to the regular training sessions for two days of the regular practice week. The Wilcoxon signed-rank and Mann-Whitney U tests were used to examine differences in groups and training effects. A time x training group effect was found in the improvement of short-passing ability for the smallsided games training group which showed significantly better scores than the repeated-sprint training group (p ≤ 0.05). Both groups showed similar improvements in RSAdecrement (p < 0.05). Only the repeated-sprint training group improved in the Yo-Yo IR1 (p < 0.05). This study clearly shows that high-intensity small-sided games training can be used as an effective training mode to enhance both repeated sprint ability and short-passing ability. PMID:29339990

Qualitative Differences Between Learning Environments Using Videos in Small Groups and Whole Class Discussions: A Preliminary Study in Physics

NASA Astrophysics Data System (ADS)

Mayo, Ashleigh; Sharma, Manjula D.; Muller, Derek A.

2009-08-01

Interactivity, group learning and student engagement are accepted as key features of social constructivist learning theories. The challenge is to understand the interplay between such features in different learning environments. This study focused on the qualitative differences between two interventions—small-groups and whole-class discussions. In both interventions, three short video slices on the abstract topic ‘the physics of superconductivity’ were interspersed with the different discussion styles. The video slices are based on the Bruner stages. Twenty-nine first year university physics students completed a pre-test, underwent the intervention and completed a post-test. The remainder of the data were collected from student drawings, video recordings, observer notes and facilitator feedback. Results indicate that the use of the video slices in both interventions were successful in changing students’ understandings of superconductivity. However, the small groups treatment tended to facilitate questioning, meaning-making and subsequent changes of ideas more so than the whole class discussions. Implications for research and practice are discussed.

Defibrillation by general practitioners: an audit of resuscitation in a Scottish rural practice.

PubMed

Macdonald, J W; Brewster, M F; Isles, C G

1993-06-01

The objective was to review the outcome of resuscitation attempts in a small remote two-partner practice of 2700 patients in Galloway, South West Scotland during the period 1985-1992. During the study period 15 attempts were made to resuscitate the victims of cardiac arrest. Two sub-groups were identified. In the first, nine out of ten patients whose arrest occurred in the presence of a doctor were successfully resuscitated and all proved to be long term survivors. In the second group of five patients whose arrest took place before the arrival of the doctor there were no survivors. We conclude that defibrillation by general practitioners has a valuable contribution to make in reducing the mortality from myocardial infarction in rural practice.

Evaluation of a theory-informed implementation intervention for the management of acute low back pain in general medical practice: the IMPLEMENT cluster randomised trial.

PubMed

French, Simon D; McKenzie, Joanne E; O'Connor, Denise A; Grimshaw, Jeremy M; Mortimer, Duncan; Francis, Jill J; Michie, Susan; Spike, Neil; Schattner, Peter; Kent, Peter; Buchbinder, Rachelle; Page, Matthew J; Green, Sally E

2013-01-01

This cluster randomised trial evaluated an intervention to decrease x-ray referrals and increase giving advice to stay active for people with acute low back pain (LBP) in general practice. General practices were randomised to either access to a guideline for acute LBP (control) or facilitated interactive workshops (intervention). We measured behavioural predictors (e.g. knowledge, attitudes and intentions) and fear avoidance beliefs. We were unable to recruit sufficient patients to measure our original primary outcomes so we introduced other outcomes measured at the general practitioner (GP) level: behavioural simulation (clinical decision about vignettes) and rates of x-ray and CT-scan (medical administrative data). All those not involved in the delivery of the intervention were blinded to allocation. 47 practices (53 GPs) were randomised to the control and 45 practices (59 GPs) to the intervention. The number of GPs available for analysis at 12 months varied by outcome due to missing confounder information; a minimum of 38 GPs were available from the intervention group, and a minimum of 40 GPs from the control group. For the behavioural constructs, although effect estimates were small, the intervention group GPs had greater intention of practising consistent with the guideline for the clinical behaviour of x-ray referral. For behavioural simulation, intervention group GPs were more likely to adhere to guideline recommendations about x-ray (OR 1.76, 95%CI 1.01, 3.05) and more likely to give advice to stay active (OR 4.49, 95%CI 1.90 to 10.60). Imaging referral was not statistically significantly different between groups and the potential importance of effects was unclear; rate ratio 0.87 (95%CI 0.68, 1.10) for x-ray or CT-scan. The intervention led to small changes in GP intention to practice in a manner that is consistent with an evidence-based guideline, but it did not result in statistically significant changes in actual behaviour. Australian New Zealand Clinical Trials Registry ACTRN012606000098538.

Evaluation of a Theory-Informed Implementation Intervention for the Management of Acute Low Back Pain in General Medical Practice: The IMPLEMENT Cluster Randomised Trial

PubMed Central

French, Simon D.; McKenzie, Joanne E.; O'Connor, Denise A.; Grimshaw, Jeremy M.; Mortimer, Duncan; Francis, Jill J.; Michie, Susan; Spike, Neil; Schattner, Peter; Kent, Peter; Buchbinder, Rachelle; Page, Matthew J.; Green, Sally E.

2013-01-01

Introduction This cluster randomised trial evaluated an intervention to decrease x-ray referrals and increase giving advice to stay active for people with acute low back pain (LBP) in general practice. Methods General practices were randomised to either access to a guideline for acute LBP (control) or facilitated interactive workshops (intervention). We measured behavioural predictors (e.g. knowledge, attitudes and intentions) and fear avoidance beliefs. We were unable to recruit sufficient patients to measure our original primary outcomes so we introduced other outcomes measured at the general practitioner (GP) level: behavioural simulation (clinical decision about vignettes) and rates of x-ray and CT-scan (medical administrative data). All those not involved in the delivery of the intervention were blinded to allocation. Results 47 practices (53 GPs) were randomised to the control and 45 practices (59 GPs) to the intervention. The number of GPs available for analysis at 12 months varied by outcome due to missing confounder information; a minimum of 38 GPs were available from the intervention group, and a minimum of 40 GPs from the control group. For the behavioural constructs, although effect estimates were small, the intervention group GPs had greater intention of practising consistent with the guideline for the clinical behaviour of x-ray referral. For behavioural simulation, intervention group GPs were more likely to adhere to guideline recommendations about x-ray (OR 1.76, 95%CI 1.01, 3.05) and more likely to give advice to stay active (OR 4.49, 95%CI 1.90 to 10.60). Imaging referral was not statistically significantly different between groups and the potential importance of effects was unclear; rate ratio 0.87 (95%CI 0.68, 1.10) for x-ray or CT-scan. Conclusions The intervention led to small changes in GP intention to practice in a manner that is consistent with an evidence-based guideline, but it did not result in statistically significant changes in actual behaviour. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN012606000098538 PMID:23785427

A pragmatic randomised controlled trial of an implementation intervention to increase healthy eating and physical activity-promoting policies, and practices in centre-based childcare services: study protocol.

PubMed

Finch, Meghan; Yoong, Sze Lin; Thomson, Rebecca J; Seward, Kirsty; Cooney, Mairead; Jones, Jannah; Fielding, Alison; Wiggers, John; Gillham, Karen; Wolfenden, Luke

2015-05-21

Promotion of healthy eating and physical activity in early childhood is recommended as a global chronic disease prevention strategy. Centre-based childcare services represent a promising setting to provide children with opportunities to improve healthy eating and physical activity. Evidence to inform implementation of childcare obesity prevention guidelines into routine practice in childcare, however, is lacking. This study aims to assess the effectiveness of an intervention, delivered to childcare staff, aiming to increasing service implementation of healthy eating and physical activity-promoting policies and practices. A pragmatic parallel group randomised controlled trial will be undertaken with 165 childcare services in the Hunter New England region of New South Wales, Australia. Services will be randomised to receive either a 10-month evidence-based performance review intervention with other resources to support practice change, or to a waitlist control group. The primary trial outcome is the proportion of services implementing all of the following recommended healthy eating and physical activity promoting practices: written nutrition, physical activity and small screen recreation policies; providing information to families regarding healthy eating (including breastfeeding), physical activity and small screen time; providing twice weekly healthy eating learning experiences to children; providing water and only plain milk to children; providing fundamental movement skills activities for children every day; and limiting and using electronic screen time more for educational purposes and learning experiences. Effectiveness will be assessed using a telephone interview of practice implementation with childcare staff at baseline and 12 months following baseline. The study was approved by the Hunter New England Human Research Ethics Committee and the University of Newcastle Human Research Ethics Committee. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. Australian New Zealand Clinical Trials Registry ACTRN12614000972628. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Clinical Development of Gamitrinib, a Novel Mitochondrial-Targeted Small Molecule Hsp90 Inhibitor

DTIC Science & Technology

2015-09-01

Group 2 and Group 3 animals examined at the end of the 7-repeated doses was comparable to those in control Group 1 animals (Figure 2). (7) Despite... posttest (for more than two- group comparisons) using a GraphPad software package (Prism 6.0) for Windows. Data are expressed as mean ± SD or mean ± SEM...Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: A practical and powerful approach to multiple testing. J R Stat Soc Series B Stat

Variations in resource utilization among medical specialties and systems of care. Results from the medical outcomes study.

PubMed

Greenfield, S; Nelson, E C; Zubkoff, M; Manning, W; Rogers, W; Kravitz, R L; Keller, A; Tarlov, A R; Ware, J E

1992-03-25

To examine whether specialty and system of care exert independent effects on resource utilization. Cross-sectional analysis of just over 20,000 patients (greater than or equal to 18 years of age) who visited providers' offices during 9-day periods in 1986. Patient- and physician-provided information was obtained by self-administered questionnaires. Offices of 349 physicians practicing family medicine, internal medicine, endocrinology, and cardiology within health maintenance organizations, large multispecialty groups, and solo practices or small single-specialty group practices in three major US cities. Indicators of the intensity of resource utilization were examined among four medical specialties (family practice, general internal medicine, cardiology, and endocrinology) and five systems of care (health maintenance organization, multispecialty group-fee-for-service, multispecialty group-prepaid; solo practice and single-specialty group-fee-for-service, and solo practice and single-specialty group-prepaid) before and after controlling for the mix of patients seen in these offices. The indicators of resource utilization were hospitalizations, annual office visits, prescription drugs, and common tests and procedures, with rates estimated on both a per-visit and per-year basis. Variation in patient mix was a major determinant of the large variations in resource use. However, increased utilization was also independently related to specialty (cardiology and endocrinology), fee-for-service payment plan, and solo and single-specialty group practice arrangements. After adjusting for patient mix, solo practice/single-specialty groups-fee-for-service had 41% more hospitalizations than health maintenance organizations. General internists had utilization rates somewhat greater than family physicians on some indicators. Although variations in patient mix should be a major determinant of variations in resource use, the independent effects of specialty training, payment system, and practice organization on utilization rates need further explication. The 2- and 4-year outcomes now being analyzed will provide information critical to interpretation of the variations reported herein.

Impact of Student vs Faculty Facilitators on Motivational Interviewing Student Outcomes

PubMed Central

Widder-Prewett, Rebecca; Cameron, Ginger; Anderson, Douglas; Pinkerton, Mark; Chen, Aleda M. H.

2017-01-01

Objective. To determine the impact of student or faculty facilitation on student self-assessed attitudes, confidence, and competence in motivational interviewing (MI) skills; actual competence; and evaluation of facilitator performance. Methods. Second-year pharmacy (P2) students were randomly assigned to a student or faculty facilitator for a four-hour, small-group practice of MI skills. MI skills were assessed in a simulated patient encounter with the mMITI (modified Motivational Interviewing Treatment Integrity) tool. Students completed a pre-post, 6-point, Likert-type assessment addressing the research objectives. Differences were assessed using a Mann-Whitney U test. Results. Student (N=44) post-test attitudes, confidence, perceived or actual competence, and evaluations of facilitator performance were not different for faculty- and student-facilitated groups. Conclusion. Using pharmacy students as small-group facilitators did not affect student performance and were viewed as equally favorable. Using pharmacy students as facilitators can lessen faculty workload and provide an outlet for students to develop communication and facilitation skills that will be needed in future practice. PMID:28970608

Some Implications of Farm Practice Diffusion--Adoption Research for Extension Program Development. A Research Summary of a Graduate Study.

ERIC Educational Resources Information Center

Jalihal, Krishna A.; Dotson, Robert S.

The study was made to consider cultural factors related to the acceptance or nonacceptance of farm practices. Some major conclusions were: (1) demonstrators should be in the age group 30-45, (2) reading material should be at the seventh or eighth grade level, (3) meetings should be convenient for small or disadvantaged farmers to attend, (4)…

"Wherever You Go, You Will Be a Polis": Spatial Practices and Political Education in Computer-Supported Collaborative Learning Discussions

ERIC Educational Resources Information Center

Slakmon, Benzi; Schwarz, Baruch B.

2017-01-01

The aim of this article is to increase understanding of the development of spatial practices in virtual learning environments. The spatial change and development in 38 small-group e-discussions taken from a data set of a yearlong 8th-grade humanities course are described and analyzed. We show that the focus on spatial changes in computer-supported…

Translating between social worlds of policy and everyday life: The development of a group-based method to support policymaking by exploring behavioural aspects of sustainable consumption.

PubMed

Horlick-Jones, Tom; Prades, Ana

2015-10-01

A large international literature on how lay citizens make sense of various aspects of science and technology has been generated by investigations which utilise small group methods. Within that literature, focus group and other group-based methods have come to co-exist, and to some extent, hybridise, with the use of small groups in citizen engagement initiatives. In this article, we report on how we drew upon these methodological developments in the design and operationalisation of a policymaking support tool (STAVE). This tool has been developed to gain insight, in a relatively speedy and cost-effective way, into practical details of the everyday lived experience of people's lives, as relating to the sustainability of corresponding practices. An important challenge we faced was how, in Kuhn's terms, to 'translate' between the forms of life corresponding to the world of policymaking and the world of everyday domestic life. We examine conceptual and methodological aspects of how the tool was designed and assembled, and then trialled in the context of active real-world collaborations with policymaking organisations. These trials were implemented in six European countries, where they were used to support work on live policy issues concerned with sustainable consumption. © The Author(s) 2014.

Evaluation of telephone first approach to demand management in English general practice: observational study.

PubMed

Newbould, Jennifer; Abel, Gary; Ball, Sarah; Corbett, Jennie; Elliott, Marc; Exley, Josephine; Martin, Adam; Saunders, Catherine; Wilson, Edward; Winpenny, Eleanor; Yang, Miaoqing; Roland, Martin

2017-09-27

Objective  To evaluate a "telephone first" approach, in which all patients wanting to see a general practitioner (GP) are asked to speak to a GP on the phone before being given an appointment for a face to face consultation. Design  Time series and cross sectional analysis of routine healthcare data, data from national surveys, and primary survey data. Participants  147 general practices adopting the telephone first approach compared with a 10% random sample of other practices in England. Intervention  Management support for workload planning and introduction of the telephone first approach provided by two commercial companies. Main outcome measures  Number of consultations, total time consulting (59 telephone first practices, no controls). Patient experience (GP Patient Survey, telephone first practices plus controls). Use and costs of secondary care (hospital episode statistics, telephone first practices plus controls). The main analysis was intention to treat, with sensitivity analyses restricted to practices thought to be closely following the companies' protocols. Results  After the introduction of the telephone first approach, face to face consultations decreased considerably (adjusted change within practices -38%, 95% confidence interval -45% to -29%; P<0.001). An average practice experienced a 12-fold increase in telephone consultations (1204%, 633% to 2290%; P<0.001). The average duration of both telephone and face to face consultations decreased, but there was an overall increase of 8% in the mean time spent consulting by GPs, albeit with large uncertainty on this estimate (95% confidence interval -1% to 17%; P=0.088). These average workload figures mask wide variation between practices, with some practices experiencing a substantial reduction in workload and others a large increase. Compared with other English practices in the national GP Patient Survey, in practices using the telephone first approach there was a large (20.0 percentage points, 95% confidence interval 18.2 to 21.9; P<0.001) improvement in length of time to be seen. In contrast, other scores on the GP Patient Survey were slightly more negative. Introduction of the telephone first approach was followed by a small (2.0%) increase in hospital admissions (95% confidence interval 1% to 3%; P=0.006), no initial change in emergency department attendance, but a small (2% per year) decrease in the subsequent rate of rise of emergency department attendance (1% to 3%; P=0.005). There was a small net increase in secondary care costs. Conclusions  The telephone first approach shows that many problems in general practice can be dealt with over the phone. The approach does not suit all patients or practices and is not a panacea for meeting demand. There was no evidence to support claims that the approach would, on average, save costs or reduce use of secondary care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Large Independent Primary Care Medical Groups

PubMed Central

Casalino, Lawrence P.; Chen, Melinda A.; Staub, C. Todd; Press, Matthew J.; Mendelsohn, Jayme L.; Lynch, John T.; Miranda, Yesenia

2016-01-01

PURPOSE In the turbulent US health care environment, many primary care physicians seek hospital employment. Large physician-owned primary care groups are an alternative, but few physicians or policy makers realize that such groups exist. We wanted to describe these groups, their advantages, and their challenges. METHODS We identified 21 groups and studied 5 that varied in size and location. We conducted interviews with group leaders, surveyed randomly selected group physicians, and interviewed external observers—leaders of a health plan, hospital, and specialty medical group that shared patients with the group. We triangulated responses from group leaders, group physicians, and external observers to identify key themes. RESULTS The groups’ physicians work in small practices, with the group providing economies of scale necessary to develop laboratory and imaging services, health information technology, and quality improvement infrastructure. The groups differ in their size and the extent to which they engage in value-based contracting, though all are moving to increase the amount of financial risk they take for their quality and cost performance. Unlike hospital-employed and multispecialty groups, independent primary care groups can aim to reduce health care costs without conflicting incentives to fill hospital beds and keep specialist incomes high. Each group was positively regarded by external observers. The groups are under pressure, however, to sell to organizations that can provide capital for additional infrastructure to engage in value-based contracting, as well as provide substantial income to physicians from the sale. CONCLUSIONS Large, independent primary care groups have the potential to make primary care attractive to physicians and to improve patient care by combining human scale advantages of physician autonomy and the small practice setting with resources that are important to succeed in value-based contracting. PMID:26755779

[Skills lab training in veterinary medicine. Effective preparation for clinical work at the small animal clinic of the University for Veterinary Medicine Hannover, Foundation].

PubMed

Engelskirchen, Simon; Ehlers, Jan; Kirk, Ansgar T; Tipold, Andrea; Dilly, Marc

2017-09-20

During five and a half years of studying veterinary medicine, students should in addition to theoretical knowledge acquire sufficient practical skills. Considering animal welfare and ethical aspects, opportunities for hands-on learning on living animals are limited because of the high annual number of students. The first German veterinary clinical-skills lab, established in 2013 at the University for Veterinary Medicine Hannover, Foundation (TiHo), offers opportunities for all students to learn, train and repeat clinical skills on simulators and models as frequently as they would like, until they feel sufficiently confident to transfer these skills to living animals. This study describes the establishment of clinical-skills lab training within the students' practical education, using the example of the small-animal clinic of the TiHo. Two groups of students were compared: without skills lab training (control group K) and with skills lab training (intervention group I). At the end of both the training and a subsequent 10-week clinical rotation in different sections of the clinic, an objective structured clinical examination (OSCE) was performed, testing the students' practical skills at 15 stations. An additional multiple-choice test was performed before and after the clinical rotation to evaluate the increased theoretical knowledge. Students of group I achieved significantly (p ≤ 0.05) better results in eight of the 15 tested skills. The multiple-choice test revealed a significant (p ≤ 0.05) gain of theoretical knowledge in both groups without any differences between the groups. Students displayed a high degree of acceptance of the skills lab training. Using simulators and models in veterinary education is an efficient teaching concept, and should be used continually and integrated in the curriculum.

Is the Cognitive Complexity of Commitment-to-Change Statements Associated With Change in Clinical Practice? An Application of Bloom's Taxonomy.

PubMed

Armson, Heather; Elmslie, Tom; Roder, Stefanie; Wakefield, Jacqueline

2015-01-01

This study categorizes 4 practice change options, including commitment-to-change (CTC) statements using Bloom's taxonomy to explore the relationship between a hierarchy of CTC statements and implementation of changes in practice. Our hypothesis was that deeper learning would be positively associated with implementation of planned practice changes. Thirty-five family physicians were recruited from existing practice-based small learning groups. They were asked to use their usual small-group process while exploring an educational module on peripheral neuropathy. Part of this process included the completion of a practice reflection tool (PRT) that incorporates CTC statements containing a broader set of practice change options-considering change, confirmation of practice, and not convinced a change is needed ("enhanced" CTC). The statements were categorized using Bloom's taxonomy and then compared to reported practice implementation after 3 months. Nearly all participants made a CTC statement and successful practice implementation at 3 months. By using the "enhanced" CTC options, additional components that contribute to practice change were captured. Unanticipated changes accounted for one-third of all successful changes. Categorizing statements on the PRT using Bloom's taxonomy highlighted the progression from knowledge/comprehension to application/analysis to synthesis/evaluation. All PRT statements were classified in the upper 2 levels of the taxonomy, and these higher-level (deep learning) statements were related to higher levels of practice implementation. The "enhanced" CTC options captured changes that would not otherwise be identified and may be worthy of further exploration in other CME activities. Using Bloom's taxonomy to code the PRT statements proved useful in highlighting the progression through increasing levels of cognitive complexity-reflecting deep learning. © 2015 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.

Approaches and Activities of Professional Development During Graduate/Postdoctoral Summer Workshops

NASA Astrophysics Data System (ADS)

Gross, N. A.; Wiltberger, M. J.; Hughes, W. J.; Bhattacharjee, A.; Schrijver, K.; Bagenal, F.; Sojka, J. J.; Munoz-Jaramillo, A.

2017-12-01

NSF and NASA each fund a space physics summer school - the Space Weather Summer School (https://www2.hao.ucar.edu/CISM-Summer-School) and the Heliophysics Summer School (https://cpaess.ucar.edu/heliophysics/summer-school) - each of which provide a comprehensive introduction to their fields at the conceptual and quantitative level for graduate and postdoctoral researchers. Along with specific content goals, each summer school also recognizes professional development goals for the students. Each school intentionally develops community among the summer school students to promote professional networking between the students and between students and instructors. Community is promoted both as part of the formal program and through informal gatherings and outings. Social media is intentionally used for this purpose as well. The summer schools also promote practice with discussing science concepts in small groups through peer instruction, practice presenting in small groups, and discussing results with minimal preparation. Short formal student presentations and poster sessions are organized as part of the formal schedule of one of the summer schools. Much of the professional development work is informed by improvisational theater approaches. Group improv training focuses on the development of the group or the community rather than the individual. Group improv activities are used to build the group and encourage full participation. This talk will outline the professional development activities in each school and how they are informed by improv.

Proceedings of the Annual Meeting of the Association for Education in Journalism and Mass Communication (83rd, Phoenix, Arizona, August 9-12, 2000). Civic Journalism Interest Group.

ERIC Educational Resources Information Center

Association for Education in Journalism and Mass Communication.

The Civic Journalism Interest Group section of the proceedings contains the following five papers: "A Tale of Two Cities: Do Small-Town Dailies Practice Public Journalism Without Knowing It?" (David Loomis); "Engaging the Literature: A Civic Approach" (Kathryn B. Campbell); "Resolving Public Conflict: Civic Journalism and…

Applied research on glucansucrases

USDA-ARS?s Scientific Manuscript database

Although glycansucrases have been known for over 70 years, they remain relatively unknown except to a small group of researchers. Practical, applied research on glycansucrases has been focused on certain key areas. The earliest of these was the development of blood plasma extenders from dextran, d...

Calling-in the Family: Dialogic Performances of Family Conflict

ERIC Educational Resources Information Center

Congdon, Mark, Jr.; Herakova, Liliana; Bishop, Jessica

2018-01-01

Courses: Introduction to Communication, Introduction to Interpersonal Communication, Family Communication, Small Group Communication, Communication and Listening. Objectives: By this end of this activity, students will be able to identify and practice supportive and defensive communication; understand a dialogic approach to conflict; and…

Technology-Enhanced Pathology Education: Nigerian Medical Students Perspectives

ERIC Educational Resources Information Center

Vhriterhire, Raymond A.; Orkuma, Joseph A.; Jegede, Olushola O.; Omotosho, Ayodele J.; Adekwu, Amali

2016-01-01

The delivery of pathology education traditionally through instructor centred didactic lectures, small group tutorials, and practical demonstrations using microscope glass slides, gross pot specimens and autopsy sessions, is paving way for electronic learner-centred methods. Successful adoption and implementation of rapidly advancing educational…

Design and baseline characteristics of the 10 Small Steps Study: a randomised controlled trial of an intervention to promote healthy behaviour using a lifestyle score and personalised feedback.

PubMed

Parekh, Sanjoti; Vandelanotte, Corneel; King, David; Boyle, Frances M

2012-03-12

Non-communicable diseases (NCDs) are the leading causes of death globally and are associated with a limited set of common, modifiable health behaviours: tobacco use, physical inactivity, harmful use of alcohol and unhealthy diet. General practice offers an ideal avenue for addressing such health behaviours on a population-wide basis. This paper describes the protocol of a multiple health behaviour change intervention designed for implementation in general practice and summarises the baseline characteristics of its participants. The 10 Small Steps (10SS) study, a randomised controlled trial, involved 4,678 adult general practice patients in Queensland, Australia. Self-reported data were collected to establish the proportion of participants meeting recommended guidelines for ten health behaviours: physical activity, body mass index, alcohol, smoking and six dietary behaviours. Participants were randomised to four groups: contact at baseline only ('single intervention' and corresponding control group) and contact at baseline and 3 months ('dual intervention' and corresponding control group). At each contact the participants received a computer-tailored feedback and one page information sheet according to their allocation to intervention or control groups. Change in the intervention group compared to the control group was assessed at 3 and12 months after baseline data collection.Responses were summed to calculate an individual lifestyle score (the Prudence Score), which ranged from 0 to 10. The baseline response was 56.5% (4678 of 8343 invited participants) and the study sample was primarily female (68.7%) with an average age of 47 years. The mean Prudence Score was 5.8 (95%CI 5.75-5.85). Baseline data from the 10SS study show that nearly all participants engage in some health behaviours but relatively few adhere simultaneously to a core set of dietary and lifestyle behaviours associated with risk of NCDs. Ample scope exists to improve health behaviour to reduce NCDs in the general practice setting and the 10SS study trial will provide data on the extent to which a minimal computer-tailored intervention can meet this objective. The protocol developed for the 10SS study has potential for translation into routine general practice as it has minimal impact on practice routine whilst contributing to primary prevention objectives. The Australian New Zealand Clinical Trials Registry ACTRN12611001213932.

Comparison of hypnosis with conventional relaxation for antenatal and intrapartum use: a feasibility study in general practice

PubMed Central

Brann, Les R.; Guzvica, Sally A.

1987-01-01

A hypnosis programme for antenatal and intrapartum use has been developed and successfully introduced into a practice as an alternative to conventional relaxation training. Of 96 women from the practice who delivered during the 10-month period of the study 51 opted for the psychoprophylaxis and 45 for the hypnosis. Details of the pregnancy, labour and postnatal period were collected for both groups, together with a subjective assessment of their satisfaction with labour. Disparity between the ages and parity of the two groups made comparisons difficult. The duration of the first stage of labour was markedly reduced in the hypnosis group by 98 minutes for primiparas and 40 minutes for multiparas. A small (five minutes) increase in the length of the second stage may have been a result of the hypnotic relaxation. The verbalization has been amended accordingly. The hypnosis group were more satisfied with labour than the psychoprophylaxis group (mean satisfaction score 7.4 versus 5.6) and they reported other benefits of hypnosis, for example, reduction in anxiety and help with getting to sleep.Further studies are planned. PMID:3333169

Single case design studies in music therapy: resurrecting experimental evidence in small group and individual music therapy clinical settings.

PubMed

Geist, Kamile; Hitchcock, John H

2014-01-01

The profession would benefit from greater and routine generation of causal evidence pertaining to the impact of music therapy interventions on client outcomes. One way to meet this goal is to revisit the use of Single Case Designs (SCDs) in clinical practice and research endeavors in music therapy. Given the appropriate setting and goals, this design can be accomplished with small sample sizes and it is often appropriate for studying music therapy interventions. In this article, we promote and discuss implementation of SCD studies in music therapy settings, review the meaning of internal study validity and by extension the notion of causality, and describe two of the most commonly used SCDs to demonstrate how they can help generate causal evidence to inform the field. In closing, we describe the need for replication and future meta-analysis of SCD studies completed in music therapy settings. SCD studies are both feasible and appropriate for use in music therapy clinical practice settings, particularly for testing effectiveness of interventions for individuals or small groups. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Integrating evidence-based practice into RN-to-BSN clinical nursing education.

PubMed

Oh, Eui Geum; Kim, Sunah; Kim, So Sun; Kim, Sue; Cho, Eun Yong; Yoo, Ji-Soo; Kim, Hee Soon; Lee, Ju Hee; You, Mi Ae; Lee, Hyejung

2010-07-01

This study examines the effects of integrating evidence-based practice (EBP) into clinical practicum on EBP efficacy and barriers to research utilization among Korean RN-to-BSN students. A one-group pretest-posttest design was used. Eighty-one students were recruited from a school of nursing in Korea. Evidence-based practice clinical practicum was composed of two consecutive programs during one semester. Lectures, individual mentoring on EBP practicum, small group, and wrap-up conferences were provided. Outcomes of EBP efficacy and barriers to research utilization were analyzed using paired t tests for 74 final participants. Evidence-based practice efficacy scores increased significantly (p < 0.05), and the barriers to research utilization scores decreased significantly after the EBP clinical practicum. The results highlight the effectiveness of EBP education among RN-to-BSN students. These results may help health educators develop effective educational strategies to integrate EBP concepts into a clinical practicum. Copyright 2010, SLACK Incorporated.

Diagnosis of bacterial vaginosis by wet mount identification of bacterial morphotypes in vaginal fluid.

PubMed

Schmidt, H; Hansen, J G

2000-03-01

In order to develop a more practical way of diagnosing bacterial vaginosis (BV), we evaluated a scoring system, weighting small bacterial morphotypes versus lactobacillary morphotypes in wet mounts, assessed criteria for BV and normalcy from this scoring, and then evaluated their reproducibility and accuracy. We examined 754 women for pH, homogeneous vaginal discharge, amine odour, clue cells and the composite clinical diagnosis. We also examined wet mounts for small bacterial morphotypes and lactobacillary morphotypes, and weighted their quantitative presence as a bacterial morphotype score. The term 'small bacterial morphotypes' denotes a group of small bacillary forms comprising coccobacilli, tiny rods, and mobile curved rods. The different characteristics of BV were all gradually associated with increased bacterial morphotype scoring. We deemed a score of 0-1 as normal, 2-4 as intermediate phase, grade I, 5-6 as intermediate phase, grade II, and 7-8 indicative of BV. Reproducibility of the interpretation was high, both for the new grading system (weighted Kappa 0.90 in women perceiving and 0.81 in women not perceiving abnormal vaginal discharge) and for the new criterion for BV (non-weighted Kappa 0.91 and 0.84 in the 2 groups of women). The new criterion also proved highly concurrent with the composite clinical diagnosis (Kappa 0.91 and 0.81 in the 2 groups). In conclusion, the wet mount bacterial morphotype scoring is valid for grading of the disorder of the vaginal microbial ecosystem, and the new criterion for BV a more practical option than existing diagnostic methods.

Interdisciplinary rural immersion week.

PubMed

Deutchman, Mark E; Nearing, Kathryn; Baumgarten, Brenda; Westfall, John M

2012-01-01

Health professions students interested in future rural practice locations spend a week learning about and investigating all aspects of small town personal, professional and community life. This augments the mainly clinical experience provided by clinical rotations they complete as part of their professional academic training program. Students from professional programs in medicine, physician assistant, pharmacy, nursing, public health and psychology travel to a small community, receive an orientation and in small interprofessional groups investigate health care, education, government, law enforcement, public health, economy and natural resources. Participants report that the experience raises their interest in future rural practice, answers questions they have about rural life and enhances their understanding of the issues they must learn more about before making a career location choice. The interdisciplinary rural immersion program provides students with the time, structure and permission to move out of their clinical 'comfort zone' and think about the cultural, economic and environmental aspects of rural life and work.

Techniques for Small-Group Discourse

ERIC Educational Resources Information Center

Kilic, Hulya; Cross, Dionne I.; Ersoz, Filyet A.; Mewborn, Denise S.; Swanagan, Diana; Kim, Jisun

2010-01-01

The nature of mathematical discourse and its influence on the development of students' mathematical understanding has received much attention from researchers in recent years. Engaging students in discursive practices can be difficult; teachers can increase their competence in facilitating discourse through greater awareness of the impact of…

Automotive Technology. Career Education Guide.

ERIC Educational Resources Information Center

Dependents Schools (DOD), Washington, DC. European Area.

The curriculum guide is designed to provide students with realistic training in automotive technology theory and practice within the secondary educational framework and to prepare them for entry into an occupation or continuing postsecondary education. The learning modules are grouped into three areas: small engines, automotive technology, and…

LANDSCAPE ECOLOGY PRACTICE BY SMALL SCALE RIVER CONSERVATION GROUPS. (R826600)

EPA Science Inventory

River_¯floodplain systems, and riparian forests in particular, offer physical contributions to human society such as flood mitigation and the maintenance of water quality, social benefits including the opportunity for recreation and solitude, as well as numerous...

Enhancing performance expectancies through visual illusions facilitates motor learning in children.

PubMed

Bahmani, Moslem; Wulf, Gabriele; Ghadiri, Farhad; Karimi, Saeed; Lewthwaite, Rebecca

2017-10-01

In a recent study by Chauvel, Wulf, and Maquestiaux (2015), golf putting performance was found to be affected by the Ebbinghaus illusion. Specifically, adult participants demonstrated more effective learning when they practiced with a hole that was surrounded by small circles, making it look larger, than when the hole was surrounded by large circles, making it look smaller. The present study examined whether this learning advantage would generalize to children who are assumed to be less sensitive to the visual illusion. Two groups of 10-year olds practiced putting golf balls from a distance of 2m, with perceived larger or smaller holes resulting from the visual illusion. Self-efficacy was increased in the group with the perceived larger hole. The latter group also demonstrated more accurate putting performance during practice. Importantly, learning (i.e., delayed retention performance without the illusion) was enhanced in the group that practiced with the perceived larger hole. The findings replicate previous results with adult learners and are in line with the notion that enhanced performance expectancies are key to optimal motor learning (Wulf & Lewthwaite, 2016). Copyright © 2017 Elsevier B.V. All rights reserved.

Eye-Hand Coordination during Visuomotor Adaptation with Different Rotation Angles: Effects of Terminal Visual Feedback

PubMed Central

Rand, Miya K.; Rentsch, Sebastian

2016-01-01

This study examined adaptive changes of eye-hand coordination during a visuomotor rotation task under the use of terminal visual feedback. Young adults made reaching movements to targets on a digitizer while looking at targets on a monitor where the rotated feedback (a cursor) of hand movements appeared after each movement. Three rotation angles (30°, 75° and 150°) were examined in three groups in order to vary the task difficulty. The results showed that the 30° group gradually reduced direction errors of reaching with practice and adapted well to the visuomotor rotation. The 75° group made large direction errors of reaching, and the 150° group applied a 180° reversal shift from early practice. The 75°and 150° groups, however, overcompensated the respective rotations at the end of practice. Despite these group differences in adaptive changes of reaching, all groups gradually adapted gaze directions prior to reaching from the target area to the areas related to the final positions of reaching during the course of practice. The adaptive changes of both hand and eye movements in all groups mainly reflected adjustments of movement directions based on explicit knowledge of the applied rotation acquired through practice. Only the 30° group showed small implicit adaptation in both effectors. The results suggest that by adapting gaze directions from the target to the final position of reaching based on explicit knowledge of the visuomotor rotation, the oculomotor system supports the limb-motor system to make precise preplanned adjustments of reaching directions during learning of visuomotor rotation under terminal visual feedback. PMID:27812093

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.

[Development of clinical trial education program for pharmaceutical science students through small group discussion and role-playing using protocol].

PubMed

Imakyure, Osamu; Shuto, Hideki; Nishikawa, Fumi; Hagiwara, Yoshifuka; Inoue, Sachiko; Koyanagi, Taeko; Hirakawa, Masaaki; Kataoka, Yasufumi

2010-08-01

The acquirement of basic knowledge of clinical trials and professional attitude in their practices is a general instructional objective in the Model Core Curriculum for Pharmaceutical Education. Unfortunately, the previous program of clinical trial education was not effective in the acquirement of a professional attitude in their practices. Then, we developed the new clinical trial education program using protocol through small group discussion (SGD) and roll-playing. Our program consists of 7 steps of practical training. In step 1, the students find some problems after presentation of the protocol including case and prescription. In step 2, they analyse the extracted problems and share the information obtained in SGD. In steps 3 and 5, five clinical case scenarios are presented to the students and they discuss which case is suitable for entry to the clinical trial or which case corresponds to the discontinuance criteria in the present designed protocol. In steps 4 and 6, the roll-playing is performed by teachers and students as doctors and clinical research coordinators (CRC) respectively. Further, we conducted a trial practice based on this program for the students. In the student's self-evaluation into five grades, the average score of the skill acquisition level in each step was 3.8-4.7 grade. Our clinical trial education program could be effective in educating the candidates for CRC or clinical pharmacists.

Should measures of patient experience in primary care be adjusted for case mix? Evidence from the English General Practice Patient Survey

PubMed Central

Paddison, Charlotte; Elliott, Marc; Parker, Richard; Staetsky, Laura; Lyratzopoulos, Georgios; Campbell, John L

2012-01-01

Objectives Uncertainties exist about when and how best to adjust performance measures for case mix. Our aims are to quantify the impact of case-mix adjustment on practice-level scores in a national survey of patient experience, to identify why and when it may be useful to adjust for case mix, and to discuss unresolved policy issues regarding the use of case-mix adjustment in performance measurement in health care. Design/setting Secondary analysis of the 2009 English General Practice Patient Survey. Responses from 2 163 456 patients registered with 8267 primary care practices. Linear mixed effects models were used with practice included as a random effect and five case-mix variables (gender, age, race/ethnicity, deprivation, and self-reported health) as fixed effects. Main outcome measures Primary outcome was the impact of case-mix adjustment on practice-level means (adjusted minus unadjusted) and changes in practice percentile ranks for questions measuring patient experience in three domains of primary care: access; interpersonal care; anticipatory care planning, and overall satisfaction with primary care services. Results Depending on the survey measure selected, case-mix adjustment changed the rank of between 0.4% and 29.8% of practices by more than 10 percentile points. Adjusting for case-mix resulted in large increases in score for a small number of practices and small decreases in score for a larger number of practices. Practices with younger patients, more ethnic minority patients and patients living in more socio-economically deprived areas were more likely to gain from case-mix adjustment. Age and race/ethnicity were the most influential adjustors. Conclusions While its effect is modest for most practices, case-mix adjustment corrects significant underestimation of scores for a small proportion of practices serving vulnerable patients and may reduce the risk that providers would ‘cream-skim’ by not enrolling patients from vulnerable socio-demographic groups. PMID:22626735

Should measures of patient experience in primary care be adjusted for case mix? Evidence from the English General Practice Patient Survey.

PubMed

Paddison, Charlotte; Elliott, Marc; Parker, Richard; Staetsky, Laura; Lyratzopoulos, Georgios; Campbell, John L; Roland, Martin

2012-08-01

Uncertainties exist about when and how best to adjust performance measures for case mix. Our aims are to quantify the impact of case-mix adjustment on practice-level scores in a national survey of patient experience, to identify why and when it may be useful to adjust for case mix, and to discuss unresolved policy issues regarding the use of case-mix adjustment in performance measurement in health care. Secondary analysis of the 2009 English General Practice Patient Survey. Responses from 2 163 456 patients registered with 8267 primary care practices. Linear mixed effects models were used with practice included as a random effect and five case-mix variables (gender, age, race/ethnicity, deprivation, and self-reported health) as fixed effects. Primary outcome was the impact of case-mix adjustment on practice-level means (adjusted minus unadjusted) and changes in practice percentile ranks for questions measuring patient experience in three domains of primary care: access; interpersonal care; anticipatory care planning, and overall satisfaction with primary care services. Depending on the survey measure selected, case-mix adjustment changed the rank of between 0.4% and 29.8% of practices by more than 10 percentile points. Adjusting for case-mix resulted in large increases in score for a small number of practices and small decreases in score for a larger number of practices. Practices with younger patients, more ethnic minority patients and patients living in more socio-economically deprived areas were more likely to gain from case-mix adjustment. Age and race/ethnicity were the most influential adjustors. While its effect is modest for most practices, case-mix adjustment corrects significant underestimation of scores for a small proportion of practices serving vulnerable patients and may reduce the risk that providers would 'cream-skim' by not enrolling patients from vulnerable socio-demographic groups.

Addition of simethicone improves small bowel capsule endoscopy visualisation quality.

PubMed

Krijbolder, M S; Grooteman, K V; Bogers, S K; de Jong, D J

2018-01-01

Small bowel capsule endoscopy (SBCE) is an important diagnostic tool for small-bowel diseases but its quality may be hampered by intraluminal gas. This study evaluated the added value of the anti-foaming agent, simethicone, to a bowel preparation with polyethylene glycol (PEG) on the quality of small bowel visualisation and its use in the Netherlands. This was a retrospective, single-blind, cohort study. Patients in the PEG group only received PEG prior to SBCE. Patients in the PEG-S group ingested additional simethicone. Two investigators assessed the quality of small-bowel visualisation using a four-point scale for 'intraluminal gas' and 'faecal contamination'. By means of a survey, the use of anti-foaming agents was assessed in a random sample of 16 Dutch hospitals performing SBCE. The quality of small bowel visualisation in the PEG group (n = 33) was significantly more limited by intraluminal gas when compared with the PEG-S group (n = 31): proximal segment 83.3% in PEG group vs. 18.5% in PEG-S group (p < 0.01), distal segment 66.7% vs. 18.5% respectively (p < 0.01). No difference was observed in the amount of faecal contamination (proximal segment 80.0% PEG vs. 59.3% PEG-S, p = 0.2; distal segment 90.0% PEG vs. 85.2% PEG-S, p = 0.7), mean small bowel transit times (4.0 PEG vs. 3.9 hours PEG-S, p = 0.7) and diagnostic yield (43.3% PEG vs. 22.2% PEG-S, p = 0.16). Frequency of anti-foaming agent use in the Netherlands was low (3/16, 18.8%). Simethicone is of added value to a PEG bowel preparation in improving the quality of visualisation of the small bowel by reducing intraluminal gas. At present, the use of anti-foaming agents in SBCE preparation is not standard practice in the Netherlands.

Teaching Emotions in Higher Education: An Emotional Rollercoaster

ERIC Educational Resources Information Center

Evans, Thomas Rhys; Steptoe-Warren, Gail

2015-01-01

Emotions are fundamental to understanding many phenomena in psychology; however, there are currently no emotion-specific evidence-based teaching practices. The current study evaluates an innovative new active learning-based teaching activity, designed to provide a structure for discussions around emotion. Small groups of third-year psychology…

A Case-Based Learning Model in Orthodontics.

ERIC Educational Resources Information Center

Engel, Francoise E.; Hendricson, William D.

1994-01-01

A case-based, student-centered instructional model designed to mimic orthodontic problem solving and decision making in dental general practice is described. Small groups of students analyze case data, then record and discuss their diagnoses and treatments. Students and instructors rated the seminars positively, and students reported improved…

Educational Transitions into the Community: Guidebook.

ERIC Educational Resources Information Center

Pawelski, Christine E., Ed.

Designed for small-group inservice training at a Connecticut state school, the working manual offers a philosophical framework and a collection of practical ideas and techniques for educators working with severely disabled, multihandicapped persons toward the ultimate goal of community integration. Chapters have the following titles and emphases:…

Staff Training Best Practices: Targeting Attitude.

ERIC Educational Resources Information Center

Grayson, Randall

2001-01-01

Enhancing the attitude of camp staff involves hiring staff that already have good attitudes, training staff in small groups that then train the rest, using the power of story, removing structural barriers, helping people understand how their actions influence organizational outcomes, identifying "termites," and placing a weak counselor…

An analysis of practice activities and instructional behaviours used by youth soccer coaches during practice: exploring the link between science and application.

PubMed

Ford, Paul R; Yates, Ian; Williams, A Mark

2010-03-01

We examined the practice activities and instructional behaviours employed by 25 youth soccer coaches during 70 different practice sessions. We evaluated the extent to which these activities and behaviours differ from those shown in contemporary research to best facilitate skill acquisition. Nine coaches worked with the under-9 years age group and eight coaches each with the under-13 and under-16 years age groups; nine of those coaches were employed at the elite level, nine at the sub-elite level, and seven at the non-elite level. Coaches had players spend more time in activities that were deemed less relevant to soccer match performance, termed "training form" (e.g. physical training, technique and skills practices), than activities deemed more relevant, termed "playing form" (e.g. small-sided/conditioned games and phase of play activities). Coaches provided high levels of instruction, feedback, and management, irrespective of the activity in which players engaged. Few differences in practice activities and instructional behaviours were reported across skill and age groups, implying the absence of any notable age- or skill-related progression. Findings are discussed with reference to recent research in the areas of skill acquisition, motor learning, and expert performance.

Identifying the needs of critical and acute cardiac care nurses within the first two years of practice in Egypt using a nominal group technique.

PubMed

Gorman, Linda L; McDowell, Joan R S

2018-01-01

Nursing in Egypt faces many challenges and working conditions in health care settings are generally poor. Little is known about the needs of new nurses transitioning in Egypt. The literature focuses on the first year of practice and only a small body of research has explored the transition needs within acute care speciality settings. This paper reports on the important professional needs of new graduate nurses working in an acute cardiac setting in Egypt during the first two years of practice and differences between their perceived most important needs. The total population participated and two group interviews were conducted (n = 5; n = 6) using the nominal group technique. Needs were identified and prioritised using both rankings and ratings to attain consensus. Content analysis was conducted to produce themes and enable cross-group comparison. Rating scores were standardised for comparison within and between groups. Both groups ranked and rated items as important: 1) education, training and continued professional development; 2) professional standards; 3) supportive clinical practice environment; 4) manageable work patterns, and 5) organisational structure. It is important that health care organisations are responsive to these needs to ensure support strategies reflect the priorities of new nurses transitioning in acute care hospitals within Egypt. Copyright © 2017 Elsevier Ltd. All rights reserved.

Examining small "c" creativity in the science classroom: Multiple case studies of five high school teachers

NASA Astrophysics Data System (ADS)

Lasky, Dorothea Shawn

As the US continues to strive toward building capacity for a workforce in STEM fields (NSF, 2006), educational organizations and researchers have constructed frameworks that focus on increasing competencies in creativity in order to achieve this goal (ISTE, 2007; Karoly & Panis, 2004; Partnership for 21st Century Skills, 2007). Despite these recommendations, many teachers either do not believe in the relevance of nurturing creativity in their students (Kaufman & Sternberg, 2007) or accept the importance of it, but do not know how best to foster it in their classrooms (Kampylis et al., 2009). Researchers conclude that teachers need to revise their ideas about the kind of creativity they can expect from their students to reflect the idea of small 'c' versus large 'C' creativity. There is a dearth of literature that looks closely at teacher practice surrounding creativity in the US and gives teachers a set of practical suggestions they can follow easily. I examined five case studies of teachers as they participated in and implemented a large-scale, NSF-funded project premised on the idea that training teachers in 21 st century pedagogies, (for example, problem-based learning), helps teachers create classrooms that increase science competencies in students. I investigated how teachers' curricular choices affect the amount of student creativity produced in their classrooms. Analysis included determining CAT scores for student products and continua scores along the Small 'c' Creativity Framework. In the study, I present an understanding of how teachers' beliefs influence practice and how creativity is fostered in students through various styles of teacher practice. The data showed a relationship between teachers' CAT scores, framework scores, and school context. Thus, alongside CAT, the framework was determined to be a successful tool for understanding the degree to which teachers foster small 'c' creativity. Other themes emerged, which included teachers' allotment of time and small group collaboration, how science teachers valued creativity, the importance of transdisciplinarity, teachers' student knowledge, and school context. This study contributes to the growing body of literature surrounding teacher practice and creativity by revealing a clear and concrete set of practical recommendations based on the Small 'c' Creativity Framework.

Student responses to the introduction of case-based learning and practical activities into a theoretical obstetrics and gynaecology teaching programme

PubMed Central

Massonetto, Júlio Cesar; Marcellini, Cláudio; Assis, Paulo Sérgio Ribeiro; de Toledo, Sérgio Floriano

2004-01-01

Background The fourth-year Obstetrics and Gynaecology course at our institution had previously been taught using theory classes alone. A new teaching model was introduced to provide a better link with professional practice. We wished to evaluate the impact of the introduction of case discussions and other practical activities upon students' perceptions of the learning process. Methods Small-group discussions of cases and practical activities were introduced for the teaching of a fourth-year class in 2003 (Group II; 113 students). Comparisons were made with the fourth-year class of 2002 (Group I; 108 students), from before the new programme was introduced. Students were asked to rate their satisfaction with various elements of the teaching programme. Statistical differences in their ratings were analysed using the chi-square and Bonferroni tests. Results Group II gave higher ratings to the clarity of theory classes and lecturers' teaching abilities (p < 0.05) and lecturers' punctuality (p < 0.001) than did Group I. Group II had greater belief that the knowledge assessment tests were useful (p < 0.001) and that their understanding of the subject was good (p < 0.001) than did Group I. Group II gave a higher overall rating to the course (p < 0.05) than did Group I. However, there was no difference in the groups' assessments of the use made of the timetabled hours available for the subject or lecturers' concern for students' learning. Conclusions Students were very receptive to the new teaching model. PMID:15569385

Small group experience for socially withdrawn girls.

PubMed

Houck, Gail M; Stember, Lisa

2002-08-01

Social competence is the effectiveness of social interaction behavior. Given its link to mental health outcomes, it is an important consideration in child and adolescent development. Social withdrawal is associated with depression. Socially withdrawn children make few social initiations and tend to be isolated in their play, further limiting their social involvement. To develop effective social behavior, experiences must be provided to learn relationship skills. This practice improvement project provided a small group experience for five socially withdrawn school-age girls. Weekly group meetings provided a social situation in which conversations could occur around a shared snack and craft project. The school nurse facilitated self-assertion and the expression of prosocial behavior in a socially safe (nonrejecting) environment and promoted social problem solving. On completion of the program, the participants not only showed more effective social reasoning and social skills, but developed friendships with each other that lasted beyond the life of the group.

Effective Practices in the Delivery of Research Ethics Education: A Qualitative Review of Instructional Methods.

PubMed

Todd, E Michelle; Torrence, Brett S; Watts, Logan L; Mulhearn, Tyler J; Connelly, Shane; Mumford, Michael D

2017-01-01

In order to delineate best practices for courses on research ethics, the goal of the present effort was to identify themes related to instructional methods reflected in effective research ethics and responsible conduct of research (RCR) courses. By utilizing a qualitative review, four themes relevant to instructional methods were identified in effective research ethics courses: active participation, case-based activities, a combination of individual and group approaches, and a small number of instructional methods. Three instructional method themes associated with less effective courses were also identified: passive learning, a group-based approach, and a large number of instructional methods. Key characteristics of each theme, along with example courses relative to each theme, are described. Additionally, implications regarding these instructional method themes and recommendations for best practices in research ethics courses are discussed.

The Transcultural Study Guide. Second Edition.

ERIC Educational Resources Information Center

Darrow, Kenneth, Ed.; Palmquist, Bradley, Ed.

This guide contains practical questions designed to facilitate inquiry into any country or culture. A small group called Volunteers in Asia, which provides volunteer work and study opportunities in Asia, wrote the guide because they believe that direct observation and participation, when complemented by systematic inquiry, can lead to a clearer…

Exploring Writing Circles as Innovative, Collaborative Writing Structures with Teacher Candidates

ERIC Educational Resources Information Center

Roberts, Sherron Killingsworth; Blanch, Norine; Gurjar, Nandita

2017-01-01

Writing circles are "small groups... meeting regularly to share drafts, choose common writing topics, practice positive response, and in general, help each other become better writers" (Vopat, 2009, p. 6). In this exploratory study, writing circles were employed with elementary teacher candidates in hopes of enhancing their perceptions…

Learning from a Wiki Way of Learning

ERIC Educational Resources Information Center

Page, Kelly L.; Reynolds, Nina

2015-01-01

There is a growing need to design learning experiences in higher education that develop collaborative and mediated social writing practices. A wiki way of learning addresses these needs. This paper reports findings from a case study involving 58 postgraduate students who in small groups participated over eight weeks in a mediated collaborative…

The Effects of Cooperative Learning on Self-Esteem: A Literature Review.

ERIC Educational Resources Information Center

Tedesco, Lucyann M.

Cooperative learning involves students working in small groups or teams to help each other learn academic material. Cooperative learning strategies are organized, highly structured methods that usually involve formal presentation of information, student practice and coaching in learning teams, individual assessment of mastery, and public…

Online Moderation of Synchronous E-Argumentation

ERIC Educational Resources Information Center

Asterhan, Christa S. C.; Schwarz, Baruch B.

2010-01-01

In this paper, we present findings on moderation of synchronous, small-group argumentation in blended, co-located learning environments. Drawing on findings from the literature on human facilitation of dialogue in face-to-face settings, we first elaborate on the potential promise of this new practice. However, little is known about what…

A Small Experiment in Online Learning

ERIC Educational Resources Information Center

Ryan, P.

2008-01-01

What constitutes successful practice for supervision of postgraduate students at an Open and Distance learning institution? In this article I describe a limited experiment in on-line teaching using a group of postgraduate students at the University of South Africa (Unisa). While the experiment has obvious limitations including the short time in…

Resisting Participation: Critiquing Participatory Research Methodologies with Young People

ERIC Educational Resources Information Center

Fox, Rachael

2013-01-01

Participatory methodologies are increasingly employed in research with young people. These practices stem from a desire to reduce problematic distributions of power in research and to construct knowledge with young people rather than for them. This paper examines research conducted with a small group of young people experiencing exclusion from…

Collaborative Learning Utilizing Case-Based Problems

ERIC Educational Resources Information Center

Hilvano, Nestor T.; Mathis, Karen M.; Schauer, Daniel P.

2014-01-01

Engaging students in discussion and creating high impact teaching and learning practices are a challenge in every classroom. Small group discussion and poster presentations were used to solve case-based problems to highlight issues for the learner and to allow each student to demonstrate understanding and application of theory to real life…

Collective Decision Making in Organizations.

ERIC Educational Resources Information Center

Svenning, Lynne L.

Based on the assumption that educators can adopt new patterns of organization and management to improve the quality of decision and change in education, this paper attempts to make decision theory and small group process theory relevant to practical decision situations confronting educational managers. Included are (1) a discussion of the…

Discursive Positioning and Emotion in School Mathematics Practices

ERIC Educational Resources Information Center

Evans, Jeff; Morgan, Candia; Tsatsaroni, Anna

2006-01-01

Our approach to emotion in school mathematics draws on social semiotics, pedagogic discourse theory and psychoanalysis. Emotions are considered as socially organised and shaped by power relations; we portray emotion as a charge (of energy) attached to ideas or signifiers. We analyse transcripts from a small group solving problems in mathematics…

Best Practices for Launching a Flipped Classroom

ERIC Educational Resources Information Center

Hall, Ashley A.; DuFrene, Debbie D.

2016-01-01

Popularity is growing for flipped classroom instruction, which replaces lectures with out-of-class delivery of streaming video, reading materials, online chats, and other modalities. Face-to-face class time is spent on instructor-student and student-student interaction, including small group problem solving and discussion. Classroom flipping has…

What Is Intensive Instruction and Why Is It Important?

ERIC Educational Resources Information Center

Fuchs, Douglas; Fuchs, Lynn S.; Vaughn, Sharon

2014-01-01

In this article, the authors present two models of intensive instruction for students with and without disabilities who are having difficulties with Response to Intervention (RTI) currently in practice (Tier 1: general instruction that all students receive in mainstream classrooms, and Tier 2: programs often involving small group instruction). The…

Shared learning in general practice--facilitators and barriers.

PubMed

van de Mortel, Thea; Silberberg, Peter; Ahern, Christine

2013-03-01

Capacity for teaching in general practice clinics is limited. Shared learning sessions are one form of vertically integrated teaching that may ameliorate capacity constraints. This study sought to understand the perceptions of general practitioner supervisors, learners and practice staff of the facilitators of shared learning in general practice clinics. Using a grounded theory approach, semistructured interviews were conducted and analysed to generate a theory about the topic. Thirty-five stakeholders from nine general practices participated. Facilitators of shared learning included enabling factors such as small group facilitation skills, space, administrative support and technological resources; reinforcing factors such as targeted funding, and predisposing factors such as participant attributes. Views from multiple stakeholders suggest that the implementation of shared learning in general practice clinics would be supported by an ecological approach that addresses all these factors.

Physicians’ Perceptions of Autonomy across Practice Types: Is Autonomy in Solo Practice a Myth?

PubMed Central

Lin, Katherine Y.

2013-01-01

Physicians in the United States are now less likely to practice in smaller, more traditional, solo practices, and more likely to practice in larger group practices. Though older theory predicts conflict between bureaucracy and professional autonomy, studies have shown that professions in general, and physicians in particular, have adapted to organizational constraints. However, much work remains in clarifying the nature of this relationship and how exactly physicians have adapted to various organizational settings. To this end, the present study examines physicians’ autonomy experiences in different decision types between organization sizes. Specifically, I ask: In what kinds of decisions do doctors perceive autonomous control? How does this vary by organizational size? Using stacked “spell” data constructed from the Community Tracking Study (CTS) Physician Survey (1996–2005) (n=16,519) I examine how physicians’ perceptions of autonomy vary between solo/two physician practices, small group practices with three to ten physicians, and large practices with ten or more physicians, in two kinds of decisions: logistic-based and knowledge-based decisions. Capitalizing on the longitudinal nature of the data I estimate how changes in practice size are associated with perceptions of autonomy, accounting for previous reports of autonomy. I also test whether managed care involvement, practice ownership, and salaried employment help explain part of this relationship. I find that while physicians practicing in larger group practices reported lower levels of autonomy in logistic-based decisions, physicians in solo/two physician practices reported lower levels of autonomy in knowledge-based decisions. Managed care involvement and ownership explain some, but not all, of the associations. These findings suggest that professional adaptation to various organizational settings can lead to varying levels of perceived autonomy across different kinds of decisions. PMID:24444835

Physicians' perceptions of autonomy across practice types: Is autonomy in solo practice a myth?

PubMed

Lin, Katherine Y

2014-01-01

Physicians in the United States are now less likely to practice in smaller, more traditional, solo practices, and more likely to practice in larger group practices. Though older theory predicts conflict between bureaucracy and professional autonomy, studies have shown that professions in general, and physicians in particular, have adapted to organizational constraints. However, much work remains in clarifying the nature of this relationship and how exactly physicians have adapted to various organizational settings. To this end, the present study examines physicians' autonomy experiences in different decision types between organization sizes. Specifically, I ask: In what kinds of decisions do doctors perceive autonomous control? How does this vary by organizational size? Using stacked "spell" data constructed from the Community Tracking Study (CTS) Physician Survey (1996-2005) (n = 16,519) I examine how physicians' perceptions of autonomy vary between solo/two physician practices, small group practices with three to ten physicians, and large practices with ten or more physicians, in two kinds of decisions: logistic-based and knowledge-based decisions. Capitalizing on the longitudinal nature of the data I estimate how changes in practice size are associated with perceptions of autonomy, accounting for previous reports of autonomy. I also test whether managed care involvement, practice ownership, and salaried employment help explain part of this relationship. I find that while physicians practicing in larger group practices reported lower levels of autonomy in logistic-based decisions, physicians in solo/two physician practices reported lower levels of autonomy in knowledge-based decisions. Managed care involvement and ownership explain some, but not all, of the associations. These findings suggest that professional adaptation to various organizational settings can lead to varying levels of perceived autonomy across different kinds of decisions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Communities of practice in support of collaborative multi-disciplinary learning and action in response to climate change

NASA Astrophysics Data System (ADS)

Heimlich, J. E.; Stylinski, C.; Palmquist, S.; Wasserman, D.

2017-12-01

Collaborative efforts reaching across interdisciplinary boundaries to address controversial issues such as climate change present significant complexities, including developing shared language, agreeing on common outcomes, and even establishing habits of regular dialogue. Such collaborative efforts should include museums, aquariums, zoos, parks, and youth groups as each of these informal education institutions provides a critical avenue for supporting learning about and responding to climate change. The community of practice framework offers a potential effective approach to support learning and action of diverse groups with a shared interest. Our study applied this framework to the NSF-funded Maryland and Delaware Climate Change Assessment and Education (MADE-CLEAR) project, facilitating informal educators across these two states to advance their climate change education practices, and could provide insight for a building a citywide multi-sector collaborative effort. We found strategies that center on the process of group evolution; support different perspectives, levels of participation, and community spaces; focus on value as defined by members; and balance familiarity and fun produced a dynamic and functional community with a shared practice where none had existed before. Also important was expanding the community-of-practice focus on relationship building to include structured professional development and spin-off opportunities for small-group team-based endeavors. Our findings suggest that this collaborative professional learning approach is well suited to diverse groups seeking creative solutions to complex and even divisive challenges.

Power Day: Addressing the Use and Abuse of Power in Medical Training.

PubMed

Angoff, Nancy R; Duncan, Laura; Roxas, Nichole; Hansen, Helena

2016-06-01

Medical student mistreatment, as well as patient and staff mistreatment by all levels of medical trainees and faculty, is still prevalent in U.S. clinical training. Largely missing in interventions to reduce mistreatment is acknowledgement of the abuse of power produced by the hierarchical structure in which medicine is practiced. Beginning in 2001, Yale School of Medicine has held annual "Power Day" workshops for third year medical students and advanced practice nursing students, to define and analyse power dynamics within the medical hierarchy and hidden curriculum using literature, guest speakers, and small groups. During rotations, medical students write narratives about the use of power witnessed in the wards. In response to student and small group leader feedback, workshop organizers have developed additional activities related to examining and changing the use of power in clinical teams. Emerging narrative themes included the potential impact of small acts and students feeling "mute" and "complicit" in morally distressing situations. Small groups provided safe spaces for advice, support, and professional identity formation. By 2005, students recognized residents that used power positively with Power Day awards and alumni served as keynote speakers on the use of power in medicine. By 2010, departments including OB/GYN, surgery, psychiatry, and paediatrics, had added weekly team Power Hour discussions. The authors highlight barriers, benefits, and lessons learned. Barriers include the notion of clinical irrelevance and resistance to the word "power" due to perceived accusation of abuse. Benefits include promoting open dialogue about power, fostering inter-professional collaboration, rewarding positive role modelling by residents and faculty, and creating a network of trainee empowerment and leadership. Furthermore, faculty have started to ask that issues of power be addressed in a more transparent way at their level of the hierarchy as well.

Prevention and treatment of hand oedema after stroke.

PubMed

Kuppens, Stefanie P M; Pijlman, Hanneke C P; Hitters, Minou W M G C; van Heugten, Caroline M

2014-01-01

As there is no evidence for a specific treatment for post-stroke-induced hand oedema, rehabilitation centre Blixembosch formalized a best practice protocol. We investigated whether the Blixembosch hand oedema protocol is usable in daily practice and leads to lower incidence (prevention) and shorter duration (treatment) compared with care as usual. In a non-randomised comparative trial, we investigated 206 post-stroke patients admitted to two Dutch rehabilitation centres. Hand volumes were measured at least bi-weekly using a volumeter. Treatment was started according the protocol (Blixembosch) or following care as usual (Leijpark). Usability was assessed with a survey among professionals. In the Blixembosch group, 16% developed oedema after admission, compared with 21% in the control group (p = 0.019). Average duration of oedema (both developed before and after admission) was 6.5 weeks in the Blixembosch group compared with 3.1 weeks in the control group (p = 0.000). Professionals were positive about the protocol. The study showed that the protocol is usable in daily practice and has a small beneficial effect on hand oedema incidence rates compared with care as usual. The negative effect on duration of hand oedema could also be caused by the difference in prognosis between the two groups.

Cheques and challenges: business performance in New Zealand general practice.

PubMed

Greatbanks, Richard; Doolan-Noble, Fiona; McKenna, Alex

2017-09-01

INTRODUCTION New Zealand general practice mainly functions as small businesses, usually owned by a single or small group of doctors. Consequently, owners often have to balance the provision of patient care with varying funding priorities, changing patient needs and the pressures of running a sustainable business. Such balancing inevitably leads to tensions developing between these factors. AIM To explore and understand these tensions and responses to them, by examining the business performance measurements used by general practice. METHODS For this study, the unit of analysis and focus were individual practices, but qualitative semi-structured interviews with general practitioners (GPs) and practice managers were used to gather the data. RESULTS All participating practices had some form of governance or board review, where high-level aggregated business performance data were presented. More sophisticated business performance measures were evident in the larger, more developed practices and in practices functioning as community trusts. Examples of such measures included doctor utilisation and efficiency, appraisal of risk, patient satisfaction with services and responses to changes in patient demand. DISCUSSION As the number of general practices based on the traditional model decrease, a corresponding increase is likely in the establishment and development of 'super practices' based on a corporatized, multi-service, single-location model. Consequently, service delivery will become increasingly complex and will drive a need for increased sophistication in how general practice measures its business performance, thus ensuring a balance between high-quality, safe patient care and the maintenance of a sustainable business.

A randomized, controlled intervention of machine guarding and related safety programs in small metal-fabrication businesses.

PubMed

Parker, David L; Brosseau, Lisa M; Samant, Yogindra; Xi, Min; Pan, Wei; Haugan, David

2009-01-01

Metal fabrication employs an estimated 3.1 million workers in the United States. The absence of machine guarding and related programs such as lockout/tagout may result in serious injury or death. The purpose of this study was to improve machine-related safety in small metal-fabrication businesses. We used a randomized trial with two groups: management only and management-employee. We evaluated businesses for the adequacy of machine guarding (machine scorecard) and related safety programs (safety audit). We provided all businesses with a report outlining deficiencies and prioritizing their remediation. In addition, the management-employee group received four one-hour interactive training sessions from a peer educator. We evaluated 40 metal-fabrication businesses at baseline and 37 (93%) one year later. Of the three nonparticipants, two had gone out of business. More than 40% of devices required for adequate guarding were missing or inadequate, and 35% of required safety programs and practices were absent at baseline. Both measures improved significantly during the course of the intervention. No significant differences in changes occurred between the two intervention groups. Machine-guarding practices and programs improved by up to 13% and safety audit scores by up to 23%. Businesses that added safety committees or those that started with the lowest baseline measures showed the greatest improvements. Simple and easy-to-use assessment tools allowed businesses to significantly improve their safety practices, and safety committees facilitated this process.

Effects of Physical Exercise on the Intestinal Mucosa of Rats Submitted to a Hypothalamic Obesity Condition.

PubMed

Gomes, J R; Freitas, J R; Grassiolli, S

2016-10-01

The small intestine plays a role in obesity as well as in satiation. However, the effect of physical exercise on the morphology and function of the small intestine during obesity has not been reported to date. This study aimed to evaluate the effects of physical exercise on morphological aspects of the rat small intestine during hypothalamic monosodium glutamate (MSG)-induced obesity. The rats were divided into four groups: Sedentary (S), Monosodium Glutamate (MSG), Exercised (E), and Exercised Monosodium Glutamate (EMSG). The MSG and EMSG groups received a daily injection of monosodium glutamate (4 g/kg) during the 5 first days after birth. The S and E groups were considered as control groups and received injections of saline. At weaning, at 21 days after birth, the EMSG and E groups were submitted to swimming practice 3 times a week until the 90th day, when all groups were sacrificed and the parameters studied recorded. Exercise significantly reduced fat deposits and the Lee Index in MSG-treated animals, and also reduced the thickness of the intestinal wall, the number of goblet cells and intestinal alkaline phosphatase activity. However, physical activity alone increased the thickness and height of villi, and the depth of the crypts. In conclusion, regular physical exercise may alter the morphology or/and functions of the small intestine, reducing the prejudicial effects of hypothalamic obesity. Anat Rec, 299:1389-1396, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Specialized disaster behavioral health training: Its connection with response, practice, trauma health, and resilience

PubMed Central

Atkins, Christiana D.; Burnett,, Harvey J.

2016-01-01

Abstract This study examined the relationship between having training in key disaster behavioral health (DBH) interventions and trauma health (compassion fatigue, burnout and compassion satisfaction), resilience, the number of crisis responses participated in within the last year, and the frequency of assembling to practice crisis interventions skills. Data was collected from a convenience sample of disaster behavioral health responders (N = 139) attending a training conference in Michigan. Measures included the Professional Quality of Life Scale, the 14-item Resilience Scale, and a demographic questionnaire. Point biserial correlations revealed that having training in large and small group crisis interventions and individual and peer crisis interventions was significantly correlated with higher resilience and lower levels of burnout. Psychological First Aid was not significantly associated with any of the trauma health variables or with resilience. Compassion fatigue and compassion satisfaction were not significantly associated with DBH training. Chi-square tests for independence found no significant association between key DBH training strategies and the number of crisis responses participated in within the past year and the frequency of assembling to practice crisis interventions skills. These findings suggest that completing training in both, large and small group and individual and peer crisis intervention techniques may help to increase resiliency and reduce burnout among disaster behavioral health providers. PMID:28229015

Small-Group Learning in an Upper-Level University Biology Class Enhances Academic Performance and Student Attitudes Toward Group Work

PubMed Central

Nakonechny, Joanne; Cragg, Jacquelyn J.; Ramer, Matt S.

2010-01-01

To improve science learning, science educators' teaching tools need to address two major criteria: teaching practice should mirror our current understanding of the learning process; and science teaching should reflect scientific practice. We designed a small-group learning (SGL) model for a fourth year university neurobiology course using these criteria and studied student achievement and attitude in five course sections encompassing the transition from individual work-based to SGL course design. All students completed daily quizzes/assignments involving analysis of scientific data and the development of scientific models. Students in individual work-based (Individualistic) sections usually worked independently on these assignments, whereas SGL students completed assignments in permanent groups of six. SGL students had significantly higher final exam grades than Individualistic students. The transition to the SGL model was marked by a notable increase in 10th percentile exam grade (Individualistic: 47.5%; Initial SGL: 60%; Refined SGL: 65%), suggesting SGL enhanced achievement among the least prepared students. We also studied student achievement on paired quizzes: quizzes were first completed individually and submitted, and then completed as a group and submitted. The group quiz grade was higher than the individual quiz grade of the highest achiever in each group over the term. All students – even term high achievers –could benefit from the SGL environment. Additionally, entrance and exit surveys demonstrated student attitudes toward SGL were more positive at the end of the Refined SGL course. We assert that SGL is uniquely-positioned to promote effective learning in the science classroom. PMID:21209910

Small-group learning in an upper-level university biology class enhances academic performance and student attitudes toward group work.

PubMed

Gaudet, Andrew D; Ramer, Leanne M; Nakonechny, Joanne; Cragg, Jacquelyn J; Ramer, Matt S

2010-12-29

To improve science learning, science educators' teaching tools need to address two major criteria: teaching practice should mirror our current understanding of the learning process; and science teaching should reflect scientific practice. We designed a small-group learning (SGL) model for a fourth year university neurobiology course using these criteria and studied student achievement and attitude in five course sections encompassing the transition from individual work-based to SGL course design. All students completed daily quizzes/assignments involving analysis of scientific data and the development of scientific models. Students in individual work-based (Individualistic) sections usually worked independently on these assignments, whereas SGL students completed assignments in permanent groups of six. SGL students had significantly higher final exam grades than Individualistic students. The transition to the SGL model was marked by a notable increase in 10th percentile exam grade (Individualistic: 47.5%; Initial SGL: 60%; Refined SGL: 65%), suggesting SGL enhanced achievement among the least prepared students. We also studied student achievement on paired quizzes: quizzes were first completed individually and submitted, and then completed as a group and submitted. The group quiz grade was higher than the individual quiz grade of the highest achiever in each group over the term. All students--even term high achievers--could benefit from the SGL environment. Additionally, entrance and exit surveys demonstrated student attitudes toward SGL were more positive at the end of the Refined SGL course. We assert that SGL is uniquely-positioned to promote effective learning in the science classroom.

Preparing Interprofessional Faculty to Be Humanistic Mentors for Medical Students: The GW-Gold Mentor Development Program.

PubMed

Blatt, Benjamin; Plack, Margaret M; Simmens, Samuel J

2018-01-01

The GW-Gold Humanistic Mentor Development Program addresses the challenge faced by medical schools to educate faculty to prepare students for humanistic practice. Grounded in Branch's Teaching Professional and Humanistic Values model, the program prepares interprofessional faculty mentoring teams in humanistic communities of practice. The teams consist of physician-psychosocial professional pairs, each mentoring a small student group in their professional development course. Through GW-Gold workshops, faculty mentors develop interprofessional humanistic communities of practice, preparing them to lead second such communities with their students. This article describes the program and its evaluation. To assess outcomes and better understand the mentor experience, we used a mixed-method validating triangulation design consisting of simultaneous collection of quantitative (mentor and student surveys) and qualitative (open-ended survey questions and focus group) data. Data were analyzed in parallel and merged at the point of interpretation, allowing for triangulation and validation of outcomes. Mentors rated the program highly, gained confidence in their humanistic skills, and received high scores from students. Three themes emerged that validated program design, confirmed outcomes, and expanded on the mentor experience: (1) Interprofessional faculty communities developed through observation, collaboration, reflection, and dialogue; (2) Humanistic mentors created safe environments for student engagement; and (3) Engaging in interprofessional humanistic communities of practice expanded mentors' personal and professional identities. Outcomes support the value of the GW-Gold program's distinctive features in preparing faculty to sustain humanism in medical education: an interprofessional approach and small communities of practice built on humanistic values.

Duration and mutual entrainment of changes in parenting practices engendered by behavioral parent training targeting recently separated mothers.

PubMed

Reed, Andrea; Snyder, James; Staats, Sarah; Forgatch, Marion S; Degarmo, David S; Patterson, Gerald R; Low, Sabina; Sinclair, Ryan; Schmidt, Nicole

2013-06-01

Parent management training (PMT) has beneficial effects on child and parent adjustment that last for 5 to 10 years. Short-term changes in parenting practices have been shown to mediate these effects, but the manner in which changes in specific components of parenting are sequenced and become reciprocally reinforcing (or mutually entrained) to engender and sustain the cascade of long-term beneficial effects resulting from PMT has received modest empirical attention. Long-term changes in parenting resulting from the Oregon model of PMT (PMTO) over a 2-year period were examined using data from the Oregon Divorce Study-II in which 238 recently separated mothers and their 6- to 10-year-old sons were randomly assigned to PMTO or a no treatment control (NTC) group. Multiple indicators of observed parenting practices were used to define constructs for positive parenting, monitoring and discipline at baseline, and at 6-, 12-, 18- and 30-months postbaseline. PMTO relative to NTC resulted in increased positive parenting and prevented deterioration in discipline and monitoring over the 30-month period. There were reliable sequential, transactional relationships among parenting practices; positive parenting supported better subsequent monitoring, and positive parenting and better monitoring supported subsequent effective discipline. Small improvements in parenting resulting from PMTO and small deteriorations in parenting in the NTC group may be sustained and amplified by mutually entrained relationships among parenting practices. These data about the change processes engendered by PMTO may provide information needed to enhance the power, effectiveness, and efficiency of behavioral parent training interventions.

Midwives in India: a delayed cord clamping intervention using simulation.

PubMed

Faucher, M A; Riley, C; Prater, L; Reddy, M P

2016-09-01

Iron deficiency is a prevalent health problem in India affecting women and newborns. Delayed umbilical cord clamping at birth is a safe and effective means for increasing serum iron levels in newborns up to 6 months of age. The study aim was to increase the utilization of delayed cord clamping in a group of midwives working in Hyderabad, India. A single group pre- and post-test design was used to evaluate knowledge, beliefs and practice before and after a delayed cord clamping intervention including follow-up at 10 months after the original intervention. The intervention included lectures and simulation. Results show significant increases in knowledge and positive beliefs about the practice of delayed cord clamping. Simulation was effective for eliciting important feedback related to learning. Results represent a small group of midwives working with a non-profit foundation in Southern India. Language discordancy and cultural norms in this group of midwives may have influenced results. Knowledge, beliefs and practice related to delayed cord clamping were all significantly improved after the intervention. The Knowledge to Action framework using simulation is an effective cross-cultural method for implementing education about evidence-based practice. Midwives are invested in learning practices that promote public health. Changing institutional policy may have limitations without first considering normative practice. Using simulation combined with institutional health policy appears to result in significant uptake of practice change. Qualitative studies exploring the interconnections between cultural norms and decision making may be informative about promoting practice change particularly in this setting. Upscaling midwifery has been recommended to improve maternal and child health in India. © 2016 International Council of Nurses.

Remediation of at-risk medical students: theory in action

PubMed Central

2013-01-01

Background Previous work has shown that a programme that draws on a blend of theories makes a positive difference to outcomes for students who fail and repeat their first semester at medical school. Exploration of student and teacher perspectives revealed that remediation of struggling medical students can be achieved through a cognitive apprenticeship within a small community of inquiry. This community needs expert teachers capable of performing a unique combination of roles (facilitator, nurturing mentor, disciplinarian, diagnostician and role model), with high levels of teaching presence and practical wisdom. Yet, despite participants’ convergent opinions on the elements of effective remediation, significant differences were found between outcomes of students working with experienced and inexperienced teachers. The current study explores the actual practice of teachers on this remediation course, aiming to exemplify elements of our theory of remediation and explore differences between teachers. Methods Since it is in the classroom context that the interactions that constitute the complex process of remediation emerge, this practice-based research has focused on direct observation of classroom teaching. Nineteen hours of small group sessions were recorded and transcribed. Drawing on ethnography and sociocultural discourse analysis, selected samples of talk-in-context demonstrate how the various elements of remediation play out in practice, highlighting aspects that are most effective, and identifying differences between experienced and novice teachers. Results Long-term student outcomes are strongly correlated to teacher experience (r, 0.81). Compared to inexperienced teachers, experienced teachers provide more challenging, disruptive facilitation, and take a dialogic stance that encourages more collaborative group dynamics. They are more expert at diagnosing cognitive errors, provide frequent metacognitive time-outs and make explicit links across the curriculum. Conclusions Remediation is effective in small groups where dialogue is used for collaborative knowledge construction and social regulation. This requires facilitation by experienced teachers who attend to details of both content and process, and use timely interventions to foster curiosity and the will to learn. These teachers should actively challenge students’ language use, logical inconsistencies and uncertainties, problematize their assumptions, and provide a metacognitive regulatory voice that can generate attitudinal shifts and nurture the development of independent critical thinkers. PMID:24070196

[Cases of suspected poisoning in small animal practice - a retrospective and prospective survey].

PubMed

Allkämper, Svenja; Kösters, Sarah; Campe, Amely; Kietzmann, Manfred; Kreienbrock, Lothar

2018-06-01

Systematic survey of data from cases of suspected poisoning in small animal practices. In 11 exemplary selected small animal practices, patient files from cases of suspected poisoning over 2006/2007, data entry forms of poisonings 2009-2010 and the contact group, which are all patients with at least one visit in 2007, were analysed. In 2007, approximately 1 in 200 dog and 1 in 500 cat patients were presented with poisoning. More than 70 % of cases concerned dogs. Some breeds of hunting dogs were more frequently affected than expected from their percentage in the practice population. Suspicion of poisoning was retrospective mainly founded in neutered dogs. In addition to numerous unspecific symptoms, bleeding was frequently observed. With central nervous system symptoms or a critical general condition a founded suspicion was observed more frequently. In cases of unfounded suspicion, inflammation of the gastrointestinal tract was mostly present. Other frequently seen diseases were infections, tumours and autoimmune diseases. The main toxins in the retrospective evaluation were coumarin derivatives (37 %), drugs (10 %) and chocolate (7 %). The prospective survey yielded a higher percentage of poisoning with drugs and plants. The diagnosis was mainly based on case history and clinical signs. Therapy was predominantly symptomatic. Poisoning with coumarin derivatives is the most frequent intoxication in dogs, but also cats. The risk from permethrin for cats remains current. In daily practice, therapy is mostly symptomatic without any specific toxicological evidence. Consequently, the causative toxin is frequently unknown. Therefore, additional methods for elimination (stomach/rectal lavage, medical coal, lipid therapy) should be included as therapeutical options. For a successful systematic prospective survey in daily practice a good collaboration between practice and investigator is necessary. Schattauer GmbH.

Using social media to support small group learning.

PubMed

Cole, Duncan; Rengasamy, Emma; Batchelor, Shafqat; Pope, Charles; Riley, Stephen; Cunningham, Anne Marie

2017-11-10

Medical curricula are increasingly using small group learning and less didactic lecture-based teaching. This creates new challenges and opportunities in how students are best supported with information technology. We explored how university-supported and external social media could support collaborative small group working on our new undergraduate medical curriculum. We made available a curation platform (Scoop.it) and a wiki within our virtual learning environment as part of year 1 Case-Based Learning, and did not discourage the use of other tools such as Facebook. We undertook student surveys to capture perceptions of the tools and information on how they were used, and employed software user metrics to explore the extent to which they were used during the year. Student groups developed a preferred way of working early in the course. Most groups used Facebook to facilitate communication within the group, and to host documents and notes. There were more barriers to using the wiki and curation platform, although some groups did make extensive use of them. Staff engagement was variable, with some tutors reviewing the content posted on the wiki and curation platform in face-to-face sessions, but not outside these times. A small number of staff posted resources and reviewed student posts on the curation platform. Optimum use of these tools depends on sufficient training of both staff and students, and an opportunity to practice using them, with ongoing support. The platforms can all support collaborative learning, and may help develop digital literacy, critical appraisal skills, and awareness of wider health issues in society.

Pre-university Chemistry Students in a Mimicked Scholarly Peer Review

NASA Astrophysics Data System (ADS)

van Rens, Lisette; Hermarij, Philip; Pilot, Albert; Beishuizen, Jos; Hofman, Herman; Wal, Marjolein

2014-10-01

Peer review is a significant component in scientific research. Introducing peer review into inquiry processes may be regarded as an aim to develop student understanding regarding quality in inquiries. This study examines student understanding in inquiry peer reviews among pre-university chemistry students, aged 16-17, when they enact a design of a mimicked scholarly peer review. This design is based on a model of a human activity system. Twenty-five different schools in Brazil, Germany, Poland and The Netherlands participated. The students (n = 880) conducted in small groups (n = 428) open inquiries on fermentation. All groups prepared an inquiry report for peer review. These reports were published on a website. Groups were randomly paired in an internet symposium, where they posted review comments to their peers. These responses were qualitatively analyzed on small groups' level of understanding regarding seven categories: inquiry question, hypothesis, management of control variables, accurate measurement, presenting results, reliability of results, discussion and conclusion. The mimicked scholarly review prompted a collective practice. Student understanding was significantly well on presenting results, discussion and conclusion, and significantly less on inquiry question and reliability of results. An enacted design, based on a model of a human activity system, created student understanding of quality in inquiries as well as an insight in a peer-reviewing practice. To what extent this model can be applied in a broader context of design research in science education needs further study.

Randomised controlled trial of educational package on management of menorrhagia in primary care: the Anglia menorrhagia education study

PubMed Central

Fender, Guy R K; Prentice, Andrew; Gorst, Tess; Nixon, Richard M; Duffy, Stephen W; Day, Nicholas E; Smith, Stephen K

1999-01-01

Objective To determine whether an educational package could influence the management of menorrhagia, increase the appropriateness of choice of non-hormonal treatment, and reduce referral rates from primary to secondary care. Design Randomised controlled trial. Setting General practices in East Anglia. Subjects 100 practices (348 doctors) in primary care were recruited and randomised to intervention (54) and control (46). Interventions An educational package based on principles of “academic detailing” with independent academics was given in small practice based interactive groups with a visual presentation, a printed evidence based summary, a graphic management flow chart, and a follow up meeting at 6 months. Outcome measures All practices recorded consultation details, treatments offered, and outcomes for women with regular heavy menstrual loss (menorrhagia) over 1 year. Results 1001 consultation data sheets for menorrhagia were returned. There were significantly fewer referrals (20% v 29%; odds ratio 0.64; 95% confidence interval 0.41 to 0.99) and a significantly higher use of tranexamic acid (odds ratio 2.38; 1.61 to 3.49) in the intervention group but no overall difference in norethisterone treatment compared with controls. There were more referrals when tranexamic acid was given with norethisterone than when it was given alone. Those practices reporting fewer than 10 cases showed the highest increase in prescribing of tranexamic acid. Conclusions The educational package positively influenced referral for menorrhagia and treatment with appropriate non-hormonal drugs. Key messagesMenorrhagia (regular excessive menstruation) affects many women and treatment is a considerable use of resourcesAppropriate non-hormonal treatments are not always offered before referral, which often results in therapeutic surgeryAn educational package with independent academics in small informal groups presenting visual, graphic, and written material can positively influence doctors’ behaviourIncreasing appropriate non-hormonal treatments for menorrhagia results in fewer referrals PMID:10231255

Virtual Action Learning: A Pilot in Building Leadership Capacity

ERIC Educational Resources Information Center

Radcliff, Phil

2017-01-01

This account of practice encompasses a pilot virtual action learning programme with a small group of learners. This was an 18-month extension to the one-week Leadership Open Programme that the participants had previously completed at the Business School. It includes insights from an evaluation study completed in early 2016. It considers in…

The Challenges of Incorporating ePortfolio into an Undergraduate Nursing Programme

ERIC Educational Resources Information Center

Haggerty, Carmel; Thompson, Trish

2017-01-01

Registered nurses today are required to maintain a portfolio of evidence of their competence to practice. This evidence collection commences at undergraduate level with nursing programmes requiring portfolio's as assessments, which are often submitted in hard copy. This paper describes the outcome when a small group of tutorial staff introduced…

LEAD at Lunch: Inquiry, Learning, and Action

ERIC Educational Resources Information Center

Roberts, Cynthia

2012-01-01

This account of practice discusses the author's experience in facilitating a small group of managers in health care over lunchtime utilizing an action learning approach. This was part of a larger leadership development initiative which took place in the organization and the intention was to create a more intimate, informal and safe setting whereby…

Evaluation of Gastrointestinal Motility in Awake Rats: A Learning Exercise for Undergraduate Biomedical Students

ERIC Educational Resources Information Center

Souza, M. A. N.; Souza, M. H. L. P.; Palheta, R. C., Jr.; Cruz, P. R. M.; Medeiros, B. A.; Rola, F. H.; Magalhaes, P. J. C.; Troncon, L. E. A.; Santos, A. A.

2009-01-01

Current medical curricula devote scarce time for practical activities on digestive physiology, despite frequent misconceptions about dyspepsia and dysmotility phenomena. Thus, we designed a hands-on activity followed by a small-group discussion on gut motility. Male awake rats were randomly submitted to insulin, control, or hypertonic protocols.…

Developing a Framework of Facilitator Competencies: Lessons from the Field

ERIC Educational Resources Information Center

Kolb, Judith A.; Jin, Sungmi; Song, Ji Hoon

2008-01-01

People in organizations are increasingly called upon to serve as small group facilitators or to assist in this role. This article uses data collected from practicing facilitators at three points of time and a building block process of collection, analysis, further collection, and consolidation to develop and refine a list of competencies. A…

Navigating the Use of Cogenerative Dialogues: Practical Considerations for Graduate Faculty

ERIC Educational Resources Information Center

Boss, Ginny Jones; Linder, Chris

2016-01-01

In this study, we explored cogenerative dialogue (cogen) as a tool for learner-centered teaching in graduate education. Cogen consists of small group dialogues among instructors and students for the purposes of improving course processes. We engaged cogen during a semester-long, graduate-level campus environments course. Using the theoretical…

Preparing Social Justice Oriented Teachers: The Potential Role of Action Research in the PDS

ERIC Educational Resources Information Center

Dodman, Stephanie L.; Lai, Kerri; Campet, Melissa; Cavallero-Lotocki, Renee; Hopkins, Aaron; Onidi, Christine

2014-01-01

Deliberate investigation into practice is an essential of the National Association for Professional Development Schools' defining elements of a Professional Development School (PDS). This article reports on the pilot efforts of one PDS as it initiated deliberate investigation through action research with a small group of teacher candidates. The…

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

ERIC Educational Resources Information Center

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

2014-01-01

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

What Happens When the Supply Chain Breaks? Implications for the Army Supply Chain Under Attack

DTIC Science & Technology

2003-05-22

Supply Chain Integration office with Secretariat level leadership to facilitate DoD Component implementation of supply chain management practices...rather than cyber attack. Tim Belcher, Chief Technology Officer for Riptech, a computer security firm said “It was always assumed that a small group of

A Trojan Horse in Birmingham

ERIC Educational Resources Information Center

Yarker, Patrick

2014-01-01

"Trojan Horse" has become journalistic shorthand for an apparent attempt by a small group in East Birmingham to secure control of local non-faith schools and impose policies and practices in keeping with the very conservative (Salafist and Wahhabi) version of Islam which they hold. In this article, Pat Yarker gives an account of two…

An Examination of the Questioning Interactions of Prospective Teachers during Mathematical Discussions

ERIC Educational Resources Information Center

Darke, Kelly Marie

2010-01-01

Questioning is an essential and generative studying practice for prospective teachers (PTs) as they develop their mathematical content knowledge needed for teaching. This study examines PTs' questioning interactions by describing the types of questions they ask during small group discussions in a required mathematics content course and how their…

Biotechnology Apprenticeship for Secondary-Level Students: Teaching Advanced Cell Culture Techniques for Research

ERIC Educational Resources Information Center

Lewis, Jennifer R.; Kotur, Mark S.; Butt, Omar; Kulcarni, Sumant; Riley, Alyssa A.; Ferrell, Nick; Sullivan, Kathryn D.; Ferrari, Mauro

2002-01-01

The purpose of this article is to discuss "small-group apprenticeships (SGAs)" as a method to instruct cell culture techniques to high school participants. The study aimed to teach cell culture practices and to introduce advanced imaging techniques to solve various biomedical engineering problems. Participants designed and completed experiments…

Finding Common Ground: Teacher Leaders and Principals Speak out about Teacher Leadership

ERIC Educational Resources Information Center

Weiner, Jennie Miles

2011-01-01

This study investigates how a small group of teacher leaders and their principals, participating in a teacher leadership program called the teacher connector (TC), understand teacher leadership and its impact on their practice. TCs' responsibilities were typical of teacher leaders; thus, their experiences can provide insights into teacher leaders'…

Interactive Shared Book Reading. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2007

2007-01-01

"Interactive Shared Book Reading" is a general practice that adults may use when reading with children and is intended to enhance young children's language and literacy skills. Typically, "Interactive Shared Book Reading" involves an adult reading a book to a child or a small group of children and using a variety of techniques…

Discursive Construction of Social Presence and Identity Positions in an International Bilingual Collaboration

ERIC Educational Resources Information Center

Walker, Ute

2017-01-01

This article examines the discursive construction of social presence and identity in a bilingual collaboration between tertiary distance learners of German in New Zealand and Academic English students in Germany. Drawing on positioning theory, this small-scale study investigated the collaborative practices of a group of students, whose synchronous…

Teaching the Teachers: Faculty Preparedness and Evaluation of a Retreat in Screening, Brief Intervention, and Referral to Treatment

ERIC Educational Resources Information Center

Childers, Julie W.; Broyles, Lauren M.; Hanusa, Barbara H.; Kraemer, Kevin L.; Conigliaro, Joseph; Spagnoletti, Carla; McNeil, Melissa; Gordon, Adam J.

2012-01-01

Effective clinical faculty are essential for disseminating substance abuse screening, brief intervention, and referral to treatment (SBIRT). The authors developed an 8-hour SBIRT training for internal medicine faculty preceptors. Trainers conducted SBIRT lectures and small-group communication practice sessions. The authors assessed participants'…

A century of grazing: The value of long-term research

USDA-ARS?s Scientific Manuscript database

A century ago, a small group of scientists at Mandan, ND set out to answer a very practical question: how many acres of native prairie does it take to sustainably support a steer during the grazing season? Part of that original experiment continues today as one of the longest running experiments in ...

One practice's experiment in refusing detail rep visits.

PubMed

Evans, David V; Hartung, Daniel M; Andeen, Gabriel; Mahler, Jo; Haxby, Dean G; Kraemer, Dale F; Fagnan, Lyle J

2011-08-01

The physician-pharmaceutical industry relationship has come under increasing scrutiny. Little guidance exists concerning how smaller practices should manage this relationship.In 2006, Madras Medical Group, a small family practice in rural Oregon, implemented a policy prohibiting visits from representatives of the pharmaceutical industry and the acceptance of drug samples. This qualitative study documents the attitudes of clinic personnel in response to this policy. Semistructured interviews were conducted using standardized questions related to 4 areas of policy perception: verification of policy decision, impact on clinic operations,influence of pharmaceutical industry, and lessons to share. Common themes were identified. Three physicians and 3 nurses participated in the study. There was consensus on the existence and effectiveness of the clinic policy. Key themes identified from both groups of interviewees included the perception of enhanced clinic operation after eliminating interruptions from pharmaceutical representatives, positive response from the public, and reduced diversion of samples for personal use. Clinicians interviewed agreed that samples were of questionable benefit,that information obtained from industry representatives was incomplete or of questionable veracity or objectivity, and that it was helpful to substitute other drug information sources and clinic-sponsored lunches for past industry offerings. In this case study, a policy prohibiting pharmaceutical representatives from a small family practice was well accepted and a source of pride among physicians and nurses. Other clinics wishing to enact a similar policy may wish to supplement their efforts by proactively using other sources of drug information.

Going interactive: six strategies to meet the challenge of teaching electrosurgery to general dental practitioners.

PubMed

Davies, B R; Millar, B J; Louca, C

2007-10-27

Mandatory continuing professional development has resulted in a recent expansion in postgraduate dental teaching. One popular type of teaching is the practical 'hands-on' course that combines the explanation of theory with the acquisition of practical skills in small groups. The challenge to dental teachers is to provide the best level of teaching on these courses where the course participants bring varied expectations and different levels of knowledge, skill or interest. This paper presents a new teaching model that has been developed for the postgraduate teaching of Electrosurgery. The key components of this course include an interactive theory lecture using multimedia, followed by hands-on practical teaching. The emphasis throughout is on the use of facilitation and group learning rather than traditional didactic teaching. A series of strategies for the effective delivery of such a hands-on course together with evaluation of findings from 31 courses are considered.

Description and student self-evaluation of a pilot integrated small group learning and simulation programme for medical students in the first clinical year.

PubMed

Levinson, Michele; Kelly, Diane; Zahariou, Krisoula; Johnson, Matthew; Jackman, Christine; Mackenzie, Sara

2017-02-01

Contemporary education for medical students should be student-centred, integrated and contextualised. Small group learning promotes clinical reasoning and skills for lifelong learning. Simulation can provide experiential learning in a safe and controlled environment. We developed a weekly integrated problem-based learning and simulation programme (IPS) over two semesters in the first clinical year to augment clinical placement experience and contextualise theory into work-relevant practice. To evaluate the new programme at Kirkpatrick level 1. An anonymous survey of participating students. The programme was well liked. Students found the programme relevant and that they had a better understanding of patient safety and the assessment of the deteriorating patient. They felt it contributed to integration of theory and practice, clinical reasoning and the acquisition of non-technical skills, particularly affective and communication elements. This IPS programme in the first clinical year can deliver a student-centred curriculum to complement clinical placement that delivers the important requirements of contemporary medical student education. © 2016 Royal Australasian College of Physicians.

Best practices: applying management analysis of excellence to immunization.

PubMed

Wishner, Amy; Aronson, Jerold; Kohrt, Alan; Norton, Gary

2005-01-01

The authors applied business management tools to analyze and promote excellence and to evaluate differences between average and above-average immunization peformers in private practices. The authors conducted a pilot study of 10 private practices in Pennsylvania using tools common in management to assess practices' organizational climate and managerial style. Authoritative and coaching styles of physician leaders were common to both groups. Managerial styles that emphasized higher levels of clarity and responsibility managerial styles were evident in the large practices; and rewards and flexibility styles were higher in the small above-average practices. The findings of this pilot study match results seen in high performers in other industries. It concludes that the authoritative style appears to have the most impact on performance. It has interesting implications for training/behavior change to improve immunization rates, along with traditional medical interventions.

Collation and comparison of multi-practice audit data: prevalence and treatment of known diabetes mellitus.

PubMed Central

Khunti, K; Goyder, E; Baker, R

1999-01-01

BACKGROUND: Different methods have been used to determine the prevalence and treatment of diabetes. Despite the large number of studies, previous estimations of prevalence and treatment have been carried out on relatively small numbers of patients, and then in only a few practices in single geographical regions. AIM: To investigate the feasibility of collating data from multi-practice audits organized by primary care audit groups in order to estimate the prevalence and treatment of patients with known diabetes, and to discuss the methodological issues and reasons for variation. METHOD: A postal questionnaire survey of all primary care audit groups in England and Wales that had conducted a multi-practice audit of diabetes between 1993-1995. Prevalence rates and patterns of diabetic care were compared with other community-based surveys of known diabetes from 1986-1996 identified on MEDLINE. RESULTS: Twenty-five (43%) audit groups supplied data from multi-practice audits of diabetes. Seven (28%) multi-practice audits involving 259 practices fulfilled the inclusion criteria for prevalence estimation. The overall prevalence of diabetes based on a population of 1,475,512 patients was 1.46% (range between audit groups = 1.18% to 1.66%; chi 2 = 308; df = 6; P < 0.0001). Male to female ratio was 1.15:1. Treatment of diabetes could be ascertained for 10 (40%) audit groups comprising 319 practices. Of these, 23.4% (range = 16.5%-27.4%) were controlled by diet, 48.5% (range = 43.6%-55.8%) were prescribed oral hypoglycaemic drugs, and 28.2% (range = 25.0%-32.4%) were treated with insulin. There were significant variations between audit groups in treatment pattern (chi 2 = 250; df = 18; P < 0.0001). CONCLUSION: Prevalence and treatment rates of diabetes and other chronic diseases can be assessed and compared using data from multi-practice audits. Collation of audit data could improve the precision of quantitative estimates of health status in populations. A standard method of data recording and collection may provide a new approach that could considerably improve our ability to monitor disease and its management. PMID:10736888

What we think we learn from watching others: the moderating role of ability on perceptions of learning from observation.

PubMed

Hodges, Nicola J; Coppola, Thomas

2015-07-01

Despite increased interest in the processes guiding action observation and observational learning, we know little about what people think they learn from watching, how well perceptions of learning marry with actual ability and how ability perceptions develop across multiple observation trials. Based on common coding ideas, we would think that ability and perceptions of ability from watching should be well matched. We conducted two studies to answer these questions that involved repeated observation of a 2-ball juggling task. After each video observation, observers judged if they could perform the skill and gave a confidence score (0-100%). In Experiment 1, an Observe-only group was compared to an Observe + Physical practice and No-practice group. Both observer groups showed a better physical approximation of the juggling action after practice and in retention and their confidence increased in a linear fashion. Confidence showed a small, yet significant relationship to actual success. In Experiment 2, we limited physical practice to 5 attempts (across 50 observation trials). In general, people who had high perceptions of ability following a demonstration were overconfident, whereas those with lower perceptions of ability were accurate in their assessments. Confidence generally increased across practice, particularly for trials following observation rather than physical practice. We conclude that while perceptions of ability and actual ability show congruence across trials and individuals, observational practice increases people's confidence in their ability to perform a skill, even despite physical experiences to the contrary.

Collaborative Learning Works! Resources for Faculty

NASA Astrophysics Data System (ADS)

Mathieu, R. D.; Brissenden, G.; NISE College Level-1 Team

1998-12-01

Recent calls for instructional innovation in undergraduate science, mathematics, engineering, and technology (SMET) courses highlight the need for a solid foundation of education research at the undergraduate level on which to base policy and practice. We report the results of a meta-analysis that integrates research on undergraduate SMET education since 1980. The meta-analysis demonstrates that various forms of small-group learning are effective in promoting greater academic achievement, more favorable attitudes toward learning, and increased persistence through SMET courses and programs. The magnitude of the effects reported in this study exceeds most findings in comparable reviews of research on educational innovations and supports more widespread implementation of small-group learning in undergraduate SMET courses. We have created a web-site to assist instructors who wish to incorporate collaborative learning in their lectures, classrooms, and laboratories. The site provides straightforward, easy-to-use ideas for those just getting started, extensive additional resources for those already using small-group techniques, and the educational research foundation for the use of collaborative learning (including the meta-analysis). You can visit the site at www.wcer.wisc.edu/nise/cl1.

Planetary Science Education - Workshop Concepts for Classrooms and Internships

NASA Astrophysics Data System (ADS)

Musiol, S.; Rosenberg, H.; Rohwer, G.; Balthasar, H.; van Gasselt, S.

2014-12-01

In Germany, education in astronomy and planetary sciences is limited to very few schools or universities and is actively pursued by only selected research groups. Our group is situated at the Freie Universität Berlin and we are actively involved in space missions such as Mars Express, Cassini in the Saturnian system, and DAWN at Vesta and Ceres. In order to enhance communication and establish a broader basis for building up knowledge on our solar-system neighborhood, we started to offer educational outreach in the form of workshops for groups of up to 20 students from primary/middle schools to high schools. Small group sizes guarantee practical, interactive, and dialog-based working environments as well as a high level of motivation. Several topical workshops have been designed which are targeted at different age groups and which consider different educational background settings. One workshop called "Impact craters on planets and moons" provides a group-oriented setting in which 3-4 students analyze spacecraft images showing diverse shapes of impact craters on planetary surfaces. It is targeted not only at promoting knowledge about processes on planetary surfaces but it also stimulates visual interpretation skills, 3D viewing and reading of map data. A second workshop "We plan a manned mission to Mars" aims at fostering practical team work by designing simple space mission scenarios which are solved within a team by collaboration and responsibility. A practical outdoor activity called "Everything rotates around the Sun" targets at developing a perception of absolute - but in particular relative - sizes, scales and dimensions of objects in our solar system. Yet another workshop "Craters, volcanoes and co. - become a geologist on Mars" was offered at the annual national "Girls' Day" aiming at motivating primary to middle school girls to deal with topics in classical natural sciences. Small groups investigated and interpreted geomorphologic features in image data of the Martian surface and presented their results in the end. Extensive handouts and high-quality print material supplemented face-to-face exercises. For the future we plan to expand our workshop concepts, to give students the possibility of conducting a week-long internship with our Planetary Sciences research group.

Recruiting primary care practices for practice-based research: a case study of a group-randomized study (TRANSLATE CKD) recruitment process.

PubMed

Loskutova, Natalia Y; Smail, Craig; Ajayi, Kemi; Pace, Wilson D; Fox, Chester H

2018-01-16

We assessed the challenging process of recruiting primary care practices in a practice-based research study. In this descriptive case study of recruitment data collected for a large practice-based study (TRANSLATE CKD), 48 single or multiple-site health care organizations in the USA with a total of 114 practices were invited to participate. We collected quantitative and qualitative measures of recruitment process and outcomes for the first 25 practices recruited. Information about 13 additional practices is not provided due to staff transitions and limited data collection resources. Initial outreach was made to 114 practices (from 48 organizations, 41% small); 52 (45%) practices responded with interest. Practices enrolled in the study (n = 25) represented 22% of the total outreach number, or 48% of those initially interested. Average time to enroll was 71 calendar days (range 11-107). There was no difference in the number of days practices remained under recruitment, based on enrolled versus not enrolled (44.8 ± 30.4 versus 46.8 ± 25.4 days, P = 0.86) or by the organization size, i.e. large versus small (defined by having ≤4 distinct practices; 52 ± 23.6 versus 43.6 ± 27.8 days; P = 0.46). The most common recruitment barriers were administrative, e.g. lack of perceived direct organizational benefit, and were more prominent among large organizations. Despite the general belief that the research topic, invitation method, and interest in research may facilitate practice recruitment, our results suggest that most of the recruitment challenges represent managerial challenges. Future research projects may need to consider relevant methodologies from businesses administration and marketing fields. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Forensic nursing science knowledge and competency: the use of simulation.

PubMed

Drake, Stacy A; Langford, Rae; Young, Anne; Ayers, Constance

2015-01-01

Forensic nursing is a nursing specialty that provides services to a variety of patient populations who have experienced violence, including interpersonal violence, sudden or unexpected death, and motor vehicle collisions. However, many critical care nurses have received the background knowledge or practical skills required to provide the level of care required by many forensic patients. The purpose of this study was to determine whether differences in knowledge or practical competence exist between participants using 2 different learning modalities: medium fidelity simulation versus face-to-face lecture. Participants who were enrolled in an elective online forensic nursing science course were randomly assigned to an intervention or control group. The 18 intervention group participants were given three 2-hour forensic simulation sessions in the laboratory. The 17 control group participants attended 3 face-to-face lectures covering forensic science topics. All study participants also received the same forensic course content via the online Blackboard platform. No significant differences were found between the 2 groups in either knowledge or practical competency. The lack of results may have been heavily influenced by the small sample size, which resulted in insufficient power to detect possible differences.

Collaborative Learning Works! Resources for Faculty

NASA Astrophysics Data System (ADS)

Brissenden, G. A.; Mathieu, R. D.; National InstituteScience Education; College Level-One Team

2000-12-01

Recent calls for instructional innovation in college Science, Mathematics, Engineering, and Technology (SMET) courses highlight the need for a solid foundation of education research at the undergraduate level on which to base policy and practice. We report the results of a meta-analysis that integrates research on undergraduate SMET education since 1980. The meta-analysis demonstrates that various forms of small-group learning are effective in promoting greater academic achievement, more favorable attitudes toward learning, and increased persistence through SMET courses and programs. Specifically, the effect of small-group learning on achievement reported in this study would move a student from the 50th percentile to the 70th percentile on a standardized test. Similarly, the effect on students'persistence is enough to reduce attrition from SMET courses and programs by 22 widespread implementation of small-group learning in college SMET courses. We have created a Collaborative Learning website designed to assist instructors who wish to incorporate collaborative learning in their lectures, classrooms, and laboratories. The site provides straightforward, easy-to-use ideas for those just getting started, extensive additional resources for those already using small-group techniques, and the educational research foundation for the use of collaborative learning (including the meta-analysis). The Collaborative Learning site can be found at the NISE "Innovations in SMET Education" website at www.wcer.wisc.edu/nise/cl1

Effects of Epoetin Alfa Titration Practices, Implemented After Changes to Product Labeling, on Hemoglobin Levels, Transfusion Use, and Hospitalization Rates.

PubMed

Molony, Julia T; Monda, Keri L; Li, Suying; Beaubrun, Anne C; Gilbertson, David T; Bradbury, Brian D; Collins, Allan J

2016-08-01

Little is known about epoetin alfa (EPO) dosing at dialysis centers after implementation of the US Medicare prospective payment system and revision of the EPO label in 2011. Retrospective cohort study. Approximately 412,000 adult hemodialysis patients with Medicare Parts A and B as primary payer in 2009 to 2012 to describe EPO dosing and hemoglobin patterns; of these, about 70,000 patients clustered in about 1,300 dialysis facilities to evaluate facility-level EPO titration practices and patient-level outcomes in 2012. Facility EPO titration practices when hemoglobin levels were <10 and >11g/dL (grouped treatment variable) determined from monthly EPO dosing and hemoglobin level patterns. Patient mean hemoglobin levels, red blood cell transfusion rates, and all-cause and cause-specific hospitalization rates using a facility-based analysis. Monthly EPO dose and hemoglobin level, red blood cell transfusion rates, and all-cause and cause-specific hospitalization rates. Monthly EPO doses declined across all hemoglobin levels, with the greatest decline in patients with hemoglobin levels < 10g/dL (July-October 2011). In 2012, nine distinct facility titration practices were identified. Across groups, mean hemoglobin levels differed slightly (10.5-10.8g/dL) but within-patient hemoglobin standard deviations were similar (∼0.68g/dL). Patients at facilities implementing greater dose reductions and smaller dose escalations had lower hemoglobin levels and higher transfusion rates. In contrast, patients at facilities that implemented greater dose escalations (and large or small dose reductions) had higher hemoglobin levels and lower transfusion rates. There were no clinically meaningful differences in all-cause or cause-specific hospitalization events across groups. Possibly incomplete claims data; excluded small facilities and those without consistent titration patterns; hemoglobin levels reported monthly; inferred facility practice from observed dosing. Following prospective payment system implementation and labeling revisions, EPO doses declined significantly. Under the new label, facility EPO titration practices were associated with mean hemoglobin levels (but not standard deviations) and transfusion use, but not hospitalization rates. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

A small unconditional non-financial incentive suggests an increase in survey response rates amongst older general practitioners (GPs): a randomised controlled trial study

PubMed Central

2013-01-01

Background Few studies have investigated the effect of small unconditional non-monetary incentives on survey response rates amongst GPs or medical practitioners. This study assessed the effectiveness of offering a small unconditional non-financial incentive to increase survey response rates amongst general practitioners within a randomised controlled trial (RCT). Methods An RCT was conducted within a general practice survey that investigated how to prolong working lives amongst ageing GPs in Australia. GPs (n = 125) were randomised to receive an attractive pen or no pen during their first invitation for participation in a survey. GPs could elect to complete the survey online or via mail. Two follow up reminders were sent without a pen to both groups. The main outcome measure was response rates. Results The response rate for GPs who received a pen was higher in the intervention group (61.9%) compared to the control group (46.8%). This study did not find a statistically significant effect of a small unconditional non-financial incentive (in the form of a pen) on survey response rates amongst GPs (Odds ratio, 95% confidence interval: 1.85 (0.91 to 3.77). No GPs completed the online version. Conclusion A small unconditional non-financial incentives, in the form of a pen, may improve response rates for GPs. PMID:23899116

A small unconditional non-financial incentive suggests an increase in survey response rates amongst older general practitioners (GPs): a randomised controlled trial study.

PubMed

Pit, Sabrina Winona; Hansen, Vibeke; Ewald, Dan

2013-07-30

Few studies have investigated the effect of small unconditional non-monetary incentives on survey response rates amongst GPs or medical practitioners. This study assessed the effectiveness of offering a small unconditional non-financial incentive to increase survey response rates amongst general practitioners within a randomised controlled trial (RCT). An RCT was conducted within a general practice survey that investigated how to prolong working lives amongst ageing GPs in Australia. GPs (n = 125) were randomised to receive an attractive pen or no pen during their first invitation for participation in a survey. GPs could elect to complete the survey online or via mail. Two follow up reminders were sent without a pen to both groups. The main outcome measure was response rates. The response rate for GPs who received a pen was higher in the intervention group (61.9%) compared to the control group (46.8%). This study did not find a statistically significant effect of a small unconditional non-financial incentive (in the form of a pen) on survey response rates amongst GPs (Odds ratio, 95% confidence interval: 1.85 (0.91 to 3.77). No GPs completed the online version. A small unconditional non-financial incentives, in the form of a pen, may improve response rates for GPs.

Developing CORE model-based worksheet with recitation task to facilitate students’ mathematical communication skills in linear algebra course

NASA Astrophysics Data System (ADS)

Risnawati; Khairinnisa, S.; Darwis, A. H.

2018-01-01

The purpose of this study was to develop a CORE model-based worksheet with recitation task that were valid and practical and could facilitate students’ communication skills in Linear Algebra course. This study was conducted in mathematics education department of one public university in Riau, Indonesia. Participants of the study were media and subject matter experts as validators as well as students from mathematics education department. The objects of this study are students’ worksheet and students’ mathematical communication skills. The results of study showed that: (1) based on validation of the experts, the developed students’ worksheet was valid and could be applied for students in Linear Algebra courses; (2) based on the group trial, the practicality percentage was 92.14% in small group and 90.19% in large group, so the worksheet was very practical and could attract students to learn; and (3) based on the post test, the average percentage of ideals was 87.83%. In addition, the results showed that the students’ worksheet was able to facilitate students’ mathematical communication skills in linear algebra course.

Improving orientation in head injured adults by repeated practice, multi-sensory input and peer participation.

PubMed

Zencius, A H; Wesolowski, M D; Rodriguez, I M

1998-01-01

The efficacy of using antecedent control procedures (practice, multi-sensory input and peer participation) in facilitating orientation to person, place and time with two survivors of traumatic brain injuries were tested in two studies. In the first investigation, a 23-year-old male was treated by presenting the orientation questions orally while being shown questions on written flashcards. Results suggest that correct responses to orientation questions only occurred when flashcards were coupled with oral questioning. The participant responded correctly to nearly 100% of all orientation questions within 2 weeks of initiating flashcards. In the second study, a 19-year-old male was asked to respond in writing to 20 orientation questions in a small group. The group had a leader and 4 TBI patients. Following this, group members who correctly answered the orientation questions, took turns reading orientation questions and providing the correct responses.

Successful affiliations: principles and practices.

PubMed

Rice, Ann Madden

2011-01-01

An affiliation can help a healthcare provider prepare for the challenges of healthcare reform, the rapidly changing landscapes of the commercial insurance industry, and the public's expectations about service and quality. UC Davis Medical Center, a 645-bed tertiary hospital in Sacramento, California, with many hospital-based clinics and a community-based group of primary care clinics, has developed a number of principles for affiliation. These principles are based on its experience in legal and financial affiliations with an academic practice group, with individual and small groups of primary care physicians, and with community hospitals around oncology services linked with U.C. Davis' National Cancer Institute-designated cancer center. This article offers a process for evaluating the appropriateness of an affiliation. The chances for a successful affiliation improve if each party has indicated the value it hopes to derive and how to measure that value, has communicated with all affected constituents, and has an agreed-upon method for resolving disputes.

Cancer education and effective dissemination: information access is not enough.

PubMed

Ousley, Anita L; Swarz, Jeffrey A; Milliken, Erin L; Ellis, Steven

2010-06-01

Education is the main avenue for disseminating new research findings into clinical practice. Understanding factors that affect translation of research into practice may help cancer educators design programs that facilitate the time it takes for research-indicated practices to become standard care. To understand various factors, the National Cancer Institute (NCI) Office of Education and Special Initiatives (OESI)(1) with individual cooperation from Oncology Nursing Society (ONS), American Society of Clinical Oncology (ASCO), and Association of Oncology Social Work (AOSW) administered a Practitioner Information Needs survey to five different types of practitioners involved in cancer care. While most of the 2,864 practitioners (83%) agreed they had access to current practice information, practitioners in large practice settings were more likely to report having access to research than those small practice settings. However, only 33% indicated that they had adequate time to access the information. Colleagues or experts within the organization were cited as the most frequently relied on information resource (60%), and peer-reviewed journals were cited as second (57%). Overall, 66% strongly or somewhat agreed that their organizations exhibit effective change management practices. A majority (69%) agreed that implementation of new practices is hindered by the lack of available staff time. Financial factors and the characteristics of the information presented were also believed to be factors contributing to research implementation. Group differences were observed among practitioner groups and practice settings for some factors.

Critical re-appraisal of blood component quality after overnight hold of whole blood outside current room temperature limits.

PubMed

Bontekoe, I J; van der Meer, P F; de Korte, D

2017-02-01

According to European guidelines, the temperature of whole blood (WB) has to be maintained at 20-24°C until processing within 24 h, but in blood bank practice, WB is frequently held at temperatures between 18-25°C. We aimed to assess the impact of these small temperature deviations on the quality of the blood components. After rapid cooling, 7 WB units were held overnight at 18°C and 8 units at 25°C, reflecting worst case holding conditions, and separated into a red cell concentrate (RCC), plasma and buffy coat (BC). RCCs were filtered at test temperature and stored for 42 days at 2-6°C. BCs were processed to single-BC platelet concentrates (sPC) and stored up to Day 8 at 20-24°C. After overnight hold at 18°C, 2,3-DPG in WB decreased by 34 ± 9%, while at 25°C the decrease was 82 ± 6%. Accordingly, the 2,3-DPG levels in the RCCs in the 25°C group were significantly lower than in the 18°C group (2·2 ± 1·4 vs. 10·4 ± 2·9 μmol/g Hb). RCCs and sPCs in the 25°C group showed higher initial lactate levels and lower pH compared to the 18°C group, but these differences levelled off at the end of storage. RCCs showed small differences in ATP levels and haemolysis. Plasma in both groups showed comparable Factor VIII:C levels. The temperature of WB during overnight hold strongly affects initial 2,3-DPG levels of RCCs and supports the maintenance of temperature limits between 20 and 24°C. Other in vitro effects of the temperature deviations were small and of no practical relevance. © 2016 International Society of Blood Transfusion.

Faculty practice in a small liberal arts college.

PubMed

Speziale, H J

2001-01-01

Small liberal arts colleges are challenged to find ways to participate in faculty practice. With limited access to large healthcare centers, small liberal arts colleges must create innovative faculty practice models. The author shares one college's experience in faculty practice that can be used by others, detailing practice development, funding, developmental challenges, and future goals.

Faculty Development in Small-Group Teaching Skills Associated with a Training Course on Office-Based Treatment of Opioid Dependence

ERIC Educational Resources Information Center

Wong, Jeffrey G.; Holmboe, Eric S.; Becker, William C.; Fiellin, David A.; Jara, Gail B.; Martin, Judith

2005-01-01

The Drug Addiction Treatment Act of 2000 (DATA-2000) allows qualified physicians to treat opioid-dependent patients with schedule III-V medications, such as buprenorphine, in practices separate from licensed, accredited opioid treatment programs. Physicians may attain this qualification by completing 8-hours of training in treating opioid…

Historic land use and grazing patterns in northern New Mexico

Treesearch

Carol Raish

1996-01-01

The entrance of the Spanish into what is now New Mexico in the 1500s permanently altered aboriginal land use and subsistence patterns by the introduction of domesticated animals such as horses, cattle. sheep, goats, and pigs. During the Spanish Colonial and Mexican periods, both the Puebloan groups and the Hispanic settlers practiced mixed farming featuring small...

Making the Familiar Strange: Creative Cultural Storytelling within the Communication Classroom

ERIC Educational Resources Information Center

Blinne, Kristen C.

2012-01-01

In this activity, students employ mock campfire storytelling to "make the familiar strange" in the same spirit as Horace Miner's (1956) classic tale of the "Nacirema." Students work individually, in pairs, or as small groups (around three) to create a whimsical story that deconstructs a mundane, everyday ritual (event, activity, practice) into a…

Theory and Practice: How Filming "Learning in the Real World" Helps Students Make the Connection

ERIC Educational Resources Information Center

Commander, Nannette Evans; Ward, Teresa E.; Zabrucky, Karen M.

2012-01-01

This article describes an assignment, titled "Learning in the Real World," designed for graduate students in a learning theory course. Students work in small groups to create high quality audio-visual films that present "real learning" through interviews and/or observations of learners. Students select topics relevant to theories we are discussing…

Can Videos Play a Role in Promoting Good Landscape Management Behaviors?

ERIC Educational Resources Information Center

Warner, Laura A.; Lamm, Alexa J.; Rumble, Joy N.

2018-01-01

This study tested the effect of four short videos appealing to environmental values on home irrigation users' intent to use good irrigation and fertilization practices. The videos were largely ineffective, and there was only a small effect on one of the behaviors within the fertilizer loss treatment group. Implications point to a need for…

Observing and Understanding Arterial and Venous Circulation Differences in a Physiology Laboratory Activity

ERIC Educational Resources Information Center

Altermann, Caroline; Gonçalves, Rithiele; Lara, Marcus Vinícius S.; Neves, Ben-Hur S.; Mello-Carpes, Pâmela B.

2015-01-01

The purpose of the present article is to describe three simple practical experiments that aim to observe and discuss the anatomic and physiological functions and differences between arteries and veins as well as the alterations observed in skin blood flow in different situations. For this activity, students were divided in small groups. In each…

Discussing Socio-Scientific Issues in Science Lessons: Pupils' Actions and the Teacher's Role.

ERIC Educational Resources Information Center

Ratcliffe, Mary

This paper reports on a research study that describes the actions of students and teachers when addressing socio-scientific issues and provides some practical advice for handling learning activities. The study involved four classes of 14-year-old students who participated in small group discussions designed to elicit their opinions about the…

Situating the "beyond": Adventure-Learning and Indigenous Cultural Competence

ERIC Educational Resources Information Center

Hill, Barbara; Mills, Jane

2013-01-01

In 2010, an Indigenous Elder from the Wiradjuri nation and a group of academics from Charles Sturt University travelled to Menindee, a small locality on the edge of the Australian outback. They were embarked upon an "adventure-learning" research journey to study ways of learning by creating a community of practice with an Elder from the…

Woodland salamander and small mammal responses to alternative silvicultural practices in the Southern Appalachians of North Carolina

Treesearch

W. Mark Ford; Michael A. Menzel; Timothy S. McCay; Jonathan W. Gassett; Joshua Laerm

2000-01-01

The effects of 2 years post-treatment of group selection and 2-aged timber harvests on woodland salamanders and mammals were assessed on stands in high elevation, southern Appalachian northern red oak (Quercus rubra)-flame azalea (Rhododendron calendulaceum) communities, in the Nantahala National Forest. We collected 4 salamander...

Pedagogical Translanguaging: Bridging Discourses in South African Science Classrooms

ERIC Educational Resources Information Center

Probyn, Margie

2015-01-01

This paper reports on the classroom languaging practices of a group of science teachers in rural and township schools in South Africa where the majority of learners learn through the medium of English, despite the fact that it is the home language of only a small minority; and learners' poor English proficiency frequently restricts their access to…

The Impact of Welfare Reform on Adult Literacy Education: Conference Papers and Themes from Small Group Sessions.

ERIC Educational Resources Information Center

National Center for the Study of Adult Learning and Literacy, Boston, MA.

This document contains three commissioned papers and other materials from a 2-day conference. "Politics, Policy, Practice and Personal Responsibility: Adult Education in an Era of Welfare Reform" (Deborah D'Amico) examines the relationship between literacy, poverty, and welfare reform and the implications of those relationships for…

What's Growing on Here? Garden-Based Pedagogy in a Concrete Jungle

ERIC Educational Resources Information Center

Jagger, Susan; Sperling, Erin; Inwood, Hilary

2016-01-01

This study explores experiences of a learning garden project at an urban faculty of education. The project opens a space for the theoretical and practical consideration of garden-based pedagogies and their influence on university students, educators, and the community as a whole. The learning garden was created by a small group of initial teacher…

Opting into a Faculty Scholarship Community: Benefiting Productivity and Personal Well-Being

ERIC Educational Resources Information Center

Francis, Dawn M.; Colbry, Stephanie L.; Hoyle, Amy Gratch; Ratmansky, Lisa A.; Sheety, Alia S.; Szpara, Michelle Yvonne

2017-01-01

A Faculty Scholarship Community (FSC) is a community of practice whose members share an interest in scholarly productivity. This descriptive study examines key factors that enabled a small group of non-tenured faculty, new to their institution, to form a thriving FSC. Members employed autoethnography as the method for examining the impact of the…

What Has "Harry Potter" Done for Me? Children's Reflections on Their "'Potter' Experience"

ERIC Educational Resources Information Center

Dempster, Steve; Oliver, Alice; Sunderland, Jane; Thistlethwaite, Joanne

2016-01-01

This article reports findings from a small-scale focus-group study funded by the British Academy. Drawing on Herbert Marsh and Richard Shavelson's notion of "Academic Self-Concept" and David Barton and Mary Hamilton's view of literacy as context-specific social practices, the authors examine what young British "Harry Potter"…

SUPERVISORY TRAINING, A NEW APPROACH FOR MANAGEMENT--A STUDY BY THE INDUSTRIAL TRAINING SERVICE.

ERIC Educational Resources Information Center

GRIEG, F.W.; MEADE, J.P.D.

THE SUPERVISORY TRAINING PRINCIPLES AND PRACTICES ADVOCATED IN THIS BOOKLET INVOLVE JOB ANALYSIS, APPRAISAL BY BOTH MANAGERS AND TRAINEES, AND CAREFULLY PLANNED TRAINING ON AN INDIVIDUAL AND SMALL GROUP BASIS. JOB ANALYSIS CAN BE CONDUCTED BY OBSERVATION, INTERVIEWS AND OTHER MEANS, AND WILL BE AIMED AT IDENTIFYING NEEDED SKILLS AND KNOWLEDGE AND…

Individual and small group interactions in learning to teach with a hypermedia case

NASA Astrophysics Data System (ADS)

Chung, Mi-Lee Ahn

The purpose of this study was to investigate the similarities and differences of individual and small group preservice teachers' interactions with a hypermedia case. Preservice teachers' interactions with a hypermedia case were defined in terms of their (1) goals and perception of accomplishments of the goals, (2) use of features of the hypermedia case, and (3) types of questions and conflicts raised. Two individuals and two small groups of three preservice teachers participated by interacting with the hypermedia case which was developed to illustrate conceptual change science teaching in an elementary classroom. Most of the previous studies in this area have addressed large group use of hypermedia cases, and this study attempted to address the gap in the literature related to different social contexts, individuals and small groups, from the constructivist perspective. The assumptions of symbolic interactionism guided data collection from think-alouds and interviews. These multiple sources of data were used to understand the participants' construction of knowledge; data were analyzed and interpreted by a process of analytic induction. The major assertion was that the preservice teachers perceived the hypermedia case to be like a tool to link theory and practice of teaching. Three sub-assertions, and several supporting categories, also emerged from the data. These findings indicated that group learning experiences with the hypermedia case were more valuable than those of individuals. In general, preservice teachers benefited from learning how to teach with the hypermedia case in both settings. However, the individuals were not as satisfied as those in small groups, and the members of small groups interacted more actively with the hypermedia case as well as with the peers. The results of this study suggest that effective use of hypermedia cases takes place in a community of learners where the learners share the context and can draw upon the resources afforded by the technology as well as each other. Implications for teacher educators' use of hypermedia cases in different social contexts, and the development and effective use of hypermedia cases are presented as well as the suggestions for the future studies.

The Effects of Plyometric Type Neuromuscular Training on Postural Control Performance of Male Team Basketball Players.

PubMed

Asadi, Abbas; Saez de Villarreal, Eduardo; Arazi, Hamid

2015-07-01

Anterior cruciate ligament injuries are common in basketball athletes; common preventive programs for decreasing these injures may be enhancing postural control (PC) or balance with plyometric training. This study investigated the efficiency of plyometric training program within basketball practice to improve PC performance in young basketball players. Sixteen players were recruited and assigned either to a plyometric + basketball training group (PT) or basketball training group (BT). All players trained twice per week, but the PT + BT followed a 6-week plyometric program implemented within basketball practice, whereas the BT followed regular practice. The star excursion balance test (SEBT) at 8 directions (anterior, A; anteromedial, AM; anterolateral, AL; medial, M; lateral, L; posterior, P; posteromedial, PM; and posterolateral, PL) was measured before and after the 6-week period. The PT group induced significant improvement (p ≤ 0.05) and small to moderate effect size in the SEBT (A = 0.95, AM = 0.62, AL = 0.61, M = 0.36, L = 0.47, P = 0.27, PM = 0.25, PL = 0.24). No significant improvements were found in the BT group. Also, there were significant differences between groups in all directions except PM and PL. An integrated plyometric program within the regular basketball practice can lead to significant improvements in SEBT and consequently PC. It can be recommended that strength and conditioning professionals use PT to enhance the athletes' joint awareness and PC to reduce possible future injuries in the lower extremity.

A qualitative exploration of the factors underlying seniors' receptiveness to entomophagy.

PubMed

Myers, Gael; Pettigrew, Simone

2018-01-01

Entomophagy presents a novel approach to securing a nutritive and environmentally sustainable food source to meet the needs of a growing and ageing population. To date, research exploring the receptiveness of Western consumers towards entomophagy has focused on younger age groups and there has been little examination of the views of older adults. The aims of this study were to (i) explore the factors associated with older people's attitudes towards entomophagy and (ii) identify strategies to encourage seniors to adopt the practice. Interviews were conducted with 77 Western Australian seniors aged 60years and over. The average age of the interviewees was 73years and most were female (n=67). Reflecting the lack of promotion of entomophagy as a desirable eating behaviour, there were very low levels of awareness of the environmental and nutritional advantages of this practice. Most of the interviewed seniors saw entomophagy as a disgusting practice that was incompatible with their cultural beliefs and values, however a small group viewed it as a novel and potentially enjoyable experience. The findings suggest that strategies to target the former group could focus on overcoming the disgust reaction, such as by disguising insects in food and providing guarantees of food safety. Consumption in the latter group could be facilitated by improving knowledge and skills relating to the preparation of insect-based foods. Strategies to increase entomophagy in the Western world need to consider the unique views of different consumer groups towards the practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

[The Marburg surgical curriculum - improving the attraction of medical education by teaching central surgical competence].

PubMed

Schwarting, T; Ruchholtz, S; Josephs, D; Oberkircher, L; Bartsch, D K; Fendrich, V

2012-04-01

The quality of medical education is an ongoing challenge due to the continuing changes of the health-care politics and general social conditions. At many German university hospitals the dominating picture is overfilled courses, lack of hands-on practice, reduced patient contact and the dull provision of theoretical, abstract knowledge. The reformed surgical curriculum at the University of Marburg university hospital is used to demonstrate that, in spite of large student numbers, a practice-oriented, small-group training at a high didactic level is possible. The surgical training courses are organized in detail and coordinated. Course contents and structure are media available in print and online versions for both students and teachers and thus fulfill not only transparency needs but also contemporary requirements. The strategy of a practice- and patient-oriented, small-group training is followed strictly in the surgical curriculum. In addition, accompanying tutorial possibilities for individual study in an up-to-date learning center are offered. Here the students have the opportunity to intensify knowledge acquired in previous or future courses with numerous attractive education means. Continuous evaluation of the individual training courses at the end of each semester not only document motivation of the students but also serve to continuously improve the training concepts. © Georg Thieme Verlag KG Stuttgart · New York.

Patient Outcomes at 26 Months in the Patient-Centered Medical Home National Demonstration Project

PubMed Central

Jaén, Carlos Roberto; Ferrer, Robert L.; Miller, William L.; Palmer, Raymond F.; Wood, Robert; Davila, Marivel; Stewart, Elizabeth E.; Crabtree, Benjamin F.; Nutting, Paul A.; Stange, Kurt C.

2010-01-01

PURPOSE The purpose of this study was to evaluate patient outcomes in the National Demonstration Project (NDP) of practices’ transition to patient-centered medical homes (PCMHs). METHODS In 2006, a total of 36 family practices were randomized to facilitated or self-directed intervention groups. Progress toward the PCMH was measured by independent assessments of how many of 39 predominantly technological NDP model components the practices adopted. We evaluated 2 types of patient outcomes with repeated cross-sectional surveys and medical record audits at baseline, 9 months, and 26 months: patient-rated outcomes and condition-specific quality of care outcomes. Patient-rated outcomes included core primary care attributes, patient empowerment, general health status, and satisfaction with the service relationship. Condition-specific outcomes were measures of the quality of care from the Ambulatory Care Quality Alliance (ACQA) Starter Set and measures of delivery of clinical preventive services and chronic disease care. RESULTS Practices adopted substantial numbers of NDP components over 26 months. Facilitated practices adopted more new components on average than self-directed practices (10.7 components vs 7.7 components, P=.005). ACQA scores improved over time in both groups (by 8.3% in the facilitated group and by 9.1% in the self-directed group, P <.0001) as did chronic care scores (by 5.2% in the facilitated group and by 5.0% in the self-directed group, P=.002), with no significant differences between groups. There were no improvements in patient-rated outcomes. Adoption of PCMH components was associated with improved access (standardized beta [Sβ]=0.32, P = .04) and better prevention scores (Sβ=0.42, P=.001), ACQA scores (Sβ=0.45, P = .007), and chronic care scores (Sβ=0.25, P =.08). CONCLUSIONS After slightly more than 2 years, implementation of PCMH components, whether by facilitation or practice self-direction, was associated with small improvements in condition-specific quality of care but not patient experience. PCMH models that call for practice change without altering the broader delivery system may not achieve their intended results, at least in the short term. PMID:20530395

Best practice guidance for the use of strategies to improve retention in randomized trials developed from two consensus workshops

PubMed Central

Brueton, Valerie; Stenning, Sally P.; Stevenson, Fiona; Tierney, Jayne; Rait, Greta

2017-01-01

Objectives To develop best practice guidance for the use of retention strategies in randomized clinical trials (RCTs). Study Design and Setting Consensus development workshops conducted at two UK Clinical Trials Units. Sixty-six statisticians, clinicians, RCT coordinators, research scientists, research assistants, and data managers associated with RCTs participated. The consensus development workshops were based on the consensus development conference method used to develop best practice for treatment of medical conditions. Workshops commenced with a presentation of the evidence for incentives, communication, questionnaire format, behavioral, case management, and methodological retention strategies identified by a Cochrane review and associated qualitative study. Three simultaneous group discussions followed focused on (1) how convinced the workshop participants were by the evidence for retention strategies, (2) barriers to the use of effective retention strategies, (3) types of RCT follow-up that retention strategies could be used for, and (4) strategies for future research. Summaries of each group discussion were fed back to the workshop. Coded content for both workshops was compared for agreement and disagreement. Agreed consensus on best practice guidance for retention was identified. Results Workshop participants agreed best practice guidance for the use of small financial incentives to improve response to postal questionnaires in RCTs. Use of second-class post was thought to be adequate for postal communication with RCT participants. The most relevant validated questionnaire was considered best practice for collecting RCT data. Barriers identified for the use of effective retention strategies were: the small improvements seen in questionnaire response for the addition of monetary incentives, and perceptions among trialists that some communication strategies are outdated. Furthermore, there was resistance to change existing retention practices thought to be effective. Face-to-face and electronic follow-up technologies were identified as retention strategies for further research. Conclusions We developed best practice guidance for the use of retention strategies in RCTs and identified potential barriers to the use of effective strategies. The extent of agreement on best practice is limited by the variability in the currently available evidence. This guidance will need updating as new retention strategies are developed and evaluated. PMID:28546093

Best practice guidance for the use of strategies to improve retention in randomized trials developed from two consensus workshops.

PubMed

Brueton, Valerie; Stenning, Sally P; Stevenson, Fiona; Tierney, Jayne; Rait, Greta

2017-08-01

To develop best practice guidance for the use of retention strategies in randomized clinical trials (RCTs). Consensus development workshops conducted at two UK Clinical Trials Units. Sixty-six statisticians, clinicians, RCT coordinators, research scientists, research assistants, and data managers associated with RCTs participated. The consensus development workshops were based on the consensus development conference method used to develop best practice for treatment of medical conditions. Workshops commenced with a presentation of the evidence for incentives, communication, questionnaire format, behavioral, case management, and methodological retention strategies identified by a Cochrane review and associated qualitative study. Three simultaneous group discussions followed focused on (1) how convinced the workshop participants were by the evidence for retention strategies, (2) barriers to the use of effective retention strategies, (3) types of RCT follow-up that retention strategies could be used for, and (4) strategies for future research. Summaries of each group discussion were fed back to the workshop. Coded content for both workshops was compared for agreement and disagreement. Agreed consensus on best practice guidance for retention was identified. Workshop participants agreed best practice guidance for the use of small financial incentives to improve response to postal questionnaires in RCTs. Use of second-class post was thought to be adequate for postal communication with RCT participants. The most relevant validated questionnaire was considered best practice for collecting RCT data. Barriers identified for the use of effective retention strategies were: the small improvements seen in questionnaire response for the addition of monetary incentives, and perceptions among trialists that some communication strategies are outdated. Furthermore, there was resistance to change existing retention practices thought to be effective. Face-to-face and electronic follow-up technologies were identified as retention strategies for further research. We developed best practice guidance for the use of retention strategies in RCTs and identified potential barriers to the use of effective strategies. The extent of agreement on best practice is limited by the variability in the currently available evidence. This guidance will need updating as new retention strategies are developed and evaluated. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Effects of wellness programs in family medicine.

PubMed

McGrady, Angele; Brennan, Julie; Lynch, Denis

2009-06-01

The objective of this research was to determine the effects of wellness programs on quality of life and utilization in an academic family medicine practice in two small controlled studies. One offered stress management and problem solving; the second offered a broader wellness intervention. Outcome measures consisted of scores on the Beck Anxiety Inventory, Hamilton Depression Inventory, CES-D (depression), Health Related Quality of Life, SF-12, and the number of office visits in 6 months. Subjects were randomly assigned to intervention or control groups. Statistical analysis compared pre-test and post-test values of the dependent variables between groups. In study one, where the focus was on relaxation, significant differences between groups were observed in anxiety at post-test (p < .03); the intervention group had lower anxiety levels. In study two which had a more general focus, significant group differences were found in days of poor mental health and number of days of depressed mood; the intervention group had fewer days of poor mental health (p < .05) and depression (p < .05) at post-test. No differences were found in utilization in either study. Based on the results of this research, short term wellness programs can be implemented in family practice and are effective in improving quality of life, but not in deceasing utilization in family practice patients. Matching the design of the program to specific patient needs may increase retention and effectiveness.

Arts and health as a practice of liminality: Managing the spaces of transformation for social and emotional wellbeing with primary school children

PubMed Central

Atkinson, Sarah; Robson, Mary

2012-01-01

Intervention to enhance wellbeing through participation in the creative arts has a transformative potential, but the spatialities to this are poorly theorised. The paper examines arts-based interventions in two primary schools in which small groups of children are taken out of their everyday classrooms to participate in weekly sessions. The paper argues that such intervention is usefully seen as a practice of liminality, a distinct time and space that needs careful management to realise a transformative potential. Such management involves negotiating multiple sources of tension to balance different modes of power, forms of art practices and permeability of the liminal time-space. PMID:22840601

Intraoperative use of a reflective blanket (Sirius rescue sheet) for temperature management in dogs less than 10 kg.

PubMed

Tünsmeyer, J; Bojarski, I; Nolte, I; Kramer, S

2009-07-01

To compare the effects of the Sirius rescue sheet with gel pads versus gel pads alone on intraoperative body temperature in dogs less than 10 kg. Forty small breed dogs undergoing elective surgical procedures were randomly assigned to two groups. One group was intraoperatively laid on warmed gel pads, and the other group was additionally wrapped in a Sirius rescue sheet. Oesophageal body temperature was determined every 10 minutes and compared between groups. Temperature of gel pads was measured preoperatively and postoperatively to compare heat loss of the gel pads between groups. The body temperature of dogs wrapped with the Sirius rescue sheet increased intraoperatively. In dogs just lying on warmed gel pads, a decrease in mean body temperature was revealed and mean body temperatures differed between groups after 40 minutes. Extent of heat loss from the gel pads did not differ between the groups. The Sirius rescue sheet, used in addition to warmed gel pads, led to higher intraoperative body temperatures in small breed dogs undergoing surgical procedures to the extremities and the head. The cost-effectiveness and ease of handling make this a useful addition to clinical practice.

Development and clinical trial of a practical vessel imaging system for vessel punctures in children

NASA Astrophysics Data System (ADS)

Cuper, Natasha J.; Verdaasdonk, Rudolf M.; de Roode, Rowland; Septer, Erica

2008-02-01

Venipunctures to draw blood for diagnostics can be cumbersome. Multiple puncture attempts are distressing, painful and traumatic, especially for small children. Drawing blood from babies, in particular, is a problem, due to the cutaneous baby fat, tiny veins and, worst case, a pigmented skin. We developed a practical vein viewing system based on IR translumination that, contrary to commercial systems available, has the advantage of: a) low cost, b) easily implemented in routine practice, c) normal and IR image simultaneously available, d) small add-on, e) child friendly IR illuminator and f) efficient IR light coupling. Before introducing the vessel viewer for clinical application in the children's department, parameters were measured in 194 patients (age 0-17 yrs): time to draw blood, number of attempts, skin characteristics, discomfort of patient, and experience of nurse. In this control group, time to draw blood increases significantly with decreasing age of the children. The instant feedback from the nurses has been valuable for the improvements of especially the illumination sources. A clinical trial has been performed in 125 patients (age 0-6 yrs) to prove effectivity of the system in the blood withdrawal procedure. There was a significant decrease from 13% to 2% in failure rate. Also time needed to search for a vein was significantly decreased. A practical and accessible vein viewing system has been developed and is being introduced for clinical application. Although the concept of patient friendliness is already accepted, measurements need to show the effectiveness for particular groups of patients.

Enhancing practice improvement by facilitating practitioner interactivity: new roles for providers of continuing medical education.

PubMed

Parboosingh, I John; Reed, Virginia A; Caldwell Palmer, James; Bernstein, Henry H

2011-01-01

Research into networking and interactivity among practitioners is providing new information that has the potential to enhance the effectiveness of practice improvement initiatives. This commentary reviews the evidence that practitioner interactivity can facilitate emergent learning and behavior change that lead to practice improvements. Insights from learning theories provide a framework for understanding emergent learning as the product of interactions between individuals in trusted relationships, such as occurs in communities of practice. This framework helps explain why some groups respond more favorably to improvement initiatives than others. Failure to take advantage of practitioner interactivity may explain in part the disappointingly low mean rates of practice improvement reported in studies of the effectiveness of practice improvement projects. Examples of improvement models in primary care settings that explicitly use relationship building and facilitation techniques to enhance practitioner interactivity are provided. Ingredients of a curriculum to teach relationship building in communities of practice and facilitation skills to enhance learning in small group education sessions are explored. Sufficient evidence exists to support the roles of relationships and interactivity in practice improvement initiatives such that we recommend the development of training programs to teach these skills to CME providers. Copyright © 2011 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Using data to improve medical practice by measuring processes and outcomes of care.

PubMed

Nelson, E C; Splaine, M E; Godfrey, M M; Kahn, V; Hess, A; Batalden, P; Plume, S K

2000-12-01

The purpose of this article is to help clinicians expand their use of data to improve medical practice performance and to do improvement research. Clinical practices can be viewed as small, complex organizations (microsystems) that produce services for specific patient populations. These services can be greatly improved by embedding measurement into the flow of daily work in the practice. WHY DO IT?: Four good reasons to build measures into daily medical practice are to (1) diagnose strengths and weaknesses in practice performance; (2) improve and innovate in providing care and services using improvement research; (3) manage patients and the practice; and (4) evaluate changes in results over time. It is helpful to have a "physiological" model of a medical practice to analyze the practice, to manage it, and to improve it. One model views clinical practices as microsystems that are designed to generate desired health outcomes for specific subsets of patients and to use resources efficiently. This article provides case study examples to show what an office-based practice might look like if it were using front-line measurement to improve care and services most of the time and to conduct clinical improvement research some of the time. WHAT ARE THE PRINCIPLES FOR USING DATA TO IMPROVE PROCESSES AND OUTCOMES OF CARE?: Principles reflected in the case study examples--such as "Keep Measurement Simple. Think Big and Start Small" and "More Data Is Not Necessarily Better Data. Seek Usefulness, Not Perfection, in Your Measures"--may help guide the development of data to study and improve practice. HOW CAN A PRACTICE START TO USE DATA TO IMPROVE CARE AND CONDUCT IMPROVEMENT RESEARCH?: Practical challenges are involved in starting to use data for enhancing care and improvement research. To increase the odds for success, it would be wise to use a change management strategy to launch the startup plan. Other recommendations include "Establish a Sense of Urgency. (Survival Is Not Mandatory)" and "Create the Guiding Coalition. (A Small, Devoted Group of People Can Change the World)." Over the long term, we must transform thousands of local practice cultures so that useful data are used every day in countless ways to assist clinicians, support staff, patients, families, and communities.

76 FR 47593 - Guidance for Small Business Entities on Current Good Manufacturing Practice for Positron Emission...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-05

...] Guidance for Small Business Entities on Current Good Manufacturing Practice for Positron Emission... entitled ``PET Drugs--Current Good Manufacturing Practice (CGMP); Small Entity Compliance Guide.'' FDA has... consistent with FDA's good guidance practices regulation (21 CFR 10.115). The guidance represents the Agency...

Innovative approach to patient-centered care coordination in primary care practices.

PubMed

Clarke, Robin; Bharmal, Nazleen; Di Capua, Paul; Tseng, Chi-Hong; Mangione, Carol M; Mittman, Brian; Skootsky, Samuel A

2015-09-01

Although care coordination is an essential component of the patient-centered medical home structure, current case manager models have limited usefulness to population health because they typically serve a small group of patients defined based on disease or utilization. Our objective was to support our health system's population health by implementing and evaluating a program that embedded nonlicensed coordinators within our primary care practices to support physicians in executing care plans and communicating with patients. Matched case-control differences-in-differences. Comprehensive care coordinators (CCC) were introduced into 14 of the system's 28 practice sites in 2 waves. After a structured training program, CCCs identified, engaged, and intervened among patients within the practice in conjunction with practice primary care providers. We counted and broadly coded CCC activities that were documented in the intervention database. We examined the impact of CCC intervention on emergency department (ED) utilization at the practice level using a negative binomial multivariate regression model controlling for age, gender, and medical complexity. CCCs touched 10,500 unique patients over a 1-year period. CCC interventions included execution of care (38%), coordination of transitions (32%), self-management support/link to community resources (15%), monitor and follow-up (10%), and patient assessment (1%). The CCC intervention group had a 20% greater reduction in its prepost ED visit rate compared with the control group (P < .0001). Our CCC intervention demonstrated a significant reduction in ED visits by focusing on the centrality of the primary care provider and practice. Our model may serve as a cost-effective and scalable alternative for care coordination in primary care.

THE EFFECTS OF COMPUTER-BASED FIRE SAFETY TRAINING ON THE KNOWLEDGE, ATTITUDES, AND PRACTICES OF CAREGIVERS

PubMed Central

Harrington, Susan S.; Walker, Bonnie L.

2010-01-01

Background Older adults in small residential board and care facilities are at a particularly high risk of fire death and injury because of their characteristics and environment. Methods The authors investigated computer-based instruction as a way to teach fire emergency planning to owners, operators, and staff of small residential board and care facilities. Participants (N = 59) were randomly assigned to a treatment or control group. Results Study participants who completed the training significantly improved their scores from pre- to posttest when compared to a control group. Participants indicated on the course evaluation that the computers were easy to use for training (97%) and that they would like to use computers for future training courses (97%). Conclusions This study demonstrates the potential for using interactive computer-based training as a viable alternative to instructor-led training to meet the fire safety training needs of owners, operators, and staff of small board and care facilities for the elderly. PMID:19263929

Engaging Undergraduate Biology Students in Scientific Modeling: Analysis of Group Interactions, Sense-Making, and Justification

PubMed Central

Bierema, Andrea M.-K.; Schwarz, Christina V.; Stoltzfus, Jon R.

2017-01-01

National calls for improving science education (e.g., Vision and Change) emphasize the need to learn disciplinary core ideas through scientific practices. To address this need, we engaged small groups of students in developing diagrammatic models within two (one large-enrollment and one medium-enrollment) undergraduate introductory biology courses. During these activities, students developed scientific models of biological phenomena such as enhanced growth in genetically modified fish. To investigate whether undergraduate students productively engaged in scientific practices during these modeling activities, we recorded groups of students as they developed models and examined three characteristics: how students 1) interacted with one another, 2) made sense of phenomena, and 3) justified their ideas. Our analysis indicates that students spent most of the time on task, developing and evaluating their models. Moreover, they worked cooperatively to make sense of core ideas and justified their ideas to one another throughout the activities. These results demonstrate that, when provided with the opportunity to develop models during class, students in large-enrollment lecture courses can productively engage in scientific practices. We discuss potential reasons for these outcomes and suggest areas of future research to continue advancing knowledge regarding engaging students in scientific practices in large-enrollment lecture courses. PMID:29196429

Peer-Assisted History-Taking Groups: A Subjective Assessment of their Impact Upon Medical Students' Interview Skills

PubMed Central

Keifenheim, Katharina Eva; Petzold, Ernst Richard; Junne, Florian; Erschens, Rebecca Sarah; Speiser, Natalie; Herrmann-Werner, Anne; Zipfel, Stephan; Teufel, Martin

2017-01-01

Background and Objectives: Among the clinical skills needed by all physicians, history taking is one of the most important. The teaching model for peer-assisted history-taking groups investigated in the present study consists of small-group courses in which students practice conducting medical interviews with real patients. The purpose of this pilot study was to investigate the expectations, experiences, and subjective learning progress of participants in peer-assisted history-taking groups. Methods: The 42 medical student participants completed a 4-month, peer-assisted, elective history-taking course, which both began and ended with a subjective assessment of their interview skills by way of a pseudonymized questionnaire. Measures comprised the students’ self-assessment of their interview skills, their expectations of, and their experiences with the course and especially with the peer tutors. Results: Medical students’ most important motivations in attending peer-assisted history-taking groups were becoming able to complete a structured medical interview, to mitigate difficult interviewing situations, and to address patients’ emotional demands appropriately. By the end of the course, students’ self-assessment of both their interview skills and management of emotional issues improved significantly. Students especially benefitted from individual feedback regarding interview style and relationship formation, as well as generally accepted and had their expectations met by peer tutors. Conclusions: To meet the important learning objectives of history-taking and management of emotional issues, as well as self-reflection and reflection of student–patient interactions, students in the field greatly appreciate practicing medical interviewing in small, peer-assisted groups with real patients. At the same time, peer tutors are experienced to be helpful and supportive and can help students to overcome inhibitions in making contact with patients. PMID:28890926

Peer-Assisted History-Taking Groups: A Subjective Assessment of their Impact Upon Medical Students' Interview Skills.

PubMed

Keifenheim, Katharina Eva; Petzold, Ernst Richard; Junne, Florian; Erschens, Rebecca Sarah; Speiser, Natalie; Herrmann-Werner, Anne; Zipfel, Stephan; Teufel, Martin

2017-01-01

Background and Objectives: Among the clinical skills needed by all physicians, history taking is one of the most important. The teaching model for peer-assisted history-taking groups investigated in the present study consists of small-group courses in which students practice conducting medical interviews with real patients. The purpose of this pilot study was to investigate the expectations, experiences, and subjective learning progress of participants in peer-assisted history-taking groups. Methods: The 42 medical student participants completed a 4-month, peer-assisted, elective history-taking course, which both began and ended with a subjective assessment of their interview skills by way of a pseudonymized questionnaire. Measures comprised the students' self-assessment of their interview skills, their expectations of, and their experiences with the course and especially with the peer tutors. Results: Medical students' most important motivations in attending peer-assisted history-taking groups were becoming able to complete a structured medical interview, to mitigate difficult interviewing situations, and to address patients' emotional demands appropriately. By the end of the course, students' self-assessment of both their interview skills and management of emotional issues improved significantly. Students especially benefitted from individual feedback regarding interview style and relationship formation, as well as generally accepted and had their expectations met by peer tutors. Conclusions: To meet the important learning objectives of history-taking and management of emotional issues, as well as self-reflection and reflection of student-patient interactions, students in the field greatly appreciate practicing medical interviewing in small, peer-assisted groups with real patients. At the same time, peer tutors are experienced to be helpful and supportive and can help students to overcome inhibitions in making contact with patients.

Power Day: Addressing the Use and Abuse of Power in Medical Training

PubMed Central

Duncan, Laura; Roxas, Nichole; Hansen, Helena

2016-01-01

Problem Medical student mistreatment, as well as patient and staff mistreatment by all levels of medical trainees and faculty, is still prevalent in U.S. clinical training. Largely missing in interventions to reduce mistreatment is acknowledgement of the abuse of power produced by the hierarchical structure in which medicine is practiced. Approach Beginning in 2001, Yale School of Medicine has held annual “Power Day” workshops for third year medical students and advanced practice nursing students, to define and analyse power dynamics within the medical hierarchy and hidden curriculum using literature, guest speakers, and small groups. During rotations, medical students write narratives about the use of power witnessed in the wards. In response to student and small group leader feedback, workshop organizers have developed additional activities related to examining and changing the use of power in clinical teams. Outcome Emerging narrative themes included the potential impact of small acts and students feeling “mute” and “complicit” in morally distressing situations. Small groups provided safe spaces for advice, support, and professional identity formation. By 2005, students recognized residents that used power positively with Power Day awards and alumni served as keynote speakers on the use of power in medicine. By 2010, departments including OB/GYN, surgery, psychiatry, and paediatrics, had added weekly team Power Hour discussions. Next Steps The authors highlight barriers, benefits, and lessons learned. Barriers include the notion of clinical irrelevance and resistance to the word “power” due to perceived accusation of abuse. Benefits include promoting open dialogue about power, fostering inter-professional collaboration, rewarding positive role modelling by residents and faculty, and creating a network of trainee empowerment and leadership. Furthermore, faculty have started to ask that issues of power be addressed in a more transparent way at their level of the hierarchy as well. PMID:26979827

Evidence based practice beliefs and implementation among nurses: a cross-sectional study

PubMed Central

2014-01-01

Background Having a positive attitude towards evidence-based practice and being able to see the value of evidence-based practice for patients have been reported as important for the implementation of evidence-based practice among nurses. The aim of this study was to map self-reported beliefs towards EBP and EBP implementation among nurses, and to investigate whether there was a positive correlation between EBP beliefs and EBP implementation. Method We carried out a cross-sectional study among 356 nurses at a specialist hospital for the treatment of cancer in Norway. The Norwegian translations of the Evidence-based Practice Belief Scale and the Evidence-based Practice Implementation Scale were used. Results In total, 185 nurses participated in the study (response rate 52%). The results showed that nurses were positive towards evidence-based practice, but only practised it to a small extent. There was a positive correlation (r) between beliefs towards evidence-based practice and implementation of evidence-based practice (r = 0.59, p = 0.001). There was a statistical significant positive, but moderate correlation between all the four subscales of the EBP Beliefs Scale (beliefs related to: 1) knowledge, 2) resources, 3) the value of EBP and 4) difficulty and time) and the EBP Implementation Scale, with the highest correlation observed for beliefs related to knowledge (r = 0.38, p < .0001). Participants who had learned about evidence-based practice had significantly higher scores on the Evidence-based Practice Belief Scale than participants who were unfamiliar with evidence-based practice. Those involved in evidence-based practice working groups also reported significantly higher scores on the Evidence-based Practice Belief Scale than participants not involved in these groups. Conclusion This study shows that nurses have a positive attitude towards evidence-based practice, but practise it to a lesser extent. There was a positive correlation between beliefs about evidence-based practice and implementation of evidence-based practice. Beliefs related to knowledge appear to have the greatest effect on implementation of evidence-based practice. Having knowledge and taking part in evidence-based practice working groups seem important. PMID:24661602

Yup'ik Women's Ways of Knowing.

ERIC Educational Resources Information Center

Bennett, Kathleen; And Others

This paper describes storyknifing activities practiced by a small group of young girls in a Yup'ik Eskimo village on the Kuskokwim River in Alaska. Storyknifing is a form of play in which girls tell stories to one another, while making drawings and designs in mud or snow. The girls will sit in a circle for hours at a time, taking turns telling…

Fiche pratique: En chantant; Recrire un scenario; Pour en decoudre avec le subjonctif; Cri d'alerte (Practical Ideas: Singing; Rewriting a Scenario; to Unravel the Subjunctive; Cry of Alarm).

ERIC Educational Resources Information Center

Delbende, Jean-Christophe; And Others

1996-01-01

Four ideas for French language classroom activities are described: an exercise in listening to popular songs; a film scenario rewriting exercise; a technique for teaching the subjunctive mood; and a paired or small-group activity to enhance understanding of advertising. (MSE)

Vygotsky from ZPD to ZCD in Moral Education: Reshaping Western Theory and Practices in Local Context

ERIC Educational Resources Information Center

Balakrishnan, Vishalache; Claiborne, Lise Bird

2012-01-01

This article explores Vygotsky's concept of the Zone of Proximal Development (ZPD) in the Malaysian context to support local reform of the Moral Education (ME) classroom. Small groups of students in three different types of school were involved in a participant action research (PAR) project. Such classrooms in Malaysia bring together students from…

High School Students' Goals for Working Together in Mathematics Class: Mediating the Practical Rationality of Studenting

ERIC Educational Resources Information Center

Webel, Corey

2013-01-01

In this article I explore high school students' perspectives on working together in a mathematics class in which they spent a significant amount of time solving problems in small groups. The data included viewing session interviews with eight students in the class, where each student watched video clips of their own participation, explaining and…

An Interactive E-Learning Tutorial for Medical Students on How to Conduct the Performance-Oriented Mobility Assessment

ERIC Educational Resources Information Center

Ruiz, Jorge G.; Smith, Michael; Rodriguez, Osvaldo; Van Zuilen, Maria H.; Mintzer, Michael J.

2007-01-01

We evaluated the effectiveness of an e-learning tutorial (iPOMA) as a supplement to traditional teaching of the Performance-Oriented Mobility Assessment. Second-year medical students (137) completed the iPOMA, in preparation for a session on fall risk assessment consisting of a lecture, practice with elder volunteers and small group debriefing.…

IMPROVING INFECTION PREVENTION AND CONTROL PRACTICES IN A CULTURALLY, LINGUISTICALLY AND SPIRITUALLY DIVERSE ENVIRONMENT.

PubMed

Sparke, Vanessa L; MacLaren, David; Mills, Jane; Asugeni, Rowena; Moutoa, Kenny; West, Caryn

2017-03-01

Atoifi Adventist Hospital (AAH) in the Solomon Islands serves a population of 80,000 people, many living in small remote villages. Atoifi is situated on the east side of the island of Malaita in the East Kwaio region. Kwaio is one of 12 language groups on Malaita and most people engage in the subsistence economy.

Continuum of eLearning: 2012 Project Summary Report

DTIC Science & Technology

2012-10-01

Taylor, Emilie Reitz, Kathleen Bartlett, and John Killilea DSCI MESH Solutions General Dynamics Information Technology 12601...goes on to write , “Joint Knowledge Online ( JKO) provides a Joint Indi- vidual Training Toolkit of web enabled individual and small group training...the interviews, we compiled relevant best practices from the academic literature. We call these “practical” limitations be- cause the technology and

Innovative Teaching Games: Climbing the Hills of Math Skills. California Demonstration Mathematics Program.

ERIC Educational Resources Information Center

Pittsburg Unified School District, CA.

The card games in this publication are an alternative activity to help students master computational skills. Games for operations with whole numbers, fractions, decimals, percents, integers, and square roots are included. They can be used to introduce math topics and for practice and review, with either the whole class or in small groups with 2 to…

Elaborating the Teacher's Role--Towards a Professional Language

ERIC Educational Resources Information Center

Siemon, Dianne; Virgona, Jo; Lasso, Maria; Parsons, Vanessa; Cathcart, Juli

2004-01-01

As part of a larger project on effective numeracy teaching practice a number of teachers took turns to teach a small group of students in front of their peers who were located on the other side of a one-way window. Observing teachers were asked to comment on what they noticed "in-the-moment" and suggest labels or metaphors that captured the…

Music and Physical Play: What Can We Learn from Early Childhood Teachers in Kenya?

ERIC Educational Resources Information Center

Freshwater, Amy; Sherwood, Elizabeth; Mbugua, Esther

2008-01-01

Sharing classroom practices across international borders can add new dimensions to teaching methods, no matter where one calls home. With this idea in mind, the authors (two U.S. early childhood teacher educators and a Kenyan-born U.S. early childhood teacher) have corresponded for several years through e-mail with a small group of early childhood…

Sol-Gel Application for Consolidating Stone: An Example of Project-Based Learning in a Physical Chemistry Lab

ERIC Educational Resources Information Center

de los Santos, Desiree´ M.; Montes, Antonio; Sa´nchez-Coronilla, Antonio; Navas, Javier

2014-01-01

A Project Based Learning (PBL) methodology was used in the practical laboratories of the Advanced Physical Chemistry department. The project type proposed simulates "real research" focusing on sol-gel synthesis and the application of the obtained sol as a stone consolidant. Students were divided into small groups (2 to 3 students) to…

Integrate oral communication with technical writing: Towards a rationale

NASA Technical Reports Server (NTRS)

Skelton, T.

1981-01-01

Integrating oral communication and technical writing instruction, to give students the opportunity to learn and practice interpersonal skills, is proposed. By linking speech and writing the importance of small-group interaction in developing transferrable ideas is acknowledged. Three reasons for integration are examined: workday activities, application of role-taking to writing, and conflict resolution. Four advantages of integration are stated.

Higher Education and the Practice of Democratic Politics: A Political Education Reader. Kettering Political Education Series.

ERIC Educational Resources Information Center

Murchland, Bernard, Ed.

This book is a collection of essays on political education for democratic citizenship in higher education developed out of meetings over 5 years of a small group of faculty, administrators and students who gathered to discuss the way academia was educating young people for political responsibility. Following a foreword and an introduction by…

Small Groups, Significant Impact: A Review of Peer-Led Team Learning Research with Implications for STEM Education Researchers and Faculty

ERIC Educational Resources Information Center

Wilson, Sarah Beth; Varma-Nelson, Pratibha

2016-01-01

Peer-led team learning (PLTL) research has expanded from its roots in program evaluation of student success measures in Workshop Chemistry to a spectrum of research questions and qualitative, quantitative, and mixed methods study approaches. In order to develop recommendations for PLTL research and propose best practices for faculty who will…

Peer-Led Team Learning: A Prospective Method for Increasing Critical Thinking in Undergraduate Science Courses

ERIC Educational Resources Information Center

Quitadamo, Ian J.; Brahler, C. Jayne; Crouch, Gregory J.

2009-01-01

Peer-Led Team Learning (PLTL) is a specific form of small group learning recognized by Project Kaleidoscope as best practice pedagogy (Varma-Nelson, 2004). PLTL was first developed by Woodward, Gosser, and Weiner (1993) as an integrated method that promoted discourse and creative problem solving in chemistry at the City College of New York. It is…

Young Travellers and the Children's Fund: Some Practical Notes on an Experimental Image-Based Research Project

ERIC Educational Resources Information Center

Dean, Charlotte

2007-01-01

The paper reflects on how photography was used during a small piece of mixed methods qualitative research with some young Travellers and their families. The context for the study was "Every Child Matters" and the accompanying push aimed to include groups considered as marginalised, such as young Travellers, in mainstream educational provision, as…

SU-E-I-68: Practical Considerations On Implementation of the Image Gently Pediatric CT Protocols

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

Zhang, J; Adams, C; Lumby, C

Purpose: One limitation associated with the Image Gently pediatric CT protocols is practical implementation of the recommended manual techniques. Inconsistency as a result of different practice is a possibility among technologist. An additional concern is the added risk of data error that would result in over or underexposure. The Automatic Exposure Control (AEC) features automatically reduce radiation for children. However, they do not work efficiently for the patients of very small size and relative large size. This study aims to implement the Image Gently pediatric CT protocols in the practical setting while maintaining the use of AEC features for pediatricmore » patients of varying size. Methods: Anthropomorphological abdomen phantoms were scanned in a CT scanner using the Image Gently pediatric protocols, the AEC technique with a fixed adult baseline, and automatic protocols with various baselines. The baselines were adjusted corresponding to patient age, weight and posterioranterior thickness to match the Image Gently pediatric CT manual techniques. CTDIvol was recorded for each examination. Image noise was measured and recorded for image quality comparison. Clinical images were evaluated by pediatric radiologists. Results: By adjusting vendor default baselines used in the automatic techniques, radiation dose and image quality can match those of the Image Gently manual techniques. In practice, this can be achieved by dividing pediatric patients into three major groups for technologist reference: infant, small child, and large child. Further division can be done but will increase the number of CT protocols. For each group, AEC can efficiently adjust acquisition techniques for children. This implementation significantly overcomes the limitation of the Image Gently manual techniques. Conclusion: Considering the effectiveness in clinical practice, Image Gently Pediatric CT protocols can be implemented in accordance with AEC techniques, with adjusted baselines, to achieve the goal of providing the most appropriate radiation dose for pediatric patients of varying sizes.« less

Modified natural clinoptilolite detoxifies small mammal's organism loaded with lead II: genetic, cell, and physiological effects.

PubMed

Topashka-Ancheva, Margarita; Beltcheva, Michaela; Metcheva, Roumiana; Rojas, J Antonio Heredia; Rodriguez-De la Fuente, Abraham O; Gerasimova, Tsvetelina; Rodríguez-Flores, Laura E; Teodorova, Svetla E

2012-06-01

The detoxification capacity of the clinoptilolite modification KLS-10-MA used as food additive in small mammals, chronically lead-exposed, was proven for the first time. The modified clinoptilolite was prepared based on natural Bulgarian clinoptilolite deposits. As a powder, it was mechanically mixed at 12.5% concentration with the conventional forage for small rodents. Lead in the form of aqueous solution of Pb(NO(3))(2) was diluted in the drinking water. In the ecotoxicological experiment covering 90 days, imprinting control region laboratory mice were used. They were allocated into four groups: group 1, (control): animals fed with conventional food for small rodents and water; group 2: animals fed with conventional food + clinosorbent KLS-10-MA and water; group 3: animals fed with conventional food and water + Pb(NO(3))(2); and group 4: animals fed with conventional food + KLS-10-MA and water + Pb(NO(3))(2). A group of non-exposed healthy animals was fed with conventional forage mixed with KLS-10-MA to prove eventual toxicity of the sorbent and influence on growth performance. The changes in the chromosome structure, mitotic index, erythrocyte form, erythropoiesis, and body weight gain were recorded. On day 90, the following relations were established: Pb-exposed and clinoptilolite-supplemented mice exhibited 2.3-fold lower chromosome aberrations frequency, 2.5-fold higher mitotic index, and 1.5-fold higher percentage normal erythrocytes 1.3-fold higher body weight compared to Pb-exposed and unsupplemented animals. The obtained data showed that the sorbent is practically non-toxic. The results of the present study encourage a further elaboration of a reliable drug based on the tested substance in the cases of chronic lead intoxication.

Instructor-Created Activities to Engage Undergraduate Nursing Research Students.

PubMed

Pierce, Linda L; Reuille, Kristina M

2018-03-01

In flipped or blended classrooms, instruction intentionally shifts to a student-centered model for a problem-based learning approach, where class time explores topics in greater depth, creating meaningful learning opportunities. This article describes instructor-created activities focused on research processes linked to evidence-based practice that engage undergraduate nursing research students. In the classroom, these activities include individual and team work to foster critical thinking and stimulate student discussion of topic material. Six activities for small and large student groups are related to quantitative, qualitative, and both research processes, as well as applying research evidence to practice. Positive student outcomes included quantitative success on assignments and robust student topic discussions, along with instructor-noted overall group engagement and interest. Using these activities can result in class time for the construction of meaning, rather than primarily information transmission. Instructors may adopt these activities to involve and stimulate students' critical thinking about research and evidence-based practice. [J Nurs Educ. 2018;57(3):174-177.]. Copyright 2018, SLACK Incorporated.

Alliances of cooperation: negotiating New Hampshire nurse practitioners' prescribing practice.

PubMed

Sampson, Deborah A

2009-01-01

Nurse practitioner legislation varies among states, particularly in relation to practice without physician oversight, altering the legal environment within which nurse practitioners can use knowledge and skills to meet patient needs. Using New Hampshire as a case study, this historical analysis of nurse practitioners' negotiations over time for independent practice, defined in state practice acts, illuminates the complex social and economic factors affecting nurses' struggle to gain legal rights over their own professional practice without supervision and intervention from another profession. In New Hampshire, not only did organized medicine oppose nurses rights to practice, but pharmacists demanded the right to control all aspects of medication management, including who could prescribe and under what circumstances prescribing could occur. Shifting social and political terrain as well as changes in legislative and state professional board leadership affected the environment and negotiations of a small group of nurses who were ultimately successful in obtaining the right to define their own professional practice.

Effectiveness of multidisciplinary team case management: difference-in-differences analysis.

PubMed

Stokes, Jonathan; Kristensen, Søren Rud; Checkland, Kath; Bower, Peter

2016-04-15

To evaluate a multidisciplinary team (MDT) case management intervention, at the individual (direct effects of intervention) and practice levels (potential spillover effects). Difference-in-differences design with multiple intervention start dates, analysing hospital admissions data. In secondary analyses, we stratified individual-level results by risk score. Single clinical commissioning group (CCG) in the UK's National Health Service (NHS). At the individual level, we matched 2049 intervention patients using propensity scoring one-to-one with control patients. At the practice level, 30 practices were compared using a natural experiment through staged implementation. Practice Integrated Care Teams (PICTs), using MDT case management of high-risk patients together with a summary record of care versus usual care. Primary measures of intervention effects were accident and emergency (A&E) visits; inpatient non-elective stays, 30-day re-admissions; inpatient elective stays; outpatient visits; and admissions for ambulatory care sensitive conditions. Secondary measures included inpatient length of stay; total cost of secondary care services; and patient satisfaction (at the practice level only). At the individual level, we found slight, clinically trivial increases in inpatient non-elective admissions (+0.01 admissions per patient per month; 95% CI 0.00 to 0.01. Effect size (ES): 0.02) and 30-day re-admissions (+0.00; 0.00 to 0.01. ES: 0.03). We found no indication that highest risk patients benefitted more from the intervention. At the practice level, we found a small decrease in inpatient non-elective admissions (-0.63 admissions per 1000 patients per month; -1.17 to -0.09. ES: -0.24). However, this result did not withstand a robustness check; the estimate may have absorbed some differences in underlying practice trends. The intervention does not meet its primary aim, and the clinical significance and cost-effectiveness of these small practice-level effects is debatable. There is an ongoing need to develop effective ways to reduce unnecessary attendances in secondary care for the high-risk population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Mindfulness Plus Reflection Training: Effects on Executive Function in Early Childhood

PubMed Central

Zelazo, Philip David; Forston, Jessica L.; Masten, Ann S.; Carlson, Stephanie M.

2018-01-01

Executive function (EF) skills are essential for academic achievement, and poverty-related stress interferes with their development. This pre-test, post-test, follow-up randomized-control trial assessed the impact of an intervention targeting reflection and stress reduction on children's EF skills. Preschool children (N = 218) from schools serving low-income families in two U.S. cities were randomly assigned to one of three options delivered in 30 small-group sessions over 6 weeks: Mindfulness + Reflection training; Literacy training; or Business as Usual (BAU). Sessions were conducted by local teachers trained in a literacy curriculum or Mindfulness + Reflection intervention, which involved calming activities and games that provided opportunities to practice reflection in the context of goal-directed problem solving. EF improved in all groups, but planned contrasts indicated that the Mindfulness + Reflection group significantly outperformed the BAU group at Follow-up (4 weeks post-test). No differences in EF were observed between the BAU and Literacy training groups. Results suggest that a brief, small-group, school-based intervention teaching mindfulness and reflection did not improve EF skills more than literacy training but is promising compared to BAU for improving EF in low-income preschool children several weeks following the intervention. PMID:29535661

Individual and group meaning-making in an urban third grade classroom: Red fog, cold cans, and seeping vapor

NASA Astrophysics Data System (ADS)

Southerland, Sherry; Kittleson, Julie; Settlage, John; Lanier, Kimberly

2005-11-01

We examined third graders' understandings of condensation using an expanded notion of the Emergent Perspective, a reflexive consideration of individual and group meaning-making situated in the culture of the classroom. Data were collected from two small groups of students in an inquiry-based, urban classroom during a unit on the water cycle. Measures included conceptual pre-/posttests, interviews, written work, and discourse analyses of a science lesson. Although we identified the supportive role of the teacher's explicit assessments of children's ideas, within the small groups, the force that most potently shaped meaning-making was students' persuasive power, which was in part influenced by the rhetorical moves employed. Specifically, students' evaluative comments (a type of rhetorical move) about contributions of other group members seemed to be particularly persuasive in these groups. Evaluative comments, apart from students' academic status, were shown to be an important influence in not only social knowledge production but also in individual internalization. Our explanation focuses on the particular discursive practices as intellectual resources of urban students, but we are also mindful of the cognitive complexity of the material and the developmental abilities of the students.

Efficacy of Gastrografin® Compared with Standard Conservative Treatment in Management of Adhesive Small Bowel Obstruction at Mulago National Referral Hospital

PubMed Central

Haule, Caspar; Ongom, Peter A; Kimuli, Timothy

2013-01-01

Introduction The treatment of adhesive small bowel obstruction is controversial, with both operative and non-operative management practiced in different centers worldwide. Non-operative management is increasingly getting popular, though operative rates still remain high. A study to compare the efficacy of an oral water-soluble medium (Gastrografin®) with standard conservative management, both non-operative methods, in the management of this condition was conducted in a tertiary Sub Saharan hospital. Methods An open randomised controlled clinical trial was conducted between September 2012 and March 2013 at Mulago National Referral and Teaching Hospital, Uganda. Fifty patients of both genders, with adhesive small bowel obstruction, in the hospital’s emergency and general surgical wards were included. Randomisation was to Gastrografin® and standard conservative treatment groups. The primary outcomes were: the time interval between admission and relief of obstruction, the length of hospital stay, and the rates of operative surgery. Results All 50 recruited patients were followed up and analysed; 25 for each group. In the Gastrografin® group, 22 (88%) patients had relief of obstruction following the intervention, with 3 (12%) requiring surgery. The conservative treatment group had 16 (64%) patients relieved of obstruction conservatively, and 9 (36%) required surgery. The difference in operative rates between the two groups was not statistically significance (P = 0.67). Average time to relief of obstruction was shorter in the Gastrografin® group (72.52 hrs) compared to the conservative treatment group (117.75 hrs), a significant difference (P = 0.023). The average length of hospital stay was shorter in the Gastrografin® group (5.62 days) compared to the conservative treatment group (10.88 days), a significant difference (P = 0.04). Conclusion The use of Gastrografin® in patients with adhesive small bowel obstruction helps in earlier resolution of obstruction and reduces the length of hospital stay compared with standard conservative management. Its role in reducing the rate of laparotomies remains inconclusive. PMID:24729947

Efficacy of Gastrografin® Compared with Standard Conservative Treatment in Management of Adhesive Small Bowel Obstruction at Mulago National Referral Hospital.

PubMed

Haule, Caspar; Ongom, Peter A; Kimuli, Timothy

2013-12-01

The treatment of adhesive small bowel obstruction is controversial, with both operative and non-operative management practiced in different centers worldwide. Non-operative management is increasingly getting popular, though operative rates still remain high. A study to compare the efficacy of an oral water-soluble medium (Gastrografin ® ) with standard conservative management, both non-operative methods, in the management of this condition was conducted in a tertiary Sub Saharan hospital. An open randomised controlled clinical trial was conducted between September 2012 and March 2013 at Mulago National Referral and Teaching Hospital, Uganda. Fifty patients of both genders, with adhesive small bowel obstruction, in the hospital's emergency and general surgical wards were included. Randomisation was to Gastrografin ® and standard conservative treatment groups. The primary outcomes were: the time interval between admission and relief of obstruction, the length of hospital stay, and the rates of operative surgery. All 50 recruited patients were followed up and analysed; 25 for each group. In the Gastrografin ® group, 22 (88%) patients had relief of obstruction following the intervention, with 3 (12%) requiring surgery. The conservative treatment group had 16 (64%) patients relieved of obstruction conservatively, and 9 (36%) required surgery. The difference in operative rates between the two groups was not statistically significance ( P = 0.67 ). Average time to relief of obstruction was shorter in the Gastrografin ® group (72.52 hrs) compared to the conservative treatment group (117.75 hrs), a significant difference ( P = 0.023 ). The average length of hospital stay was shorter in the Gastrografin ® group (5.62 days) compared to the conservative treatment group (10.88 days), a significant difference ( P = 0.04 ). The use of Gastrografin ® in patients with adhesive small bowel obstruction helps in earlier resolution of obstruction and reduces the length of hospital stay compared with standard conservative management. Its role in reducing the rate of laparotomies remains inconclusive.

Investigating Flow Experience and Scientific Practices During a Mobile Serious Educational Game

NASA Astrophysics Data System (ADS)

Bressler, Denise M.; Bodzin, Alec M.

2016-10-01

Mobile serious educational games (SEGs) show promise for promoting scientific practices and high engagement. Researchers have quantified this engagement according to flow theory. This study investigated whether a mobile SEG promotes flow experience and scientific practices with eighth-grade urban students. Students playing the game ( n = 59) were compared with students in a business-as-usual control activity ( n = 120). In both scenarios, students worked in small teams. Data measures included an open-ended instrument designed to measure scientific practices, a self-report flow survey, and classroom observations. The game players had significantly higher levels of flow and scientific practices compared to the control group. Observations revealed that game teams received less whole-class instruction and review compared to the control teams. Game teachers had primarily a guide-on-the-side role when facilitating the game, while control teachers predominantly used didactic instruction when facilitating the control activity. Implications for these findings are discussed.

Best practices for preventing musculoskeletal disorders in masonry: stakeholder perspectives.

PubMed

Entzel, Pamela; Albers, Jim; Welch, Laura

2007-09-01

Brick masons and mason tenders report a high prevalence of work-related musculoskeletal disorders (WMSDs), many of which can be prevented with changes in materials, work equipment or work practices. To explore the use of "best practices" in the masonry industry, NIOSH organized a 2-day meeting of masonry stakeholders. Attendees included 30 industry representatives, 5 health and safety researchers, 4 health/safety specialists, 2 ergonomic consultants, and 2 representatives of state workers' compensation programs. Small groups discussed ergonomic interventions currently utilized in the masonry industry, including factors affecting intervention implementation and ways to promote diffusion of interventions. Meeting participants also identified various barriers to intervention implementation, including business considerations, quality concerns, design issues, supply problems, jobsite conditions and management practices that can slow or limit intervention diffusion. To be successful, future diffusion efforts must not only raise awareness of available solutions but also address these practical concerns.

Collection time again.

PubMed

Elder, D L

1984-01-01

Looking forward to your next round of collection calls? Few of us do, yet collections play a vital role in every group practice, large or small. This crop of practical collection tips is guaranteed to boost the morale of everyone involved in the collection process. Not only are the basics of a good collection call set down, but result-getting responses to frequent debtor excuses are provided. Telephoning the debtor patient need not be a dreaded task. Just have confidence, keep in mind that the patient does owe you for services rendered in good faith, and pick up the phone--it's a snap!

Strategy for an Extensible Microcomputer-Based Mumps System for Private Practice

PubMed Central

Walters, Richard F.; Johnson, Stephen L.

1979-01-01

A macro expander technique has been adopted to generate a machine independent single user version of ANSI Standard MUMPS running on an 8080 Microcomputer. This approach makes it possible to have the medically oriented MUMPS language available on inexpensive systems suitable for small group practice settings. Substitution of another macro expansion set allows the same interpreter to be implemented on another computer, thereby providing compatibility with comparable or larger scale systems. Furthermore, since the global file handler can be separated from the interpreter, this approach permits development of a distributed MUMPS system with no change in applications software.

Medical school 2.0: How we developed a student-generated question bank using small group learning.

PubMed

Gooi, Adrian C C; Sommerfeld, Connor S

2015-01-01

The multiple-choice question (MCQ) is one of the most common methods for formative and summative assessment in medical school. Common challenges with this format include (1) creating vetted questions and (2) involving students in higher-order learning activities. Involving medical students in the creation of MCQs may ameliorate both of these challenges. What we did: We used a small group learning structure to develop a student-generated question bank. Students created their own MCQ based on self-study materials, and then reviewed each other's questions within small groups. Selected questions were reviewed with the class as a whole. All questions were later vetted by the instructor and incorporated into a question bank that students could access for formative learning. Post-session survey indicated that 91% of the students felt that the class-created MCQ question bank was a valuable resource, and 86% of students would be interested in collaborating with the class for creating practice questions in future sessions. Developing a student-generated question bank can improve the depth and interactivity of student learning, increase session enjoyment and provide a potential resource for student assessment.

Getting (the most) out of the research business: interventions for youth with T1DM.

PubMed

Harris, Michael A; Freeman, Kurt A; Duke, Danny C

2010-12-01

We review research on psychosocial interventions to improve outcomes for youth with type 1 diabetes mellitus. Specifically, we discuss individual- and small group-focused, family-focused, group-focused, and other interventions. After reviewing extant research in each area, we discuss how the current evidence base may be used to inform clinical practice. Finally, we conclude by discussing variations in effects of interventions on different outcomes (eg, glycemic control, family functioning) and how to consider this evidence when selecting treatments to transport into clinical settings.

Labrets in Africa and Amazonia: medical implications and cultural determinants.

PubMed

Garve, Roland; Garve, Miriam; Türp, Jens C; Meyer, Christian G

2017-02-01

The custom of wearing labrets has a long tradition. Labrets appeared independently several thousand years ago in various culture groups in Asia, Europe, Africa and the Americas. Today, apart from diverse body modifications as increasingly practiced in western civilisations, lip plates and plugs are found among a small number of tribal groups only in Africa and Amazonia. We summarise the history of labrets in different societies, describe medical consequences of wearing lip plates and plugs for jaws and teeth and address relevant cultural issues. © 2016 John Wiley & Sons Ltd.

Construction managers' perceptions of construction safety practices in small and large firms: a qualitative investigation.

PubMed

Gillen, Marion; Kools, Susan; McCall, Cade; Sum, Juliann; Moulden, Kelli

2004-01-01

Despite the institution of explicit safety practices in construction, there continue to be exceedingly high rates of morbidity and mortality from work-related injury. This study's purpose was to identify, compare and contrast views of construction managers from large and small firms regarding construction safety practices. A complementary analysis was conducted with construction workers. A semi-structured interview guide was used to elicit information from construction managers (n = 22) in a series of focus groups. Questions were designed to obtain information on direct safety practices and indirect practices such as communication style, attitude, expectations, and unspoken messages. Data were analyzed using thematic content analysis. Managers identified a broad commitment to safety, worker training, a changing workplace culture, and uniform enforcement as key constructs in maintaining safe worksites. Findings indicate that successful managers need to be involved, principled, flexible, and innovative. Best practices, as well as unsuccessful injury prevention programs, were discussed in detail. Obstacles to consistent safety practice include poor training, production schedules and financial constraints. Construction managers play a pivotal role in the definition and implementation of safety practices in the workplace. In order to succeed in this role, they require a wide variety of management skills, upper management support, and tools that will help them instill and maintain a positive safety culture. Developing and expanding management skills of construction managers may assist them in dealing with the complexity of the construction work environment, as well as providing them with the tools necessary to decrease work-related injuries.

Changes in body weight, C-reactive protein, and total adiponectin in non-obese women after 12 months of a small-volume, home-based exercise program.

PubMed

Mediano, Mauro Felippe Felix; Neves, Fabiana Alves; Cunha, Alessandra Cordeiro de Souza Rodrigues; Souza, Erica Patricia Garcia de; Moura, Anibal Sanchez; Sichieri, Rosely

2013-01-01

Our objective was to evaluate the effects of small-volume, home-based exercise combined with slight caloric restriction on the inflammatory markers C-reactive protein and adiponectin. In total, 54 women were randomly assigned to one of two groups for exercise intervention: the control or home-based exercise groups. Weight, waist and hip circumferences, and inflammatory markers were measured at baseline and after 6 and 12 months. Women allocated to the home-based exercise group received a booklet explaining the physical exercises to be practiced at home at least 3 times per week, 40 minutes per session, at low-to-moderate intensity. All participants received dietary counseling aimed at reducing caloric intake by 100-300 calories per day, with a normal distribution of macro-nutrients (26-28% of energy as fat). Clinicaltrials.gov: NCT01206413 RESULTS: The home-based exercise group showed a significantly greater reduction in weight and body mass index at six months, but no difference between groups was observed thereafter. With regard to the inflammatory markers, a greater but non-statistically significant reduction was found for C-reactive protein in the home-based exercise group at six months; however, this difference disappeared after adjusting for weight change. No differences in adiponectin were found at the 6- or 12-month follow-up. Small-volume, home-based exercise did not promote changes in inflammatory markers independent of weight change.

Achieving 90% Adoption of Clinical Practice Guidelines Using the Delphi Consensus Method in a Large Orthopedic Group.

PubMed

Bini, Stefano A; Mahajan, John

2016-11-01

Little is known about the implementation rate of clinical practice guidelines (CPGs). Our purpose was to report on the adoption rate of CPGs created and implemented by a large orthopedic group using the Delphi consensus method. The draft CPGs were created before the group's annual meeting by 5 teams each assigned a subset of topics. The draft guidelines included a statement and a summary of the available evidence. Each guideline was debated in both small-group and plenary sessions. Voting was anonymous and a 75% supermajority was required for passage. A Likert scale was used to survey the patient's experience with the process at 1 week, and the Kirkpatrick evaluation model was used to gauge the efficacy of the process over a 6-month time frame. Eighty-five orthopedic surgeons attended the meeting. Fifteen guidelines grouped into 5 topics were created. All passed. Eighty-six percent of attendees found the process effective and 84% felt that participating in the process made it more likely that they would adopt the guidelines. At 1 week, an average of 62% of attendees stated they were practicing the guideline as written (range: 35%-72%), and at 6 months, 96% stated they were practicing them (range: 82%-100%). We have demonstrated that a modified Delphi method for reaching consensus can be very effective in both creating CPGs and leading to their adoption. Further we have shown that the process is well received by participants and that an inclusionary approach can be highly successful. Copyright © 2016 Elsevier Inc. All rights reserved.

Music therapy with bereaved teenagers: a mixed methods perspective.

PubMed

McFerran, Katrina; Roberts, Melina; O'Grady, Lucy

2010-07-01

Qualitative investigations have indicated that music therapy groups may be beneficial for bereaved teenagers. The existing relationship between young people and music serves as a platform for connectedness and emotional expression that is utilised within a therapeutic, support group format. This investigation confirms this suggestion through grounded theory analysis of focus group interviews. Changes in self-perception were not found as a result of participation, however practically significant results were found on adolescent coping. These cannot be generalized because of the small sample size. Grief specific tools are recommended for use in future investigations in order to capture the emotional impact of music therapy grief work with adolescents.

Work Loads and Practice Patterns of General Surgeons in the United States, 1995–1997

PubMed Central

Ritchie, Wallace P.; Rhodes, Robert S.; Biester, Thomas W.

1999-01-01

Objective To characterize the work loads and practice patterns of general surgeons in the United States over a 3-year period (1995 to 1997). Methods The surgical operative logs of 2434 “generalist” general surgeons recertifying in surgery form the basis of this report. Selected demographics of the group are as follows: location: 50% Northeast and Southeast, 21% Midwest, 29% West and Southwest; practice type: 45% solo, 40% group, 9% academics; size of practice community: 46% highly urban, 19% rural. Parameters evaluated were the average number of procedures and their distribution by category related to geographic area, practice type, community size, and other parameters. Statistical analysis was accomplished using analysis of variance. Results No significant year-to-year differences were observed between cohorts. The average numbers of procedures per surgeon per year was 398, distributed as follows: abdomen 102, alimentary tract 63, breast 54, endoscopic 51, vascular 39, trauma 6, endocrine 4, and head and neck, 3. Eleven percent of the 398 procedures were performed laparoscopically. Major index cases were largely concentrated with small groups of surgeons representing 5% to 10% of the total. Significant differences were as follows: surgeons in the Northeast and West performed far fewer procedures than those elsewhere. Urban surgeons performed a few more tertiary-type procedures than did rural ones; however, rural surgeons performed many more total procedures, especially in endoscopy, laparoscopy, gynecology, genitourinary, and orthopedics. Academic surgeons performed substantially fewer total procedures as a group than did nonacademic ones and in all categories except liver, transplant, and pancreas. Male surgeons performed more procedures than did female surgeons, except those involving the breast. More procedures were done by surgeons in group practice than by those in solo practice. U.S. medical graduates and international medical graduates had similar work loads but with a different distribution. Conclusions This unique database will be useful in tracking trends over time. More importantly, it demonstrates that general surgery practice in the United States is extremely heterogeneous, a fact that must be acknowledged in any future workforce deliberations. PMID:10522723

Modification of Peyton's four-step approach for small group teaching - a descriptive study.

PubMed

Nikendei, Christoph; Huber, Julia; Stiepak, Jan; Huhn, Daniel; Lauter, Jan; Herzog, Wolfgang; Jünger, Jana; Krautter, Markus

2014-04-02

Skills-lab training as a methodological teaching approach is nowadays part of the training programs of almost all medical faculties. Specific ingredients have been shown to contribute to a successful learning experience in skills-labs. Although it is undoubted that the instructional approach used to introduce novel clinical technical skills to learners has a decisive impact on subsequent skills performance, as yet, little is known about differential effects of varying instructional methods. An instructional approach that is becoming increasingly prevalent in medical education is "Peyton's Four-Step Approach". As Peyton's Four Step Approach was designed for a 1:1 teacher : student ratio, the aim of the present study was to develop and evaluate a modified Peyton's Approach for small group teaching. The modified Peyton's Approach was applied in three skills-lab training sessions on IV catheter insertion, each with three first- or second year medical students (n = 9), delivered by three different skills-lab teachers. The presented descriptive study investigated the practicability and subjective impressions of skills-lab trainees and tutors. Skills-lab sessions were evaluated by trainees' self-assessment, expert ratings, and qualitative analysis of semi-standardized interviews conducted with trainees and tutors. The model was well accepted by trainees, and was rated as easy to realize, resulting in a good flow of teaching and success in attracting trainee's attention when observed by expert raters. Qualitative semi-standardized interviews performed with all of the trainees and tutors revealed that trainees valued repeated observation, instruction of trainees and the opportunity for independent performance, while tutors stressed that trainees were highly concentrated throughout the training and that they perceived repeated observation to be a valuable preparation for their own performance. The modified Peyton's Approach to instruct small groups of students in skills-lab training sessions has revealed to be practicable, well accepted by trainees, and easy for tutors to realize. Further research should address the realization of the model in larger skills-lab training groups.

[Nutritional traffic light system for processed foods: qualitative study of awareness, understanding, attitudes, and practices in Ecuador].

PubMed

Freire, Wilma B; Waters, William F; Rivas-Mariño, Gabriela

2017-01-01

To analyze awareness, understanding, attitudes, and practices related to the nutritional traffic light system (NTLS) on processed food packaging in Ecuador. 21 discussions were held in focus groups (FG) in populations of various sizes in the coastal, mountainous, and eastern regions. Nine interviews were conducted with key informants (KI) representing large, medium, and small enterprises producing or selling processed foods. There were 171 FG participants, the majority of whom recognized and understood the NTLS. There was a certain amount of discussion around awareness of the NTLS and purchasing attitudes, and other factors such as taste, brand, or accessibility were considered. Attitudes were different between age groups: while the group of five- to nine-year-olds knew little about the NTLS and preferred homemade foods, the group of 15- to 19-year-olds was indifferent to the NTLS information and placed more value on other features, such as taste. Practices related to the purchase and consumption of processed foods highlighted seven different strategies that ranged from replacing the product to ignoring the NTLS information. The KIs did not agree with the policy, but they acknowledged having amended the content of some products to reduce fat, sugar, and salt. The NTLS has had a positive effect on awareness and understanding of the content of processed products. Practices related to purchasing and consuming processed foods would be improved by promotion of the nutritional labeling policy, trade control, and the monitoring and surveillance of its implementation.

Additive benefits of autonomy support and enhanced expectancies for motor learning.

PubMed

Wulf, Gabriele; Chiviacowsky, Suzete; Cardozo, Priscila Lopes

2014-10-01

Two factors that have been shown to facilitate motor learning are autonomy support (AS) and enhanced expectancies (EE) for performance. We examined the individual and combined influences of these factors. In a 2 × 2 design, participants learning a novel motor skill (throwing with the non-dominant arm) were or were not provided a choice (AS) about the ball color on each of 6 10-trial blocks during practice, and were or were not given bogus positive social-comparative feedback (EE). This resulted in four groups: AS/EE, AS, EE, and C (control). One day after the practice phase, participants completed 10 retention and 10 transfer trials. The distance to the target--a bull's eye with a 1m radius and 10 concentric circles--was 7.5m during practice and retention, and 8.5m during transfer. Autonomy support and enhanced expectancies had additive advantages for learning, with both main effects being significant for retention and transfer. On both tests, the AS/EE group showed the greatest throwing accuracy. Also, the accuracy scores of the AS and EE groups were higher than those of the C group. Furthermore, self-efficacy measured after practice and before retention and transfer was increased by both AS and EE. Thus, supporting learners' need for autonomy by given them a small choice--even though it was not directly related to task performance--and enhancing their performance expectancies appeared to independently influence learning. Copyright © 2014 Elsevier B.V. All rights reserved.

Arts and health as a practice of liminality: managing the spaces of transformation for social and emotional wellbeing with primary school children.

PubMed

Atkinson, Sarah; Robson, Mary

2012-11-01

Intervention to enhance wellbeing through participation in the creative arts has a transformative potential, but the spatialities to this are poorly theorised. The paper examines arts-based interventions in two primary schools in which small groups of children are taken out of their everyday classrooms to participate in weekly sessions. The paper argues that such intervention is usefully seen as a practice of liminality, a distinct time and space that needs careful management to realise a transformative potential. Such management involves negotiating multiple sources of tension to balance different modes of power, forms of art practices and permeability of the liminal time-space. Copyright © 2012 Elsevier Ltd. All rights reserved.

The effect of Reiki on work-related stress of the registered nurse.

PubMed

Cuneo, Charlotte L; Curtis Cooper, Maureen R; Drew, Carolyn S; Naoum-Heffernan, Christine; Sherman, Tricia; Walz, Kathleen; Weinberg, Janice

2011-03-01

The Reiki Master Teacher group at a large academic, urban medical center studied the effects of Reiki on work-related stress in Registered Nurse Reiki I class participants. Research suggests that work-related stress is an influential factor in nursing burn out and retention. Reiki, an ancient form of Oriental "energy work" or healing, has been found to decrease stress. The Perceived Stress Scale tool was administered prior to the Reiki I class and after three weeks of practicing self-Reiki. Seventeen participants returned follow-up data. Results indicated that practicing Reiki more often resulted in reduced perceived stress levels. Data from this small pilot study supports educating nurses about Reiki practice to decrease work-related stress.

Found in Translation: Exporting Patient-Centered Communication and Small Group Teaching Skills to China

PubMed Central

Blatt, Benjamin; Kallenberg, Gene; Lang, Forrest; Mahoney, Patrick; Patterson, JoEllen; Dugan, Beverly; Sun, Shaobang

2009-01-01

The Chinese Medical Doctor's Association asked us to develop a train-the-trainers program in doctor-patient communication and in teaching skills for a select group of Chinese health care professionals, who would then serve as trainers for practicing physicians throughout China. The request came in the context of increasing doctor-patient friction related, in part, to the dissolution of the socialist health care safety net in China. In this article we recount the implementation of our 5-day training program in Beijing. We explore cross-cultural issues that arose in presenting the program's two principal training domains: small group teaching and patient-centered doctor-patient communication. We also explore the linguistic challenges we encountered as non-Chinese speaking teachers. Finally, we reflect on the lessons learned from this project that may be of value to others called upon to export Western doctor-patient communications training to other cultures. In this age of increasing globalization, cross-cultural sharing of medical education represents a growing trend. PMID:20165520

Executive summary: the health and fitness benefits of regular participation in small-sided football games.

PubMed

Krustrup, P; Dvorak, J; Junge, A; Bangsbo, J

2010-04-01

The present special issue of Scandinavian Journal of Medicine & Science in Sports deals with health and fitness benefits of regular participation in small-sided football games. One review article and 13 original articles were the result of a 2-year multi-center study in Copenhagen and Zurich and include studies of different age groups analyzed from a physiological, medical, social and psychological perspective. The main groups investigated were middle-aged, former untrained, healthy men and women who were followed for up to 16 months. In addition, elderly, children and hypertensive patients were studied. A summary and interpretations of the main findings divided into an analysis of the physical demands during training of various groups and the effect of a period of training on performance, muscle adaptations and health profile follow. In addition, social and psychological effects on participation in recreational football are considered, the comparison of football training and endurance running is summarized and the effects of football practice on the elderly and children and youngsters are presented.

Practical Solutions for Pesticide Safety: A Farm and Research Team Participatory Model

PubMed Central

Galvin, Kit; Krenz, Jen; Harrington, Marcy; Palmández, Pablo; Fenske, Richard A.

2018-01-01

Development of the Practical Solutions for Pesticide Safety guide used participatory research strategies to identify and evaluate solutions that reduce pesticide exposures for workers and their families and to disseminate these solutions. Project principles were (1) workplace chemicals belong in the workplace, and (2) pesticide handlers and farm managers are experts, with direct knowledge of production practices. The project’s participatory methods were grounded in self-determination theory. Practical solutions were identified and evaluated based on five criteria: practicality, adaptability, health and safety, novelty, and regulatory compliance. Research activities that had more personal contact provided better outcomes. The Expert Working Group, composed of farm managers and pesticide handlers, was key to the identification of solutions, as were farm site visits. Audience participation, hands-on testing, and orchard field trials were particularly effective in the evaluation of potential solutions. Small work groups in a Regional Advisory Committee provided the best direction and guidance for a “user-friendly” translational document that provided evidence-based practical solutions. The “farmer to farmer” format of the guide was endorsed by both the Expert Working Group and the Regional Advisory Committee. Managers and pesticide handlers wanted to share their solutions in order to “help others stay safe,” and they appreciated attribution in the guide. The guide is now being used in educational programs across the region. The fundamental concept that farmers and farmworkers are innovators and experts in agricultural production was affirmed by this study. The success of this process demonstrates the value of participatory industrial hygiene in agriculture. PMID:26488540

Practical Solutions for Pesticide Safety: A Farm and Research Team Participatory Model.

PubMed

Galvin, Kit; Krenz, Jen; Harrington, Marcy; Palmández, Pablo; Fenske, Richard A

2016-01-01

Development of the Practical Solutions for Pesticide Safety guide used participatory research strategies to identify and evaluate solutions that reduce pesticide exposures for workers and their families and to disseminate these solutions. Project principles were (1) workplace chemicals belong in the workplace, and (2) pesticide handlers and farm managers are experts, with direct knowledge of production practices. The project's participatory methods were grounded in self-determination theory. Practical solutions were identified and evaluated based on five criteria: practicality, adaptability, health and safety, novelty, and regulatory compliance. Research activities that had more personal contact provided better outcomes. The Expert Working Group, composed of farm managers and pesticide handlers, was key to the identification of solutions, as were farm site visits. Audience participation, hands-on testing, and orchard field trials were particularly effective in the evaluation of potential solutions. Small work groups in a Regional Advisory Committee provided the best direction and guidance for a "user-friendly" translational document that provided evidence-based practical solutions. The "farmer to farmer" format of the guide was endorsed by both the Expert Working Group and the Regional Advisory Committee. Managers and pesticide handlers wanted to share their solutions in order to "help others stay safe," and they appreciated attribution in the guide. The guide is now being used in educational programs across the region. The fundamental concept that farmers and farmworkers are innovators and experts in agricultural production was affirmed by this study. The success of this process demonstrates the value of participatory industrial hygiene in agriculture.

Telling It like It Is: Developing Social Stories[TM] for Children in Mainstream Primary Schools

ERIC Educational Resources Information Center

Whitehead, Jo

2007-01-01

In this article, the author reports on a practical strategy originally developed for use with pupils with Autism Spectrum Condition (ASC). Based on a small-scale research project, the article focuses on the use of Social Stories to promote pro-social behaviour with a group of non-ASC pupils. The topic was chosen for systematic enquiry by the…

Catering for EAL/D Students' Language Needs in Mainstream Classes: Early Childhood Teachers' Perspectives and Practices in One Australian Setting

ERIC Educational Resources Information Center

Dobinson, Toni J.; Buchori, Sylvia

2016-01-01

This article aims to highlight the complexity of English language related experiences and interactions of a small group of teachers in an Australian, Early Childhood (EC), mainstream setting with children four to eight years old. It draws on data collected from a qualitative case study which investigated four teachers' perspectives and anxieties…

The Effects of Personalized Practice Software on Learning Math Standards in the Third through Fifth Grades

ERIC Educational Resources Information Center

Gomez, Angela Nicole

2012-01-01

The purpose of this study was to investigate the effectiveness of "MathFacts in a Flash" software in helping students learn math standards. In each of their classes, the third-, fourth-, and fifth-grade students in a small private Roman Catholic school from the Pacific Northwest were randomly assigned either to a control group that used…

Update on the use of blood and blood products in ruminants.

PubMed

Balcomb, Christie; Foster, Derek

2014-07-01

The use of whole blood and/or blood products is indicated in ruminant medicine. The goal of this article is to summarize previous literature on blood groups in ruminants and camelids, list indications for transfusion, and describe collection and transfusion techniques applicable to small ruminants and cattle that can be used in practice. Copyright © 2014 Elsevier Inc. All rights reserved.

The Evolution of Comprehensive Musicianship through Performance (CMP)--A Model for Teaching Performing with Understanding in the Ensemble Setting

ERIC Educational Resources Information Center

Sindberg, Laura K.

2009-01-01

Principles and practices of comprehensive musicianship have occupied a place in music education for many years. Many of these initiatives descended from educational reform efforts begun in the post-Sputnik era. In 1977, a group of music educators gathered on the campus of a small Midwestern college to explore new possibilities for comprehensive…

Educational Policy and Children's Experience: Running Records in the Lower Primary Singaporean English Language Classroom

ERIC Educational Resources Information Center

Jones, Sally Ann

2011-01-01

In this article, I report on a small project involving the use of guided reading groups, levelled texts and running records in a multilingual primary school in Singapore. I focus on running records and ask whether their use is suitable pedagogically and practically for the Singaporean context. The analysis of 22 records of primary one and primary…

Talent Development Research, Policy, and Practice in Europe and the United States: Outcomes from a Summit of International Researchers

ERIC Educational Resources Information Center

Subotnik, Rena F.; Stoeger, Heidrun; Olszewski-Kubilius, Paula

2017-01-01

The goal of this article is to convey a summary of research and conversation on talent development on the part of a small group of European and American researchers who participated in the Inaugural American European Research Summit in Washington. In the final hours of the summit, participants discussed the state of research on talent development…

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.

Development of Chemistry Triangle Oriented Module on Topic of Reaction Rate for Senior High School Level Grade XI Chemistry Learning.

NASA Astrophysics Data System (ADS)

Sari, D. R.; Hardeli; Bayharti

2018-04-01

This study aims to produce chemistry triangle oriented module on topic of reaction rate, and to reveal the validity and practicality level of the generated module. The type of research used is EducationalDesign Research (EDR) with development model is Plompmodel. This model consists of three phases, which are preliminary research, prototyping phase, and assessment phase. The instrument used in this research is questionnaire validity and practicality. The data of the research were analyzed by using Kappa Cohen formula. The chemistry triangle oriented module validation sheet was given to 5 validators consisting of 3 chemistry lecturers and 2 high school chemistry teachers, while the practicality sheet was given to 2 chemistry teachers, 6 students of SMAN 10 Padang grade XII MIA 5 on the small groupevaluation and 25 students of SMAN 10 Padang grade XII MIA 6 on the field test. Based on the questionnaire validity analysis, the validity level of the module is very high with the value of kappa moment 0.87. The level of practicality based on teacher questionnaire response is very high category with a kappa moment value 0.96. Based on the questionnaire of student responses on small group evaluation, the level of practicality is very high category with a kappa moment 0.81, and the practicality is very high category with kappa moment value 0.83 based on questionnaire of student response on field test.

'Big needles, small bodies'-the absence of acupuncture treatment for infants in contemporary Shanghai: a qualitative study.

PubMed

Skjeie, Holgeir; Brekke, Mette

2015-11-09

To explore contemporary practices and clinical recommendations regarding the use of acupuncture for infants by Traditional Chinese Medicine (TCM) practitioners in Shanghai. A qualitative study consisting of four field visits between February 2014 and March 2015. Data was collected using participant observation, focus group interview, in-depth interview, textbook page analysis and informant validation. 14 Shanghainese professionals, including interpreters and TCM practitioners, of which seven were acupuncturists. The Longhua Hospital (paediatric, acupuncture and Tui na departments) in southern Shanghai and the campus of the Shanghai University of Traditional Chinese Medicine. The Longhua Hospital outpatient acupuncture clinic receives 400 consultations on average per day. Children, including patients from the paediatric department, are referred to this clinic. During 3 days of participant observations at this department, we saw two children. No infants. During 3 days at the paediatric department and 1 day at the Tui na department we saw no referrals. Formal interviews and informal conversations with acupuncturists and other TCM professionals revealed that acupuncture was neither routinely practiced nor recommended for infants and small children. Acupuncture was considered potentially painful for this young patient population. Alternative treatment options such as herbal treatments or medical massage were widely available and preferred. Western medical diagnostics and treatment were also used, recommended, and trusted. Acupuncture for infants is not a preferred therapeutic method among TCM practitioners working in contemporary Shanghai. Acupuncture on broad indications in infants appears to be a Western practice with little basis in TCM modern-day practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The accelerated residency program: the Marshall University family practice 9-year experience.

PubMed

Petrany, Stephen M; Crespo, Richard

2002-10-01

In 1989, the American Board of Family Practice (ABFP) approved the first of 12 accelerated residency programs in family practice. These experimental programs provide a 1-year experience for select medical students that combines the requirements of the fourth year of medical school with those of the first year of residency, reducing the total training time by 1 year. This paper reports on the achievements and limitations of the Marshall University accelerated residency program over a 9-year period that began in 1992. Several parameters have been monitored since the inception of the accelerated program and provide the basis for comparison of accelerated and traditional residents. These include initial resident characteristics, performance outcomes, and practice choices. A total of 16 students were accepted into the accelerated track from 1992 through 1998. During the same time period, 44 residents entered the traditional residency program. Accelerated resident tended to be older and had more career experience than their traditional counterparts. As a group, the accelerated residents scored an average of 30 points higher on the final in-training exams provided by the ABFP. All residents in both groups remained at Marshall to complete the full residency training experience, and all those who have taken the ABFP certifying exam have passed. Accelerated residents were more likely to practice in West Virginia, consistent with one of the initial goals for the program. In addition, accelerated residents were more likely to be elected chief resident and choose an academic career than those in the traditional group. Both groups opted for small town or rural practice equally. The Marshall University family practice 9-year experience with the accelerated residency track demonstrates that for carefully selected candidates, the program can provide an overall shortened path to board certification and attract students who excel academically and have high leadership potential. Reports from other accelerated programs are needed to fully assess the outcomes of this experiment in postgraduate medical education.

Evaluation of a practice team-supported exposure training for patients with panic disorder with or without agoraphobia in primary care - study protocol of a cluster randomised controlled superiority trial.

PubMed

Gensichen, Jochen; Hiller, Thomas S; Breitbart, Jörg; Teismann, Tobias; Brettschneider, Christian; Schumacher, Ulrike; Piwtorak, Alexander; König, Hans-Helmut; Hoyer, Heike; Schneider, Nico; Schelle, Mercedes; Blank, Wolfgang; Thiel, Paul; Wensing, Michel; Margraf, Jürgen

2014-04-06

Panic disorder and agoraphobia are debilitating and frequently comorbid anxiety disorders. A large number of patients with these conditions are treated by general practitioners in primary care. Cognitive behavioural exposure exercises have been shown to be effective in reducing anxiety symptoms. Practice team-based case management can improve clinical outcomes for patients with chronic diseases in primary care. The present study compares a practice team-supported, self-managed exposure programme for patients with panic disorder with or without agoraphobia in small general practices to usual care in terms of clinical efficacy and cost-effectiveness. This is a cluster randomised controlled superiority trial with a two-arm parallel group design. General practices represent the units of randomisation. General practitioners recruit adult patients with panic disorder with or without agoraphobia according to the International Classification of Diseases, version 10 (ICD-10). In the intervention group, patients receive cognitive behaviour therapy-oriented psychoeducation and instructions to self-managed exposure exercises in four manual-based appointments with the general practitioner. A trained health care assistant from the practice team delivers case management and is continuously monitoring symptoms and treatment progress in ten protocol-based telephone contacts with patients. In the control group, patients receive usual care from general practitioners. Outcomes are measured at baseline (T0), at follow-up after six months (T1), and at follow-up after twelve months (T2). The primary outcome is clinical severity of anxiety of patients as measured by the Beck Anxiety Inventory (BAI). To detect a standardised effect size of 0.35 at T1, 222 patients from 37 general practices are included in each group. Secondary outcomes include anxiety-related clinical parameters and health-economic costs. Current Controlled Trials [http://ISCRTN64669297].

Evaluation of a practice team-supported exposure training for patients with panic disorder with or without agoraphobia in primary care - study protocol of a cluster randomised controlled superiority trial

PubMed Central

2014-01-01

Background Panic disorder and agoraphobia are debilitating and frequently comorbid anxiety disorders. A large number of patients with these conditions are treated by general practitioners in primary care. Cognitive behavioural exposure exercises have been shown to be effective in reducing anxiety symptoms. Practice team-based case management can improve clinical outcomes for patients with chronic diseases in primary care. The present study compares a practice team-supported, self-managed exposure programme for patients with panic disorder with or without agoraphobia in small general practices to usual care in terms of clinical efficacy and cost-effectiveness. Methods/Design This is a cluster randomised controlled superiority trial with a two-arm parallel group design. General practices represent the units of randomisation. General practitioners recruit adult patients with panic disorder with or without agoraphobia according to the International Classification of Diseases, version 10 (ICD-10). In the intervention group, patients receive cognitive behaviour therapy-oriented psychoeducation and instructions to self-managed exposure exercises in four manual-based appointments with the general practitioner. A trained health care assistant from the practice team delivers case management and is continuously monitoring symptoms and treatment progress in ten protocol-based telephone contacts with patients. In the control group, patients receive usual care from general practitioners. Outcomes are measured at baseline (T0), at follow-up after six months (T1), and at follow-up after twelve months (T2). The primary outcome is clinical severity of anxiety of patients as measured by the Beck Anxiety Inventory (BAI). To detect a standardised effect size of 0.35 at T1, 222 patients from 37 general practices are included in each group. Secondary outcomes include anxiety-related clinical parameters and health-economic costs. Trial registration Current Controlled Trials [http://ISCRTN64669297] PMID:24708672

High-resolution mitochondrial DNA analysis sheds light on human diversity, cultural interactions, and population mobility in Northwestern Amazonia.

PubMed

Arias, Leonardo; Barbieri, Chiara; Barreto, Guillermo; Stoneking, Mark; Pakendorf, Brigitte

2018-02-01

Northwestern Amazonia (NWA) is a center of high linguistic and cultural diversity. Several language families and linguistic isolates occur in this region, as well as different subsistence patterns, with some groups being foragers and others agriculturalists. In addition, speakers of Eastern Tukanoan languages are known for practicing linguistic exogamy, a marriage system in which partners are taken from different language groups. In this study, we use high-resolution mitochondrial DNA sequencing to investigate the impact of this linguistic and cultural diversity on the genetic relationships and population structure of NWA groups. We collected saliva samples from individuals representing 40 different NWA ethnolinguistic groups and sequenced 439 complete mitochondrial genomes to an average coverage of 1,030×. The mtDNA data revealed that NWA populations have high genetic diversity with extensive sharing of haplotypes among groups. Moreover, groups who practice linguistic exogamy have higher genetic diversity, while the foraging Nukak have lower genetic diversity. We also find that rivers play a more important role than either geography or language affiliation in structuring the genetic relationships of populations. Contrary to the view of NWA as a pristine area inhabited by small human populations living in isolation, our data support a view of high diversity and contact among different ethnolinguistic groups, with movement along rivers probably facilitating this contact. Additionally, we provide evidence for the impact of cultural practices, such as linguistic exogamy, on patterns of genetic variation. Overall, this study provides new data and insights into a remote and little-studied region of the world. © 2017 Wiley Periodicals, Inc.

Effectiveness of a perinatal and pediatric End-of-Life Nursing Education Consortium (ELNEC) curricula integration.

PubMed

O'Shea, Eileen R; Campbell, Suzanne Hetzel; Engler, Arthur J; Beauregard, Rachel; Chamberlin, Elizabeth C; Currie, Leanne M

2015-06-01

Educational practices and national guidelines for best practices of providing palliative care to children and their families have been developed and are gaining support; however, the dissemination of those practices lags behind expectations. Incorporating education for pediatric palliative care into nursing pre-licensure programs will provide guidelines for best practices with opportunities to enact them prior to graduation. To evaluate the effect of an integrated curriculum for palliative care on nursing students' knowledge. Matched pretest-posttest. One private and one public university in the northeastern United States. Two groups of baccalaureate nursing students, one exposed to an integrated curriculum for palliative care and one without the same exposure. Pre-testing of the students with a 50-item multiple choice instrument prior to curriculum integration and post-testing with the same instrument at the end of the term. This analysis demonstrated changes in knowledge scores among the experimental (n=40) and control (n=19) groups that were statistically significant by time (Wilks' Lambda=.90, F(1, 57)=6.70, p=.012) and study group (Wilks' Lambda=.83, F(1, 57)=11.79, p=.001). An integrated curriculum for pediatric and perinatal palliative and end-of-life care can demonstrate an increased knowledge in a small convenience sample of pre-licensure baccalaureate nursing students when compared to a control group not exposed to the same curriculum. Future research can examine the effect on graduates' satisfaction with program preparation for this specialty area; the role of the use of the curriculum with practice-partners to strengthen transfer of knowledge to the clinical environment; and the use of this curriculum interprofessionally. Copyright © 2015 Elsevier Ltd. All rights reserved.

To observe or not to observe peers when learning physical examination skills; that is the question

PubMed Central

2013-01-01

Background Learning physical examination skills is an essential element of medical education. Teaching strategies include practicing the skills either alone or in-group. It is unclear whether students benefit more from training these skills individually or in a group, as the latter allows them to observing their peers. The present study, conducted in a naturalistic setting, investigated the effects of peer observation on mastering psychomotor skills necessary for physical examination. Methods The study included 185 2nd-year medical students, participating in a regular head-to-toe physical examination learning activity. Students were assigned either to a single-student condition (n = 65), in which participants practiced alone with a patient instructor, or to a multiple-student condition (n = 120), in which participants practiced in triads under patient instructor supervision. The students subsequently carried out a complete examination that was videotaped and subsequently evaluated. Student’s performance was used as a measure of learning. Results Students in the multiple-student condition learned more than those who practiced alone (81% vs 76%, p < 0.004). This result possibly derived from a positive effect of observing peers; students who had the possibility to observe a peer (the second and third students in the groups) performed better than students who did not have this possibility (84% vs 76%, p <. 001). There was no advantage of observing more than one peer (83.7% vs 84.1%, p > .05). Conclusions The opportunity to observe a peer during practice seemed to improve the acquisition of physical examination skills. By using small groups instead of individual training to teach physical examination skills, health sciences educational programs may provide students with opportunities to improve their performance by learning from their peers through modelling. PMID:23594455

To observe or not to observe peers when learning physical examination skills; that is the question.

PubMed

Martineau, Bernard; Mamede, Sílvia; St-Onge, Christina; Rikers, Remy M J P; Schmidt, Henk G

2013-04-17

Learning physical examination skills is an essential element of medical education. Teaching strategies include practicing the skills either alone or in-group. It is unclear whether students benefit more from training these skills individually or in a group, as the latter allows them to observing their peers. The present study, conducted in a naturalistic setting, investigated the effects of peer observation on mastering psychomotor skills necessary for physical examination. The study included 185 2nd-year medical students, participating in a regular head-to-toe physical examination learning activity. Students were assigned either to a single-student condition (n = 65), in which participants practiced alone with a patient instructor, or to a multiple-student condition (n = 120), in which participants practiced in triads under patient instructor supervision. The students subsequently carried out a complete examination that was videotaped and subsequently evaluated. Student's performance was used as a measure of learning. Students in the multiple-student condition learned more than those who practiced alone (81% vs 76%, p < 0.004). This result possibly derived from a positive effect of observing peers; students who had the possibility to observe a peer (the second and third students in the groups) performed better than students who did not have this possibility (84% vs 76%, p <. 001). There was no advantage of observing more than one peer (83.7% vs 84.1%, p > .05). The opportunity to observe a peer during practice seemed to improve the acquisition of physical examination skills. By using small groups instead of individual training to teach physical examination skills, health sciences educational programs may provide students with opportunities to improve their performance by learning from their peers through modelling.

Creating a Space for Acknowledgment and Generativity in Reflective Group Supervision.

PubMed

Paré, David

2016-06-01

Small group supervision is a powerful venue for generative conversations because of the multiplicity of perspectives available and the potential for an appreciative audience to a practitioner's work. At the same time, the well-intentioned reflections by a few practitioners in a room can inadvertently duplicate normative discourses that circulate in the wider culture and the profession. This article explores the use of narrative practices for benefiting from the advantages of group supervision while mindful of the vulnerability that comes with sharing one's work among colleagues. The reflective group supervision processes described were modified from the work of Tom Andersen and Michael White to provide a venue that encourages the creative multiplicity of group conversation while discouraging unhelpful discourses which constrain generative conversation. © 2016 Family Process Institute.

Negotiation techniques to resolve western water disputes

USGS Publications Warehouse

Lamb, Berton L.; Taylor, Jonathan G.

1990-01-01

There is a growing literature on the resolution of natural resources conflicts. Much of it is practical, focusing on guidelines for hands-on negotiation. This literature can be a guide in water conflicts. This is especially true for negotiations over new environmental values such as instream flow. The concepts of competitive, cooperative, and integrative styles of conflict resolution are applied to three cases of water resource bargaining. Lessons for the effective use of these ideas include: break a large number of parties into small working groups, approach value differences in small steps, be cautious in the presence of an attentive public, keeps decisions at the local level, and understand the opponent's interests.

Teaching evidence-based medicine more effectively.

PubMed

Hatmi, Zinat Nadia; Tahvildari, Sousan; Dabiran, Soheila; Soheili, Suraya; Sabouri Kashani, Ahmad; Raznahan, Maedeh

2010-01-01

Evidence-based Medicine (EBM) is becoming an integral component of graduate medical education competency and a requirement for grad medical education practice-based learning core competency. This study tries to compare the efficacy of conferences utilizing small-group discussions with the traditional conference method in enhancing EBM competency. The participants in this randomized controlled trial (RCT) were 170 members of the medical faculty who were divided into two groups of 86 (intervention) and 84 (control). Following the intervention, EBM competency was assessed by a written examination. statistical analysis made use of chi-square test, independent sample t-test and relative risks for univariate analysis. Mantel-Hanszel was used for bivariate analysis. Cox proportional hazard models were used to evaluate multivariate-adjusted associations between EBM educational intervention and EBM knowledge, attitude and skills. A new indicator of number needed to intervention (NNI) was defined and computed. The results proved conference along with small-group discussion to be a more effective teaching method with P=0.001 on knowledge, P<0.001 for attitude and skills P<0.001 in an EBM exam when compared with medical faculty members who did not participate in EBM educational intervention (n=84). Moreover, they had also increased confidence with critical appraisal skills, and searching EBM resources. Conferences followed by small-group discussions significantly enhance EBM knowledge, attitude, critical appraisal skills and literature review skills.

Japanese style total quality control: A first hand experience

NASA Astrophysics Data System (ADS)

Cook, S. C.

1991-11-01

The scope, concepts and practices of Total Quality Control (TQC) as operated in Japan today are described. The following mechanisms and elements are introduced: policy deployment, cross functional management, small group activities, suggestion systems, standardization, the TQC promotion department, and TQC education. It is shown on a practical level, how TQC operates in the research and engineering divisions of the aeroengine and space operation at Ishikawajima Harima Industries in Japan. Japanese style TQC is a well developed, well promoted, well structured, common approach to achieving customer satisfaction through continuous improvements. Furthermore, TQC itself is being continuously improved with the Japanese still refining, extending, and developing TQC.

Twelve tips for delivering successful interprofessional case conferences.

PubMed

O'Brien, Bridget C; Patel, Shalini R; Pearson, Meg; Eastburn, Abigail P; Earnest, Gillian E; Strewler, Anna; Gager, Krista; Manuel, Jennifer K; Dulay, Maya; Bachhuber, Melissa R; Shunk, Rebecca

2017-12-01

Interprofessional case conferences (ICCs) offer an interactive, practical way to engage members of two or more health professions in discussions that involve learning and working together to improve patient care. Well-orchestrated ICCs provide opportunities to integrate interprofessional (IP) education into routine clinical practice. The authors provide 12 tips to support the conceptualization, planning, implementation, facilitation, evaluation, and sustainability of ICCs. They draw from extensive experience as IP educators and facilitators of ICCs and from literature on IP education, case-based learning, small-group facilitation, peer-assisted learning, and learner engagement - all of which offer insights into ICCs but have not been integrated and applied to this context.

Natural regeneration - small ownerships from concept to practice

Treesearch

Arthur G., Jr. Dodge

1977-01-01

Established concepts of successful natural regeneration are not necessarily practiced on small ownerships of ten to 500 acres. Unevenage management will be the primary management system on small ownerships and natural regeneration is the most practical method of providing for continuous forest production. We can obtain satisfactory natural regeneration by good planning...

Learning New Practices in Small Business: Engagement and Localised Support

ERIC Educational Resources Information Center

Ehrich, Lisa C.; Billett, Stephen

2004-01-01

Discusses the findings of a study that investigated how the learning of innovative practices might best proceed in small businesses. The recent implementation of the Goods and Service Tax (GST) in Australia presented an opportunity for understanding how small business operatives learned to implement a new practice. The procedures comprised…

Small Traditional Human Communities Sustain Genomic Diversity over Microgeographic Scales despite Linguistic Isolation

PubMed Central

Cox, Murray P.; Hudjashov, Georgi; Sim, Andre; Savina, Olga; Karafet, Tatiana M.; Sudoyo, Herawati; Lansing, J. Stephen

2016-01-01

At least since the Neolithic, humans have largely lived in networks of small, traditional communities. Often socially isolated, these groups evolved distinct languages and cultures over microgeographic scales of just tens of kilometers. Population genetic theory tells us that genetic drift should act quickly in such isolated groups, thus raising the question: do networks of small human communities maintain levels of genetic diversity over microgeographic scales? This question can no longer be asked in most parts of the world, which have been heavily impacted by historical events that make traditional society structures the exception. However, such studies remain possible in parts of Island Southeast Asia and Oceania, where traditional ways of life are still practiced. We captured genome-wide genetic data, together with linguistic records, for a case–study system—eight villages distributed across Sumba, a small, remote island in eastern Indonesia. More than 4,000 years after these communities were established during the Neolithic period, most speak different languages and can be distinguished genetically. Yet their nuclear diversity is not reduced, instead being comparable to other, even much larger, regional groups. Modeling reveals a separation of time scales: while languages and culture can evolve quickly, creating social barriers, sporadic migration averaged over many generations is sufficient to keep villages linked genetically. This loosely-connected network structure, once the global norm and still extant on Sumba today, provides a living proxy to explore fine-scale genome dynamics in the sort of small traditional communities within which the most recent episodes of human evolution occurred. PMID:27274003

Effect of the Web-Based Intervention MyPlan 1.0 on Self-Reported Fruit and Vegetable Intake in Adults Who Visit General Practice: A Quasi-Experimental Trial.

PubMed

Plaete, Jolien; Crombez, Geert; Van der Mispel, Celien; Verloigne, Maite; Van Stappen, Vicky; De Bourdeaudhuij, Ilse

2016-02-29

Web-based interventions typically have small intervention effects on adults' health behavior because they primarily target processes leading to an intention to change leaving individuals in an intention-behavior gap, they often occur without contact with health care providers, and a limited amount of feedback is provided only at the beginning of these interventions, but not further on in the behavior change process. Therefore, we developed a Web-based intervention ("MyPlan 1.0") to promote healthy behavior in adults. The intervention was based on a self-regulation perspective that also targets postintentional processes and guides individuals during all phases of behavior change. The study investigated the effectiveness of MyPlan1.0 on fruit and vegetable intake of Flemish adults visiting general practice (3 groups: control group, intervention group recruited by researchers, and intervention group recruited and guided by general practitioners [GPs]). Second, it examined whether there was a larger intervention effect for the intervention group guided by GPs compared to the intervention group recruited by researchers. Adults (≥ 18 years) were recruited in 19 Flemish general practices. In each general practice, patients were systematically allocated by a researcher either for the intervention group (researchers' intervention group) or the waiting-list control group that received general advice. In a third group, the GP recruited adults for the intervention (GPs intervention group). The two intervention groups filled in evaluation questionnaires and received MyPlan 1.0 for a behavior of choice (fruit, vegetable, or physical activity). The waiting-list control group filled in the evaluation questionnaires and received only general information. Self-reported fruit and vegetable intake were assessed at baseline (T0), 1 week (T1), and 1 month (T2) postbaseline. Three-level (general practice, adults, time) linear regression models were conducted in MLwiN. A total of 426 adults initially agreed to participate (control group: n=149; GPs' intervention group: n=41; researchers' intervention group: n=236). A high attrition rate was observed in both intervention groups (71.8%, 199/277) and in the control group (59.1%, 88/149). In comparison to no change in the control group, both the GPs' intervention group (fruit: χ(2)1=10.9, P=.004; vegetable: χ(2)1=5.3, P=.02) and the researchers' intervention group (fruit: χ(2)1=18.0, P=.001; vegetable: χ(2)1=12.8, P<.001) increased their intake of fruit and vegetables. A greater increase in fruit and vegetable intake was found when the Web-based intervention MyPlan 1.0 was used compared to usual care of health promotion in general practice (ie, flyers with general information). However, further investigation on which (or combinations of which) behavior change techniques are effective, how to increase response rates, and the influence of delivery mode in routine practice is required. ClinicalTrials.gov NCT02211040; https://clinicaltrials.gov/ct2/show/NCT02211040 (Archived by WebCite® at http://www.webcitation.org/6f8yxTRii).

Effect of the Web-Based Intervention MyPlan 1.0 on Self-Reported Fruit and Vegetable Intake in Adults Who Visit General Practice: A Quasi-Experimental Trial

PubMed Central

Crombez, Geert; Van der Mispel, Celien; Verloigne, Maite; Van Stappen, Vicky; De Bourdeaudhuij, Ilse

2016-01-01

Background Web-based interventions typically have small intervention effects on adults’ health behavior because they primarily target processes leading to an intention to change leaving individuals in an intention-behavior gap, they often occur without contact with health care providers, and a limited amount of feedback is provided only at the beginning of these interventions, but not further on in the behavior change process. Therefore, we developed a Web-based intervention (“MyPlan 1.0”) to promote healthy behavior in adults. The intervention was based on a self-regulation perspective that also targets postintentional processes and guides individuals during all phases of behavior change. Objective The study investigated the effectiveness of MyPlan1.0 on fruit and vegetable intake of Flemish adults visiting general practice (3 groups: control group, intervention group recruited by researchers, and intervention group recruited and guided by general practitioners [GPs]). Second, it examined whether there was a larger intervention effect for the intervention group guided by GPs compared to the intervention group recruited by researchers. Methods Adults (≥18 years) were recruited in 19 Flemish general practices. In each general practice, patients were systematically allocated by a researcher either for the intervention group (researchers’ intervention group) or the waiting-list control group that received general advice. In a third group, the GP recruited adults for the intervention (GPs intervention group). The two intervention groups filled in evaluation questionnaires and received MyPlan 1.0 for a behavior of choice (fruit, vegetable, or physical activity). The waiting-list control group filled in the evaluation questionnaires and received only general information. Self-reported fruit and vegetable intake were assessed at baseline (T0), 1 week (T1), and 1 month (T2) postbaseline. Three-level (general practice, adults, time) linear regression models were conducted in MLwiN. Results A total of 426 adults initially agreed to participate (control group: n=149; GPs’ intervention group: n=41; researchers’ intervention group: n=236). A high attrition rate was observed in both intervention groups (71.8%, 199/277) and in the control group (59.1%, 88/149). In comparison to no change in the control group, both the GPs’ intervention group (fruit: χ2 1=10.9, P=.004; vegetable: χ2 1=5.3, P=.02) and the researchers’ intervention group (fruit: χ2 1=18.0, P=.001; vegetable: χ2 1=12.8, P<.001) increased their intake of fruit and vegetables. Conclusions A greater increase in fruit and vegetable intake was found when the Web-based intervention MyPlan 1.0 was used compared to usual care of health promotion in general practice (ie, flyers with general information). However, further investigation on which (or combinations of which) behavior change techniques are effective, how to increase response rates, and the influence of delivery mode in routine practice is required. Trial Registration ClinicalTrials.gov NCT02211040; https://clinicaltrials.gov/ct2/show/NCT02211040 (Archived by WebCite® at http://www.webcitation.org/6f8yxTRii) PMID:26929095

Understanding the impact of interprofessional collaboration on the quality of care: a case report from a small-scale resource limited health care environment.

PubMed

Busari, Jamiu O; Moll, Franka M; Duits, Ashley J

2017-01-01

A critical assessment of current health care practices, as well as the training needs of various health care providers, is crucial for improving patient care. Several approaches have been proposed for defining these needs with attention on communication as a key competency for effective collaboration. Taking our cultural context, resource limitations, and small-scale setting into account, we researched the applicability of a mixed focus group approach for analysis of the communication between doctors and nurses, as well as the measures for improvement. Assessment of nurse-physician communication perception in patient care in a Caribbean setting. Focus group sessions consisting of nurses, interns, and medical specialists were conducted using an ethnographic approach, paying attention to existing communication, risk evaluation, and recommendations for improvement. Data derived from the focus group sessions were analyzed by thematic synthesis method with descriptive themes and development of analytic themes. The initial focus group sessions produced an extensive list of key recommendations which could be clustered into three domains (standardization, sustainment, and collaboration). Further discussion of these domains in focus groups showed nurses' and physicians' domain perspectives and effects on patient care to be broadly similar. Risks related to lack of information, knowledge sharing, and professional respect were clearly described by the participants. The described mixed focus group session approach for effectively determining current interprofessional communication and key improvement areas seems suitable for our small-scale, limited resource setting. The impact of the cultural context should be further evaluated by a similar study in a different cultural context.

Small Combatants for the Homeland Defense Mission

DTIC Science & Technology

2013-03-01

MONITORING AGENCY NAME(S) AND ADDRESS(ES) N/ A 10. SPONSORING/MONITORING AGENCY REPORT NUMBER 11. SUPPLEMENTARY NOTES The views expressed in...the U.S. Navy relies on a shrinking group of aging Oliver Hazard Perry class frigates to conduct counter- piracy, counter-narcotics, counter maritime...the ideal ship: it is too expensive, too vulnerable, and undermanned, and it has a modular concept that is too underdeveloped for practical naval

JPRS Report. Soviet Union: World Economy & International Relations, No. 2, February 1989

DTIC Science & Technology

1989-05-13

a small group of the biggest companies of a number of highly concentrated base sectors of industry—steel casting, automotive, chemical , industrial...forth. As of the present the TNC practically share among themselves the capitalist markets for automobiles and steel and a number of chemical ...automobile, textile, chemical and agricultural commodity, electronics and transport services markets. Competition is now heating up not only in the sphere of

Young Driver Attitude Scale: The Development and Field-Testing of an Instrument To Measure Young Driver Risk-Taking Attitudes.

ERIC Educational Resources Information Center

Malfetti, James L.; And Others

It has been postulated that young people are open to driving accidents because of age, lack of experience and risk-taking attitudes. The Young Driver Attitude Scale (YDAS) was developed to measure attitudes likely to influence driving practices. Over 200 items relating to the risk-taking attitudes of young people were shown to a small group of…

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

PubMed

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

2015-01-01

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

Incentives and control in primary health care: findings from English pay-for-performance case studies.

PubMed

McDonald, Ruth; Harrison, Stephen; Checkland, Kath

2008-01-01

The authors' aim was to investigate mechanisms and perceptions of control following the implementation of a new "pay-for-performance" contract (the new General Medical Services, or GMS, contract) in general practice. This article was based on an in-depth qualitative case study approach in two general practices in England. A distinction is emerging amongst ostensibly equal partners between those general practitioners conducting and those subject to surveillance. Attitudes towards the contract were largely positive, although discontent was higher in the practice which employed a more intensive surveillance regime and greater amongst nurses than doctors. The sample was small and opportunistic. Further research is required to examine the longer-term effects as new contractual arrangements evolve. Increased surveillance and feedback mechanisms associated with new pay-for-performance schemes have the potential to constrain and shape clinical practice. The paper highlights the emergence of new tensions within and between existing professional groupings.

Differences in healthy food supply and stocking practices between small grocery stores, gas-marts, pharmacies and dollar stores.

PubMed

Caspi, Caitlin Eicher; Pelletier, Jennifer E; Harnack, Lisa; Erickson, Darin J; Laska, Melissa N

2016-02-01

Little is known about the practices for stocking and procuring healthy food in non-traditional food retailers (e.g., gas-marts, pharmacies). The present study aimed to: (i) compare availability of healthy food items across small food store types; and (ii) examine owner/manager perceptions and stocking practices for healthy food across store types. Descriptive analyses were conducted among corner/small grocery stores, gas-marts, pharmacies and dollar stores. Data from store inventories were used to examine availability of twelve healthy food types and an overall healthy food supply score. Interviews with managers assessed stocking practices and profitability. Small stores in Minneapolis and St. Paul, MN, USA, not participating in the Special Supplemental Nutrition Program for Women, Infants, and Children. One hundred and nineteen small food retailers and seventy-one store managers. Availability of specific items varied across store type. Only corner/small grocery stores commonly sold fresh vegetables (63% v. 8% of gas-marts, 0% of dollar stores and 23% of pharmacies). More than half of managers stocking produce relied on cash-and-carry practices to stock fresh fruit (53%) and vegetables (55%), instead of direct store delivery. Most healthy foods were perceived by managers to have at least average profitability. Interventions to improve healthy food offerings in small stores should consider the diverse environments, stocking practices and supply mechanisms of small stores, particularly non-traditional food retailers. Improvements may require technical support, customer engagement and innovative distribution practices.

Differences in healthy food supply and stocking practices between small grocery stores, gas-marts, pharmacies and dollar stores

PubMed Central

Caspi, Caitlin Eicher; Pelletier, Jennifer E.; Harnack, Lisa; Erikson, Darin J.; Laska, Melissa N.

2015-01-01

Objective Little is known about the practices for stocking and procuring healthy food in non-traditional food retailers (e.g., gas-marts, pharmacies). This study aimed to: (i) compare availability of healthy food items across small food store types, and (ii) examine owner/manager perceptions and stocking practices for healthy food across store types. Design Descriptive analyses were conducted among corner/small grocery stores, gas-marts, pharmacies, and dollar stores. Data from store inventories were used to examine availability of 12 healthy food types and an overall healthy food supply score. Interviews with managers assessed stocking practices and profitability. Setting Small stores in Minneapolis and St. Paul, MN not participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Subjects 119 small food retailers and 71 store managers Results Availability of specific items varied across store types. Only corner/small grocery stores commonly sold fresh vegetables (63%, versus 8% of food-gas marts, 0% dollar stores, and 23% pharmacies). More than half of managers stocking produce relied on cash and carry practices to stock fresh fruit (53%) and vegetables (55%), instead of direct store delivery. Most healthy foods were perceived by managers to have at least average profitability. Conclusions Interventions to improve healthy food offerings in small stores should consider the diverse environments, stocking practices and supply mechanisms of small stores, particularly non-traditional food retailers. Improvements may require technical support, customer engagement, and innovative distribution practices. PMID:26411535

16 CFR 1020.4 - What is the Small Business Program?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false What is the Small Business Program? 1020.4 Section 1020.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL SMALL BUSINESS § 1020.4 What is the Small Business Program? (a) Whenever the Commission is aware of the interests of small...

16 CFR 1020.4 - What is the Small Business Program?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false What is the Small Business Program? 1020.4 Section 1020.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL SMALL BUSINESS § 1020.4 What is the Small Business Program? (a) Whenever the Commission is aware of the interests of small...

16 CFR 1020.4 - What is the Small Business Program?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 2 2014-01-01 2014-01-01 false What is the Small Business Program? 1020.4 Section 1020.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL SMALL BUSINESS § 1020.4 What is the Small Business Program? (a) Whenever the Commission is aware of the interests of small...

16 CFR 1020.4 - What is the Small Business Program?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 2 2012-01-01 2012-01-01 false What is the Small Business Program? 1020.4 Section 1020.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL SMALL BUSINESS § 1020.4 What is the Small Business Program? (a) Whenever the Commission is aware of the interests of small...

Cost effectiveness of computer tailored and non-tailored smoking cessation letters in general practice: randomised controlled trial

PubMed Central

Lennox, A Scott; Osman, Liesl M; Reiter, Ehud; Robertson, Roma; Friend, James; McCann, Ian; Skatun, Diane; Donnan, Peter T

2001-01-01

Objectives To develop and evaluate, in a primary care setting, a computerised system for generating tailored letters about smoking cessation. Design Randomised controlled trial. Setting Six general practices in Aberdeen, Scotland. Participants 2553 smokers aged 17 to 65. Interventions All participants received a questionnaire asking about their smoking. Participants subsequently received either a computer tailored or a non-tailored, standard letter on smoking cessation, or no letter. Main outcome measures Prevalence of validated abstinence at six months; change in intention to stop smoking in the next six months. Results The validated cessation rate at six months was 3.5% (30/857) (95% confidence interval 2.3% to 4.7%) for the tailored letter group, 4.4% (37/846) (3.0% to 5.8%) for the non-tailored letter group, and 2.6% (22/850) (1.5% to 3.7%) for the control (no letter) group. After adjustment for significant covariates, the cessation rate was 66% greater (−4% to 186%; P=0.07) in the non-tailored letter group than that in the no letter group. Among participants who smoked <20 cigarettes per day, the cessation rate in the non-tailored letter group was 87% greater (0% to 246%; P=0.05) than that in the no letter group. Among heavy smokers who did not quit, a 76% higher rate of positive shift in “stage of change” (intention to quit within a particular period of time) was seen compared with those who received no letter (11% to 180%; P=0.02). The increase in cost for each additional quitter in the non-tailored letter group compared with the no letter group was £89. Conclusions In a large general practice, a brief non-tailored letter effectively increased cessation rates among smokers. A tailored letter was not effective in increasing cessation rates but promoted shift in movement towards cessation (“stage of change”) in heavy smokers. As a pragmatic tool to encourage cessation of smoking, a mass mailing of non-tailored letters from general practices is more cost effective than computer tailored letters or no letters. What is already known on this topicBrief opportunistic advice on stopping smoking that is given face to face by health professionals increases rates of cessation by 2-3%Intensive, expert-led interventions increase cessation rates by up to 20% or more but are expensive and reach only a small proportion of smokersWritten advice tailored to an individual's “stage of change” (intention to stop in a particular period of time) has been claimed to be as effective as intensive interventions, but previous studies of tailored written advice did not biochemically validate cessationWhat this paper addsA simple standard letter sent to patients of general practices that gave brief advice on stopping smoking increased the biochemically validated rate of cessation by 2%A letter tailored to the individual's “stage of change” was not more effective than the non-tailored standard letterAlthough the increase in cessation resulting from the non-tailored standard letter was small, this intervention was highly cost effective PMID:11397745

An Update on Physician Practice Cost Shares

PubMed Central

Dayhoff, Debra A.; Cromwell, Jerry; Rosenbach, Margo L.

1993-01-01

The 1988 physicians' practice costs and income survey (PPCIS) collected detailed costs, revenues, and incomes data for a sample of 3,086 physicians. These data are utilized to update the Health Care Financing Administration (HCFA) cost shares used in calculating the medicare economic index (MEI) and the geographic practice cost index (GPCI). Cost shares were calculated for the national sample, for 16 specialty groupings, for urban and rural areas, and for 9 census divisions. Although statistical tests reveal that cost shares differ across specialties and geographic areas, sensitivity analysis shows that these differences are small enough to have trivial effects in computing the MEI and GPCI. These results may inform policymakers on one aspect of the larger issue of whether physician payments should vary by geographic location or specialty. PMID:10130573

The roles of engineering notebooks in shaping elementary engineering student discourse and practice

NASA Astrophysics Data System (ADS)

Hertel, Jonathan D.; Cunningham, Christine M.; Kelly, Gregory J.

2017-06-01

Engineering design challenges offer important opportunities for students to learn science and engineering knowledge and practices. This study examines how students' engineering notebooks across four units of the curriculum Engineering is Elementary (EiE) support student work during design challenges. Through educational ethnography and discourse analysis, transcripts of student talk and action were created and coded around the uses of notebooks in the accomplishment of engineering tasks. Our coding process identified two broad categories of roles of the notebooks: they scaffold student activity and support epistemic practices of engineering. The study showed the importance of prompts to engage students in effective uses of writing, the roles the notebook assumes in the students' small groups, and the ways design challenges motivate children to write and communicate.

An Empirical Study of Enterprise Conceptual Modeling

NASA Astrophysics Data System (ADS)

Anaby-Tavor, Ateret; Amid, David; Fisher, Amit; Ossher, Harold; Bellamy, Rachel; Callery, Matthew; Desmond, Michael; Krasikov, Sophia; Roth, Tova; Simmonds, Ian; de Vries, Jacqueline

Business analysts, business architects, and solution consultants use a variety of practices and methods in their quest to understand business. The resulting work products could end up being transitioned into the formal world of software requirement definitions or as recommendations for all kinds of business activities. We describe an empirical study about the nature of these methods, diagrams, and home-grown conceptual models as reflected in real practice at IBM. We identify the models as artifacts of "enterprise conceptual modeling". We study important features of these models, suggest practical classifications, and discuss their usage. Our survey shows that the "enterprise conceptual modeling" arena presents a variety of descriptive models, each used by a relatively small group of colleagues. Together they form a "long tail" that extends from "drawings" on one end to "standards" on the other.

Mathematical modeling in realistic mathematics education

NASA Astrophysics Data System (ADS)

Riyanto, B.; Zulkardi; Putri, R. I. I.; Darmawijoyo

2017-12-01

The purpose of this paper is to produce Mathematical modelling in Realistics Mathematics Education of Junior High School. This study used development research consisting of 3 stages, namely analysis, design and evaluation. The success criteria of this study were obtained in the form of local instruction theory for school mathematical modelling learning which was valid and practical for students. The data were analyzed using descriptive analysis method as follows: (1) walk through, analysis based on the expert comments in the expert review to get Hypothetical Learning Trajectory for valid mathematical modelling learning; (2) analyzing the results of the review in one to one and small group to gain practicality. Based on the expert validation and students’ opinion and answers, the obtained mathematical modeling problem in Realistics Mathematics Education was valid and practical.

Learning a visuomotor rotation: simultaneous visual and proprioceptive information is crucial for visuomotor remapping.

PubMed

Shabbott, Britne A; Sainburg, Robert L

2010-05-01

Visuomotor adaptation is mediated by errors between intended and sensory-detected arm positions. However, it is not clear whether visual-based errors that are shown during the course of motion lead to qualitatively different or more efficient adaptation than errors shown after movement. For instance, continuous visual feedback mediates online error corrections, which may facilitate or inhibit the adaptation process. We addressed this question by manipulating the timing of visual error information and task instructions during a visuomotor adaptation task. Subjects were exposed to a visuomotor rotation, during which they received continuous visual feedback (CF) of hand position with instructions to correct or not correct online errors, or knowledge-of-results (KR), provided as a static hand-path at the end of each trial. Our results showed that all groups improved performance with practice, and that online error corrections were inconsequential to the adaptation process. However, in contrast to the CF groups, the KR group showed relatively small reductions in mean error with practice, increased inter-trial variability during rotation exposure, and more limited generalization across target distances and workspace. Further, although the KR group showed improved performance with practice, after-effects were minimal when the rotation was removed. These findings suggest that simultaneous visual and proprioceptive information is critical in altering neural representations of visuomotor maps, although delayed error information may elicit compensatory strategies to offset perturbations.

Essential pediatric hypertension: defining the educational needs of primary care pediatricians.

PubMed

Cha, Stephen D; Chisolm, Deena J; Mahan, John D

2014-07-27

In order to better understand the educational needs regarding appropriate recognition, diagnosis and management of pediatric hypertension (HTN), we asked practicing pediatricians questions regarding their educational needs and comfort level on this topic. We conducted 4 focus group sessions that included 27 participants representing pediatric residents, adolescent medicine physicians, clinic based pediatricians and office based pediatricians. Each focus group session lasted for approximately an hour and 90 pages of total transcriptions were produced verbatim from audio recordings. Four reviewers read each transcript and themes were elucidated from these transcripts. Overall, 5 major themes related to educational needs and clinical concerns were found: utilization of resources to define blood pressure (BP), correct BP measurement method(s), co-morbidities, barriers to care, and experience level with HTN. Six minor themes were also identified: differences in BP measurement, accuracy of BP, recognition of HTN, practice pattern of care, education of families and patients, and differences in level of training. The focus group participants were also questioned on their preferences regarding educational methods (i.e. e-learning, small group sessions, self-study, large group presentations) and revealed varied teaching and learning preferences. There are multiple methods to approach education regarding pediatric HTN for primary care pediatricians based on provider preferences and multiple educational activities should be pursued to achieve best outcomes. Based on this data, the next direction will be to develop and deliver multiple educational methods and to evaluate the impact on practice patterns of care for children and adolescents with HTN.

A Practice-Based Theory of Healing Through Therapeutic Touch: Advancing Holistic Nursing Practice.

PubMed

Hanley, Mary Anne; Coppa, Denise; Shields, Deborah

2017-08-01

For nearly 50 years, Therapeutic Touch (TT) has contributed to advancing holistic nursing practice and has been recognized as a uniquely human approach to healing. This narrative explores the development of a practice-based theory of healing through TT, which occurred between 2010 and 2016. Through the in-depth self-inquiry of participatory reflective dialogue in concert with constant narrative analysis, TT practitioners revealed the meaning of healing within the context of their TT practice. As the community of TT experts participated in an iterative process of small group and community dialogues with analysis and synthesis of emerging themes, the assumptions and concepts central to a theory of healing emerged, were clarified and verified. Exemplars of practice illustrate the concepts. A model of the theory of healing illuminates the movement and relationship among concepts and evolved over time. Feedback from nursing and inter-professional practitioners indicate that the theory of healing, while situated within the context of TT, may be useful in advancing holistic nursing practice, informing healing and caring approaches, stimulating research and education, and contributing to future transformations in health care.

Monoclonal gammopathy of undetermined significance (MGUS) and smoldering myeloma (SMM): a practical guide to management.

PubMed

Maciocia, Nicola; Wechalekar, Ashutosh; Yong, Kwee

2017-12-01

Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma are precursor conditions of symptomatic multiple myeloma (MM). Diagnostic principles are aimed at excluding MM requiring therapy, other conditions associated with paraproteins that may require different management, and risk stratifying patients for the purposes of tailored follow-up and investigation. The International Myeloma Working Group have recently published a revised definition of MM, which singles out a small group of patients with smoldering multiple myeloma who are at very high risk of progression and organ damage; such patients are now included under the definition of MM and recommended to start anti-myeloma treatment. Furthermore, the recently published National Institute of Health and Care Excellence guideline recommends cross-sectional imaging techniques in place of skeletal survey. These recent recommendations are discussed, and practical guidance for investigation and management are presented. Copyright © 2016 John Wiley & Sons, Ltd.

Bimodal Programming: A Survey of Current Clinical Practice.

PubMed

Siburt, Hannah W; Holmes, Alice E

2015-06-01

The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.

Entrance surface dose measurements using a small OSL dosimeter with a computed tomography scanner having 320 rows of detectors.

PubMed

Takegami, Kazuki; Hayashi, Hiroaki; Yamada, Kenji; Mihara, Yoshiki; Kimoto, Natsumi; Kanazawa, Yuki; Higashino, Kousaku; Yamashita, Kazuta; Hayashi, Fumio; Okazaki, Tohru; Hashizume, Takuya; Kobayashi, Ikuo

2017-03-01

Entrance surface dose (ESD) measurements are important in X-ray computed tomography (CT) for examination, but in clinical settings it is difficult to measure ESDs because of a lack of suitable dosimeters. We focus on the capability of a small optically stimulated luminescence (OSL) dosimeter. The aim of this study is to propose a practical method for using an OSL dosimeter to measure the ESD when performing a CT examination. The small OSL dosimeter has an outer width of 10 mm; it is assumed that a partial dose may be measured because the slice thickness and helical pitch can be set to various values. To verify our method, we used a CT scanner having 320 rows of detectors and checked the consistencies of the ESDs measured using OSL dosimeters by comparing them with those measured using Gafchromic™ films. The films were calibrated using an ionization chamber on the basis of half-value layer estimation. On the other hand, the OSL dosimeter was appropriately calibrated using a practical calibration curve previously proposed by our group. The ESDs measured using the OSL dosimeters were in good agreement with the reference ESDs from the Gafchromic™ films. Using these data, we also estimated the uncertainty of ESDs measured with small OSL dosimeters. We concluded that a small OSL dosimeter can be considered suitable for measuring the ESD with an uncertainty of 30 % during CT examinations in which pitch factors below 1.000 are applied.

"Named Small but Doing Great": An Investigation of Small-Scale Chemistry Experimentation for Effective Undergraduate Practical Work

ERIC Educational Resources Information Center

Tesfamariam, Gebrekidan Mebrahtu; Lykknes, Annette; Kvittingen, Lise

2017-01-01

In theory, practical work is an established part of university-level chemistry courses. However, mainly due to budget constraints, large class size, time constraints and inadequate teacher preparations, practical activities are frequently left out from chemistry classroom instruction in most developing countries. Small-scale chemistry (SSC)…

Human Factors for Nursing: From In-Situ Testing to Mobile Usability Engineering.

PubMed

Kushniruk, Andre W; Borycki, Elizabeth M; Solvoll, Terje; Hullin, Carola

2016-01-01

The tutorial goal is to familiarize participants with human aspects of health informatics and human-centered approaches to the design, evaluation and deployment of both usable and safe healthcare information systems. The focus will be on demonstrating and teaching practical and low-cost methods for evaluating mobile applications in nursing. Basic background to testing methods will be provided, followed by live demonstration of the methods. Then the audience will break into small groups to explore the application of the methods to applications of interest (there will be a number of possible applications that will be available for applications in areas such as electronic health records and decision support, however, if the groups have applications of specific interest to them that will be possible). The challenges of conducting usability testing, and in particular mobile usability testing will be discussed along with practical solutions. The target audience includes practicing nurses and nurse researchers, nursing informatics specialists, nursing students, nursing managers and health informatics professionals interested in improving the usability and safety of healthcare applications.

Knowledge into action - supporting the implementation of evidence into practice in Scotland.

PubMed

Davies, Sandra; Herbert, Paul; Wales, Ann; Ritchie, Karen; Wilson, Suzanne; Dobie, Laura; Thain, Annette

2017-03-01

The knowledge into action model for NHS Scotland provides a framework for librarians and health care staff to support getting evidence into practice. Central to this model is the development of a network of knowledge brokers to facilitate identification, use, creation and sharing of knowledge. To translate the concepts described in the model into tangible activities with the intention of supporting better use of evidence in health care and subsequently improving patient outcomes. Four areas of activity were addressed by small working groups comprising knowledge services staff in local and national boards. The areas of activity were as follows: defining existing and required capabilities and developing learning opportunities for the knowledge broker network; establishing national search and summarising services; developing actionable knowledge tools; and supporting person-to-person knowledge sharing. This work presents the development of practical tools and support to translate a conceptual model for getting knowledge into action into a series of activities and outputs to support better use of evidence in health care and subsequently improved patient outcomes. © 2017 Health Libraries Group.

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

PubMed

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

2016-07-01

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

Factors influencing workers to follow food safety management systems in meat plants in Ontario, Canada.

PubMed

Ball, Brita; Wilcock, Anne; Aung, May

2009-06-01

Small and medium sized food businesses have been slow to adopt food safety management systems (FSMSs) such as good manufacturing practices and Hazard Analysis Critical Control Point (HACCP). This study identifies factors influencing workers in their implementation of food safety practices in small and medium meat processing establishments in Ontario, Canada. A qualitative approach was used to explore in-plant factors that influence the implementation of FSMSs. Thirteen in-depth interviews in five meat plants and two focus group interviews were conducted. These generated 219 pages of verbatim transcripts which were analysed using NVivo 7 software. Main themes identified in the data related to production systems, organisational characteristics and employee characteristics. A socio-psychological model based on the theory of planned behaviour is proposed to describe how these themes and underlying sub-themes relate to FSMS implementation. Addressing the various factors that influence production workers is expected to enhance FSMS implementation and increase food safety.

16 CFR 1020.2 - What is the definition of “small business”?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false What is the definition of âsmall businessâ? 1020.2 Section 1020.2 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL SMALL BUSINESS § 1020.2 What is the definition of “small business”? As used in this part, the term small business means...

Development of a practical tool to measure the impact of publications on the society based on focus group discussions with scientists.

PubMed

Niederkrotenthaler, Thomas; Dorner, Thomas E; Maier, Manfred

2011-07-25

A 'societal impact factor' that complements the scientific impact factor would contribute to a more comprehensive evaluation of scientific research. In order to develop a practical tool for its assessment, it is important to learn about perceptions of scientists on how to measure a societal impact factor. This qualitative study presents the development of a practical tool to measure the societal impact of publications based on 8 focus group discussions with 24 biomedical scientists at the Medical University Vienna between May 2008 and May 2009. Topics focused on (1) features of an ideal tool, (2) criteria that should be considered in the assessment, and (3) the identification of practical pitfalls. In an iterative exercise involving the repeated application of the drafted tool to scientific papers, criteria for the assessment were refined. A small-scale exercise to evaluate the tool in terms of its comprehensibility, relevance and practicability was conducted using questionnaires for 6 external experts in leading positions of public health, and yielded acceptable results. The tool developed consists of three quantitative dimensions, that is (1) the aim of a publication, (2) the efforts of the authors to translate their research results, and, if translation was accomplished, (3) (a) the size of the area where translation was accomplished (regional, national or international), (b) its status (preliminary versus permanent) and (c) the target group of the translation (individuals, subgroup of population, total population). Focus group discussions with scientists suggested that the societal impact factor of a publication should consider the effect of the publication in a wide set of non-scientific areas, but also the motivation behind the publication, and efforts by the authors to translate their findings. The proposed tool provides some valuable insights for further research and practical applications in the topic area.

Development of a practical tool to measure the impact of publications on the society based on focus group discussions with scientists

PubMed Central

2011-01-01

Background A 'societal impact factor' that complements the scientific impact factor would contribute to a more comprehensive evaluation of scientific research. In order to develop a practical tool for its assessment, it is important to learn about perceptions of scientists on how to measure a societal impact factor. Methods This qualitative study presents the development of a practical tool to measure the societal impact of publications based on 8 focus group discussions with 24 biomedical scientists at the Medical University Vienna between May 2008 and May 2009. Topics focused on (1) features of an ideal tool, (2) criteria that should be considered in the assessment, and (3) the identification of practical pitfalls. In an iterative exercise involving the repeated application of the drafted tool to scientific papers, criteria for the assessment were refined. A small-scale exercise to evaluate the tool in terms of its comprehensibility, relevance and practicability was conducted using questionnaires for 6 external experts in leading positions of public health, and yielded acceptable results. Results The tool developed consists of three quantitative dimensions, that is (1) the aim of a publication, (2) the efforts of the authors to translate their research results, and, if translation was accomplished, (3) (a) the size of the area where translation was accomplished (regional, national or international), (b) its status (preliminary versus permanent) and (c) the target group of the translation (individuals, subgroup of population, total population). Conclusions Focus group discussions with scientists suggested that the societal impact factor of a publication should consider the effect of the publication in a wide set of non-scientific areas, but also the motivation behind the publication, and efforts by the authors to translate their findings. The proposed tool provides some valuable insights for further research and practical applications in the topic area. PMID:21787432

Does the North Staffordshire slot system control demand of orthopaedic referrals from primary care?

PubMed Central

Bridgman, Stephen; Li, Xuefang; Mackenzie, Gilbert; Dawes, Peter

2005-01-01

Background Attempts to manage general practice demand for orthopaedic outpatient consultations have been made in several areas of the NHS, with little robust evidence on whether or not they work. Aim To evaluate the effect of the North Staffordshire ‘orthopaedic slot system’ on the demand for general practice referrals to orthopaedic outpatients. Method A prospective study of 12 general practices in the slot system, 24 controls, and the 63 other general practices in North Staffordshire. Comparison periods were the baseline year (0); the first calendar year (1); and the first half of the second calendar year (2). A multifactor linear regression model was used. Results Mean referral rate decreased 22% in the slot group in period 1, and was maintained in period 2 (9.40, 7.29, 7.31 referrals per 10 000 population per month for periods 0, 1 and 2, respectively). The control and other groups showed a small decrease in period 1, but in period 2 higher referral rates were observed. The reduction in referrals of 20–40% in participating practices compared to other practices equates to 2–4 referrals per 10 000 patients per month. Conclusions Our study suggests that practices willing and able to take up an offer of a slot system for managing their orthopaedic referrals will be able to significantly reduce referral rates for their patients when compared to similar practices who do not. Further research on the generalisability, effectiveness and cost-effectiveness of such systems is warranted. PMID:16176738

Reflective practice as a tool to teach digital professionalism.

PubMed

Kung, Justin W; Eisenberg, Ronald L; Slanetz, Priscilla J

2012-11-01

Digital professionalism is increasingly being integrated into postgraduate medical education. We developed a small-group, reflective practice-based session incorporating radiology-specific cases to heighten residents' awareness about digital professionalism. Case-based, radiology-specific scenarios were created for a small-group, reflective practice-based session on digital professionalism. Anonymous pre- and postsession surveys evaluating residents' use of social media and their thoughts about the session were administered to the radiology residents. Twenty-five of 38 (66%) residents responded to the presession survey with 40% (10/25) reporting daily social media use; 50% (12/24) witnessing an unprofessional posting on Facebook; and 8% (2/25) posting something unprofessional themselves. Of the 21 residents who attended the session, 13 (62%) responded to the postsession survey. Residents reported that the session added to their understanding of professionalism 3.92, 95% CI (3.57-4.27). As a result of the session, residents stated that they were more aware of protecting patient privacy and confidentiality on social media sites 3.92, 95% CI (3.47-4.37), and would take a more active role in ensuring professional use of social media as it relates to patient care 4.00, 95% CI (3.66-4.34). Residents favorably viewed the reflective case-based session on digital professionalism as a means to be more aware of ways to avoid unprofessional interactions on the internet. Our results suggest that such reflective sessions are an effective method to educate residents on key concepts regarding digital professionalism. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Small Business Pedagogic Practices

ERIC Educational Resources Information Center

Billett, Stephen; Hernon-Tinning, Barnie; Ehrich, Lisa

2003-01-01

Understanding how learning for small businesses should best proceed constitutes a worthwhile, yet challenging, pedagogic project. In order to maintain their viability, small businesses need to be able to respond to new practices and tasks. Yet small businesses seem neither attracted to nor to value the kinds of taught courses that are the standard…

A controlled trial of an expert system and self-help manual intervention based on the stages of change versus standard self-help materials in smoking cessation.

PubMed

Aveyard, Paul; Griffin, Carl; Lawrence, Terry; Cheng, K K

2003-03-01

To examine the population impact and effectiveness of the Pro-Change smoking cessation course based on the Transtheoretical Model (TTM) compared to standard self-help smoking cessation literature. Randomized controlled trial. Sixty-five West Midlands general practices. Randomly sampled patients recorded as smokers by their general practitioners received an invitation letter and 2471 current smokers agreed. Responders were randomized to one of four interventions. The control group received standard self-help literature. In the Manual intervention group, participants received the Pro-Change system, a self-help workbook and three questionnaires at 3-monthly intervals, which generated individually tailored feedback. In the Phone intervention group, participants received the Manual intervention plus three telephone calls. In the Nurse intervention group, participants received the Manual intervention plus three visits to the practice nurse. Biochemically confirmed point prevalence of being quit and 6-month sustained abstinence, 12 months after study commencement. A total of 9.1% of registered current smokers participated, of whom 83.0% were not ready to quit. Less than half of participants returned questionnaires to generate second and third individualized feedback. Telephone calls reached 75% of those scheduled, but few participants visited the nurse. There were small differences between the three Pro-Change arms. The odds ratio (95% confidence intervals) for all Pro-Change arms combined versus the control arm were 1.50 (0.85-2.67) and 1.53 (0.76-3.10), for point prevalence and 6-month abstinence, respectively. This constitutes 2.1% of the TTM group versus 1.4% of the control group achieving confirmed 6-month sustained abstinence. There was no statistically significant benefit of the intervention apparent in this trial and the high relapse of quitters means that any population impact is small.

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The...

Organizational culture, team climate and diabetes care in small office-based practices.

PubMed

Bosch, Marije; Dijkstra, Rob; Wensing, Michel; van der Weijden, Trudy; Grol, Richard

2008-08-21

Redesigning care has been proposed as a lever for improving chronic illness care. Within primary care, diabetes care is the most widespread example of restructured integrated care. Our goal was to assess to what extent important aspects of restructured care such as multidisciplinary teamwork and different types of organizational culture are associated with high quality diabetes care in small office-based general practices. We conducted cross-sectional analyses of data from 83 health care professionals involved in diabetes care from 30 primary care practices in the Netherlands, with a total of 752 diabetes mellitus type II patients participating in an improvement study. We used self-reported measures of team climate (Team Climate Inventory) and organizational culture (Competing Values Framework), and measures of quality of diabetes care and clinical patient characteristics from medical records and self-report. We conducted multivariate analyses of the relationship between culture, climate and HbA1c, total cholesterol, systolic blood pressure and a sum score on process indicators for the quality of diabetes care, adjusting for potential patient- and practice level confounders and practice-level clustering. A strong group culture was negatively associated to the quality of diabetes care provided to patients (beta = -0.04; p = 0.04), whereas a more 'balanced culture' was positively associated to diabetes care quality (beta = 5.97; p = 0.03). No associations were found between organizational culture, team climate and clinical patient outcomes. Although some significant associations were found between high quality diabetes care in general practice and different organizational cultures, relations were rather marginal. Variation in clinical patient outcomes could not be attributed to organizational culture or teamwork. This study therefore contributes to the discussion about the legitimacy of the widespread idea that aspects of redesigning care such as teamwork and culture can contribute to higher quality of care. Future research should preferably combine quantitative and qualitative methods, focus on possible mediating or moderating factors and explore the use of instruments more sensitive to measure such complex constructs in small office-based practices.

Volunteer patients and small groups contribute to abdominal examination’s success

PubMed Central

Shields, Helen M; Fernandez-Becker, Nielsen Q; Flier, Sarah N; Vaughn, Byron P; Tukey, Melissa H; Pelletier, Stephen R; Horst, Douglas A

2017-01-01

Background Prior to 2007, we taught the abdominal examination in a hospital based group to 40 students, at one hospital. We used volunteer patients, small groups, repetition, and required faculty development sessions. In 2007, our medical school changed its “Introduction to Physical Examination” session so that the entire class was to be taught in a geographically central session. Our hospital was selected to lead the abdominal examination portion of the session. Aim Our aim was to answer three questions. First, could we quadruple the recruitment of volunteer patients, and faculty? Second, was it volunteer patients, small groups, repetition, or faculty training that was most valued by the students? Third, would volunteer patients and/or faculty agree to participate a second time? Methods A total of 43–46 patients and 43–46 faculty were recruited and 43–46 examining rooms were obtained for each of the 5 years of this study. Teachers were required to attend a 1-hour faculty development session. The class of about 170 students was divided into 43–46 groups each year. The teacher demonstrated the abdominal examination and each student practiced the examination on another student. Each student then repeated the full abdominal examination on a volunteer patient. Results Over the 5-year time period (2008–2012), the abdominal examination ranked first among all organ systems’ “Introductory Sessions”. The abdominal examination ratings had the best mean score (1.35) on a Likert scale where 1 is excellent and 5 is poor. The students gave the most positive spontaneous comments to having volunteer patients, with small groups coming in as the second most appreciated educational element. Conclusion We successfully quadrupled the number of faculty, patients, and examining rooms and created a highly rated educational program as measured by anonymous student evaluations, patient and faculty participation, and the medical school’s selecting the abdominal examination methods as an “Advanced Examination” for the Pathways Curriculum. PMID:29138611

Volunteer patients and small groups contribute to abdominal examination's success.

PubMed

Shields, Helen M; Fernandez-Becker, Nielsen Q; Flier, Sarah N; Vaughn, Byron P; Tukey, Melissa H; Pelletier, Stephen R; Horst, Douglas A

2017-01-01

Prior to 2007, we taught the abdominal examination in a hospital based group to 40 students, at one hospital. We used volunteer patients, small groups, repetition, and required faculty development sessions. In 2007, our medical school changed its "Introduction to Physical Examination" session so that the entire class was to be taught in a geographically central session. Our hospital was selected to lead the abdominal examination portion of the session. Our aim was to answer three questions. First, could we quadruple the recruitment of volunteer patients, and faculty? Second, was it volunteer patients, small groups, repetition, or faculty training that was most valued by the students? Third, would volunteer patients and/or faculty agree to participate a second time? A total of 43-46 patients and 43-46 faculty were recruited and 43-46 examining rooms were obtained for each of the 5 years of this study. Teachers were required to attend a 1-hour faculty development session. The class of about 170 students was divided into 43-46 groups each year. The teacher demonstrated the abdominal examination and each student practiced the examination on another student. Each student then repeated the full abdominal examination on a volunteer patient. Over the 5-year time period (2008-2012), the abdominal examination ranked first among all organ systems' "Introductory Sessions". The abdominal examination ratings had the best mean score (1.35) on a Likert scale where 1 is excellent and 5 is poor. The students gave the most positive spontaneous comments to having volunteer patients, with small groups coming in as the second most appreciated educational element. We successfully quadrupled the number of faculty, patients, and examining rooms and created a highly rated educational program as measured by anonymous student evaluations, patient and faculty participation, and the medical school's selecting the abdominal examination methods as an "Advanced Examination" for the Pathways Curriculum.

Remediation for Students With Mathematics Difficulties: An Intervention Study in Middle Schools.

PubMed

Moser Opitz, Elisabeth; Freesemann, Okka; Prediger, Susanne; Grob, Urs; Matull, Ina; Hußmann, Stephan

As empirical studies have consistently shown, low achievement in mathematics at the secondary level can often be traced to deficits in the understanding of certain basic arithmetic concepts taught in primary school. The present intervention study in middle schools evaluated whether such learning deficits can be reduced effectively and whether the type of instruction influences students' progress. The sample consisted of 123 students in 34 classes, split among one control group and two intervention groups: (a) small group instruction and (b) independent work partially integrated into regular classrooms. Over a period of 14 weeks, students were taught basic concepts, such as place value and basic operations. In addition, they practiced fact retrieval and counting (in groups). Multilevel regression analyses demonstrated that the interventions can be used to reduce given deficits.

Utility of Liquid Biopsy by Improved PNA-LNA PCR Clamp Method for Detecting EGFR Mutation at Initial Diagnosis of Non-Small-Cell Lung Cancer: Observational Study of 190 Consecutive Cases in Clinical Practice.

PubMed

Ito, Kentaro; Suzuki, Yuta; Saiki, Haruko; Sakaguchi, Tadashi; Hayashi, Kosuke; Nishii, Yoichi; Watanabe, Fumiaki; Hataji, Osamu

2018-03-01

The clinical benefit of liquid biopsy for unselected patients at initial diagnosis has thus far been unclear. We aimed to evaluate the utility of liquid biopsy at initial diagnosis, as well as the efficacy of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) based on liquid biopsy results in clinical practice, using the improved peptide nucleic acid-locked nucleic acid (PNA-LNA) PCR clamp method. We routinely performed liquid biopsy using the improved PNA-LNA PCR clamp method for all patients diagnosed with non-small-cell lung cancer (NSCLC) between June 2015 and October 2016. We retrospectively evaluated the reliability of liquid biopsy based either on clinical stage or between sensitizing EGFR mutation and T790M mutation, and the clinical benefit of EGFR-TKI based on the liquid biopsy results in practice. A total of 244 patients underwent liquid biopsies, with 168 patients tested at diagnosis and 22 tested for T790M after pretreatment of EGFR-TKI. For detecting a sensitizing EGFR mutation, the sensitivity, specificity, positive predictive value, and negative predictive value were 72.7%, 100%, 100%, and 93.7% in the group with advanced-stage NSCLC and 0, 100%, not evaluable, and 70.5% in the group with early-stage NSCLC. The positive predictive value and negative predictive value for T790M were 33.3% and 55.6%, respectively. Fourteen patients in the liquid-positive group and 16 patients in the tissue-positive group received EGFR-TKI. The objective response rates of first- and second-generation EGFR-TKI for the liquid-positive and tissue-positive groups were 90.0% and 90.9%, respectively. There was no significant difference in median progression-free survival between the liquid-positive and tissue-positive groups (P = .839). Patients with early-stage NSCLC should not be candidates for this liquid biopsy method. We recommend tissue biopsy as the preferred initial method of molecular analysis, with the exception of patients who are T790M positive or patients who are unable to tolerate invasive biopsy. Copyright © 2017 Elsevier Inc. All rights reserved.

Peer Assisted Experiential Learning (PAEL) in extending fieldwork practice in the Earth Sciences

NASA Astrophysics Data System (ADS)

Anderson, M. W.; FitzPatrick, M.; Truscott, J.

2012-04-01

Traditional approaches to developing students practical (applied) skills (most especially, but not exclusively, fieldwork) make significant demands on resources, particularly staff time. Extending opportunities for experiential learning through independent (student centred) work is acknowledged, therefore, as being vital to the successful spiralling of Kolb's experiential learning cycle. This project outlines e-learning support as a means of assisting student peer groups in extending the experiential learning cycle for fieldwork. We have developed mobile support for independent fieldwork in a small, accessible and safe area north of Kingsand village, Cornwall, UK. The area is ideal for reinforcing skills in recording basic geological observations and in formulating a simple geological history based on these observations. Independent fieldwork can be undertaken throughout the academic year by small student groups (which can comprise mixed year groups). equipped with PDA's and integrated GPS units. Students are prepared for fieldwork through a dedicated website, linked to support materials in the University's unique Labplus facility. PDA's, running MSCAPE, provide automatic prompts to locations where key observations can be made and detail the nature of the activities that should be carried out at each location. The e-guide takes students from 1st principles of observation and measurement, through recording methodology and eventually links to packages for analysis and interpretation (again using support provided through Labplus). There is no limit to the number of times any particular student can carry out the fieldwork, provided they are organised into groups of three or more. The work is not assessed but links into several components of the field skills training that are formally assessed, including independent geological mapping.

The Value of Clinical Jazz: Teaching Critical Reflection on, in, and Toward Action.

PubMed

Casapulla, Sharon; Longenecker, Randall; Beverly, Elizabeth A

2016-05-01

Clinical Jazz is a small-group strategy in medical education designed to develop interpersonal skills and improve doctor-patient and interprofessional relationships. The purpose of this study was to explore medical students' and faculty facilitators' perceived value of Clinical Jazz. We conducted a modified Nominal Group Process with participating medical students (n=21), faculty facilitators (n=5), and research team members (n=3). Students and faculty facilitators independently answered the question, "What do you value about Clinical Jazz?" We then conducted content and thematic analyses on the resulting data. Three themes emerged during analysis: (1) students and faculty appreciated the opportunity to learn and practice a thoughtful and structured process for problem solving, (2) students and faculty valued the safety of the group process in sharing a diversity of perspectives on topics in medicine, and (3) students and faculty acknowledged the importance of addressing real and challenging problems that are rarely addressed in formal lectures and other planned small-group settings. Clinical Jazz provides students and faculty with the opportunity to address the hidden and/or informal curriculum in medical education, while providing a safe space and time to solve important clinical and interprofessional problems.

The pearls of using real-world evidence to discover social groups

NASA Astrophysics Data System (ADS)

Cardillo, Raymond A.; Salerno, John J.

2005-03-01

In previous work, we introduced a new paradigm called Uni-Party Data Community Generation (UDCG) and a new methodology to discover social groups (a.k.a., community models) called Link Discovery based on Correlation Analysis (LDCA). We further advanced this work by experimenting with a corpus of evidence obtained from a Ponzi scheme investigation. That work identified several UDCG algorithms, developed what we called "Importance Measures" to compare the accuracy of the algorithms based on ground truth, and presented a Concept of Operations (CONOPS) that criminal investigators could use to discover social groups. However, that work used a rather small random sample of manually edited documents because the evidence contained far too many OCR and other extraction errors. Deferring the evidence extraction errors allowed us to continue experimenting with UDCG algorithms, but only used a small fraction of the available evidence. In attempt to discover techniques that are more practical in the near-term, our most recent work focuses on being able to use an entire corpus of real-world evidence to discover social groups. This paper discusses the complications of extracting evidence, suggests a method of performing name resolution, presents a new UDCG algorithm, and discusses our future direction in this area.

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

PubMed

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

2017-01-27

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

Developing support for remote nursing education through workplace culture that values learning.

PubMed

Gibb, Heather; Anderson, Judith; Forsyth, Katreena

2004-10-01

The present study presents the cultural challenges of introducing workplace learning associated with a nursing educational pathway into small rural hospitals. Focus groups were conducted before and after an action research intervention to determine whether changes in understanding and values on learning had occurred. Eight multipurpose services or small rural hospitals across rural New South Wales were involved in the intervention. Nursing staff from eight rural health facilities participated voluntarily in the present study. Two outcomes were achieved: The development of mentoring, locally tailored to the needs and expectations of nursing participants; Values and understanding of learning were enhanced, with advanced levels of learning being identified and demonstrated by staff in the practice setting. Small rural hospitals can provide opportunities for advanced clinical learning. Forms of major mentoring are, however, critical to this process.

Considerations to Enhance the Florida Domestic Security Strategic Plan

DTIC Science & Technology

2011-03-01

In his book, Implementing your Strategic Plan How to Turn “Intent” Into Effective Action for Sustainable Change, C. Davis Fogg suggests that...companies that are long-term, strategic winners faithfully practice 18 keys to strategy implementation (1999). Fogg states to begin, a company must have a...this small group of strategic priority issues will lead one toward an envisioned future ( Fogg , 1999, p. 6). Fogg suggests that it is important

Ignition of combustible/air mixtures by small radiatively heated surfaces.

PubMed

Welzel, M M; Schenk, S; Hau, M; Cammenga, H K; Bothe, H

2000-02-01

Optical radiation as an ignition source in potentially explosive atmospheres was investigated for a number of explosive mixtures with respect to the most important case occurring in practice, i.e., absorption of the radiation by a solid target. Iron oxide was used as the target material. The combustibles were selected in compliance with the well-known temperature classes and apparatus groups to allow a useful graduation of the power limits to be applied.

Treatment of rabbit cheyletiellosis with selamectin or ivermectin: a retrospective case study.

PubMed

Mellgren, Marianne; Bergvall, Kerstin

2008-01-02

A retrospective study of rabbits treated against cheyletiellosis was performed to evaluate the efficacy and safety of selamectin or ivermectin in clinical practice. Medical records from 53 rabbits with microscopically confirmed Cheyletiella infestation were collected from two small animal clinics. The rabbits were divided into three groups, based on treatment protocols. Group 1 included 11 rabbits treated with ivermectin injections at 200-476 microg kg-1 subcutaneously 2-3 times, with a mean interval of 11 days. In Group 2, 27 rabbits were treated with a combination of subcutaneous ivermectin injections (range 618-2185 microgkg-1) and oral ivermectin (range 616-2732 microgkg-1) administered by the owners, 3-6 times at 10 days interval. The last group (Group 3) included 15 rabbits treated with selamectin spot-on applications of 6.2-20,0 mgkg-1, 1-3 times with an interval of 2-4 weeks. Follow-up time was 4 months-4.5 years. Rabbits in remission were 9/11 (81,8%), 14/27 (51,9%) and 12/15 (80,8%) in groups 1, 2 and 3, respectively. All treatment protocols seemed to be sufficiently effective and safe for practice use. Though very high doses were used in Group 2 (ivermectin injections followed by oral administration), the protocol seemed less efficacious compared to ivermectin injections (Group 1) and selamectin spot on (Group 3), respectively, although not statistically significant. Controlled prospective studies including larger groups are needed to further evaluate efficacy of the treatment protocols.

Looking at Graduate Medical Education Through a Different Lens: A Health Care System's Perspective.

PubMed

Roemer, Beth M; Azevedo, Theresa; Blumberg, Bruce

2015-09-01

In the era of the accountable care organization, U.S. models of physician practice are shifting from the solo, independent practitioner to the physician who is part of a multispecialty group practice or is employed by a health care institution, and from paper-based small offices to practice settings that emphasize technology-enabled, team-based systems of care. In this light, Kaiser Permanente's (KP's) long experience as an integrated, population-based health care delivery system makes it an increasingly relevant model in which to consider how graduate medical education (GME) can best prepare physicians for 21st-century health care. KP's multiple perspectives-as a GME setting, a health care delivery system, a health research enterprise, a community benefit organization, and the nation's largest private, multispecialty group practice of physicians-provide a multifaceted opportunity to consider GME in the context of health care transformation. The authors suggest that all participants in medical education have a role to play in preparing physicians for this future. They recommend that partnerships between universities and health care delivery systems serve as a highly effective model for education; that to better serve the needs of society, medical education institutions must adopt a broad community benefit mindset; and that, when medical groups and other institutions that employ physicians take the baton from GME, they need to commit to ongoing development and lifelong learning to enable their new physicians to reach their full potential.

Student experiences of creating and sharing material in online learning.

PubMed

Potts, Henry W W

2011-01-01

User-generated content in an online environment has significant implications in both education and health. Instead of a model of knowledge being something transferred from the expert to the student or to the patient, Web 2.0 technologies offer the hope of making learning, and healthcare delivery, a more collaborative and participative process. However, some evidence suggests that this supposed democratisation of production is not entirely democratic and, in an educational context, many students are uncomfortable about sharing material they create with their peers. To understand students' affective and other experiences of generating content to be shared online with peers (e.g. in online discussions). Online interviews, face-to-face focus groups and further methods with two student groups in medical education, one undergraduate and one postgraduate. Students were broadly positive about creating and sharing material online, but were also quite anxious about doing so. Many practical issues, including around course design, student workload and assessment pressures, were barriers to students creating and sharing material. Group size is also important, with self-sustaining activity less likely in small groups. Successfully introducing user-generated content into medical education requires attention to practical details and an awareness of the student anxiety that can arise.

Participants' evaluation of a group-based organisational assessment tool in Danish general practice: the Maturity Matrix.

PubMed

Buch, Martin Sandberg; Edwards, Adrian; Eriksson, Tina

2009-01-01

The Maturity Matrix is a group-based formative self-evaluation tool aimed at assessing the degree of organisational development in general practice and providing a starting point for local quality improvement. Earlier studies of the Maturity Matrix have shown that participants find the method a useful way of assessing their practice's organisational development. However, little is known about participants' views on the resulting efforts to implement intended changes. To explore users' perspectives on the Maturity Matrix method, the facilitation process, and drivers and barriers for implementation of intended changes. Observation of two facilitated practice meetings, 17 semi-structured interviews with participating general practitioners (GPs) or their staff, and mapping of reasons for continuing or quitting the project. General practices in Denmark Main outcomes: Successful change was associated with: a clearly identified anchor person within the practice, a shared and regular meeting structure, and an external facilitator who provides support and counselling during the implementation process. Failure to implement change was associated with: a high patient-related workload, staff or GP turnover (that seemed to affect small practices more), no clearly identified anchor person or anchor persons who did not do anything, no continuous support from an external facilitator, and no formal commitment to working with agreed changes. Future attempts to improve the impact of the Maturity Matrix, and similar tools for quality improvement, could include: (a) attention to matters of variation caused by practice size, (b) systematic counselling on barriers to implementation and support to structure the change processes, (c) a commitment from participants that goes beyond participation in two-yearly assessments, and (d) an anchor person for each identified goal who takes on the responsibility for improvement in practice.

Preserving third year medical students' empathy and enhancing self-reflection using small group "virtual hangout" technology.

PubMed

Duke, Pamela; Grosseman, Suely; Novack, Dennis H; Rosenzweig, Steven

2015-01-01

Medical student professionalism education is challenging in scope, purpose, and delivery, particularly in the clinical years when students in large universities are dispersed across multiple clinical sites. We initiated a faculty-facilitated, peer small group course for our third year students, creating virtual classrooms using social networking and online learning management system technologies. The course emphasized narrative self-reflection, group inquiry, and peer support. We conducted this study to analyze the effects of a professionalism course on third year medical students' empathy and self-reflection (two elements of professionalism) and their perceptions about the course. Students completed the Groningen Reflection Ability Scale (GRAS) and the Jefferson Scale of Empathy (JSE) before and after the course and provided anonymous online feedback. The results of the JSE before and after the course demonstrated preservation of empathy rather than its decline. In addition, there was a statistically significant increase in GRAS scores (p < 0.001), suggesting that the sharing of personal narratives may foster reflective ability and reflective practice among third year students. This study supports previous findings showing that students benefit from peer groups and discussion in a safe environment, which may include the use of a virtual group video platform.

What are patients' expectations about the organization of their primary care physicians' practices?

PubMed

Sebo, Paul; Herrmann, François R; Bovier, Patrick; Haller, Dagmar M

2015-08-14

To our knowledge no study has at the same time assessed patients' satisfaction and their expectations concerning the organizational and contextual aspects of health care provided by their primary care physician (PCP). Assessing these aspects is important to inform future primary healthcare service planning. Our objective was thus to document patients' satisfaction with and expectations from their PCP, in terms of availability and organization of their practices, and to assess whether these indicators varied across age groups and type of practice (solo, duo, group). Cross-sectional study based on the answers to questionnaires completed by patients consulting their PCP in Geneva, Switzerland. A random sample of PCPs was asked to recruit consecutively between 50 and 100 patients coming to the practice for a scheduled medical consultation. The patients were asked to complete an anonymous questionnaire centered on their satisfaction levels and expectations towards their PCP. One thousand six hundred thirty-seven patients agreed to participate (participation rate: 97%, women: 63%, mean age: 54 years). Patient satisfaction was high for all the items, except for the availability of the doctor by phone and for the waiting time in the waiting room. The satisfaction rate increased with age and was higher for small practices. In relation to patients' expectations from their doctor, older patients and patients visiting larger practices tended to be more demanding. Patients are generally highly satisfied with their PCP. They have a wide range of expectations which should be taken into account when considering potential improvements.

Participatory Training to Improve Safety and Health in Small Construction Sites in Some Countries in Asia: Development and Application of the WISCON Training Program.

PubMed

Kawakami, Tsuyoshi

2016-08-01

A participatory training program, Work Improvement in Small Construction Sites, was developed to provide practical support measures to the small construction sector. Managers and workers from selected small sites were interviewed about their occupational safety and health risks. The Work Improvement in Small Construction Sites training program comprised a 45-item action checklist, photos, and illustrations showing local examples and group work methods. Pilot training workshops were carried out with workers and employers in Cambodia, Laos, Mongolia, Thailand, and Vietnam. Participants subsequently planned, and using locally available low-cost materials, implemented their own improvements such as hand-made hand trucks to carry heavy materials, removal of projecting nails from timber materials, and fences to protect roof workers from falling. Local Work Improvement in Small Construction Sites trainers consisting of government officials, workers, employers, and nongovernment organization representatives were then trained to implement the Work Improvement in Small Construction Sites training widely. Keys to success were easy-to-apply training tools aiming at immediate, low-cost improvements, and collaboration with various local people's networks. © The Author(s) 2016.

@OceanSeaIceNPI: Positive Practice of Science Outreach via Social Media

NASA Astrophysics Data System (ADS)

Meyer, A.; Pavlov, A.; Rösel, A.; Granskog, M. A.; Gerland, S.; Hudson, S. R.; King, J.; Itkin, P.; Negrel, J.; Cohen, L.; Dodd, P. A.; de Steur, L.

2016-12-01

As researchers, we are keen to share our passion for science with the general public. We are encouraged to do so by colleagues, journalists, policy-makers and funding agencies. How can we best achieve this in a small research group without having specific resources and skills such as funding, dedicated staff, and training? How do we sustain communication on a regular basis as opposed to the limited lifetime of a specific project? The emerging platforms of social media have become powerful and inexpensive tools to communicate science for various audiences. Many research institutions and individual researchers are already advanced users of social media, but small research groups and labs remain underrepresented. A small group of oceanographers, sea ice, and atmospheric scientists at the Norwegian Polar Institute have been running their social media science outreach for two years @OceanSeaIceNPI. Here we share our successful experience of developing and maintaining a researcher-driven outreach through Instagram, Twitter and Facebook. We present our framework for sharing responsibilities within the group to maximize effectiveness. Each media channel has a target audience for which the posts are tailored. Collaboration with other online organizations and institutes is key for the growth of the channels. The @OceanSeaIceNPI posts reach more than 4000 followers on a weekly basis. If you have questions about our @OceanSeaIceNPI initiative, you can tweet them with a #ask_oceanseaicenpi hashtag anytime.

Mechatronic Wearable Exoskeletons for Bionic Bipedal Standing and Walking: A New Synthetic Approach

PubMed Central

Onose, Gelu; Cârdei, Vladimir; Crăciunoiu, Ştefan T.; Avramescu, Valeriu; Opriş, Ioan; Lebedev, Mikhail A.; Constantinescu, Marian Vladimir

2016-01-01

During the last few years, interest has been growing to mechatronic and robotic technologies utilized in wearable powered exoskeletons that assist standing and walking. The available literature includes single-case reports, clinical studies conducted in small groups of subjects, and several recent systematic reviews. These publications have fulfilled promotional and marketing objectives but have not yet resulted in a fully optimized, practical wearable exoskeleton. Here we evaluate the progress and future directions in this field from a joint perspective of health professionals, manufacturers, and consumers. We describe the taxonomy of existing technologies and highlight the main improvements needed for the development and functional optimization of the practical exoskeletons. PMID:27746711

Introduction to Small Telescope Research Communities of Practice

NASA Astrophysics Data System (ADS)

Genet, Russell M.

2016-06-01

Communities of practice are natural, usually informal groups of people who work together. Experienced members teach new members the “ropes.” Social learning theorist Etienne Wenger’s book, Communities of Practice: Learning, Meaning, and Identity, defined the field. There are, in astronomy, many communities of practice. One set of communities uses relatively small telescopes to observe brighter objects such as eclipsing binaries, intrinsically variable stars, transiting exoplanets, tumbling asteroids, and the occultation of background stars by asteroids and the Moon. Advances in low cost but increasingly powerful instrumentation and automation have greatly increased the research capabilities of smaller telescopes. These often professional-amateur (pro-am) communities engage in research projects that require a large number of observers as exemplified by the American Association of Variable Star Observers. For high school and community college students with an interest in science, joining a student-centered, small telescope community of practice can be both educational and inspirational. An example is the now decade-long Astronomy Research Seminar offered by Cuesta College in San Luis Obispo, California. Each student team is required to plan a project, obtain observations (either locally or via a remote robotic telescope), analyze their data, write a paper, and submit it for external review and publication. Well over 100 students, composed primarily of high school juniors and seniors, have been coauthors of several dozen published papers. Being published researchers has boosted these students’ educational careers with admissions to choice schools, often with scholarships. This seminar was recently expanded to serve multiple high schools with a volunteer assistant instructor at each school. The students meet regularly with their assistant instructor and also meet online with other teams and the seminar’s overall community college instructor. The seminar features a textbook, self-paced learning units, and a website sponsored by the Institute for Student Astronomical Research.

The high vaginal swab in general practice: clinical correlates of possible pathogens.

PubMed

Dykhuizen, R S; Harvey, G; Gould, I M

1995-06-01

Clinical features, diagnosis and treatment of 286 women whose high vaginal swabs (HVS) submitted by their general practitioners showed pure, heavy growth of Staphylococcus aureus, beta haemolytic streptococci groups A, C or G, Streptococcus milleri, Streptococcus pneumoniae or Haemophilus influenzae were analysed. Women with group A, C and G streptococci frequently had clinical vulvovaginitis and although the numbers were too small for statistical confirmation, S. pneumoniae and H. influenzae appeared to cause clinical disease as well. The association of S. aureus or S. milleri with clinical vulvovaginitis was much less convincing. It seems relevant for laboratories to report sensitivities for group A, C and G streptococci. Further research is needed to determine the pathogenicity of S. pneumoniae and H. influenzae.

A family-centred model of care in paediatric speech-language pathology.

PubMed

McKean, Kate; Phillips, Bev; Thompson, Acushla

2012-06-01

Developments in paediatric models of care support family-centred practice (FCP); however, there is limited evidence for its use in speech-language pathology. This randomized controlled study examined whether parent satisfaction with FCP (n = 10) was greater than with usual practice (UP; n = 10) over 14 weeks for children with mild-moderate speech and/or language disorders. The FCP included parental goal decision-making; greater parent responsibility for clinic therapy tasks; and two home visits. There was a non-significant trend for the FCP group to have a higher mean score for the "Providing specific information" scale of the Measures of Process of Care. Goals for the FCP and UP groups were respectively targeted towards the Activities and Participation or the Body Function components of the International Classification of Functioning, Disability and Health-Children and Youth. While there were no significant differences between groups for speech/language outcomes post-intervention; it is clinically interesting that more children in the FCP group improved on the Renfrew Action Picture Test than the UP group. This study did not demonstrate a significant benefit for FCP over a relatively short timeframe in a small sample of children. Further research is warranted to determine if there is evidence for the use of FCP in speech-language pathology.

Effect of Tetracycline Dose and Treatment Mode on Selection of Resistant Coliform Bacteria in Nursery Pigs

PubMed Central

Græsbøll, Kaare; Damborg, Peter; Mellerup, Anders; Herrero-Fresno, Ana; Larsen, Inge; Holm, Anders; Nielsen, Jens Peter; Christiansen, Lasse Engbo; Angen, Øystein; Ahmed, Shahana

2017-01-01

ABSTRACT This study describes the results of a randomized clinical trial investigating the effect of oxytetracycline treatment dose and mode of administration on the selection of antibiotic-resistant coliform bacteria in fecal samples from nursery pigs. Nursery pigs (pigs of 4 to 7 weeks of age) in five pig herds were treated with oxytetracycline for Lawsonia intracellularis-induced diarrhea. Each group was randomly allocated to one of five treatment groups: oral flock treatment with a (i) high (20 mg/kg of body weight), (ii) medium (10 mg/kg), or (iii) low (5 mg/kg) dose, (iv) oral pen-wise (small-group) treatment (10 mg/kg), and (v) individual intramuscular injection treatment (10 mg/kg). All groups were treated once a day for 5 days. In all groups, treatment caused a rise in the numbers and proportions of tetracycline-resistant coliform bacteria right after treatment, followed by a significant drop by the time that the pigs left the nursery unit. The counts and proportions of tetracycline-resistant coliforms did not vary significantly between treatment groups, except immediately after treatment, when the highest treatment dose resulted in the highest number of resistant coliforms. A control group treated with tiamulin did not show significant changes in the numbers or proportions of tetracycline-resistant coliforms. Selection for tetracycline-resistant coliforms was significantly correlated to selection for ampicillin- and sulfonamide-resistant strains but not to selection for cefotaxime-resistant strains. In conclusion, the difference in the dose of oxytetracycline and the way in which the drug was applied did not cause significantly different levels of selection of tetracycline-resistant coliform bacteria under the conditions tested. IMPORTANCE Antimicrobial resistance is a global threat to human health. Treatment of livestock with antimicrobials has a direct impact on this problem, and there is a need to improve the ways that we use antimicrobials in livestock production. We hypothesized that antibiotic resistance development following treatment of diarrhea in nursery pigs could be reduced either by lowering the dose of oxytetracycline or by replacing the commonly used practice of flock treatment with individual or small-group treatments, since this would reduce the number of pigs treated. However, the study showed no significant difference between treatment groups with respect to the number or proportion of tetracycline-resistant coliforms selected. The most important conclusion is that under practical field conditions, there will be no added value, in terms of lowering resistance development, by exchanging flock treatment for individual or small-group treatment of nursery pigs. The reason for the lack of an effect of single-animal treatment is probably that such animals share the environment with treated animals and take up resistant bacteria from the environment. PMID:28389548

Effect of Tetracycline Dose and Treatment Mode on Selection of Resistant Coliform Bacteria in Nursery Pigs.

PubMed

Græsbøll, Kaare; Damborg, Peter; Mellerup, Anders; Herrero-Fresno, Ana; Larsen, Inge; Holm, Anders; Nielsen, Jens Peter; Christiansen, Lasse Engbo; Angen, Øystein; Ahmed, Shahana; Folkesson, Anders; Olsen, John Elmerdahl

2017-06-15

This study describes the results of a randomized clinical trial investigating the effect of oxytetracycline treatment dose and mode of administration on the selection of antibiotic-resistant coliform bacteria in fecal samples from nursery pigs. Nursery pigs (pigs of 4 to 7 weeks of age) in five pig herds were treated with oxytetracycline for Lawsonia intracellularis -induced diarrhea. Each group was randomly allocated to one of five treatment groups: oral flock treatment with a (i) high (20 mg/kg of body weight), (ii) medium (10 mg/kg), or (iii) low (5 mg/kg) dose, (iv) oral pen-wise (small-group) treatment (10 mg/kg), and (v) individual intramuscular injection treatment (10 mg/kg). All groups were treated once a day for 5 days. In all groups, treatment caused a rise in the numbers and proportions of tetracycline-resistant coliform bacteria right after treatment, followed by a significant drop by the time that the pigs left the nursery unit. The counts and proportions of tetracycline-resistant coliforms did not vary significantly between treatment groups, except immediately after treatment, when the highest treatment dose resulted in the highest number of resistant coliforms. A control group treated with tiamulin did not show significant changes in the numbers or proportions of tetracycline-resistant coliforms. Selection for tetracycline-resistant coliforms was significantly correlated to selection for ampicillin- and sulfonamide-resistant strains but not to selection for cefotaxime-resistant strains. In conclusion, the difference in the dose of oxytetracycline and the way in which the drug was applied did not cause significantly different levels of selection of tetracycline-resistant coliform bacteria under the conditions tested. IMPORTANCE Antimicrobial resistance is a global threat to human health. Treatment of livestock with antimicrobials has a direct impact on this problem, and there is a need to improve the ways that we use antimicrobials in livestock production. We hypothesized that antibiotic resistance development following treatment of diarrhea in nursery pigs could be reduced either by lowering the dose of oxytetracycline or by replacing the commonly used practice of flock treatment with individual or small-group treatments, since this would reduce the number of pigs treated. However, the study showed no significant difference between treatment groups with respect to the number or proportion of tetracycline-resistant coliforms selected. The most important conclusion is that under practical field conditions, there will be no added value, in terms of lowering resistance development, by exchanging flock treatment for individual or small-group treatment of nursery pigs. The reason for the lack of an effect of single-animal treatment is probably that such animals share the environment with treated animals and take up resistant bacteria from the environment. Copyright © 2017 American Society for Microbiology.

Novel point estimation from a semiparametric ratio estimator (SPRE): long-term health outcomes from short-term linear data, with application to weight loss in obesity.

PubMed

Weissman-Miller, Deborah

2013-11-02

Point estimation is particularly important in predicting weight loss in individuals or small groups. In this analysis, a new health response function is based on a model of human response over time to estimate long-term health outcomes from a change point in short-term linear regression. This important estimation capability is addressed for small groups and single-subject designs in pilot studies for clinical trials, medical and therapeutic clinical practice. These estimations are based on a change point given by parameters derived from short-term participant data in ordinary least squares (OLS) regression. The development of the change point in initial OLS data and the point estimations are given in a new semiparametric ratio estimator (SPRE) model. The new response function is taken as a ratio of two-parameter Weibull distributions times a prior outcome value that steps estimated outcomes forward in time, where the shape and scale parameters are estimated at the change point. The Weibull distributions used in this ratio are derived from a Kelvin model in mechanics taken here to represent human beings. A distinct feature of the SPRE model in this article is that initial treatment response for a small group or a single subject is reflected in long-term response to treatment. This model is applied to weight loss in obesity in a secondary analysis of data from a classic weight loss study, which has been selected due to the dramatic increase in obesity in the United States over the past 20 years. A very small relative error of estimated to test data is shown for obesity treatment with the weight loss medication phentermine or placebo for the test dataset. An application of SPRE in clinical medicine or occupational therapy is to estimate long-term weight loss for a single subject or a small group near the beginning of treatment.

Flowing together: a longitudinal study of collective efficacy and collective flow among workgroups.

PubMed

Salanova, Marisa; Rodríguez-Sánchez, Alma M; Schaufeli, Wilmar B; Cifre, Eva

2014-01-01

The aim of this study is to extend the Channel Model of Flow (Csikszentmihalyi, 1975, 1990) at the collective level (workgroups) by including collective efficacy beliefs as a predictor of collective flow based on the Social Cognitive Theory (Bandura, 1997, 2001). A two-wave longitudinal lab study was conducted with 250 participants working in 52 small groups. Longitudinal results from Structural Equation Modeling with data aggregated at the group level showed, as expected, that collective efficacy beliefs predict collective flow over time, both being related reciprocally. Findings and their theoretical and practical implications in the light of Social Cognitive Theory are discussed.

Small business, cash budgets and general practice.

PubMed

Jackson, A R

1991-01-01

In practice management, general practice falls into the category of small business with all its attendant generic problems. Disciplined planning and good financial management are not often seen in small business. These are required if general practitioners are to continue (or return to) the provision of high quality medical services. An effective budget process, especially cash-flow budgeting, is the key to successful planning and financial management. Budgeting will bring Control, Co-ordination, and Credibility to your practice. It will enable you to set goals and to achieve them.

A profile of solo/two-physician practices.

PubMed

Lee, Doohee; Fiack, Kelly James; Knapp, Kenneth Michael

2014-01-01

Understanding practice behaviors of solo/dual physician ownership and associated factors at the national level is important information for policymakers and clinicians in response to the Affordable Care Act (ACA) of 2010, but poorly understood in the literature. We analyzed nationally representative data (n = 4,720). The study results reveal nearly 33% of the sample reported solo/two-physician practices. Male/minority/older physicians, psychiatrists, favor small practices. Greater market competition was perceived and less charity care was given among solo/two-physician practitioners. The South region was favored by small physician practitioners. Physicians in solo or two-person practices provided fewer services to chronic patients and were dissatisfied with their overall career in medicine. Small practices were favored by international medical graduates (IMGs) and primary care physicians (PCPs). Overall our data suggest that the role of solo/dual physician practices is fading away in the delivery of medicine. Our findings shed light on varied characteristics and practice behaviors of solo/two-physician practitioners, but more research may be needed to reevaluate the potential role of small physician practitioners and find a way to foster a private physician practice model in the context of the newly passed ACA of 2010.

16 CFR § 1020.4 - What is the Small Business Program?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 2 2013-01-01 2013-01-01 false What is the Small Business Program? § 1020.4 Section § 1020.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL SMALL BUSINESS § 1020.4 What is the Small Business Program? (a) Whenever the Commission is aware of the interests of...

Essential pediatric hypertension: defining the educational needs of primary care pediatricians

PubMed Central

2014-01-01

Background In order to better understand the educational needs regarding appropriate recognition, diagnosis and management of pediatric hypertension (HTN), we asked practicing pediatricians questions regarding their educational needs and comfort level on this topic. Methods We conducted 4 focus group sessions that included 27 participants representing pediatric residents, adolescent medicine physicians, clinic based pediatricians and office based pediatricians. Each focus group session lasted for approximately an hour and 90 pages of total transcriptions were produced verbatim from audio recordings. Results Four reviewers read each transcript and themes were elucidated from these transcripts. Overall, 5 major themes related to educational needs and clinical concerns were found: utilization of resources to define blood pressure (BP), correct BP measurement method(s), co-morbidities, barriers to care, and experience level with HTN. Six minor themes were also identified: differences in BP measurement, accuracy of BP, recognition of HTN, practice pattern of care, education of families and patients, and differences in level of training. The focus group participants were also questioned on their preferences regarding educational methods (i.e. e-learning, small group sessions, self-study, large group presentations) and revealed varied teaching and learning preferences. Conclusions There are multiple methods to approach education regarding pediatric HTN for primary care pediatricians based on provider preferences and multiple educational activities should be pursued to achieve best outcomes. Based on this data, the next direction will be to develop and deliver multiple educational methods and to evaluate the impact on practice patterns of care for children and adolescents with HTN. PMID:25063988

Effects on readiness to change of an educational intervention on depressive disorders for general physicians in primary care based on a modified Prochaska model--a randomized controlled study.

PubMed

Shirazi, M; Zeinaloo, A A; Parikh, S V; Sadeghi, M; Taghva, A; Arbabi, M; Kashani, A Sabouri; Alaeddini, F; Lonka, K; Wahlström, R

2008-04-01

The Prochaska model of readiness to change has been proposed to be used in educational interventions to improve medical care. To evaluate the impact on readiness to change of an educational intervention on management of depressive disorders based on a modified version of the Prochaska model in comparison with a standard programme of continuing medical education (CME). This is a randomized controlled trial within primary care practices in southern Tehran, Iran. The participants included 192 general physicians working in primary care (GPs) were recruited after random selection and randomized to intervention (96) and control (96). Intervention consisted of interactive, learner-centred educational methods in large and small group settings depending on the GPs' stages of readiness to change. Change in stage of readiness to change measured by the modified version of the Prochaska questionnaire was the The final number of participants was 78 (81%) in the intervention arm and 81 (84%) in the control arm. Significantly (P < 0.01), more GPs (57/96 = 59% versus 12/96 = 12%) in the intervention group changed to higher stages of readiness to change. The intervention effect was 46% points (P < 0.001) and 50% points (P < 0.001) in the large and small group setting, respectively. Educational formats that suit different stages of learning can support primary care doctors to reach higher stages of behavioural change in the topic of depressive disorders. Our findings have practical implications for conducting CME programmes in Iran and are possibly also applicable in other parts of the world.

Software engineering risk factors in the implementation of a small electronic medical record system: the problem of scalability.

PubMed

Chiang, Michael F; Starren, Justin B

2002-01-01

The successful implementation of clinical information systems is difficult. In examining the reasons and potential solutions for this problem, the medical informatics community may benefit from the lessons of a rich body of software engineering and management literature about the failure of software projects. Based on previous studies, we present a conceptual framework for understanding the risk factors associated with large-scale projects. However, the vast majority of existing literature is based on large, enterprise-wide systems, and it unclear whether those results may be scaled down and applied to smaller projects such as departmental medical information systems. To examine this issue, we discuss the case study of a delayed electronic medical record implementation project in a small specialty practice at Columbia-Presbyterian Medical Center. While the factors contributing to the delay of this small project share some attributes with those found in larger organizations, there are important differences. The significance of these differences for groups implementing small medical information systems is discussed.

Two conceptions of conscience and the problem of conscientious objection.

PubMed

Symons, Xavier

2017-04-01

Schuklenk and Smalling argue that it is practically impossible for civic institutions to meet the conditions necessary to ensure that conscientious objection does not conflict with the core principles of liberal democracies. In this response, I propose an alternative definition of conscience to that offered by Schuklenk and Smalling. I discuss what I call the 'traditional' notion of conscience, and contrast this with the existentialist conception of conscience (which I take to be a close cousin of the view targeted by Schuklenk and Smalling). I argue that the traditional notion, grounded in an objective moral order, avoids the criticisms advanced by Schuklenk and Smalling; the existentialist conception, in contrast, does not. I conclude by discussing the benefits and risks of a 'restricted view' of respect for conscience. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Euro-NOTES Status Paper: from the concept to clinical practice.

PubMed

Fuchs, K H; Meining, A; von Renteln, D; Fernandez-Esparrach, G; Breithaupt, W; Zornig, C; Lacy, A

2013-05-01

The concept of natural orifice transluminal endoscopic surgery (NOTES) consists of the reduction of access trauma by using a natural orifice access to the intra-abdominal cavity. This could possibly lead to less postoperative pain, quicker recovery from surgery, fewer postoperative complications, fewer wound infections, and fewer long-term problems such as hernias. The Euro-NOTES Foundation has organized yearly meetings to work on this concept to bring it safely into clinical practice. The aim of this Euro-NOTES status update is to assess the yearly scientific working group reports and provide an overview on the current clinical practice of NOTES procedures. After the Euro-NOTES meeting 2011 in Frankfurt, Germany, an analysis was started regarding the most important topics of the European working groups. All prospectively documented information was gathered from Euro-NOTES and D-NOTES working groups from 2007 to 2011. The top five topics were analyzed. The statements of the working group activities demonstrate the growing information and changing insights. The most important selected topics were infection issue, peritoneal access, education and training, platforms and new technology, closure, suture, and anastomosis. The focus on research topics changed over time. The principle of hybrid access has overcome the technical and safety limitations of pure NOTES. Currently the following NOTES access routes are established for several indications: transvaginal access for cholecystectomy, appendectomy and colon resections; transesophageal access for myotomy; transgastric access for full-thickness small-tumor resections; and transanal/transcolonic access for rectal and colon resections. NOTES and hybrid NOTES techniques have emerged for all natural orifices and were introduced into clinical practice with a good safety record. There are different indications for different natural orifices. Each technique has been optimized for the purpose of finding a safe and realistic solution to perform the procedure according to the specific indication.

One bad apple: experimental effects of psychological conflict on social resilience

PubMed Central

Pincus, David

2014-01-01

Past research suggests that small groups are self-organizing systems, and that social resilience may be measured as the meta-flexibility of group dynamics: the ability to shift back and forth from flexiblity to rigidity in response to conflict. This study extends these prior results, examining the impact of experimentally induced internal conflict and group-level conflict resolution on group dynamics—whether one bad apple can spoil the bunch. Six experimental groups with four members each participated in a series of four 25 min discussions. The first two discussions served as a baseline condition. Internal conflict was induced to one or more group members prior to discussion three, with the prediction that higher levels of conflict induction would lead to significant drops in group flexibility—creating a press on the group's resilience, whereas conflict resolution in discussion four was expected to allow for a rebound in group flexibility. Consistent with prior research, the turn-taking dynamics of each the 24 groups were distributed as inverse power laws (R2 = 0.86–0.99) providing evidence for self-organization. Furthermore, there were significant study-wise negative correlation between levels of personality conflict and two measures of flexibility: information entropy (r = −0.47, p = 0.019) and fractal dimension (r = −0.42, p = 0.037). Altogether, these results suggest that: (i) small groups are self-organizing systems with structure and flexibility providing social resilience and (ii) individual conflict is able to spread to higher level social dynamics, creating pressure on social resilience. Practical implications for assessment of, and intervention with, psychosocial resilience are discussed. PMID:25285194

PRogram In Support of Moms (PRISM): a pilot group randomized controlled trial of two approaches to improving depression among perinatal women.

PubMed

Byatt, Nancy; Moore Simas, Tiffany A; Biebel, Kathleen; Sankaran, Padma; Pbert, Lori; Weinreb, Linda; Ziedonis, Douglas; Allison, Jeroan

2017-10-10

This pilot study was designed to inform a larger effectiveness trial by: (1) assessing the feasibility of the PRogram In Support of Moms (PRISM) and our study procedures; and, (2) determining the extent to which PRISM as compared to an active comparison group, the Massachusetts Child Access Psychiatry Program (MCPAP) for Moms alone, improves depression among perinatal women. Four practices were randomized to either PRISM or MCPAP for Moms alone, a state-wide telephonic perinatal psychiatry program. PRISM includes MCPAP for Moms plus implementation assistance with local champions, training, and implementation of office prompts and procedures to enhance depression screening, assessment and treatment. Patients with Edinburgh Postnatal Depression Scales (EPDS) ≥ 10 were recruited during pregnancy, and completed the EPDS and a structured interview at baseline and 3-12 weeks' postpartum. Among MCPAP for Moms alone practices, patients' (n = 9) EPDS scores improved from 15.22 to 10.11 (p = 0.010), whereas in PRISM practices patients' (n = 21) EPDS scores improved from 13.57 to 6.19 (p = 0.001); the between groups difference-of-differences was 2.27 (p = 0.341). PRISM was beneficial for patients, clinicians, and support staff. Both PRISM and MCPAP for Moms alone improve depression symptom severity and the percentage of women with an EPDS >10. The improvement difference between groups was not statistically significant due to limited power associated with small sample size.

Communicating polar science to the general public: sharing the social media experience of @OceanSeaIceNPI

NASA Astrophysics Data System (ADS)

Rösel, Anja; Pavlov, Alexey K.; Granskog, Mats A.; Gerland, Sebastian; Meyer, Amelie; Hudson, Stephen R.; King, Jennifer; Itkin, Polona; Cohen, Lana; Dodd, Paul; de Steur, Laura

2016-04-01

The findings of climate science need to be communicated to the general public. Researchers are encouraged to do so by journalists, policy-makers and funding agencies and many of us want to become better science communicators. But how can we do this at the lab or small research group level without specifically allocated resources in terms of funds and communication officers? And how do we sustain communication on a regular basis and not just during the limited lifetime of a specific project? One of the solutions is to use the emerging platform of social media, which has become a powerful and inexpensive tool for communicating science to different target audiences. Many research institutions and individual researchers are already advanced users of social media, but small research groups and labs remain underrepresented. The group of oceanographers, sea ice and atmospheric scientists at the Norwegian Polar Institute (@OceanSeaIceNPI( will share our experiences developing and maintaining researcher-driven outreach for over a year through Instagram, Twitter and Facebook. We will present our solutions to some of the practical considerations such as identifying key target groups, defining the framework for sharing responsibilities and interactions within the research group, and choosing an up-to-date and appropriate social medium. By sharing this information, we aim to inspire and assist other research groups and labs in conducting their own effective science communication.

How to manage organisational change and create practice teams: experiences of a South African primary care health centre.

PubMed

Mash, B J; Mayers, P; Conradie, H; Orayn, A; Kuiper, M; Marais, J

2008-07-01

In South Africa, first-contact primary care is delivered by nurses in small clinics and larger community health centres (CHC). CHCs also employ doctors, who often work in isolation from the nurses, with poor differentiation of roles and little effective teamwork or communication. Worcester CHC, a typical public sector CHC in rural South Africa, decided to explore how to create more successful practice teams of doctors and nurses. This paper is based on their experience of both unsuccessful and successful attempts to introduce practice teams and reports on their learning regarding organisational change. An emergent action research study design utilised a co-operative inquiry group. The first nine months of inquiry focused on understanding the initial unsuccessful attempt to create practice teams. This paper reports primarily on the subsequent nine months (four cycles of planning, action, observation and reflection) during which practice teams were re-introduced. The central question was how more effective practice teams of doctors and nurses could be created. The group utilised outcome mapping to assist with planning, monitoring and evaluation. Outcome mapping defined a vision, mission, boundary partners, outcome challenges, progress markers and strategies for the desired changes and supported quantitative monitoring of the process. Qualitative data were derived from the co-operative inquiry group (CIG) meetings and interviews with doctors, nurses, practice teams and patients. The CIG engaged effectively with 68% of the planned strategies, and more than 60% of the progress markers were achieved for clinical nurse practitioners, doctors, support staff and managers, but not for patients. Key themes that emerged from the inquiry group's reflection on their experience of the change process dealt with the amount of interaction, type of communication, team resilience, staff satisfaction, leadership style, reflective capacity, experimentation and evolution of new structures. The group's learning supported a view of change that sees the organisation as a living system in which information flow, participation and the development of resilience are key aspects. These themes fit well into an understanding of change based on complexity theory. If managers of the health system wish to enhance organisational change, then their goal may need to shift from optimising health care delivery in a mechanistic model to optimising health care workers in a living system.

When is bigger better? The effects of group size on the evolution of helping behaviours.

PubMed

Powers, Simon T; Lehmann, Laurent

2017-05-01

Understanding the evolution of sociality in humans and other species requires understanding how selection on social behaviour varies with group size. However, the effects of group size are frequently obscured in the theoretical literature, which often makes assumptions that are at odds with empirical findings. In particular, mechanisms are suggested as supporting large-scale cooperation when they would in fact rapidly become ineffective with increasing group size. Here we review the literature on the evolution of helping behaviours (cooperation and altruism), and frame it using a simple synthetic model that allows us to delineate how the three main components of the selection pressure on helping must vary with increasing group size. The first component is the marginal benefit of helping to group members, which determines both direct fitness benefits to the actor and indirect fitness benefits to recipients. While this is often assumed to be independent of group size, marginal benefits are in practice likely to be maximal at intermediate group sizes for many types of collective action problems, and will eventually become very small in large groups due to the law of decreasing marginal returns. The second component is the response of social partners on the past play of an actor, which underlies conditional behaviour under repeated social interactions. We argue that under realistic conditions on the transmission of information in a population, this response on past play decreases rapidly with increasing group size so that reciprocity alone (whether direct, indirect, or generalised) cannot sustain cooperation in very large groups. The final component is the relatedness between actor and recipient, which, according to the rules of inheritance, again decreases rapidly with increasing group size. These results explain why helping behaviours in very large social groups are limited to cases where the number of reproducing individuals is small, as in social insects, or where there are social institutions that can promote (possibly through sanctioning) large-scale cooperation, as in human societies. Finally, we discuss how individually devised institutions can foster the transition from small-scale to large-scale cooperative groups in human evolution. © 2016 Cambridge Philosophical Society.

Paying physician group practices for quality: A statewide quasi-experiment.

PubMed

Conrad, Douglas A; Grembowski, David; Perry, Lisa; Maynard, Charles; Rodriguez, Hector; Martin, Diane

2013-12-01

This article presents the results of a unique quasi-experiment of the effects of a large-scale pay-for-performance (P4P) program implemented by a leading health insurer in Washington state during 2001-2007. The authors received external funding to provide an objective impact evaluation of the program. The program was unique in several respects: (1) It was designed dynamically, with two discrete intervention periods-one in which payment incentives were based on relative performance (the "contest" period) and a second in which payment incentives were based on absolute performance compared to achievable benchmarks. (2) The program was designed in collaboration with large multispecialty group practices, with an explicit run-in period to test the quality metrics. Public reporting of the quality scorecard for all participating medical groups was introduced 1 year before the quality incentive payment program's inception, and continued throughout 2002-2007. (3) The program was implemented in stages with distinct medical groups. A control group of comparable group practices also was assembled, and difference-in-differences methodology was applied to estimate program effects. Case mix measures were included in all multivariate analyses. The regression design permitted a contrast of intervention effects between the "contest" approach in the sub-period of 2003-2004 and the absolute standard, "achievable benchmarks of care" approach in sub-period 2005-2007. Most of the statistically significant quality incentive program coefficients were small and negative (opposite to program intent). A consistent pattern of differential intervention impact in the sub-periods did not emerge. Cumulatively, the probit regression estimates indicate that neither the quality scorecard nor the quality incentive payment program had a significant positive effect on general clinical quality. Based on key informant interviews with medical leaders, practicing physicians, and administrators of the participating groups, the authors conclude that several factors likely combined to dampen program effects: (1) modest size of the incentive; (2) use of rewards only, rather than a balance of rewards and penalties; (3) targeting incentive payments to the group, thus potentially weakening incentive effects at the individual level. Copyright © 2013 Elsevier Inc. All rights reserved.

The value of job analysis, job description and performance.

PubMed

Wolfe, M N; Coggins, S

1997-01-01

All companies, regardless of size, are faced with the same employment concerns. Efficient personnel management requires the use of three human resource techniques--job analysis, job description and performance appraisal. These techniques and tools are not for large practices only. Small groups can obtain the same benefits by employing these performance control measures. Job analysis allows for the development of a compensation system. Job descriptions summarize the most important duties. Performance appraisals help reward outstanding work.

Herbal and nutrient complementary medicines for weight loss: community pharmacists' practices, attitudes, recommendations, information and education needs.

PubMed

Taing, Meng-Wong; Tan, Eunice Tze Xin; Williams, Gail M; Clavarino, Alexandra M; McGuire, Treasure M

2016-05-01

To investigate pharmacists' herbal/nutrient weight loss complementary medicine (WLCM) practices in the context of other pharmacist weight management support practices (provision of lifestyle advice, orlistat and meal replacement treatments); and gain insight into their attitudes, recommendations, information and education needs. Pharmacists from a randomly selected sample of 214 community pharmacies from different socioeconomic areas in the Greater Brisbane region, Australia, were invited to complete a survey to explore their weight management practices, with a specific focus on herbal/nutrient WLCM practices. Data collected from the sample group represented pharmacist practices within the metropolitan Greater Brisbane region. This survey achieved a 51% response rate. During weight management consultations, a high proportion of customers (37%) sought advice from community pharmacists relating to WLCMs relative to other weight management practices; however, only a small proportion (10%) of pharmacists recommended them. Most were also found to be using resources that may not be evidence-based or do not provide sufficient WLCMs' information. Study results highlight the need for pharmacy professional bodies to develop evidence-based continuing education programmes to assist consumers with popular and widely available WLCMs products. © 2015 Royal Pharmaceutical Society.

The effects of working memory training on functional brain network efficiency.

PubMed

Langer, Nicolas; von Bastian, Claudia C; Wirz, Helen; Oberauer, Klaus; Jäncke, Lutz

2013-10-01

The human brain is a highly interconnected network. Recent studies have shown that the functional and anatomical features of this network are organized in an efficient small-world manner that confers high efficiency of information processing at relatively low connection cost. However, it has been unclear how the architecture of functional brain networks is related to performance in working memory (WM) tasks and if these networks can be modified by WM training. Therefore, we conducted a double-blind training study enrolling 66 young adults. Half of the subjects practiced three WM tasks and were compared to an active control group practicing three tasks with low WM demand. High-density resting-state electroencephalography (EEG) was recorded before and after training to analyze graph-theoretical functional network characteristics at an intracortical level. WM performance was uniquely correlated with power in the theta frequency, and theta power was increased by WM training. Moreover, the better a person's WM performance, the more their network exhibited small-world topology. WM training shifted network characteristics in the direction of high performers, showing increased small-worldness within a distributed fronto-parietal network. Taken together, this is the first longitudinal study that provides evidence for the plasticity of the functional brain network underlying WM. Copyright © 2013 Elsevier Ltd. All rights reserved.

System level airworthiness tool: A comprehensive approach to small unmanned aircraft system airworthiness

NASA Astrophysics Data System (ADS)

Burke, David A.

One of the pillars of aviation safety is assuring sound engineering practices through airworthiness certification. As Unmanned Aircraft Systems (UAS) grow in popularity, the need for airworthiness standards and verification methods tailored for UAS becomes critical. While airworthiness practices for large UAS may be similar to manned aircraft, it is clear that small UAS require a paradigm shift from the airworthiness practices of manned aircraft. Although small in comparison to manned aircraft these aircraft are not merely remote controlled toys. Small UAS may be complex aircraft flying in the National Airspace System (NAS) over populated areas for extended durations and beyond line of sight of the operators. A comprehensive systems engineering framework for certifying small UAS at the system level is needed. This work presents a point based tool that evaluates small UAS by rewarding good engineering practices in design, analysis, and testing. The airworthiness requirements scale with vehicle size and operational area, while allowing flexibility for new technologies and unique configurations.

Parental feeding practices in families with children aged 2-13 years: Psychometric properties and child age-specific norms of the German version of the Child Feeding Questionnaire (CFQ).

PubMed

Schmidt, Ricarda; Richter, Robert; Brauhardt, Anne; Hiemisch, Andreas; Kiess, Wieland; Hilbert, Anja

2017-02-01

The Child Feeding Questionnaire (CFQ) is a self-report questionnaire for assessing parental attitudes to child weight and parental feeding practices. Previous evaluations of its psychometric properties were conducted primarily with small to medium-sized samples (N < 500) and a small range of children's age. The present study aims to analyze the psychometric properties of the CFQ in a large German community sample and, for the first time, to establish normative data. Within the population-based LIFE Child study, the CFQ was administered to N = 982 mothers of 2- to 13-year-old children. Psychometric analyses on item statistics and internal consistency were conducted. Using structural equation modeling, four empirically-based factorial models of the CFQ were evaluated, and measurement invariance across child age groups and sex was examined. Age-specific norms for the CFQ subscales were computed. Item statistics were highly favorable for the majority of items, but floor and ceiling effects were found for 14 of 31 items. Internal consistency of the CFQ subscales ranged from acceptable to excellent (0.71 ≤ α ≤ 0.91), except for the subscale Perceived Responsibility (α = 0.65). Regarding factorial validity, an eight-factor model with the newly created Reward subscale provided the best fit to the data. This model was factorial invariant across child sex and adjacent age groups. Maternal and child weight status showed large effects on CFQ subscale scores. The analyses established good psychometric properties for the German version of the CFQ and confirmed an eight-factor model. The provided norms allow for the comparison of individual parental feeding practices and change over time. The CFQ's sensitivity to change and longitudinal associations of parental feeding practices and child weight status warrant further research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Confidentiality in participatory research: Challenges from one study.

PubMed

Petrova, Elmira; Dewing, Jan; Camilleri, Michelle

2016-06-01

This article presents key ethical challenges that were encountered when conducting a participatory qualitative research project with a very specific, small group of nurses, in this case with practice development nurses in Malta. With the small number of nurses employed in practice development roles in Malta, there are numerous difficulties of maintaining confidentiality. Poorly constructed interventions by the researcher could have resulted in detrimental effects to research participants and the overall trustworthiness of the research. Generally, ethical guidelines for research exist to reinforce validity of research; however, there is not an established consensus on how these strategies can be utilised in some types of qualitative field work. The researcher used an exploratory case study methodology. The sample consisted of 10 participants who were interviewed twice using face-to-face interviews, over a period of 2 months. The study was ethically reviewed by the University Research Ethics Committee and the Faculty Research Ethics Committee, University of Malta. The participants referred to in this article have been given adequate information about the study and their consent has been obtained. Numerous strategies for ensuring confidentiality during recruitment of the participants, during data collection, during transcription and data analysis and during dissemination of research results assisted the researcher in responding to potential and actual ethical issues. This article emphasises the main strategies that can be used to respond to ethical challenges when researching with a small easily identifiable group. The learning discussed here may be relevant to or even transferable to other similar research studies or research contexts. These methods fostered a greater credibility throughout the research process and predisposed the participants to greater trust, and thus, they disclosed their experiences and speak more freely, thus enhancing the quality of the study. © The Author(s) 2014.

Feasibility of re-biopsy and EGFR mutation analysis in patients with non-small cell lung cancer.

PubMed

Kim, Tae-Ok; Oh, In-Jae; Kho, Bo Gun; Park, Ha Young; Chang, Jin Sun; Park, Cheol-Kyu; Shin, Hong-Joon; Lim, Jung-Hwan; Kwon, Yong-Soo; Kim, Yu-Il; Lim, Sung-Chul; Kim, Young-Chul; Choi, Yoo-Duk

2018-05-14

In cases of EGFR-tyrosine kinase inhibitor (TKI) failure, re-biopsy may be useful to understand resistance mechanisms and guide further treatment decisions. However, performing re-biopsy is challenging because of several hurdles. We assessed the feasibility of re-biopsy in advanced non-small cell lung cancer (NSCLC) patients in real-world clinical practice. We retrospectively reviewed the clinical and pathologic data of advanced NSCLC patients who experienced disease progression after previous treatment with EGFR-TKIs at a single tertiary hospital in Korea between January 2014 and December 2016. Re-biopsy specimens included small biopsy, surgical tissue, or liquid-based cytology. EGFR mutation was tested using peptide nucleic acid-mediated clamping PCR. Of the 230 NSCLC patients that experienced progression after EGFR-TKI therapy, 105 (45.7%) underwent re-biopsy. Re-biopsy was successfully performed in 94 (89.5%) patients, and 11 patients were diagnosed with no malignancy. The complication rate was 8.6%, including seven cases of pneumothorax. EGFR mutation testing was performed on 75 patients using re-biopsy specimens. Of the 57 patients who had sensitizing mutations at diagnosis, T790M mutations were found in 19 (33.3%), while 38 (66.7%) had no T790M mutation. Multivariate analysis showed that the re-biopsy group was younger (P = 0.002) and exhibited a previous response to EGFR-TKIs (P < 0.001). Re-biopsy in advanced NSCLC is feasible in real world clinical practice, particularly in younger patients and those who achieved a previous response to EGFR-TKIs. © 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Fishing Farmers or Farming Fishers? Fishing Typology of Inland Small-Scale Fishing Households and Fisheries Management in Singkarak Lake, West Sumatra, Indonesia

NASA Astrophysics Data System (ADS)

Yuerlita; Perret, Sylvain Roger; Shivakoti, Ganesh P.

2013-07-01

Technical and socio-economic characteristics are known to determine different types of fishers and their livelihood strategies. Faced with declining fish and water resources, small-scale fisheries engage into transformations in livelihood and fishing practices. The paper is an attempt to understand these changes and their socio-economic patterns, in the case of Singkarak Lake in West Sumatra, Indonesia. Based upon the hypothesis that riparian communities have diverse, complex yet structured and dynamic livelihood systems, the paper's main objective is to study, document and model the actual diversity in livelihood, practices and performance of inland small-scale fisheries along the Singkarak Lake, to picture how households are adapted to the situation, and propose an updated, workable model (typology) of those for policy. Principal component analysis and cluster analysis were used to develop a typology of fishing households. The results show that small-scale fishers can be classified into different types characterized by distinct livelihood strategies. Three household types are identified, namely "farming fishers" households (type I, 30 %), "fishing farmers" households (type II, 30 %), and "mainly fishers" households (type III, 40 %). There are significant differences among these groups in the number of boats owned, annual fishing income, agriculture income and farming experience. Type I consists of farming fishers, well equipped, with high fishing costs and income, yet with the lowest return on fishing assets. They are also landowners with farming income, showing the lowest return on land capital. Type II includes poor fishing farmers, landowners with higher farming income; they show the highest return on land asset. They have less fishing equipment, costs and income. Type III (mainly fishers) consists of poorer, younger fishers, with highest return on fishing assets and on fishing costs. They have little land, low farming income, and diversified livelihood sources. The nature of their livelihood strategies is discussed for each identified group. This helps to understand the complexity and diversity of small-scale fishers, particularly in the study area which is still poorly known. This paper concludes with policy implication and possible management initiatives for environmentally prudent policy aiming at improvement of fishers' livelihood.

Fishing farmers or farming fishers? Fishing typology of inland small-scale fishing households and fisheries management in singkarak lake, west sumatra, indonesia.

PubMed

Yuerlita; Perret, Sylvain Roger; Shivakoti, Ganesh P

2013-07-01

Technical and socio-economic characteristics are known to determine different types of fishers and their livelihood strategies. Faced with declining fish and water resources, small-scale fisheries engage into transformations in livelihood and fishing practices. The paper is an attempt to understand these changes and their socio-economic patterns, in the case of Singkarak Lake in West Sumatra, Indonesia. Based upon the hypothesis that riparian communities have diverse, complex yet structured and dynamic livelihood systems, the paper's main objective is to study, document and model the actual diversity in livelihood, practices and performance of inland small-scale fisheries along the Singkarak Lake, to picture how households are adapted to the situation, and propose an updated, workable model (typology) of those for policy. Principal component analysis and cluster analysis were used to develop a typology of fishing households. The results show that small-scale fishers can be classified into different types characterized by distinct livelihood strategies. Three household types are identified, namely "farming fishers" households (type I, 30 %), "fishing farmers" households (type II, 30 %), and "mainly fishers" households (type III, 40 %). There are significant differences among these groups in the number of boats owned, annual fishing income, agriculture income and farming experience. Type I consists of farming fishers, well equipped, with high fishing costs and income, yet with the lowest return on fishing assets. They are also landowners with farming income, showing the lowest return on land capital. Type II includes poor fishing farmers, landowners with higher farming income; they show the highest return on land asset. They have less fishing equipment, costs and income. Type III (mainly fishers) consists of poorer, younger fishers, with highest return on fishing assets and on fishing costs. They have little land, low farming income, and diversified livelihood sources. The nature of their livelihood strategies is discussed for each identified group. This helps to understand the complexity and diversity of small-scale fishers, particularly in the study area which is still poorly known. This paper concludes with policy implication and possible management initiatives for environmentally prudent policy aiming at improvement of fishers' livelihood.

Small enterprise opportunities in municipal solid waste management.

PubMed

Grierson, J P; Brown, A

1999-02-01

Most developing countries are rapidly urbanizing, with growing urban populations fueling demand for more and better urban services which many cities simply cannot provide given the current financial constraints. With the public sector unable to service the needs of expanding cities, small businesses are moving in to fill the vacuum. Such fledgling private sector initiatives have often prevented problems from becoming crises, while also demonstrating that private sector enterprises have an important role to play in meeting the demand for municipal services. Waste collection and processing is an area which could benefit from private sector involvement and greater public-private coordination. The authors examine the progress to date of an action-research initiative led by the Collaborative Group on Municipal Solid Waste Management in Low-income Countries which is developing best practice guidelines for expanding the involvement of micro- and small enterprises in municipal solid waste management.

An Active-Learning Assignment Involving Peer-to-Peer Presentations to Improve Pharmacy Students’ Attitudes and Knowledge of Dietary Supplements

PubMed Central

Singh, Renu F.; Best, Brookie M.; Freedman, Beverley A.; Morello, Candis M.

2012-01-01

Objective. To design and implement a small-group self-guided active-learning format for a complementary and alternative medicine (CAM) curriculum, and assess changes in first-year doctor of pharmacy (PharmD) students' attitudes and knowledge of CAM. Design. Students received an overview CAM lecture from a faculty member, and brief presentations with defined parameters on natural products from their peers. Assessment. Based on pre- and post-intervention survey responses, the percentage of students who strongly agreed about the importance of CAM in pharmacy practice increased from 28% to 55% and the percentage of students who agreed or strongly agreed about the harmful effects of dietary supplements increased from 60% to 96%. Overall, students' attitude toward and self-assessed knowledge of dietary supplements improved significantly from pre- to post-intervention survey. Conclusion. Small-group self-guided learning of CAM, followed by peer presentations on dietary supplements, was successful in significantly improving pharmacy students' attitude toward and knowledge of CAM. PMID:22919089

An active-learning assignment involving peer-to-peer presentations to improve pharmacy students' attitudes and knowledge of dietary supplements.

PubMed

Atayee, Rabia S; Singh, Renu F; Best, Brookie M; Freedman, Beverley A; Morello, Candis M

2012-08-10

To design and implement a small-group self-guided active-learning format for a complementary and alternative medicine (CAM) curriculum, and assess changes in first-year doctor of pharmacy (PharmD) students' attitudes and knowledge of CAM. Students received an overview CAM lecture from a faculty member, and brief presentations with defined parameters on natural products from their peers. Based on pre- and post-intervention survey responses, the percentage of students who strongly agreed about the importance of CAM in pharmacy practice increased from 28% to 55% and the percentage of students who agreed or strongly agreed about the harmful effects of dietary supplements increased from 60% to 96%. Overall, students' attitude toward and self-assessed knowledge of dietary supplements improved significantly from pre- to post-intervention survey. Small-group self-guided learning of CAM, followed by peer presentations on dietary supplements, was successful in significantly improving pharmacy students' attitude toward and knowledge of CAM.

Spatial Pattern and Population Structure of Artemisia ordosica Shrub in a Desert Grassland under Enclosure, Northwest China.

PubMed

Liu, Jiankang; Zhang, Kebin

2018-05-09

Enclosure is an effective practice for restoring and rehabilitating the degraded grassland ecosystem caused by overgrazing. Shrub species, which are dominant in most desert grasslands in arid and semiarid regions, have some beneficial ecological functions for grassland restoration. However, how the population structure and spatial pattern of the Artemisia ordosica shrub changes in a grassland ecosystem under enclosed practice is not well understood. This study, conducted in the Mu Us desert in northwest China, was designed to measure the A. ordosica population according to the chronosequence of enclosure (enclosure periods ranged from 5 years, 10 years, 15 years, and 25 years), contrasting this with an adjacent continuously grazed grassland. The results showed that the enclosed grasslands had a higher number of individuals of different age classes (seedling, adult, aging, and dead group) and greater population coverage, but shrubs had significant lower ( p < 0.05) crown diameter and height in comparison with those in continuously grazed grassland. Further, enclosed grasslands had a significantly higher ( p < 0.05) Shannon-Wiener index (H) and Evenness index (E), but a significantly lower ( p < 0.05) Richness index (R) than continuously grazed grassland. The crown of A. ordosica showed a significant linear positive correlation with height in all plots across succession, indicating that it was feasible to analyze the age structure by crown. The crown-class distribution structure of the A. ordosica population approximated a Gaussian distribution model in all survey plots. Within the population, seedling and adult groups exhibited aggregated spatial distribution at small scales, while aging and dead A. ordosica groups showed random distribution at almost all scales in different plots. The seedling A. ordosica group showed a positive correlation with adults at small scales in all plots except in 10 years of enclosure. However, it showed independent correlation with aging and dead groups at almost all scales. In long-term enclosed plots, the mortality rate of the A. ordosica population increased, therefore assistance management practices, such as fertilization, mowing, interval grazing, and seasonal grazing, must be employed to maintain population stability after long-term enclosure. This study can improve understanding and clarify the effects of enclosures in the desert grasslands of northwest China.

Teachers As Researchers: Improving Practice in Rural and Small Schools. Rural, Small Schools Network Information Exchange: Number 11, Fall 1991.

ERIC Educational Resources Information Center

Regional Laboratory for Educational Improvement of the Northeast & Islands, Andover, MA.

This packet includes reprints of journal articles and other information exploring reflective practice and action research among rural educators. The four sections of the packet cover concepts of reflective practice and action research; examples of reflective practice at both the elementary and secondary levels; issues such as encouraging…

Collaborative Irrationality, Akrasia, and Groupthink: Social Disruptions of Emotion Regulation

PubMed Central

Szanto, Thomas

2017-01-01

The present paper proposes an integrative account of social forms of practical irrationality and corresponding disruptions of individual and group-level emotion regulation (ER). I will especially focus on disruptions in ER by means of collaborative agential and doxastic akrasia. I begin by distinguishing mutual, communal and collaborative forms of akrasia. Such a taxonomy seems all the more needed as, rather surprisingly, in the face of huge philosophical interest in analysing the possibility, structure, and mechanisms of individual practical irrationality, with very little exception, there are no comparable accounts of social and collaborative cases. However, I believe that, if it is true that individual akrasia is, in the long run, harmful for those who entertain it, this is even more so in social contexts. I will illustrate this point by drawing on various small group settings, and explore a number of socio-psychological mechanisms underlying collaborative irrationality, in particular groupthink. Specifically, I suggest that in collaborative cases there is what I call a spiraling of practical irrationality at play. I will argue that this is typically correlated and indeed partly due to biases in individual members’ affect control and eventually the group’s with whom the members identify. PMID:29867617

Focus group interview: an underutilized research technique for improving theory and practice in health education.

PubMed

Basch, C E

1987-01-01

The purpose of this article is to increase awareness about and stimulate interest in using focus group interviews, a qualitative research technique, to advance the state-of-the-art of education and learning about health. After a brief discussion of small group process in health education, features of focus group interviews are presented, and a theoretical framework for planning a focus group study is summarized. Then, literature describing traditional and health-related applications of focus group interviews is reviewed and a synthesis of methodological limitations and advantages of this technique is presented. Implications are discussed regarding: need for more inductive qualitative research in health education; utility of focus group interviews for research and for formative and summative evaluation of health education programs; applicability of marketing research to understanding and influencing consumer behavior, despite notable distinctions between educational initiatives and marketing; and need for professional preparation faculty to consider increasing emphasis on qualitative research methods.

A practical strategy for the accurate measurement of residual dipolar couplings in strongly aligned small molecules

NASA Astrophysics Data System (ADS)

Liu, Yizhou; Cohen, Ryan D.; Martin, Gary E.; Williamson, R. Thomas

2018-06-01

Accurate measurement of residual dipolar couplings (RDCs) requires an appropriate degree of alignment in order to optimize data quality. An overly weak alignment yields very small anisotropic data that are susceptible to measurement errors, whereas an overly strong alignment introduces extensive anisotropic effects that severely degrade spectral quality. The ideal alignment amplitude also depends on the specific pulse sequence used for the coupling measurement. In this work, we introduce a practical strategy for the accurate measurement of one-bond 13C-1H RDCs up to a range of ca. -300 to +300 Hz, corresponding to an alignment that is an order of magnitude stronger than typically employed for small molecule structural elucidation. This strong alignment was generated in the mesophase of the commercially available poly-γ-(benzyl-L-glutamate) polymer. The total coupling was measured by the simple and well-studied heteronuclear two-dimensional J-resolved experiment, which performs well in the presence of strong anisotropic effects. In order to unequivocally determine the sign of the total coupling and resolve ambiguities in assigning total couplings in the CH2 group, coupling measurements were conducted at an isotropic condition plus two anisotropic conditions of different alignment amplitudes. Most RDCs could be readily extracted from these measurements whereas more complicated spectral effects resulting from strong homonuclear coupling could be interpreted either theoretically or by simulation. Importantly, measurement of these very large RDCs actually offers significantly improved data quality and utility for the structure determination of small organic molecules.

Treatment of rabbit cheyletiellosis with selamectin or ivermectin: a retrospective case study

PubMed Central

Mellgren, Marianne; Bergvall, Kerstin

2008-01-01

Background A retrospective study of rabbits treated against cheyletiellosis was performed to evaluate the efficacy and safety of selamectin or ivermectin in clinical practice. Methods Medical records from 53 rabbits with microscopically confirmed Cheyletiella infestation were collected from two small animal clinics. The rabbits were divided into three groups, based on treatment protocols. Group 1 included 11 rabbits treated with ivermectin injections at 200–476 μg kg-1 subcutaneously 2–3 times, with a mean interval of 11 days. In Group 2, 27 rabbits were treated with a combination of subcutaneous ivermectin injections (range 618–2185 μgkg-1) and oral ivermectin (range 616–2732 μgkg-1) administered by the owners, 3–6 times at 10 days interval. The last group (Group 3) included 15 rabbits treated with selamectin spot-on applications of 6.2–20,0 mgkg-1, 1–3 times with an interval of 2–4 weeks. Follow-up time was 4 months–4.5 years. Results Rabbits in remission were 9/11 (81,8%), 14/27 (51,9%) and 12/15 (80,8%) in groups 1, 2 and 3, respectively. Conclusion All treatment protocols seemed to be sufficiently effective and safe for practice use. Though very high doses were used in Group 2 (ivermectin injections followed by oral administration), the protocol seemed less efficacious compared to ivermectin injections (Group 1) and selamectin spot on (Group 3), respectively, although not statistically significant. Controlled prospective studies including larger groups are needed to further evaluate efficacy of the treatment protocols. PMID:18171479

Energetics in robotic flight at small scales

PubMed Central

Kumar, Vijay

2017-01-01

Recent advances in design, sensing and control have led to aerial robots that offer great promise in a range of real-world applications. However, one critical open question centres on how to improve the energetic efficiency of aerial robots so that they can be useful in practical situations. This review paper provides a survey on small-scale aerial robots (i.e. less than 1 m2 area foot print, and less than 3 kg weight) from the point of view of energetics. The paper discusses methods to improve the efficiency of aerial vehicles, and reports on recent findings by the authors and other groups on modelling the impact of aerodynamics for the purpose of building energy-aware motion planners and controllers. PMID:28163880

Energetics in robotic flight at small scales.

PubMed

Karydis, Konstantinos; Kumar, Vijay

2017-02-06

Recent advances in design, sensing and control have led to aerial robots that offer great promise in a range of real-world applications. However, one critical open question centres on how to improve the energetic efficiency of aerial robots so that they can be useful in practical situations. This review paper provides a survey on small-scale aerial robots (i.e. less than 1 m 2 area foot print, and less than 3 kg weight) from the point of view of energetics. The paper discusses methods to improve the efficiency of aerial vehicles, and reports on recent findings by the authors and other groups on modelling the impact of aerodynamics for the purpose of building energy-aware motion planners and controllers.

Evaluation of a Local Anesthesia Simulation Model with Dental Students as Novice Clinicians.

PubMed

Lee, Jessica S; Graham, Roseanna; Bassiur, Jennifer P; Lichtenthal, Richard M

2015-12-01

The aim of this study was to evaluate the use of a local anesthesia (LA) simulation model in a facilitated small group setting before dental students administered an inferior alveolar nerve block (IANB) for the first time. For this pilot study, 60 dental students transitioning from preclinical to clinical education were randomly assigned to either an experimental group (N=30) that participated in a small group session using the simulation model or a control group (N=30). After administering local anesthesia for the first time, students in both groups were given questionnaires regarding levels of preparedness and confidence when administering an IANB and level of anesthesia effectiveness and pain when receiving an IANB. Students in the experimental group exhibited a positive difference on all six questions regarding preparedness and confidence when administering LA to another student. One of these six questions ("I was prepared in administering local anesthesia for the first time") showed a statistically significant difference (p<0.05). Students who received LA from students who practiced on the simulation model also experienced fewer post-injection complications one day after receiving the IANB, including a statistically significant reduction in trismus. No statistically significant difference was found in level of effectiveness of the IANB or perceived levels of pain between the two groups. The results of this pilot study suggest that using a local anesthesia simulation model may be beneficial in increasing a dental student's level of comfort prior to administering local anesthesia for the first time.

Intrauterine Growth Restricted Rats Exercised at Pregnancy: Maternal-Fetal Repercussions.

PubMed

Corvino, S B; Netto, A O; Sinzato, Y K; Campos, K E; Calderon, I M P; Rudge, M V C; Volpato, G T; Zambrano, E; Damasceno, D C

2015-08-01

To evaluate the effect of swimming in pregnant rats born with intrauterine growth restriction (IUGR) and their offspring, IUGR rats were obtained using the streptozotocin-induced severe diabetic (SD) rats. In this study, the nondiabetic parental generation presented 10 rats and diabetic parental generation presented 116 rats. Of these, the mated nondiabetic female rats were 10 and the number of diabetic rats was 45. In relation to term pregnancy, there were 10 animals in the nondiabetic group and 15 rats in the diabetic group. In the offspring of SD rats (IUGR group), 43 females were classified as small for pregnancy age, 19 rats were classified as appropriate for pregnancy age, and 0 female was classified as large for pregnancy age. The nondiabetic and SD pregnant rats generated offspring with appropriate (control [C]) and small (IUGR) weight for pregnancy age, respectively. At adult life, the C group was maintained as nonexercised C group and IUGR rats were distributed into 2 subgroups, namely, nonexercised (IUGR) and exercised (IUGRex). The rate of mated rats in the IUGR group was reduced compared to the C group. During pregnancy, the IUGR rats presented hyperinsulinemia, impaired reproductive outcomes, decreased body weight, hypertriglyceridemia, and hyperlactacidemia. The IUGRex presented reduced insulin and triglyceride levels. Thus, swimming improved lipid metabolism and increased insulin sensitivity. However, the offspring showed retarded growth, reinforcing the need to stimulate the exercise practice in women under supervision with different professional expertise to promote appropriate gestational conditions and improve perinatal outcomes. © The Author(s) 2015.

Feminist pedagogy: a framework for nursing education?

PubMed

Hezekiah, J

1993-02-01

This article describes the feminist pedagogical strategies used in a nursing course in the post-RN Bachelor of Science in Nursing (BScN) program, Aga Khan University, Karachi, Pakistan. A variety of concepts that have direct relevance for nurses were discussed within small groups. These settings provided the venue for an examination of the issues that nurses, as primarily female, face in a patriarchal Muslim society and an androcentric health care system. Emphasis is on the process used in terms of feminist pedagogical practices and its relationship to feminist theory and critical pedagogy. The five process goals suggested by Schniedewind (1983) formed the basis for an exploration of this relationship through an analysis of the content and practices used in the course. It is demonstrated that the teaching practices advocated by feminist pedagogy hold much promise for nursing education to empower nurses and to make an impact on the health care system.

Erich Fromm's Involvement With Zen Buddhism: Psychoanalysts and the Spiritual Quest in Subsequent Decades.

PubMed

Roland, Alan

2017-08-01

The first section of this paper covers Erich Fromm's profound involvement with Zen Buddhism, culminating in his co-authoring the book Zen Buddhism and Psychoanalysis in 1960. It details why this was a groundbreaking endeavor, as it countered the pervasive psychoanalytic denigration of spiritual traditions, practices, and experiences. The second section describes the effect of Fromm's Zen Buddhism and Psychoanalysis on the author of this paper, as he came to clinical psychology and psychoanalysis from involvement in Indian philosophy. The third section is a case study of a spiritually advanced Hindu woman seen in intensive short-term psychoanalytic therapy in Bombay, describing the interface of the spiritual with psychoanalytic therapy. The fourth section explains what eventually led to a sea change in psychoanalytic attitudes toward spiritual traditions and practices, with a small but significant group of psychoanalysts becoming involved in one or another spiritual practice, and working with patients also so involved.

Evidence-based best practices for EGFR T790M testing in lung cancer in Canada.

PubMed

Stockley, T; Souza, C A; Cheema, P K; Melosky, B; Kamel-Reid, S; Tsao, M S; Spatz, A; Karsan, A

2018-04-01

Epidermal growth factor receptor (egfr) tyrosine kinase inhibitors (tkis) are recommended as first-line systemic therapy for patients with non-small-cell lung cancer (nsclc) having mutations in the EGFR gene. Resistance to tkis eventually occurs in all nsclc patients treated with such drugs. In patients with resistance to tkis caused by the EGFR T790M mutation, the third-generation tki osimertinib is now the standard of care. For optimal patient management, accurate EGFR T790M testing is required. A multidisciplinary working group of pathologists, laboratory medicine specialists, medical oncologists, a respirologist, and a thoracic radiologist from across Canada was convened to discuss best practices for EGFR T790M mutation testing in Canada. The group made recommendations in the areas of the testing algorithm and the pre-analytic, analytic, and post-analytic aspects of clinical testing for both tissue testing and liquid biopsy circulating tumour dna testing. The recommendations aim to improve EGFR T790M testing in Canada and to thereby improve patient care.

Canadian Consumer Food Safety Practices and Knowledge: Foodbook Study.

PubMed

Murray, Regan; Glass-Kaastra, Shiona; Gardhouse, Christine; Marshall, Barbara; Ciampa, Nadia; Franklin, Kristyn; Hurst, Matt; Thomas, M Kate; Nesbitt, Andrea

2017-10-01

Understanding consumers' food safety practices and knowledge supports food safety education for the prevention of foodborne illness. The objective of this study was to describe Canadian consumer food safety practices and knowledge. This study identifies demographic groups for targeted food safety education messaging and establishes a baseline measurement to assess the effectiveness of food safety interventions over time. Questions regarding consumer food safety practices and knowledge were included in a population-based telephone survey, Foodbook, conducted from November 2014 to March 2015. The results were analyzed nationally by age group and by gender. The results showed that approximately 90% of Canadians reported taking the recommended cleaning and separating precautions when handling raw meat to prevent foodborne illness. Only 29% of respondents reported using a food thermometer when cooking any meat, and even fewer (12%) reported using a food thermometer for small cuts of meat such as chicken pieces. The majority (>80%) of Canadians were aware of the foodborne illness risks related to chicken and hamburger, but fewer (<40%) were aware of the risks related to frozen chicken nuggets, alfalfa sprouts, soft unpasteurized cheese, and unpasteurized juices. Generally, men were less likely to follow cooking instructions on packaging and took fewer steps to prevent cross-contamination than women. The youngest (18 to 29 years) age group was less likely to take steps to avoid cross-contamination and was less aware of the risks associated with eating an undercooked hamburger. The oldest (60+ years) respondents were less likely to be aware of the risks associated with raw eggs, alfalfa sprouts, and unpasteurized juice than the middle (30 to 59 years) age group. As a priority, food safety education in Canada should focus on increasing people's awareness of high-risk foods, specifically foods for which the awareness of risk found in this study was low; targeting messaging to demographic groups as appropriate; and promoting the use of food thermometers when cooking meat and poultry.

Anxiety management groups in clinical practice.

PubMed

Childs-Clarke, A; Whitfield, W; Cadbury, S; Sandu, S

Anxiety symptoms are commonly reported both in patients and in the general population. There is also increasing concern being expressed over the widespread use of prescribed anxiolytics. This has encouraged the development of psychological interventions for both specific and generalised anxiety. In this paper, 29 patients, most of whom suffered from generalised or free-floating anxiety, were treated in small groups as part of a staff training programme. Their treatment was standardised, and consisted of progressive muscular relaxation, cognitive therapy and an educational input as to the nature of anxiety. Two measures, the Spielberger Trait Scale and an individualised problem rating scale were completed before and after the group and at three months follow-up. All but one of the results was statistically significant. The implications of these results are discussed.

Effects of a multidisciplinary group rehabilitation programme on participation of the visually impaired elderly: a pilot study.

PubMed

Alma, Manna A; Groothoff, Johan W; Melis-Dankers, Bart J M; Post, Marcel W M; Suurmeijer, Theo P B M; van der Mei, Sijrike F

2012-01-01

To pilot test the newly developed multidisciplinary group rehabilitation programme Visually Impaired elderly Persons Participating (VIPP). A single group pretest-posttest design pilot study included 29 visually impaired persons (≥ 55 years). The intervention (20 weekly meetings) consisted of four components (practical training; education, social interaction, counselling and training of problem-solving skills; individual and group goal setting; home-based exercise programme). Participation was assessed with the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) and the Impact on Participation and Autonomy (IPA) questionnaire at baseline, immediately and 6 months after the intervention. At scale level, no statistical significant changes over time were found whereas the effect size indicated small effects for restrictions and satisfaction with participation, and a medium effect for autonomy outdoors. At item level, improvements tended to occur in frequency of housekeeping, in restrictions in housekeeping and outdoor activities and in satisfaction with the partner relationship. Satisfaction with leisure indoors and autonomy regarding using leisure time tended to increase as well. The tentative conclusion of this small-scale pilot study is that the VIPP programme modestly benefits perceived restrictions in participation, satisfaction with participation and autonomy outdoors of the visually impaired elderly. These preliminary findings warrant further investigation.

Untangling nociceptive, neuropathic and neuroplastic mechanisms underlying the biological domain of back pain.

PubMed

Hush, Julia M; Stanton, Tasha R; Siddall, Philip; Marcuzzi, Anna; Attal, Nadine

2013-05-01

SUMMARY Current clinical practice guidelines advocate a model of diagnostic triage for back pain, underpinned by the biopsychosocial paradigm. However, limitations of this clinical model have become apparent: it can be difficult to classify patients into the diagnostic triage categories; patients with 'nonspecific back pain' are clearly not a homogenous group; and mean effects of treatments based on this approach are small. In this article, it is proposed that the biological domain of the biopsychosocial model needs to be reconceptualized using a neurobiological mechanism-based approach. Recent evidence about nociceptive and neuropathic contributors to back pain is outlined in the context of maladaptive neuroplastic changes of the somatosensory system. Implications for clinical practice and research are discussed.

The institutional turn in professional ethics.

PubMed

Thompson, Dennis F

1999-01-01

The traditional ideal in which professionals alone or in small groups serve their patients and clients in accord with a public-spirited goal is giving way to practice in which professionals serve in organizations that value mainly their expertise and expect them to act in accord with the organization's goals. The study of professional ethics has not kept pace with this trend and, as a result, has neglected the institutional aspects of ethical problems. I focus attention on these aspects by considering a case that raises 2 problems that are particularly relevant in the context in which professionals now practice: the problem of representation (whom does the professional act for) and the problem of authority (who has the right to make the policy for the institution).