Recent Reliability Reporting Practices in "Psychological Assessment": Recognizing the People behind the Data

ERIC Educational Resources Information Center

Green, Carlton E.; Chen, Cynthia E.; Helms, Janet E.; Henze, Kevin T.

2011-01-01

Helms, Henze, Sass, and Mifsud (2006) defined good practices for internal consistency reporting, interpretation, and analysis consistent with an alpha-as-data perspective. Their viewpoint (a) expands on previous arguments that reliability coefficients are group-level summary statistics of samples' responses rather than stable properties of scales…

Statistics? You Must Be Joking: The Application and Evaluation of Humor when Teaching Statistics

ERIC Educational Resources Information Center

Neumann, David L.; Hood, Michelle; Neumann, Michelle M.

2009-01-01

Humor has been promoted as a teaching tool that enhances student engagement and learning. The present report traces the pathway from research to practice by reflecting upon various ways to incorporate humor into the face-to-face teaching of statistics. The use of humor in an introductory university statistics course was evaluated via interviews…

A Quantitative Assessment of Utility Reporting Practices for Reporting Electric Power Distribution Events

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

Hamachi La Commare, Kristina

Metrics for reliability, such as the frequency and duration of power interruptions, have been reported by electric utilities for many years. This study examines current utility practices for collecting and reporting electricity reliability information and discusses challenges that arise in assessing reliability because of differences among these practices. The study is based on reliability information for year 2006 reported by 123 utilities in 37 states representing over 60percent of total U.S. electricity sales. We quantify the effects that inconsistencies among current utility reporting practices have on comparisons of System Average Interruption Duration Index (SAIDI) and System Average Interruption Frequency Indexmore » (SAIFI) reported by utilities. We recommend immediate adoption of IEEE Std. 1366-2003 as a consistent method for measuring and reporting reliability statistics.« less

42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.568 Adequate... definitions and accounting, statistics, and reporting practices that are widely accepted in the health care... 42 Public Health 3 2010-10-01 2010-10-01 false Adequate financial records, statistical data, and...

42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., COMPETITIVE MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.568 Adequate... definitions and accounting, statistics, and reporting practices that are widely accepted in the health care... 42 Public Health 3 2011-10-01 2011-10-01 false Adequate financial records, statistical data, and...

A Constructivist Approach in a Blended E-Learning Environment for Statistics

ERIC Educational Resources Information Center

Poelmans, Stephan; Wessa, Patrick

2015-01-01

In this study, we report on the students' evaluation of a self-constructed constructivist e-learning environment for statistics, the compendium platform (CP). The system was built to endorse deeper learning with the incorporation of statistical reproducibility and peer review practices. The deployment of the CP, with interactive workshops and…

Statistical testing of baseline differences in sports medicine RCTs: a systematic evaluation.

PubMed

Peterson, Ross L; Tran, Matthew; Koffel, Jonathan; Stovitz, Steven D

2017-01-01

The CONSORT (Consolidated Standards of Reporting Trials) statement discourages reporting statistical tests of baseline differences between groups in randomised controlled trials (RCTs). However, this practice is still common in many medical fields. Our aim was to determine the prevalence of this practice in leading sports medicine journals. We conducted a comprehensive search in Medline through PubMed to identify RCTs published in the years 2005 and 2015 from 10 high-impact sports medicine journals. Two reviewers independently confirmed the trial design and reached consensus on which articles contained statistical tests of baseline differences. Our search strategy identified a total of 324 RCTs, with 85 from the year 2005 and 239 from the year 2015. Overall, 64.8% of studies (95% CI (59.6, 70.0)) reported statistical tests of baseline differences; broken down by year, this percentage was 67.1% in 2005 (95% CI (57.1, 77.1)) and 64.0% in 2015 (95% CI (57.9, 70.1)). Although discouraged by the CONSORT statement, statistical testing of baseline differences remains highly prevalent in sports medicine RCTs. Statistical testing of baseline differences can mislead authors; for example, by failing to identify meaningful baseline differences in small studies. Journals that ask authors to follow the CONSORT statement guidelines should recognise that many manuscripts are ignoring the recommendation against statistical testing of baseline differences.

Is the statistic value all we should care about in neuroimaging?

PubMed

Chen, Gang; Taylor, Paul A; Cox, Robert W

2017-02-15

Here we address an important issue that has been embedded within the neuroimaging community for a long time: the absence of effect estimates in results reporting in the literature. The statistic value itself, as a dimensionless measure, does not provide information on the biophysical interpretation of a study, and it certainly does not represent the whole picture of a study. Unfortunately, in contrast to standard practice in most scientific fields, effect (or amplitude) estimates are usually not provided in most results reporting in the current neuroimaging publications and presentations. Possible reasons underlying this general trend include (1) lack of general awareness, (2) software limitations, (3) inaccurate estimation of the BOLD response, and (4) poor modeling due to our relatively limited understanding of FMRI signal components. However, as we discuss here, such reporting damages the reliability and interpretability of the scientific findings themselves, and there is in fact no overwhelming reason for such a practice to persist. In order to promote meaningful interpretation, cross validation, reproducibility, meta and power analyses in neuroimaging, we strongly suggest that, as part of good scientific practice, effect estimates should be reported together with their corresponding statistic values. We provide several easily adaptable recommendations for facilitating this process. Published by Elsevier Inc.

Medication safety knowledge, attitudes and practices among community pharmacists in Lebanon.

PubMed

Hajj, Aline; Hallit, Souheil; Ramia, Elsy; Salameh, Pascale

2018-01-01

The effectiveness of a national post-marketing surveillance program depends directly on the active participation of all health professionals. There is no current comprehensive and active pharmacovigilance program available in Lebanon. To assess the knowledge, attitudes, and practices (KAP) among community pharmacists in Lebanon with respect to potential pharmacovigilance and adverse-drug-reaction reporting in Lebanon. A cross-sectional descriptive study, using a self-administered KAP questionnaire and conducted between March and July 2016, included 1857 pharmacists practicing in community settings. Statistical analysis included χ 2 test for dichotomous or multinomial qualitative variables, and Wilcoxon test for quantitative variables with non-homogeneous variances or non-normal distribution. The majority of responders had good knowledge concerning the concept and purpose of pharmacovigilance as well as adverse drug reactions (how to report these/the importance of reporting adverse events/the definition of an adverse event and pharmacovigilance). Concerning community pharmacists' attitudes and practice towards pharmacovigilance, the majority described having a positive attitude towards their role in adverse drug reaction reporting and this activity was even seen as one of their core duties. The questionnaire revealed a lack of practice and training regarding pharmacovigilance. Nonetheless, the pharmacists agreed on the Order of Pharmacists in Lebanon and the Ministry of Health's role in promoting this practice and helping them be more involved in reporting adverse drug reactions (ADRs). The pharmacists thought that they are well positioned regarding patient-safety practice in their pharmacies and the results were not statistically different between pharmacy employers and employees. Lebanese pharmacists have the required knowledge and positive attitude to start reporting ADRs, were aware of ADRs occurring with various medicines post-marketing, yet were currently not able to disseminate this information widely or to record it centrally, emphasizing the importance of establishing a national ADR reporting system.

Perspectives on clinical trial data transparency and disclosure.

PubMed

Alemayehu, Demissie; Anziano, Richard J; Levenstein, Marcia

2014-09-01

The increased demand for transparency and disclosure of data from clinical trials sponsored by pharmaceutical companies poses considerable challenges and opportunities from a statistical perspective. A central issue is the need to protect patient privacy and adhere to Good Clinical and Statistical Practices, while ensuring access to patient-level data from clinical trials to the wider research community. This paper offers options to navigate this dilemma and balance competing priorities, with emphasis on the role of good clinical and statistical practices as proven safeguards for scientific integrity, the importance of adopting best practices for reporting of data from secondary analyses, and the need for optimal collaboration among stakeholders to facilitate data sharing. Copyright © 2014 Elsevier Inc. All rights reserved.

Jordanian twelfth-grade science teachers' self-reported usage of science and engineering practices in the next generation science standards

NASA Astrophysics Data System (ADS)

Malkawi, Amal Reda; Rababah, Ebtesam Qassim

2018-06-01

This study investigated the degree that Science and Engineering Practices (SEPs) criteria from the Next Generation Science Standards (NGSS) were included in self-reported teaching practices of twelfth-grade science teachers in Jordan. This study sampled (n = 315) science teachers recruited from eight different public school directorates. The sample was surveyed using an instrument adapted from Kawasaki (2015). Results found that Jordanian science teachers incorporate (SEPs) in their classroom teaching at only a moderate level. SEPs applied most frequently included 'using the diagram, table or graphic through instructions to clarify the subject of a new science,' and to 'discuss with the students how to interpret the quantitative data from the experiment or investigation'. The practice with the lowest frequency was 'teach a lesson on interpreting statistics or quantitative data,' which was moderately applied. No statistically significant differences at (α = 0.05) were found among these Jordanian science teachers' self-estimations of (SEP) application into their own teaching according to the study's demographic variables (specialisation, educational qualification, teaching experience). However, a statistically significant difference at (α = 0.05) was found among Jordanian high school science teachers' practice means based on gender, with female teachers using SEPs at a higher rate than male teachers.

From micro to mainframe. A practical approach to perinatal data processing.

PubMed

Yeh, S Y; Lincoln, T

1985-04-01

A new, practical approach to perinatal data processing for a large obstetric population is described. This was done with a microcomputer for data entry and a mainframe computer for data reduction. The Screen Oriented Data Access (SODA) program was used to generate the data entry form and to input data into the Apple II Plus computer. Data were stored on diskettes and transmitted through a modern and telephone line to the IBM 370/168 computer. The Statistical Analysis System (SAS) program was used for statistical analyses and report generations. This approach was found to be most practical, flexible, and economical.

Determining Differences in Efficacy of Two Disinfectants Using t-Tests.

ERIC Educational Resources Information Center

Brehm, Michael A.; And Others

1996-01-01

Presents an experiment to compare the effectiveness of 95% ethanol to 20% bleach as disinfectants using t-tests for the statistical analysis of the data. Reports that bleach is a better disinfectant. Discusses the statistical and practical significance of the results. (JRH)

Standard Errors and Confidence Intervals of Norm Statistics for Educational and Psychological Tests.

PubMed

Oosterhuis, Hannah E M; van der Ark, L Andries; Sijtsma, Klaas

2016-11-14

Norm statistics allow for the interpretation of scores on psychological and educational tests, by relating the test score of an individual test taker to the test scores of individuals belonging to the same gender, age, or education groups, et cetera. Given the uncertainty due to sampling error, one would expect researchers to report standard errors for norm statistics. In practice, standard errors are seldom reported; they are either unavailable or derived under strong distributional assumptions that may not be realistic for test scores. We derived standard errors for four norm statistics (standard deviation, percentile ranks, stanine boundaries and Z-scores) under the mild assumption that the test scores are multinomially distributed. A simulation study showed that the standard errors were unbiased and that corresponding Wald-based confidence intervals had good coverage. Finally, we discuss the possibilities for applying the standard errors in practical test use in education and psychology. The procedure is provided via the R function check.norms, which is available in the mokken package.

The Effects of Using a Wiki on Student Engagement and Learning of Report Writing Skills in a University Statistics Course

ERIC Educational Resources Information Center

Neumann, David L.; Hood, Michelle

2009-01-01

A wiki was used as part of a blended learning approach to promote collaborative learning among students in a first year university statistics class. One group of students analysed a data set and communicated the results by jointly writing a practice report using a wiki. A second group analysed the same data but communicated the results in a…

Seeking Explanation in Theory: Reflections on the Social Practices of Organizations that Distribute Public Use Microdata Files for Research Purposes.

ERIC Educational Resources Information Center

Robbin, Alice; Koball, Heather

2001-01-01

Reports findings from a small-scale survey of organizational practices to limit disclosure of confidential information prior to publishing public use microdata files and illustrates how rules for preserving confidentiality were applied in practice. Discusses Internet data security, statistical disclosure limitation (SDL) methods, and improving…

Teacher Quality Indicators as Predictors of Instructional Assessment Practices in Science Classrooms in Secondary Schools in Barbados

ERIC Educational Resources Information Center

Ogunkola, Babalola J.; Archer-Bradshaw, Ramona E.

2013-01-01

This study investigated the self-reported instructional assessment practices of a selected sample of secondary school science teachers in Barbados. The study sought to determine if there were statistically significant differences in the instructional assessment practices of teachers based on their sex and teacher quality (teaching experience,…

Improving Research Clarity and Usefulness with Effect Size Indices as Supplements to Statistical Significance Tests.

ERIC Educational Resources Information Center

Thompson, Bruce

1999-01-01

A study examined effect-size reporting in 23 quantitative articles reported in "Exceptional Children". Findings reveal that effect sizes are rarely being reported, although exemplary reporting practices were also noted. Reasons why encouragement by the American Psychological Association to report effect size has been ineffective are…

48 CFR 1609.7001 - Minimum standards for health benefits carriers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... accordance with 5 CFR 890.204. (1) It must be lawfully engaged in the business of supplying health benefits... and statistical records, and furnish such reasonable financial and statistical reports with respect to... must perform the contract in accordance with prudent business practices. A carrier's sustained poor...

Comparison of lifestyle and practice patterns between male and female Canadian ophthalmologists.

PubMed

McAlister, Chryssa; Jin, Ya-Ping; Braga-Mele, Rosa; DesMarchais, Beatrice F; Buys, Yvonne M

2014-06-01

To identify sex differences in lifestyle and practice patterns of Canadian ophthalmologists. Web-based national survey. Members of the Canadian Ophthalmological Society. A 48-item questionnaire was sent electronically. Analysis of results was completed using χ(2) and Fisher's exact tests where appropriate. Of 385 respondents (30%), 102 were female and 283 male. Several statistically significant differences exist in lifestyle and practice patterns. Fifty-one percent of females operate less than 2 days per month as compared with 36% of males (p = 0.01) despite similar clinical hours. No statistically significant differences were found in other practice pattern parameters including laser refractive surgery, hospital affiliation, university appointment/rank, and number of peer-review publications. Ninety percent of males and 81% of females report having ≥1 children, but males report greater number of children (p < 0.001). Females are commonly the primary caregiver, whereas males report their partner as primary caregiver (p < 0.001). Fifty-two percent of females are unhappy with the amount of parental leave (p < 0.001). Fifty-one percent of females believe that childbearing slowed or markedly slowed career progress, as compared with 15% of males (p < 0.001). Both female (83%) and male (87%) ophthalmologists report high career satisfaction (p = 0.43). Differences in practice patterns between males and females in our analysis surround surgical time, with no difference seen in other practice patterns or academic achievements. Differences in family patterns surround household and childrearing duties. Despite differences, both males and females report high satisfaction across several professional and personal parameters. Compared with previous studies, this suggests a change in practice patterns over time. Copyright © 2014 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Statistical Reporting Errors and Collaboration on Statistical Analyses in Psychological Science.

PubMed

Veldkamp, Coosje L S; Nuijten, Michèle B; Dominguez-Alvarez, Linda; van Assen, Marcel A L M; Wicherts, Jelte M

2014-01-01

Statistical analysis is error prone. A best practice for researchers using statistics would therefore be to share data among co-authors, allowing double-checking of executed tasks just as co-pilots do in aviation. To document the extent to which this 'co-piloting' currently occurs in psychology, we surveyed the authors of 697 articles published in six top psychology journals and asked them whether they had collaborated on four aspects of analyzing data and reporting results, and whether the described data had been shared between the authors. We acquired responses for 49.6% of the articles and found that co-piloting on statistical analysis and reporting results is quite uncommon among psychologists, while data sharing among co-authors seems reasonably but not completely standard. We then used an automated procedure to study the prevalence of statistical reporting errors in the articles in our sample and examined the relationship between reporting errors and co-piloting. Overall, 63% of the articles contained at least one p-value that was inconsistent with the reported test statistic and the accompanying degrees of freedom, and 20% of the articles contained at least one p-value that was inconsistent to such a degree that it may have affected decisions about statistical significance. Overall, the probability that a given p-value was inconsistent was over 10%. Co-piloting was not found to be associated with reporting errors.

Statistical Reporting Errors and Collaboration on Statistical Analyses in Psychological Science

PubMed Central

Veldkamp, Coosje L. S.; Nuijten, Michèle B.; Dominguez-Alvarez, Linda; van Assen, Marcel A. L. M.; Wicherts, Jelte M.

2014-01-01

Statistical analysis is error prone. A best practice for researchers using statistics would therefore be to share data among co-authors, allowing double-checking of executed tasks just as co-pilots do in aviation. To document the extent to which this ‘co-piloting’ currently occurs in psychology, we surveyed the authors of 697 articles published in six top psychology journals and asked them whether they had collaborated on four aspects of analyzing data and reporting results, and whether the described data had been shared between the authors. We acquired responses for 49.6% of the articles and found that co-piloting on statistical analysis and reporting results is quite uncommon among psychologists, while data sharing among co-authors seems reasonably but not completely standard. We then used an automated procedure to study the prevalence of statistical reporting errors in the articles in our sample and examined the relationship between reporting errors and co-piloting. Overall, 63% of the articles contained at least one p-value that was inconsistent with the reported test statistic and the accompanying degrees of freedom, and 20% of the articles contained at least one p-value that was inconsistent to such a degree that it may have affected decisions about statistical significance. Overall, the probability that a given p-value was inconsistent was over 10%. Co-piloting was not found to be associated with reporting errors. PMID:25493918

Common Scientific and Statistical Errors in Obesity Research

PubMed Central

George, Brandon J.; Beasley, T. Mark; Brown, Andrew W.; Dawson, John; Dimova, Rositsa; Divers, Jasmin; Goldsby, TaShauna U.; Heo, Moonseong; Kaiser, Kathryn A.; Keith, Scott; Kim, Mimi Y.; Li, Peng; Mehta, Tapan; Oakes, J. Michael; Skinner, Asheley; Stuart, Elizabeth; Allison, David B.

2015-01-01

We identify 10 common errors and problems in the statistical analysis, design, interpretation, and reporting of obesity research and discuss how they can be avoided. The 10 topics are: 1) misinterpretation of statistical significance, 2) inappropriate testing against baseline values, 3) excessive and undisclosed multiple testing and “p-value hacking,” 4) mishandling of clustering in cluster randomized trials, 5) misconceptions about nonparametric tests, 6) mishandling of missing data, 7) miscalculation of effect sizes, 8) ignoring regression to the mean, 9) ignoring confirmation bias, and 10) insufficient statistical reporting. We hope that discussion of these errors can improve the quality of obesity research by helping researchers to implement proper statistical practice and to know when to seek the help of a statistician. PMID:27028280

Power, effects, confidence, and significance: an investigation of statistical practices in nursing research.

PubMed

Gaskin, Cadeyrn J; Happell, Brenda

2014-05-01

To (a) assess the statistical power of nursing research to detect small, medium, and large effect sizes; (b) estimate the experiment-wise Type I error rate in these studies; and (c) assess the extent to which (i) a priori power analyses, (ii) effect sizes (and interpretations thereof), and (iii) confidence intervals were reported. Statistical review. Papers published in the 2011 volumes of the 10 highest ranked nursing journals, based on their 5-year impact factors. Papers were assessed for statistical power, control of experiment-wise Type I error, reporting of a priori power analyses, reporting and interpretation of effect sizes, and reporting of confidence intervals. The analyses were based on 333 papers, from which 10,337 inferential statistics were identified. The median power to detect small, medium, and large effect sizes was .40 (interquartile range [IQR]=.24-.71), .98 (IQR=.85-1.00), and 1.00 (IQR=1.00-1.00), respectively. The median experiment-wise Type I error rate was .54 (IQR=.26-.80). A priori power analyses were reported in 28% of papers. Effect sizes were routinely reported for Spearman's rank correlations (100% of papers in which this test was used), Poisson regressions (100%), odds ratios (100%), Kendall's tau correlations (100%), Pearson's correlations (99%), logistic regressions (98%), structural equation modelling/confirmatory factor analyses/path analyses (97%), and linear regressions (83%), but were reported less often for two-proportion z tests (50%), analyses of variance/analyses of covariance/multivariate analyses of variance (18%), t tests (8%), Wilcoxon's tests (8%), Chi-squared tests (8%), and Fisher's exact tests (7%), and not reported for sign tests, Friedman's tests, McNemar's tests, multi-level models, and Kruskal-Wallis tests. Effect sizes were infrequently interpreted. Confidence intervals were reported in 28% of papers. The use, reporting, and interpretation of inferential statistics in nursing research need substantial improvement. Most importantly, researchers should abandon the misleading practice of interpreting the results from inferential tests based solely on whether they are statistically significant (or not) and, instead, focus on reporting and interpreting effect sizes, confidence intervals, and significance levels. Nursing researchers also need to conduct and report a priori power analyses, and to address the issue of Type I experiment-wise error inflation in their studies. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Computer use in primary care practices in Canada.

PubMed

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

2017-05-01

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

A decade of individual participant data meta-analyses: A review of current practice.

PubMed

Simmonds, Mark; Stewart, Gavin; Stewart, Lesley

2015-11-01

Individual participant data (IPD) systematic reviews and meta-analyses are often considered to be the gold standard for meta-analysis. In the ten years since the first review into the methodology and reporting practice of IPD reviews was published much has changed in the field. This paper investigates current reporting and statistical practice in IPD systematic reviews. A systematic review was performed to identify systematic reviews that collected and analysed IPD. Data were extracted from each included publication on a variety of issues related to the reporting of IPD review process, and the statistical methods used. There has been considerable growth in the use of "one-stage" methods to perform IPD meta-analyses. The majority of reviews consider at least one covariate other than the primary intervention, either using subgroup analysis or including covariates in one-stage regression models. Random-effects analyses, however, are not often used. Reporting of review methods was often limited, with few reviews presenting a risk-of-bias assessment. Details on issues specific to the use of IPD were little reported, including how IPD were obtained; how data was managed and checked for consistency and errors; and for how many studies and participants IPD were sought and obtained. While the last ten years have seen substantial changes in how IPD meta-analyses are performed there remains considerable scope for improving the quality of reporting for both the process of IPD systematic reviews, and the statistical methods employed in them. It is to be hoped that the publication of the PRISMA-IPD guidelines specific to IPD reviews will improve reporting in this area. Copyright © 2015 Elsevier Inc. All rights reserved.

Randomized clinical trials in implant therapy: relationships among methodological, statistical, clinical, paratextual features and number of citations.

PubMed

Nieri, Michele; Clauser, Carlo; Franceschi, Debora; Pagliaro, Umberto; Saletta, Daniele; Pini-Prato, Giovanpaolo

2007-08-01

The aim of the present study was to investigate the relationships among reported methodological, statistical, clinical and paratextual variables of randomized clinical trials (RCTs) in implant therapy, and their influence on subsequent research. The material consisted of the RCTs in implant therapy published through the end of the year 2000. Methodological, statistical, clinical and paratextual features of the articles were assessed and recorded. The perceived clinical relevance was subjectively evaluated by an experienced clinician on anonymous abstracts. The impact on research was measured by the number of citations found in the Science Citation Index. A new statistical technique (Structural learning of Bayesian Networks) was used to assess the relationships among the considered variables. Descriptive statistics revealed that the reported methodology and statistics of RCTs in implant therapy were defective. Follow-up of the studies was generally short. The perceived clinical relevance appeared to be associated with the objectives of the studies and with the number of published images in the original articles. The impact on research was related to the nationality of the involved institutions and to the number of published images. RCTs in implant therapy (until 2000) show important methodological and statistical flaws and may not be appropriate for guiding clinicians in their practice. The methodological and statistical quality of the studies did not appear to affect their impact on practice and research. Bayesian Networks suggest new and unexpected relationships among the methodological, statistical, clinical and paratextual features of RCTs.

Comparing the Lifetimes of Two Brands of Batteries

ERIC Educational Resources Information Center

Dunn, Peter K.

2013-01-01

In this paper, we report a case study that illustrates the importance in interpreting the results from statistical tests, and shows the difference between practical importance and statistical significance. This case study presents three sets of data concerning the performance of two brands of batteries. The data are easy to describe and…

Work-related musculoskeletal disorders among Brazilian dental students.

PubMed

de Carvalho, Marcus Vitor Diniz; Soriano, Evelyne Pessoa; de França Caldas, Arnaldo; Campello, Reginaldo Inojosa Carneiro; de Miranda, Hênio Ferreira; Cavalcanti, Francisco Ivo Dantas

2009-05-01

The aim of this analytical cross-sectional study was to evaluate the presence of work-related musculoskeletal disorders (WMSD) among dental students in two Brazilian dental schools. The sample included 227 randomized subjects from fifth to ninth semesters who were developing clinical activities. Each student signed an informed consent form. A self-reporting questionnaire was used to obtain data on the practice of physical exercise, the presence of pain during or soon after treating patients, and the adoption of preventive measures related to clinical activities. Results were analyzed using the Statistical Package for Social Sciences 13.0. The chi(2) test was used to identify associations between variables. The presence of pain during or after clinical work was reported by 173 participants (76.2 percent). Statistically significant differences were found between gender and the occurrence of pain. Pain was present during clinical activities (p=0.006) and imposed limitations on the work routine (p=0.011). Among those who practiced physical exercise, eighty-eight (74.6 percent) reported pain. The high percentage of pain reported by dental students suggests the value of reviewing work conditions in dental practices in order to minimize the exposure of all workers to WMSD.

7 CFR 4284.656 - Reporting.

Code of Federal Regulations, 2010 CFR

2010-01-01

... development or application of a “best practice,” to describe that “best practice.” (d) The grantee will..., statistical records, and all other records pertinent to the grant for a period of at least 3 years after grant... representatives, shall have access to any books, documents, papers, and records of the grantee which are pertinent...

Ten Ways to Improve the Use of Statistical Mediation Analysis in the Practice of Child and Adolescent Treatment Research

ERIC Educational Resources Information Center

Maric, Marija; Wiers, Reinout W.; Prins, Pier J. M.

2012-01-01

Despite guidelines and repeated calls from the literature, statistical mediation analysis in youth treatment outcome research is rare. Even more concerning is that many studies that "have" reported mediation analyses do not fulfill basic requirements for mediation analysis, providing inconclusive data and clinical implications. As a result, after…

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

Picard, Richard Roy

Through years of technological improvements, cultural change, advances in statistical theory, revisions of federal government structure and policies, Laboratory re-organizations, offce re-locations, and so on, the practice of statistics at Los Alamos has evolved from its origins in the early 1950s, with a handful of statisticians working in LASL group T-1, to present-day group CCS-6. This report chronicles that history.

Description and evaluation of an initiative to develop advanced practice nurses in mainland China.

PubMed

Wong, Frances Kam Yuet; Peng, Gangyi; Kan, Eva C; Li, Yajie; Lau, Ada T; Zhang, Liying; Leung, Annie F; Liu, Xueqin; Leung, Vilna O; Chen, Weiju; Li, Ming

2010-05-01

This paper describes an initiative to develop Advanced Practice Nurses (APNs) in mainland China and evaluation of the outcomes of the described programme. The pioneer project was an APN postgraduate programme involving 38 students conducted in Guangzhou, China during 2004-2005. Data related to curriculum content and process, student performance, self-reported competence and programme effects were collected. Quantitative data such as demographic data, student performance were analysed using descriptive statistics and the pre and post self-reported practice of competence was compared using chi-square test. Qualitative data such as case reports and interviews were examined using thematic analyses. Reflective journals and case studies revealed the attributes of APNs in managing clinical cases at advanced level, applying theory into practice and exercising evidence-based practice. The relatively modest self-reported practice of competence suggested that the graduates were novice APNs and needed continued development after the completion of the programme. This study reports the experience of an initiative in China and suggests a useful curriculum framework for educating APNs. Copyright 2009 Elsevier Ltd. All rights reserved.

Israeli nurse practice environment characteristics, retention, and job satisfaction.

PubMed

Dekeyser Ganz, Freda; Toren, Orly

2014-02-24

There is an international nursing shortage. Improving the practice environment has been shown to be a successful strategy against this phenomenon, as the practice environment is associated with retention and job satisfaction. The Israeli nurse practice environment has not been measured. The purpose of this study was to measure practice environment characteristics, retention and job satisfaction and to evaluate the association between these variables. A demographic questionnaire, the Practice Environment Scale, and a Job Satisfaction Questionnaire were administered to Israeli acute and intensive care nurses working in 7 hospitals across the country. Retention was measured by intent to leave the organization and work experience. A convenience sample of registered nurses was obtained using a bi-phasic, stratified, cluster design. Data were collected based on the preferences of each unit, either distribution during various shifts or at staff meetings; or via staff mailboxes. Descriptive statistics were used to describe the sample and results of the questionnaires. Pearson Product Moment Correlations were used to determine significant associations among the variables. A multiple regression model was designed where the criterion variable was the practice environment. Analyses of variance determined differences between groups on nurse practice environment characteristics. 610 nurses reported moderate levels of practice environment characteristics, where the lowest scoring characteristic was 'appropriate staffing and resources'. Approximately 9% of the sample reported their intention to leave and the level of job satisfaction was high. A statistically significant, negative, weak correlation was found between intention to leave and practice environment characteristics, with a moderate correlation between job satisfaction and practice environment characteristics. 'Appropriate staffing and resources' was the only characteristic found to be statistically different based on hospital size and geographic region. This study supports the international nature of the vicious cycle that includes a poor quality practice environment, decreased job satisfaction and low nurse retention. Despite the extreme nursing shortage in Israel, perceptions of the practice environment were similar to other countries. Policy makers and hospital managers should address the practice environment, in order to improve job satisfaction and increase retention.

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

PubMed

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

2005-02-01

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

Nurses' readiness for evidence-based practice at Finnish university hospitals: a national survey.

PubMed

Saunders, Hannele; Stevens, Kathleen R; Vehviläinen-Julkunen, Katri

2016-08-01

The aim of this study was to determine nurses' readiness for evidence-based practice at Finnish university hospitals. Although systematic implementation of evidence-based practice is essential to effectively improving patient outcomes and value of care, nurses do not consistently use evidence in practice. Uptake is hampered by lack of nurses' individual and organizational readiness for evidence-based practice. Although nurses' evidence-based practice competencies have been widely studied in countries leading the evidence-based practice movement, less is known about nurses' readiness for evidence-based practice in the non-English-speaking world. A cross-sectional descriptive survey design. The study was conducted in November-December 2014 in every university hospital in Finland with a convenience sample (n = 943) of practicing nurses. The electronic survey data were collected using the Stevens' Evidence-Based Practice Readiness Inventory, which was translated into Finnish according to standardized guidelines for translation of research instruments. The data were analysed using descriptive and inferential statistics. Nurses reported low to moderate levels of self-efficacy and low levels of evidence-based practice knowledge. A statistically significant, direct correlation was found between nurses' self-efficacy in employing evidence-based practice and their actual evidence-based practice knowledge level. Several statistically significant differences were found between nurses' socio-demographic variables and nurses' self-efficacy in employing evidence-based practice, and actual and perceived evidence-based practice knowledge. Finnish nurses at university hospitals are not ready for evidence-based practice. Although nurses are familiar with the concept of evidence-based practice, they lack the evidence-based practice knowledge and self-efficacy in employing evidence-based practice required for integrating best evidence into clinical care delivery. © 2016 John Wiley & Sons Ltd.

50 CFR 600.133 - Scientific and Statistical Committee (SSC).

Code of Federal Regulations, 2010 CFR

2010-10-01

..., and achieving rebuilding targets, and reports on stock status and health, bycatch, habitat status, social and economic impacts of management measures, and sustainability of fishing practices. (c) Members...

American Organization of Nurse Executives Care Innovation and Transformation program: improving care and practice environments.

PubMed

Oberlies, Amanda Stefancyk

2014-09-01

The American Organization of Nurse Executives conducted an evaluation of the hospitals participating in the Care Innovation and Transformation (CIT) program. A total of 24 hospitals participated in the 2-year CIT program from 2012 to 2013. Reported outcomes include increased patient satisfaction, decreased falls, and reductions in nurse turnover and overtime. Nurses reported statistically significant improvements in 4 domains of the principles and elements of a healthful practice environment developed by the Nursing Organizations Alliance.

Computer use in primary care practices in Canada

PubMed Central

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

2017-01-01

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

Cluster randomised controlled trial of a theory-based multiple behaviour change intervention aimed at healthcare professionals to improve their management of type 2 diabetes in primary care.

PubMed

Presseau, Justin; Mackintosh, Joan; Hawthorne, Gillian; Francis, Jill J; Johnston, Marie; Grimshaw, Jeremy M; Steen, Nick; Coulthard, Tom; Brown, Heather; Kaner, Eileen; Elovainio, Marko; Sniehotta, Falko F

2018-05-02

National diabetes audits in the UK show room for improvement in the quality of care delivered to people with type 2 diabetes in primary care. Systematic reviews of quality improvement interventions show that such approaches can be effective but there is wide variability between trials and little understanding concerning what explains this variability. A national cohort study of primary care across 99 UK practices identified modifiable predictors of healthcare professionals' prescribing, advising and foot examination. Our objective was to evaluate the effectiveness of an implementation intervention to improve six guideline-recommended health professional behaviours in managing type 2 diabetes in primary care: prescribing for blood pressure and glycaemic control, providing physical activity and nutrition advice and providing updated diabetes education and foot examination. Two-armed cluster randomised trial involving 44 general practices. Primary outcomes (at 12 months follow-up): from electronic medical records, the proportion of patients receiving additional prescriptions for blood pressure and insulin initiation for glycaemic control and having a foot examination; and from a patient survey of a random sample of 100 patients per practice, reported receipt of updated diabetes education and physical activity and nutrition advice. The implementation intervention did not lead to statistically significant improvement on any of the six clinical behaviours. 1,138,105 prescriptions were assessed. Intervention (29% to 37% patients) and control arms (31% to 35%) increased insulin initiation relative to baseline but were not statistically significantly different at follow-up (IRR 1.18, 95%CI 0.95-1.48). Intervention (45% to 53%) and control practices (45% to 50%) increased blood pressure prescription from baseline to follow-up but were not statistically significantly different at follow-up (IRR 1.05, 95%CI 0.96 to 1.16). Intervention (75 to 78%) and control practices (74 to 79%) increased foot examination relative to baseline; control practices increased statistically significantly more (OR 0.84, 95%CI 0.75-0.94). Fewer patients in intervention (33%) than control practices (40%) reported receiving updated diabetes education (OR = 0.74, 95%CI 0.57-0.97). No statistically significant differences were observed in patient reports of having had a discussion about nutrition (intervention = 73%; control = 72%; OR = 0.98, 95%CI 0.59-1.64) or physical activity (intervention = 57%; control = 62%; OR = 0.79, 95%CI 0.56-1.11). Development and delivery of the intervention cost £1191 per practice. There was no measurable benefit to practices' participation in this intervention. Despite widespread use of outreach interventions worldwide, there is a need to better understand which techniques at which intensity are optimally suited to address the multiple clinical behaviours involved in improving care for type 2 diabetes. ISRCTN, ISRCTN66498413 . Registered April 4, 2013.

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

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

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

Adult Education in Portugal. Adult Education in Europe Studies and Documents No. 16.

ERIC Educational Resources Information Center

Melo, Alberto

This report on Portuguese adult education is focused on the principles and practices adopted by the Directorate-General, due to adult education's present embryonic state. Basic statistics and a brief introduction appear first. Part I, The System of Adult Education, is presented as a succession of initiatives and takes practically the entire length…

How Variances in Business School Rankings Affect Enrollment Trends and Practices

ERIC Educational Resources Information Center

De Veyga, Guillermo A.

2016-01-01

This study examined the effect that variances in the"U.S. News & World Report" rankings have on enrollment trends and practices in both top and non-top 25 business schools. The purpose of this study was to determine whether mobility in the rankings was met with a statistically significant response to the research questions presented.…

A national cross-sectional survey of social networking practices of U.S. anesthesiology residency program directors.

PubMed

Barker, Andrew L; Wehbe-Janek, Hania; Bhandari, Naumit S; Bittenbinder, Timothy M; Jo, ChanHee; McAllister, Russell K

2012-12-01

To determine the social networking practices of directors of anesthesiology residency programs. Cross-sectional survey. Online and paper survey tool. 132 anesthesiology residency program directors in the United States. A 13-item survey including dichotomous and multiple choice responses was administered using an online survey tool and a paper survey. Data analysis was conducted by descriptive and analytical statistics (chi-square test). A P-value < 0.05 indicated statistical significance. 50% of anesthesiology program directors responded to the survey (66/132). Policies governing social networking practices were in place for 30.3% (n=20) of the programs' hospitals. The majority of program directors (81.8%, 54) reported never having had an incident involving reprimand of a resident or fellow for inappropriate social networking practices. The majority (66.7%, n=44) of responding programs reported that departments did not provide lectures or educational activities related to appropriate social networking practices. Monitoring of social networking habits of residents/fellows by program directors mainly occurs if they are alerted to a problem (54.5%, n=36). Frequent use of the Internet for conducting searches on a resident applicant was reported by 12.1% (n=8) of program directors, 30.3% (n=20) reported use a few times, and 57.6% (n=38) reported never using the Internet in this capacity. Residency programs should have a written policy related to social media use. Residency program directors should be encouraged to become familiar with the professionalism issues related to social media use in order to serve as adequate resident mentors within this new and problematic aspect of medical ethics and professionalism. Copyright © 2012 Elsevier Inc. All rights reserved.

Manifesto: towards a clinically-oriented psychometrics.

PubMed

Vickers, Andrew J; Chen, Ling Y

2017-04-26

New technologies to collect patient - reported outcomes have substantially solved the challenge of integrating a questionnaire in a busy clinical practice. At Memorial Sloan Kettering, we have been collecting patient reported outcomes electronically for many years. Our experience confirms the predicted benefits of obtaining patient reported outcomes but has also raised serious concerns about whether instruments developed for the research setting are appropriate for routine clinical use. We summarize four principles for a clinically - relevant psychometrics. First, minimize patient burden: the use of a large number of items for a single domain may be of interest for research but additional items have little clinical utility. Secondly, use simplified language: patients who do not have good language skills are typically excluded from research studies but will nonetheless present in clinical practice. Third, avoid dumb questions: many questionnaire items are inappropriate when applied to a more general population. Fourth, what works for the group may not work for the individual: group level statistics used to validate survey instruments can obscure problems when applied to a subgroup of patients. There is a need for a clinically-oriented psychometrics to help design, test, and evaluate questionnaires that would be used in routine practice. Developing statistical methods to optimize questionnaires will be highly challenging but needed to bring the potential of patient reported outcomes into widespread clinical use.

The challenges for scientific publishing, 60 years on.

PubMed

Hausmann, Laura; Murphy, Sean P

2016-10-01

The most obvious difference in science publishing between 'then' and 'now' is the dramatic change in the communication of data and in their interpretation. The democratization of science via the Internet has brought not only benefits but also challenges to publishing including fraudulent behavior and plagiarism, data and statistics reporting standards, authorship confirmation and other issues which affect authors, readers, and publishers in different ways. The wide accessibility of data on a global scale permits acquisition and meta-analysis to mine for novel synergies, and has created a highly commercialized environment. As we illustrate here, identifying unacceptable practices leads to changes in the standards for data reporting. In the past decades, science publishing underwent dramatic changes in the communication of data and in their interpretation, in the increasing pressure and commercialization, and the democratization of science on a global scale via the Internet. This article reviews the benefits and challenges to publishing including fraudulent behavior and plagiarism, data and statistics reporting standards, authorship confirmation and other issues, with the aim to provide readers with practical examples and hands-on guidelines. As we illustrate here, identifying unacceptable practices leads to changes in the standards for data reporting. This article is part of the 60th Anniversary special issue. © 2016 International Society for Neurochemistry.

A Different Shade Of Blue: An Evaluation Of The Civilian Detective Concept And Its Impact On Police Capabilities

DTIC Science & Technology

2016-03-01

statistics from the California State Controller’s website, the Register reported that while inflation rose 27 percent from years 2003 to 2013, spending on...Recruitment and Retention for the New Millennium, 7. 24 Brian Reaves, Hiring and Retention of State and Local Law Enforcement Officers, 2008— Statistical ...Personnel, Policies, and Practices (NCJ 248677) (Washington, DC: Bureau of Justice Statistics , 2015), 3, http://www.bjs.gov/index.cfm?ty= pbdetail&iid

Use of care management practices in small- and medium-sized physician groups: do public reporting of physician quality and financial incentives matter?

PubMed

Alexander, Jeffrey A; Maeng, Daniel; Casalino, Lawrence P; Rittenhouse, Diane

2013-04-01

To examine the effect of public reporting (PR) and financial incentives tied to quality performance on the use of care management practices (CMPs) among small- and medium-sized physician groups. Survey data from The National Study of Small and Medium-sized Physician Practices were used. Primary data collection was also conducted to assess community-level PR activities. The final sample included 643 practices engaged in quality reporting; about half of these practices were subject to PR. We used a treatment effects model. The instrumental variables were the community-level variables that capture the level of PR activity in each community in which the practices operate. (1) PR is associated with increased use of CMPs, but the estimate is not statistically significant; (2) financial incentives are associated with greater use of CMPs; (3) practices' awareness/sensitivity to quality reports is positively related to their use of CMPs; and (4) combined PR and financial incentives jointly affect CMP use to a greater degree than either of these factors alone. Small- to medium-sized practices appear to respond to PR and financial incentives by greater use of CMPs. Future research needs to investigate the appropriate mix and type of incentive arrangements and quality reporting. © Health Research and Educational Trust.

Considerations for the design, analysis and presentation of in vivo studies.

PubMed

Ranstam, J; Cook, J A

2017-03-01

To describe, explain and give practical suggestions regarding important principles and key methodological challenges in the study design, statistical analysis, and reporting of results from in vivo studies. Pre-specifying endpoints and analysis, recognizing the common underlying assumption of statistically independent observations, performing sample size calculations, and addressing multiplicity issues are important parts of an in vivo study. A clear reporting of results and informative graphical presentations of data are other important parts. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Forensic genetic analyses in isolated populations with examples of central European Valachs and Roma.

PubMed

Ehler, Edvard; Vanek, Daniel

2017-05-01

Isolated populations present a constant threat to the correctness of forensic genetic casework. In this review article we present several examples of how analyzing samples from isolated populations can bias the results of the forensic statistics and analyses. We select our examples from isolated populations from central and southeastern Europe, namely the Valachs and the European Roma. We also provide the reader with general strategies and principles to improve the laboratory practice (best practice) and reporting of samples from supposedly isolated populations. These include reporting the precise population data used for computing the forensic statistics, using the appropriate θ correction factor for calculating allele frequencies, typing ancestry informative markers in samples of unknown or uncertain ethnicity and establishing ethnic-specific forensic databases. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of quality of life outcome measures in clinical practice.

PubMed

Janicak, Philip G; Dunner, David L; Aaronson, Scott T; Carpenter, Linda L; Boyadjis, Terrence A; Brock, David G; Cook, Ian A; Lanocha, Karl; Solvason, Hugh B; Bonneh-Barkay, Dafna; Demitrack, Mark A

2013-12-01

Transcranial magnetic stimulation (TMS) is an effective and safe therapy for major depressive disorder (MDD). This study assessed quality of life (QOL) and functional status outcomes for depressed patients after an acute course of TMS. Forty-two, U.S.-based, clinical TMS practice sites treated 307 outpatients with a primary diagnosis of MDD and persistent symptoms despite prior adequate antidepressant pharmacotherapy. Treatment parameters were based on individual clinical considerations and followed the labeled procedures for use of the approved TMS device. Patient self-reported QOL outcomes included change in the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the EuroQol 5-Dimensions (EQ-5D) ratings from baseline to end of the acute treatment phase. Statistically significant improvement in functional status on a broad range of mental health and physical health domains was observed on the SF-36 following acute TMS treatment. Similarly, statistically significant improvement in patient-reported QOL was observed on all domains of the EQ-5D and on the General Health Perception and Health Index scores. Improvement on these measures was observed across the entire range of baseline depression symptom severity. These data confirm that TMS is effective in the acute treatment of MDD in routine clinical practice settings. This symptom benefit is accompanied by statistically and clinically meaningful improvements in patient-reported QOL and functional status outcomes.

Efforts to improve international migration statistics: a historical perspective.

PubMed

Kraly, E P; Gnanasekaran, K S

1987-01-01

During the past decade, the international statistical community has made several efforts to develop standards for the definition, collection and publication of statistics on international migration. This article surveys the history of official initiatives to standardize international migration statistics by reviewing the recommendations of the International Statistical Institute, International Labor Organization, and the UN, and reports a recently proposed agenda for moving toward comparability among national statistical systems. Heightening awareness of the benefits of exchange and creating motivation to implement international standards requires a 3-pronged effort from the international statistical community. 1st, it is essential to continue discussion about the significance of improvement, specifically standardization, of international migration statistics. The move from theory to practice in this area requires ongoing focus by migration statisticians so that conformity to international standards itself becomes a criterion by which national statistical practices are examined and assessed. 2nd, the countries should be provided with technical documentation to support and facilitate the implementation of the recommended statistical systems. Documentation should be developed with an understanding that conformity to international standards for migration and travel statistics must be achieved within existing national statistical programs. 3rd, the call for statistical research in this area requires more efforts by the community of migration statisticians, beginning with the mobilization of bilateral and multilateral resources to undertake the preceding list of activities.

Can parent reports serve as a proxy for teacher ratings in medication management of attention-deficit hyperactivity disorder?

PubMed

Lavigne, John V; Dulcan, Mina K; LeBailly, Susan A; Binns, Helen J

2012-05-01

While American Academy of Pediatrics guidelines recommend obtaining symptom reports from both parents and teachers when treating children with attention-deficit hyperactivity disorder (ADHD), information from parents is easier to obtain and practitioners may prefer to rely solely on parent report when managing medications. There are, however, few empirical data on the relationship between parent and teacher reports during medication management of ADHD. This study examined the relationship between parent and teacher reports of symptoms of ADHD during a clinical trial. A study to improve medication management of ADHD was conducted in 24 pediatric practices with 270 children. Children meeting criteria for ADHD were randomized by practice to treatment-as-usual or specialized care groups, with data combined from the groups to examine parent-teacher agreement. Parent and teacher reports on the ADHD Rating Scale-IV were obtained at pretreatment, 4 months, and 12 months follow-up. At each assessment, correlations between parent and teacher ratings were statistically significant, but the magnitudes of the correlations were low, accounting for no more than approximately 17% of the variance between measures. Correlations between change scores on parent and teacher ratings were statistically significant but low for Total and Inattentive scales and not significant for the Hyperactive-Impulsive scale. For agreement on extreme scores, 6 of 9 kappas were statistically significant but all were unacceptably low. Agreement between parent and teacher ratings of symptoms of ADHD is too low for clinicians to rely on parent reports while managing medications. Teacher reports are still needed to ensure optimal management.

A survey of marketing practices by family practice residency programs.

PubMed

Buckley, R L; Presley, R; Barrigar, R

1995-06-01

The purpose of the study reported in this article was to identify marketing practices that are being utilized by family practice residencies in the United States and to differentiate which strategies were felt to be most useful. A survey questionnaire on marketing strategies was mailed to 361 civilian family practice residencies listed in the 1992 Director of Family Practice Residency Programs. A total of 151 questionnaires were returned for a total response rate of 42.1 percent. The results were summarized using descriptive statistics and Chi-square analysis. Family practice residency programs use a number of different strategies to attract patients. The effectiveness of a given program is dependent on local factors, program strengths and the target population desired. The three most useful marketing strategies reported in the survey were HMO listings, emergency department referrals, and patient referrals. The three least effective strategies were health fairs, sports physicals, and school presentations.

Knowledge level of effect size statistics, confidence intervals and meta-analysis in Spanish academic psychologists.

PubMed

Badenes-Ribera, Laura; Frias-Navarro, Dolores; Pascual-Soler, Marcos; Monterde-I-Bort, Héctor

2016-11-01

The statistical reform movement and the American Psychological Association (APA) defend the use of estimators of the effect size and its confidence intervals, as well as the interpretation of the clinical significance of the findings. A survey was conducted in which academic psychologists were asked about their behavior in designing and carrying out their studies. The sample was composed of 472 participants (45.8% men). The mean number of years as a university professor was 13.56 years (SD= 9.27). The use of effect-size estimators is becoming generalized, as well as the consideration of meta-analytic studies. However, several inadequate practices still persist. A traditional model of methodological behavior based on statistical significance tests is maintained, based on the predominance of Cohen’s d and the unadjusted R2/η2, which are not immune to outliers or departure from normality and the violations of statistical assumptions, and the under-reporting of confidence intervals of effect-size statistics. The paper concludes with recommendations for improving statistical practice.

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

ERIC Educational Resources Information Center

Lynton, Edith F.; Seldin, Joel R.

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

Cypriot nurses' knowledge and attitudes towards alternative medicine.

PubMed

Zoe, Roupa; Charalambous, Charalambos; Popi, Sotiropoulou; Maria, Rekleiti; Aris, Vasilopoulos; Agoritsa, Koulouri; Evangelia, Kotrotsiou

2014-02-01

To investigate Cypriot nurses' knowledge and attitude towards alternative treatments. Two hundred randomly selected registered Nurses from public hospitals in Cyprus were administered an anonymous self-report questionnaire with closed-type questions. The particular questionnaire has previously been used in similar surveys. Six questions referred to demographic data and 14 questions to attitudes and knowledge towards alternative medicine. One hundred and thirty-eight questionnaires were adequately completed and evaluated. Descriptive and inferential statistics was performed. SPSS 17.0 was used. Statistical significance was set at p < 0.05. Over 1/3 of our sample nurses reported that they had turned to some form of alternative treatment at some point in their lives in order to deal with a certain medical situation. Most of these nurses who reported some knowledge on specific alternative treatment methods, (75.9%) also reported using such methods within their clinical practice. The nurses who had received some form of alternative treatment reported using them more often in their clinical practice, in comparison to those who had never received such treatment (Mann-Whitney U = 1137, p = 0.006). The more frequently nurses used alternative treatment in their clinical practice, the more interested they got in expanding their knowledge on the subject (Pearson's r = 0.250, p = 0.006). Most nurses are familiar with alternative medicine and interested in expanding their knowledge on subject, despite the fact that they do not usually practice it. Special education and training as well as legislative actions are necessary for alternative medicine to be broadly accepted. Copyright © 2013 Elsevier Ltd. All rights reserved.

The influence of journal submission guidelines on authors' reporting of statistics and use of open research practices.

PubMed

Giofrè, David; Cumming, Geoff; Fresc, Luca; Boedker, Ingrid; Tressoldi, Patrizio

2017-01-01

From January 2014, Psychological Science introduced new submission guidelines that encouraged the use of effect sizes, estimation, and meta-analysis (the "new statistics"), required extra detail of methods, and offered badges for use of open science practices. We investigated the use of these practices in empirical articles published by Psychological Science and, for comparison, by the Journal of Experimental Psychology: General, during the period of January 2013 to December 2015. The use of null hypothesis significance testing (NHST) was extremely high at all times and in both journals. In Psychological Science, the use of confidence intervals increased markedly overall, from 28% of articles in 2013 to 70% in 2015, as did the availability of open data (3 to 39%) and open materials (7 to 31%). The other journal showed smaller or much smaller changes. Our findings suggest that journal-specific submission guidelines may encourage desirable changes in authors' practices.

Parent Expectations and Planning for College. Statistical Analysis Report. NCES 2008-079

ERIC Educational Resources Information Center

Lippman, Laura; Guzman, Lina; Keith, Julie Dombrowski; Kinukawa, Akemi; Shwalb, Rebecca; Tice, Peter

2008-01-01

This report uses data from the 2003 National Household Education Surveys Program (NHES) Parent and Family Involvement Survey (PFI) to examine the characteristics associated with the educational expectations parents had for their children and the postsecondary education planning practices families and schools engaged in. The results presented in…

High Impact = High Statistical Standards? Not Necessarily So

PubMed Central

Tressoldi, Patrizio E.; Giofré, David; Sella, Francesco; Cumming, Geoff

2013-01-01

What are the statistical practices of articles published in journals with a high impact factor? Are there differences compared with articles published in journals with a somewhat lower impact factor that have adopted editorial policies to reduce the impact of limitations of Null Hypothesis Significance Testing? To investigate these questions, the current study analyzed all articles related to psychological, neuropsychological and medical issues, published in 2011 in four journals with high impact factors: Science, Nature, The New England Journal of Medicine and The Lancet, and three journals with relatively lower impact factors: Neuropsychology, Journal of Experimental Psychology-Applied and the American Journal of Public Health. Results show that Null Hypothesis Significance Testing without any use of confidence intervals, effect size, prospective power and model estimation, is the prevalent statistical practice used in articles published in Nature, 89%, followed by articles published in Science, 42%. By contrast, in all other journals, both with high and lower impact factors, most articles report confidence intervals and/or effect size measures. We interpreted these differences as consequences of the editorial policies adopted by the journal editors, which are probably the most effective means to improve the statistical practices in journals with high or low impact factors. PMID:23418533

High impact  =  high statistical standards? Not necessarily so.

PubMed

Tressoldi, Patrizio E; Giofré, David; Sella, Francesco; Cumming, Geoff

2013-01-01

What are the statistical practices of articles published in journals with a high impact factor? Are there differences compared with articles published in journals with a somewhat lower impact factor that have adopted editorial policies to reduce the impact of limitations of Null Hypothesis Significance Testing? To investigate these questions, the current study analyzed all articles related to psychological, neuropsychological and medical issues, published in 2011 in four journals with high impact factors: Science, Nature, The New England Journal of Medicine and The Lancet, and three journals with relatively lower impact factors: Neuropsychology, Journal of Experimental Psychology-Applied and the American Journal of Public Health. Results show that Null Hypothesis Significance Testing without any use of confidence intervals, effect size, prospective power and model estimation, is the prevalent statistical practice used in articles published in Nature, 89%, followed by articles published in Science, 42%. By contrast, in all other journals, both with high and lower impact factors, most articles report confidence intervals and/or effect size measures. We interpreted these differences as consequences of the editorial policies adopted by the journal editors, which are probably the most effective means to improve the statistical practices in journals with high or low impact factors.

On a logical basis for division of responsibilities in statistical practice

NASA Technical Reports Server (NTRS)

Deming, W. Edwards

1966-01-01

The purpose of this paper is to explain principles for division of responsibilities between the statistician and the people that he works with, and reasons why this division of responsibilities is important -- that is, how it improves the performance of both statistician and expert in subject-matter. The aim is to find and illustrate principles of practice by which statisticians may make effective use of their knowledge of theory. The specialist in statistical methods may find himself applying the same basic theory in a dozen different fields in a week, rotating through the same projects the next week. Or, he may work day after day primarily in a single substantive field. Either way, he requires rules of practice. A statement of statistical reliability should present any information that might help the reader to form his own opinion concerning the validity of conclusions likely to be drawn from the results. The aim of a statistical report is to protect the client from seeing merely what he would like to see; to protect him from losses that could come from misuse of results. A further aim is to forestall unwarranted claims of accuracy that the client's public might otherwise accept.

Optimizing construction quality management of pavements using mechanistic performance analysis.

DOT National Transportation Integrated Search

2004-08-01

This report presents a statistical-based algorithm that was developed to reconcile the results from several pavement performance models used in the state of practice with systematic process control techniques. These algorithms identify project-specif...

Statistical primer: how to deal with missing data in scientific research?

PubMed

Papageorgiou, Grigorios; Grant, Stuart W; Takkenberg, Johanna J M; Mokhles, Mostafa M

2018-05-10

Missing data are a common challenge encountered in research which can compromise the results of statistical inference when not handled appropriately. This paper aims to introduce basic concepts of missing data to a non-statistical audience, list and compare some of the most popular approaches for handling missing data in practice and provide guidelines and recommendations for dealing with and reporting missing data in scientific research. Complete case analysis and single imputation are simple approaches for handling missing data and are popular in practice, however, in most cases they are not guaranteed to provide valid inferences. Multiple imputation is a robust and general alternative which is appropriate for data missing at random, surpassing the disadvantages of the simpler approaches, but should always be conducted with care. The aforementioned approaches are illustrated and compared in an example application using Cox regression.

HIV/AIDS information by African companies: an empirical analysis.

PubMed

Barako, Dulacha G; Taplin, Ross H; Brown, Alistair M

2010-01-01

This article investigates the extent of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Disclosures (HIV/AIDSD) in online annual reports by 200 listed companies from 10 African countries for the year ending 2006. Descriptive statistics reveal a very low level of overall HIV/AIDSD practices with a mean of 6 per cent disclosure, with half (100 out of 200) of the African companies making no disclosures at all. Logistic regression analysis reveals that company size and country are highly significant predictors of any disclosure of HIV/AIDS in annual reports. Profitability is also statistically significantly associated with the extent of disclosure.

Survey of the Methods and Reporting Practices in Published Meta-analyses of Test Performance: 1987 to 2009

ERIC Educational Resources Information Center

Dahabreh, Issa J.; Chung, Mei; Kitsios, Georgios D.; Terasawa, Teruhiko; Raman, Gowri; Tatsioni, Athina; Tobar, Annette; Lau, Joseph; Trikalinos, Thomas A.; Schmid, Christopher H.

2013-01-01

We performed a survey of meta-analyses of test performance to describe the evolution in their methods and reporting. Studies were identified through MEDLINE (1966-2009), reference lists, and relevant reviews. We extracted information on clinical topics, literature review methods, quality assessment, and statistical analyses. We reviewed 760…

The new statistics: why and how.

PubMed

Cumming, Geoff

2014-01-01

We need to make substantial changes to how we conduct research. First, in response to heightened concern that our published research literature is incomplete and untrustworthy, we need new requirements to ensure research integrity. These include prespecification of studies whenever possible, avoidance of selection and other inappropriate data-analytic practices, complete reporting, and encouragement of replication. Second, in response to renewed recognition of the severe flaws of null-hypothesis significance testing (NHST), we need to shift from reliance on NHST to estimation and other preferred techniques. The new statistics refers to recommended practices, including estimation based on effect sizes, confidence intervals, and meta-analysis. The techniques are not new, but adopting them widely would be new for many researchers, as well as highly beneficial. This article explains why the new statistics are important and offers guidance for their use. It describes an eight-step new-statistics strategy for research with integrity, which starts with formulation of research questions in estimation terms, has no place for NHST, and is aimed at building a cumulative quantitative discipline.

Assessment of practices, capacities and incentives of poultry chain actors in implementation of highly pathogenic avian influenza mitigation measures in Ghana.

PubMed

Turkson, Paa Kobina; Okike, Iheanacho

2016-02-01

The animal health services-seeking behaviour of animal owners related to prevention and control of animal diseases may influence their decisions as to whether or not to use services provided by the public or private sectors. The specific objective of this paper was to assess the practices, capacities and incentives of actors involved in highly pathogenic avian influenza (HPAI) control to provide information for prevention and control in Ghana. Questionnaires were designed based on specific practices, incentives and capacities associated with each mitigation measure that was being assessed. Two peacetime preventive mitigation measures (biosecurity and reporting) and two outbreak containment measures (culling with compensation and movement control) were selected for evaluation. Supply chain actors were characterised based on baseline information. Tables were generated showing proportions of respondents in the various response categories in Likert-scale type itemised questionnaire. Mean scores (and their standard deviations) for the various actors with regard to mitigation measures were calculated. Pair-wise comparisons were done using t -ratio statistic and significance of differences were determined at a Bonferroni adjusted P -value of 0.0024. The study found statistically significant differences between certain actors for practices (biosecurity, reporting, culling and compensation and movement controls), incentives (reporting and movement control) and capacities (reporting and movement control). The findings provide lessons to help improve education and messages on HPAI and to help provide technical assistance targeted at specific actors to prevent and control future HPAI H5N1 outbreaks in Ghana.

The Australasian Resuscitation in Sepsis Evaluation (ARISE) trial statistical analysis plan.

PubMed

Delaney, Anthony P; Peake, Sandra L; Bellomo, Rinaldo; Cameron, Peter; Holdgate, Anna; Howe, Belinda; Higgins, Alisa; Presneill, Jeffrey; Webb, Steve

2013-09-01

The Australasian Resuscitation in Sepsis Evaluation (ARISE) study is an international, multicentre, randomised, controlled trial designed to evaluate the effectiveness of early goal-directed therapy compared with standard care for patients presenting to the emergency department with severe sepsis. In keeping with current practice, and considering aspects of trial design and reporting specific to non-pharmacological interventions, our plan outlines the principles and methods for analysing and reporting the trial results. The document is prepared before completion of recruitment into the ARISE study, without knowledge of the results of the interim analysis conducted by the data safety and monitoring committee and before completion of the two related international studies. Our statistical analysis plan was designed by the ARISE chief investigators, and reviewed and approved by the ARISE steering committee. We reviewed the data collected by the research team as specified in the study protocol and detailed in the study case report form. We describe information related to baseline characteristics, characteristics of delivery of the trial interventions, details of resuscitation, other related therapies and other relevant data with appropriate comparisons between groups. We define the primary, secondary and tertiary outcomes for the study, with description of the planned statistical analyses. We have developed a statistical analysis plan with a trial profile, mock-up tables and figures. We describe a plan for presenting baseline characteristics, microbiological and antibiotic therapy, details of the interventions, processes of care and concomitant therapies and adverse events. We describe the primary, secondary and tertiary outcomes with identification of subgroups to be analysed. We have developed a statistical analysis plan for the ARISE study, available in the public domain, before the completion of recruitment into the study. This will minimise analytical bias and conforms to current best practice in conducting clinical trials.

Family-centred care delivery: comparing models of primary care service delivery in Ontario.

PubMed

Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

2013-11-01

To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Cross-sectional study. Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. A total of 137 practices, 363 providers, and 5144 patients. Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC.

Mental health and debt collection: a story of progress? Exploring changes in debt collectors' attitudes and practices when working with customers with mental health problems, 2010-2016.

PubMed

Evans, Jamie; Fitch, Christopher; Collard, Sharon; Henderson, Claire

2018-04-27

In recent years, the UK debt collection industry has taken steps to improve its policies and practices in relation to customers with mental health problems. Little data, however, have been collected to evidence change. This paper examines whether the reported attitudes and practices of debt collection staff when working with customers with mental health problems have changed between 2010 and 2016. This paper draws on descriptive and regression analyses of two cross-sectional surveys of debt collection staff: one conducted in 2010 and one conducted in 2016. All variables analysed show statistically significant changes between 2010 and 2016 indicative of improved reported attitudes and practices. While results suggest an improvement in attitudes and practice may have occurred between 2010 and 2016, research is required to understand this potential shift, its likely causes, and concrete impact on customers.

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

PubMed

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

2013-11-01

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

Using basic statistics on the individual patient's own numeric data.

PubMed

Hart, John

2012-12-01

This theoretical report gives an example for how coefficient of variation (CV) and quartile analysis (QA) to assess outliers might be able to be used to analyze numeric data in practice for an individual patient. A patient was examined for 8 visits using infrared instrumentation for measurement of mastoid fossa temperature differential (MFTD) readings. The CV and QA were applied to the readings. The participant also completed the Short Form-12 health perception survey on each visit, and these findings were correlated with CV to determine if CV had outcomes support (clinical significance). An outlier MFTD reading was observed on the eighth visit according to QA that coincided with the largest CV value for the MFTDs. Correlations between the Short Form-12 and CV were low to negligible, positive, and statistically nonsignificant. This case provides an example of how basic statistical analyses could possibly be applied to numerical data in chiropractic practice for an individual patient. This might add objectivity to analyzing an individual patient's data in practice, particularly if clinical significance of a clinical numerical finding is unknown.

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

PubMed

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

2016-01-01

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

Measuring the statistical validity of summary meta-analysis and meta-regression results for use in clinical practice.

PubMed

Willis, Brian H; Riley, Richard D

2017-09-20

An important question for clinicians appraising a meta-analysis is: are the findings likely to be valid in their own practice-does the reported effect accurately represent the effect that would occur in their own clinical population? To this end we advance the concept of statistical validity-where the parameter being estimated equals the corresponding parameter for a new independent study. Using a simple ('leave-one-out') cross-validation technique, we demonstrate how we may test meta-analysis estimates for statistical validity using a new validation statistic, Vn, and derive its distribution. We compare this with the usual approach of investigating heterogeneity in meta-analyses and demonstrate the link between statistical validity and homogeneity. Using a simulation study, the properties of Vn and the Q statistic are compared for univariate random effects meta-analysis and a tailored meta-regression model, where information from the setting (included as model covariates) is used to calibrate the summary estimate to the setting of application. Their properties are found to be similar when there are 50 studies or more, but for fewer studies Vn has greater power but a higher type 1 error rate than Q. The power and type 1 error rate of Vn are also shown to depend on the within-study variance, between-study variance, study sample size, and the number of studies in the meta-analysis. Finally, we apply Vn to two published meta-analyses and conclude that it usefully augments standard methods when deciding upon the likely validity of summary meta-analysis estimates in clinical practice. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

Are general practice characteristics predictors of good glycaemic control in patients with diabetes? A cross-sectional study.

PubMed

Esterman, Adrian J; Fountaine, Tim; McDermott, Robyn

2016-01-18

To determine whether certain characteristics of general practices are associated with good glycaemic control in patients with diabetes and with completing an annual cycle of care (ACC). Our cross-sectional analysis used baseline data from the Australian Diabetes Care Project conducted between 2011 and 2014. Practice characteristics were self-reported. Characteristics of the patients that were assessed included glycaemic control (HbA1c level ≤ 53 mmol/mol), age, sex, duration of diabetes, socio-economic disadvantage (SEIFA) score, the complexity of the patient's condition, and whether the patient had completed an ACC for diabetes in the past 18 months. Clustered logistic regression was used to establish predictors of glycaemic control and a completed ACC. Data were available from 147 general practices and 5455 patients with established type 1 or type 2 diabetes in three Australian states. After adjustment for other patient characteristics, only the patient completing an ACC was statistically significant as a predictor of glycaemic control (P = 0.011). In a multivariate model, the practice having a chronic disease-focused practice nurse (P = 0.036) and running educational events for patients with diabetes (P = 0.004) were statistically significant predictors of the patient having complete an ACC. Patient characteristics are moderately good predictors of whether the patient is in glycaemic control, whereas practice characteristics appear to predict only the likelihood of patients completing an ACC. The ACC is an established indicator of good diabetes management. This is the first study to report a positive association between having completed an ACC and the patient being in glycaemic control.

Researchers’ Intuitions About Power in Psychological Research

PubMed Central

Bakker, Marjan; Hartgerink, Chris H. J.; Wicherts, Jelte M.; van der Maas, Han L. J.

2016-01-01

Many psychology studies are statistically underpowered. In part, this may be because many researchers rely on intuition, rules of thumb, and prior practice (along with practical considerations) to determine the number of subjects to test. In Study 1, we surveyed 291 published research psychologists and found large discrepancies between their reports of their preferred amount of power and the actual power of their studies (calculated from their reported typical cell size, typical effect size, and acceptable alpha). Furthermore, in Study 2, 89% of the 214 respondents overestimated the power of specific research designs with a small expected effect size, and 95% underestimated the sample size needed to obtain .80 power for detecting a small effect. Neither researchers’ experience nor their knowledge predicted the bias in their self-reported power intuitions. Because many respondents reported that they based their sample sizes on rules of thumb or common practice in the field, we recommend that researchers conduct and report formal power analyses for their studies. PMID:27354203

Researchers' Intuitions About Power in Psychological Research.

PubMed

Bakker, Marjan; Hartgerink, Chris H J; Wicherts, Jelte M; van der Maas, Han L J

2016-08-01

Many psychology studies are statistically underpowered. In part, this may be because many researchers rely on intuition, rules of thumb, and prior practice (along with practical considerations) to determine the number of subjects to test. In Study 1, we surveyed 291 published research psychologists and found large discrepancies between their reports of their preferred amount of power and the actual power of their studies (calculated from their reported typical cell size, typical effect size, and acceptable alpha). Furthermore, in Study 2, 89% of the 214 respondents overestimated the power of specific research designs with a small expected effect size, and 95% underestimated the sample size needed to obtain .80 power for detecting a small effect. Neither researchers' experience nor their knowledge predicted the bias in their self-reported power intuitions. Because many respondents reported that they based their sample sizes on rules of thumb or common practice in the field, we recommend that researchers conduct and report formal power analyses for their studies. © The Author(s) 2016.

Identifying biologically relevant differences between metagenomic communities.

PubMed

Parks, Donovan H; Beiko, Robert G

2010-03-15

Metagenomics is the study of genetic material recovered directly from environmental samples. Taxonomic and functional differences between metagenomic samples can highlight the influence of ecological factors on patterns of microbial life in a wide range of habitats. Statistical hypothesis tests can help us distinguish ecological influences from sampling artifacts, but knowledge of only the P-value from a statistical hypothesis test is insufficient to make inferences about biological relevance. Current reporting practices for pairwise comparative metagenomics are inadequate, and better tools are needed for comparative metagenomic analysis. We have developed a new software package, STAMP, for comparative metagenomics that supports best practices in analysis and reporting. Examination of a pair of iron mine metagenomes demonstrates that deeper biological insights can be gained using statistical techniques available in our software. An analysis of the functional potential of 'Candidatus Accumulibacter phosphatis' in two enhanced biological phosphorus removal metagenomes identified several subsystems that differ between the A.phosphatis stains in these related communities, including phosphate metabolism, secretion and metal transport. Python source code and binaries are freely available from our website at http://kiwi.cs.dal.ca/Software/STAMP CONTACT: beiko@cs.dal.ca Supplementary data are available at Bioinformatics online.

Parenting practices and adolescent depressive symptoms in Chinese American families.

PubMed

Kim, S Y; Ge, X

2000-09-01

This study examined parenting practices and adolescent depressive symptoms among Chinese Americans. First, confirmatory factor analyses revealed that self-reported parenting practices by mothers and fathers and adolescent perception of parenting practices loaded adequately on three subscales: Inductive Reasoning, Monitoring, and Harsh Discipline. Second, parents' depressive symptoms were related to disrupted parenting practices, which, in turn, were significantly related to the negative evaluation of these behaviors by the adolescents. Adolescents' perceptions of such parenting practices were significantly associated with their depressive symptoms. Third, the relationships were robust even after parental income, education, and generation status were statistically controlled. Overall, the relationships between parenting practices and adolescent depressive symptoms among Chinese Americans seemed to echo those found among European Americans.

The kappa statistic in rehabilitation research: an examination.

PubMed

Tooth, Leigh R; Ottenbacher, Kenneth J

2004-08-01

The number and sophistication of statistical procedures reported in medical rehabilitation research is increasing. Application of the principles and methods associated with evidence-based practice has contributed to the need for rehabilitation practitioners to understand quantitative methods in published articles. Outcomes measurement and determination of reliability are areas that have experienced rapid change during the past decade. In this study, distinctions between reliability and agreement are examined. Information is presented on analytical approaches for addressing reliability and agreement with the focus on the application of the kappa statistic. The following assumptions are discussed: (1) kappa should be used with data measured on a categorical scale, (2) the patients or objects categorized should be independent, and (3) the observers or raters must make their measurement decisions and judgments independently. Several issues related to using kappa in measurement studies are described, including use of weighted kappa, methods of reporting kappa, the effect of bias and prevalence on kappa, and sample size and power requirements for kappa. The kappa statistic is useful for assessing agreement among raters, and it is being used more frequently in rehabilitation research. Correct interpretation of the kappa statistic depends on meeting the required assumptions and accurate reporting.

Recommendations for evaluation of computational methods

NASA Astrophysics Data System (ADS)

Jain, Ajay N.; Nicholls, Anthony

2008-03-01

The field of computational chemistry, particularly as applied to drug design, has become increasingly important in terms of the practical application of predictive modeling to pharmaceutical research and development. Tools for exploiting protein structures or sets of ligands known to bind particular targets can be used for binding-mode prediction, virtual screening, and prediction of activity. A serious weakness within the field is a lack of standards with respect to quantitative evaluation of methods, data set preparation, and data set sharing. Our goal should be to report new methods or comparative evaluations of methods in a manner that supports decision making for practical applications. Here we propose a modest beginning, with recommendations for requirements on statistical reporting, requirements for data sharing, and best practices for benchmark preparation and usage.

Diagnostic proficiency and reporting of Lassa fever by physicians in Osun State of Nigeria.

PubMed

Olowookere, Samuel Anu; Fatiregun, Akinola Ayoola; Gbolahan, Olalere Omoyosola; Adepoju, Ebenezer Gbenga

2014-06-20

Lassa fever is highly contagious and commonly results in death. It is therefore necessary to diagnose and report any suspected case of Lassa fever to facilitate preventive strategies. This study assessed the preparedness of physicians in the diagnosis and reporting of Lassa fever. The study design was descriptive cross-sectional. The consenting medical doctors completed a self-administered questionnaire on the diagnosis and reporting of Lassa fever. Descriptive and inferential statistics were used in data analyses. One hundred seventy-five physicians participated in the study. The mean age was 41.5 ± 10.9 years (range, 24-75 years). Most of the physicians were male (78.9%) and had practiced medicine ≥ 20 years (51.5%). Most of the physicians had a good knowledge regarding the diagnosis and reporting of Lassa fever; however, none of the physicians had ever diagnosed or reported a suspected case. Predictors of good knowledge include male sex, not practicing at a secondary health care level and post graduation year more than 20 years. There is disparity in knowledge and practices of physicians regarding the diagnosis and reporting of Lassa fever. Thus, it is necessary to improve the knowledge and practices of physicians regarding the diagnosis and reporting of Lassa fever.

Primer of statistics in dental research: part I.

PubMed

Shintani, Ayumi

2014-01-01

Statistics play essential roles in evidence-based dentistry (EBD) practice and research. It ranges widely from formulating scientific questions, designing studies, collecting and analyzing data to interpreting, reporting, and presenting study findings. Mastering statistical concepts appears to be an unreachable goal among many dental researchers in part due to statistical authorities' limitations of explaining statistical principles to health researchers without elaborating complex mathematical concepts. This series of 2 articles aim to introduce dental researchers to 9 essential topics in statistics to conduct EBD with intuitive examples. The part I of the series includes the first 5 topics (1) statistical graph, (2) how to deal with outliers, (3) p-value and confidence interval, (4) testing equivalence, and (5) multiplicity adjustment. Part II will follow to cover the remaining topics including (6) selecting the proper statistical tests, (7) repeated measures analysis, (8) epidemiological consideration for causal association, and (9) analysis of agreement. Copyright © 2014. Published by Elsevier Ltd.

Toward standardized reporting for a cohort study on functioning: The Swiss Spinal Cord Injury Cohort Study.

PubMed

Prodinger, Birgit; Ballert, Carolina S; Brach, Mirjam; Brinkhof, Martin W G; Cieza, Alarcos; Hug, Kerstin; Jordan, Xavier; Post, Marcel W M; Scheel-Sailer, Anke; Schubert, Martin; Tennant, Alan; Stucki, Gerold

2016-02-01

Functioning is an important outcome to measure in cohort studies. Clear and operational outcomes are needed to judge the quality of a cohort study. This paper outlines guiding principles for reporting functioning in cohort studies and addresses some outstanding issues. Principles of how to standardize reporting of data from a cohort study on functioning, by deriving scores that are most useful for further statistical analysis and reporting, are outlined. The Swiss Spinal Cord Injury Cohort Study Community Survey serves as a case in point to provide a practical application of these principles. Development of reporting scores must be conceptually coherent and metrically sound. The International Classification of Functioning, Disability and Health (ICF) can serve as the frame of reference for this, with its categories serving as reference units for reporting. To derive a score for further statistical analysis and reporting, items measuring a single latent trait must be invariant across groups. The Rasch measurement model is well suited to test these assumptions. Our approach is a valuable guide for researchers and clinicians, as it fosters comparability of data, strengthens the comprehensiveness of scope, and provides invariant, interval-scaled data for further statistical analyses of functioning.

Statistics, Adjusted Statistics, and Maladjusted Statistics.

PubMed

Kaufman, Jay S

2017-05-01

Statistical adjustment is a ubiquitous practice in all quantitative fields that is meant to correct for improprieties or limitations in observed data, to remove the influence of nuisance variables or to turn observed correlations into causal inferences. These adjustments proceed by reporting not what was observed in the real world, but instead modeling what would have been observed in an imaginary world in which specific nuisances and improprieties are absent. These techniques are powerful and useful inferential tools, but their application can be hazardous or deleterious if consumers of the adjusted results mistake the imaginary world of models for the real world of data. Adjustments require decisions about which factors are of primary interest and which are imagined away, and yet many adjusted results are presented without any explanation or justification for these decisions. Adjustments can be harmful if poorly motivated, and are frequently misinterpreted in the media's reporting of scientific studies. Adjustment procedures have become so routinized that many scientists and readers lose the habit of relating the reported findings back to the real world in which we live.

Statistical Methods for the Analysis of Discrete Choice Experiments: A Report of the ISPOR Conjoint Analysis Good Research Practices Task Force.

PubMed

Hauber, A Brett; González, Juan Marcos; Groothuis-Oudshoorn, Catharina G M; Prior, Thomas; Marshall, Deborah A; Cunningham, Charles; IJzerman, Maarten J; Bridges, John F P

2016-06-01

Conjoint analysis is a stated-preference survey method that can be used to elicit responses that reveal preferences, priorities, and the relative importance of individual features associated with health care interventions or services. Conjoint analysis methods, particularly discrete choice experiments (DCEs), have been increasingly used to quantify preferences of patients, caregivers, physicians, and other stakeholders. Recent consensus-based guidance on good research practices, including two recent task force reports from the International Society for Pharmacoeconomics and Outcomes Research, has aided in improving the quality of conjoint analyses and DCEs in outcomes research. Nevertheless, uncertainty regarding good research practices for the statistical analysis of data from DCEs persists. There are multiple methods for analyzing DCE data. Understanding the characteristics and appropriate use of different analysis methods is critical to conducting a well-designed DCE study. This report will assist researchers in evaluating and selecting among alternative approaches to conducting statistical analysis of DCE data. We first present a simplistic DCE example and a simple method for using the resulting data. We then present a pedagogical example of a DCE and one of the most common approaches to analyzing data from such a question format-conditional logit. We then describe some common alternative methods for analyzing these data and the strengths and weaknesses of each alternative. We present the ESTIMATE checklist, which includes a list of questions to consider when justifying the choice of analysis method, describing the analysis, and interpreting the results. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Female genital mutilation: prevalence, perceptions and effect on women’s health in Kersa district of Ethiopia

PubMed Central

Yirga, Wondimu Shanko; Kassa, Nega Assefa; Gebremichael, Mengistu Welday; Aro, Arja R

2012-01-01

Background Female genital mutilation (FGM) is nontherapeutic surgical modification of the female genitalia. It is an ancient tradition in large parts of Africa, including Ethiopia, especially in the eastern part of the country. This study aimed to identify the prevalence, perceptions, perpetuators, reasons for conducting FGM, and factors associated with this practice with regard to women’s health. Methods Community-based cross-sectional house-to-house interviews were conducted during 2008 among 858 females of reproductive age (15–49 years), in Kersa district, East Hararge, Oromia region, Ethiopia. Proportions and Chi-square tests were used to describe the data and logistic regression was used to describe statistical associations. Statistical significance was set at P < 0.05. Results FGM was reported to be known by 327 (38.5%) of the interviewees. The majority (n = 249, 76.1%) reported that local healers were the main performers of FGM, and 258 (78.9%) respondents stated that the clitoris was the part removed during circumcision. The main reason for the practice of FGM was reduction of female sexual hyperactivity (reported by 198 women [60.3%]). Circumcision of daughters was reported by 288 (88.1%) respondents, and this showed a statistically significant association with the Christian religion (P = 0.003), illiteracy (P = 0.01), and Amhara ethnicity (P = 0.012). The majority of the respondents (792, 92.3%) were themselves circumcised and 68.8% did not know of any health-related problems associated with FGM. Conclusion In spite of FGM being a common practice in the study area, only one third of the respondents stated that they knew about it. Local healers were the main performers of FGM. Some of the women knew about the negative reproductive health effects of FGM and some had also experienced these themselves. However, only a few had tried to stop the practice and the majority had taken no steps to do so. This may be attributable to the fear of becoming alienated from the cultural system and fear of isolation. PMID:22371659

Power Analysis Software for Educational Researchers

ERIC Educational Resources Information Center

Peng, Chao-Ying Joanne; Long, Haiying; Abaci, Serdar

2012-01-01

Given the importance of statistical power analysis in quantitative research and the repeated emphasis on it by American Educational Research Association/American Psychological Association journals, the authors examined the reporting practice of power analysis by the quantitative studies published in 12 education/psychology journals between 2005…

Review of Well Operator Files for Hydraulically Fractured Oil and Gas Production Wells: Well Design and Construction Fact Sheet

EPA Pesticide Factsheets

EPA reviewed a statistically representative sample of oil and gas production wells reported by nine service companies to help understand the role of well design and construction practices preventing pathways for subsurface fluid movement.

Family-centred care delivery

PubMed Central

Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

2013-01-01

Abstract Objective To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Design Cross-sectional study. Setting Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. Participants A total of 137 practices, 363 providers, and 5144 patients. Main outcome measures Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Results Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Conclusion Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC. PMID:24235195

STRengthening analytical thinking for observational studies: the STRATOS initiative.

PubMed

Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

2014-12-30

The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even 'standard' analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. © 2014 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

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

ERIC Educational Resources Information Center

BURKET, GEORGE R.; FLANAGAN, JOHN C.

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

When and why do doctors decide to become general practitioners? Implications for recruitment into UK general practice specialty training.

PubMed

Irish, Bill; Lake, Jonathan

2011-01-01

All applicants to round 1 of national recruitment into the general practice specialty recruitment process were surveyed as to the reasons for, and the timing of their career choices. Most applicants reported decision making after completing undergraduate training citing variety, continuity of care and work-life balance as their main drivers for a career in general practice. Applicants were statistically more likely to have undertaken a Foundation placement in general practice than their peers on a Foundation programme. Reasons for choice of deanery were largely related to location and social ties, rather than to the educational 'reputation' of its programmes.

STRengthening Analytical Thinking for Observational Studies: the STRATOS initiative

PubMed Central

Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

2014-01-01

The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even ‘standard’ analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. PMID:25074480

Equivalent statistics and data interpretation.

PubMed

Francis, Gregory

2017-08-01

Recent reform efforts in psychological science have led to a plethora of choices for scientists to analyze their data. A scientist making an inference about their data must now decide whether to report a p value, summarize the data with a standardized effect size and its confidence interval, report a Bayes Factor, or use other model comparison methods. To make good choices among these options, it is necessary for researchers to understand the characteristics of the various statistics used by the different analysis frameworks. Toward that end, this paper makes two contributions. First, it shows that for the case of a two-sample t test with known sample sizes, many different summary statistics are mathematically equivalent in the sense that they are based on the very same information in the data set. When the sample sizes are known, the p value provides as much information about a data set as the confidence interval of Cohen's d or a JZS Bayes factor. Second, this equivalence means that different analysis methods differ only in their interpretation of the empirical data. At first glance, it might seem that mathematical equivalence of the statistics suggests that it does not matter much which statistic is reported, but the opposite is true because the appropriateness of a reported statistic is relative to the inference it promotes. Accordingly, scientists should choose an analysis method appropriate for their scientific investigation. A direct comparison of the different inferential frameworks provides some guidance for scientists to make good choices and improve scientific practice.

Changing volatility of U.S. annual tornado reports

NASA Astrophysics Data System (ADS)

Tippett, Michael K.

2014-10-01

United States (U.S.) tornado activity results in substantial loss of life and property damage each year. A simple measure of the U.S. tornado climatology is the average number of tornadoes per year. However, even this statistic is elusive because of nonstationary behavior due in large part to changes in reporting practices. Differencing of the annual report data results in a quantity without mean trends and whose standard deviation we denote as volatility, since it is an indication of the likely year-to-year variation in the number of tornadoes reported. While volatility changes detected prior to 2000 can be associated with known reporting practice changes, an increase in volatility in the 2000s across intensity levels cannot. A volatility increase is also seen in a tornado environment index which measures the favorability of atmospheric conditions to tornado activity, providing evidence that the recent increase in tornado report volatility is related to the physical environment.

A Regional Assessment of the Effects of Conservation Practices on In-stream Water Quality

NASA Astrophysics Data System (ADS)

Garcia, A. M.; Alexander, R. B.; Arnold, J.; Norfleet, L.; Robertson, D. M.; White, M.

2011-12-01

The Conservation Effects Assessment Program (CEAP), initiated by USDA Natural Resources Conservation Service (NRCS), has the goal of quantifying the environmental benefits of agricultural conservation practices. As part of this effort, detailed farmer surveys were compiled to document the adoption of conservation practices. Survey data showed that up to 38 percent of cropland in the Upper Mississippi River basin is managed to reduce sediment, nutrient and pesticide loads from agricultural activities. The broader effects of these practices on downstream water quality are challenging to quantify. The USDA-NRCS recently reported results of a study that combined farmer surveys with process-based models to deduce the effect of conservation practices on sediment and chemical loads in farm runoff and downstream waters. As a follow-up collaboration, USGS and USDA scientists conducted a semi-empirical assessment of the same suite of practices using the USGS SPARROW (SPAtially Referenced Regression On Watershed attributes) modeling framework. SPARROW is a hybrid statistical and mechanistic stream water quality model of annual conditions that has been used extensively in studies of nutrient sources and delivery. In this assessment, the USDA simulations of the effects of conservation practices on loads in farm runoff were used as an explanatory variable (i.e., change in farm loads per unit area) in a component of an existing a SPARROW model of the Upper Midwest. The model was then re-calibrated and tested to determine whether the USDA estimate of conservation adoption intensity explained a statistically significant proportion of the spatial variability in stream nutrient loads in the Upper Mississippi River basin. The results showed that the suite of conservation practices that NRCS has catalogued as complete nutrient and sediment management are a statistically significant feature in the Midwestern landscape associated with phosphorous runoff and delivery to downstream waters. Effects on the delivery of nitrogen will be also be studied. Estimates of the magnitude of this effect using SPARROW indicated that phosphorus load reductions ranged from about 2 - 38% for various spatial scales. This is less than reported by the USDA CEAP simulations, which ranged from 15 - 49%. Nevertheless, the results indicated that conservation practices play a significant role in reducing phosphorus pollution from agricultural activities to downstream receiving water bodies.

Accrual and recruitment practices at Clinical and Translational Science Award (CTSA) institutions: a call for expectations, expertise, and evaluation.

PubMed

Kost, Rhonda G; Mervin-Blake, Sabrena; Hallarn, Rose; Rathmann, Charles; Kolb, H Robert; Himmelfarb, Cheryl Dennison; D'Agostino, Toni; Rubinstein, Eric P; Dozier, Ann M; Schuff, Kathryn G

2014-08-01

To respond to increased public and programmatic demand to address underenrollment of clinical translational research studies, the authors examined participant recruitment practices at Clinical and Translational Science Award (CTSA) sites and make recommendations for performance metrics and accountability. The CTSA Recruitment and Retention taskforce in 2010 invited representatives at 46 CTSAs to complete an online 48-question survey querying accrual and recruitment outcomes, practices, evaluation methods, policies, and perceived gaps in related knowledge/practice. Descriptive statistical and thematic analyses were conducted. Forty-six respondents representing 44 CTSAs completed the survey. Recruitment conducted by study teams was the most common practice reported (78%-91%, by study type); 39% reported their institution offered recruitment services to investigators. Respondents valued study feasibility assessment as a successful practice (39%); desired additional resources included feasibility assessments (49%) and participant registries (44%). None reported their institution systematically required justification of feasibility; some indicated relevant information was considered prior to institutional review board (IRB) review (30%) or contract approval (22%). All respondents' IRBs tracked study progress, but only 10% of respondents could report outcome data for timely accrual. Few reported written policies addressing poor accrual or provided data to support recruitment practice effectiveness. Many CTSAs lack the necessary frame work to support study accrual. Recom men dations to enhance accrual include articulating institutional expectations and policy for routine recruitment plan ning; providing recruitment expertise to inform feasibility assessment and recruit ment planning; and developing interdepartmental coordination and integrated informatics infrastructure to drive the conduct, evaluation, and improvement of recruitment practices.

Accrual and Recruitment Practices at Clinical and Translational Science Award (CTSA) Institutions: A Call for Expectations, Expertise, and Evaluation

PubMed Central

Kost, Rhonda G.; Mervin-Blake, Sabrena; Hallarn, Rose; Rathmann, Charles; Kolb, H. Robert; Himmelfarb, Cheryl Dennison; D’Agostino, Toni; Rubinstein, Eric P.; Dozier, Ann M.; Schuff, Kathryn G.

2014-01-01

Purpose To respond to increased public and programmatic demand to address underenrollment of clinical translational research studies, the authors examine participant recruitment practices at Clinical and Translational Science Award sites (CTSAs) and make recommendations for performance metrics and accountability. Method The CTSA Recruitment and Retention taskforce developed and, in 2010, invited representatives at 46 CTSAs to complete an online 48-question survey querying CTSA accrual and recruitment outcomes, practices, evaluation methods, policies, and perceived gaps in related knowledge/practice. Descriptive statistical and thematic analyses were conducted. Results Forty-six respondents representing 44 CTSAs completed the survey. Recruitment conducted by study teams was the most common practice reported (78–91%, by study type); 39% reported their institution offered recruitment services to investigators. Respondents valued study feasibility assessment as a successful practice (39%); their desired additional resources included feasibility assessments (49%) and participant registries (44%). None reported their institution systematically required justification of feasibility; some indicated relevant information was considered prior to IRB review (30%) or contract approval (22%). All respondents’ IRBs tracked study progress, but only 10% of respondents could report outcome data for timely accrual. Few reported written policies addressing poor accrual or provided data to support recruitment practice effectiveness. Conclusions Many CTSAs lack the necessary framework to support study accrual. Recommendations to enhance accrual include articulating institutional expectations and policy for routine recruitment planning; providing recruitment expertise to inform feasibility assessment and recruitment planning; and developing interdepartmental coordination and integrated informatics infrastructure to drive the conduct, evaluation, and improvement of recruitment practices. PMID:24826854

Effects of patient safety culture interventions on incident reporting in general practice: a cluster randomised trial.

PubMed

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

2015-05-01

A constructive safety culture is essential for the successful implementation of patient safety improvements. To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. A three-arm cluster randomised trial was conducted in a mixed method study, studying the effect of administering a patient safety culture questionnaire (intervention I), the questionnaire complemented with a practice-based workshop (intervention II) and no intervention (control) in 30 general practices in the Netherlands. The primary outcome, the number of reported incidents, was measured with a questionnaire at baseline and a year after. Analysis was performed using a negative binomial model. Secondary outcomes were quality and safety indicators and safety culture. Mixed effects linear regression was used to analyse the culture questionnaires. The number of incidents increased in both intervention groups, to 82 and 224 in intervention I and II respectively. Adjusted for baseline number of incidents, practice size and accreditation status, the study showed that practices that additionally participated in the workshop reported 42 (95% confidence interval [CI] = 9.81 to 177.50) times more incidents compared to the control group. Practices that only completed the questionnaire reported 5 (95% CI = 1.17 to 25.49) times more incidents. There were no statistically significant differences in staff perception of patient safety culture at follow-up between the three study groups. Educating staff and facilitating discussion about patient safety culture in their own practice leads to increased reporting of incidents. It is beneficial to invest in a team-wise effort to improve patient safety. © British Journal of General Practice 2015.

Regression assumptions in clinical psychology research practice-a systematic review of common misconceptions.

PubMed

Ernst, Anja F; Albers, Casper J

2017-01-01

Misconceptions about the assumptions behind the standard linear regression model are widespread and dangerous. These lead to using linear regression when inappropriate, and to employing alternative procedures with less statistical power when unnecessary. Our systematic literature review investigated employment and reporting of assumption checks in twelve clinical psychology journals. Findings indicate that normality of the variables themselves, rather than of the errors, was wrongfully held for a necessary assumption in 4% of papers that use regression. Furthermore, 92% of all papers using linear regression were unclear about their assumption checks, violating APA-recommendations. This paper appeals for a heightened awareness for and increased transparency in the reporting of statistical assumption checking.

The other half of the story: effect size analysis in quantitative research.

PubMed

Maher, Jessica Middlemis; Markey, Jonathan C; Ebert-May, Diane

2013-01-01

Statistical significance testing is the cornerstone of quantitative research, but studies that fail to report measures of effect size are potentially missing a robust part of the analysis. We provide a rationale for why effect size measures should be included in quantitative discipline-based education research. Examples from both biological and educational research demonstrate the utility of effect size for evaluating practical significance. We also provide details about some effect size indices that are paired with common statistical significance tests used in educational research and offer general suggestions for interpreting effect size measures. Finally, we discuss some inherent limitations of effect size measures and provide further recommendations about reporting confidence intervals.

Diagnostic proficiency and reporting of Lassa fever by physicians in Osun State of Nigeria

PubMed Central

2014-01-01

Background Lassa fever is highly contagious and commonly results in death. It is therefore necessary to diagnose and report any suspected case of Lassa fever to facilitate preventive strategies. This study assessed the preparedness of physicians in the diagnosis and reporting of Lassa fever. Methods The study design was descriptive cross-sectional. The consenting medical doctors completed a self-administered questionnaire on the diagnosis and reporting of Lassa fever. Descriptive and inferential statistics were used in data analyses. Results One hundred seventy-five physicians participated in the study. The mean age was 41.5 ± 10.9 years (range, 24–75 years). Most of the physicians were male (78.9%) and had practiced medicine ≥ 20 years (51.5%). Most of the physicians had a good knowledge regarding the diagnosis and reporting of Lassa fever; however, none of the physicians had ever diagnosed or reported a suspected case. Predictors of good knowledge include male sex, not practicing at a secondary health care level and post graduation year more than 20 years. Conclusion There is disparity in knowledge and practices of physicians regarding the diagnosis and reporting of Lassa fever. Thus, it is necessary to improve the knowledge and practices of physicians regarding the diagnosis and reporting of Lassa fever. PMID:24950705

Multi-institutional analysis of CT and MRI reports evaluating indeterminate renal masses: comparison to a national survey investigating desired report elements.

PubMed

Hu, Eric M; Zhang, Andrew; Silverman, Stuart G; Pedrosa, Ivan; Wang, Zhen J; Smith, Andrew D; Chandarana, Hersh; Doshi, Ankur; Shinagare, Atul B; Remer, Erick M; Kaffenberger, Samuel D; Miller, David C; Davenport, Matthew S

2018-04-17

To determine the need for a standardized renal mass reporting template by analyzing reports of indeterminate renal masses and comparing their contents to stated preferences of radiologists and urologists. The host IRB waived regulatory oversight for this multi-institutional HIPAA-compliant quality improvement effort. CT and MRI reports created to characterize an indeterminate renal mass were analyzed from 6 community (median: 17 reports/site) and 6 academic (median: 23 reports/site) United States practices. Report contents were compared to a published national survey of stated preferences by academic radiologists and urologists from 9 institutions. Descriptive statistics and Chi-square tests were calculated. Of 319 reports, 85% (271; 192 CT, 79 MRI) reported a possibly malignant mass (236 solid, 35 cystic). Some essential elements were commonly described: size (99% [269/271]), mass type (solid vs. cystic; 99% [268/271]), enhancement (presence vs. absence; 92% [248/271]). Other essential elements had incomplete penetrance: the presence or absence of fat in solid masses (14% [34/236]), size comparisons when available (79% [111/140]), Bosniak classification for cystic masses (54% [19/35]). Preferred but non-essential elements generally were described in less than half of reports. Nephrometry scores usually were not included for local therapy candidates (12% [30/257]). Academic practices were significantly more likely than community practices to include mass characterization details, probability of malignancy, and staging. Community practices were significantly more likely to include management recommendations. Renal mass reporting elements considered essential or preferred often are omitted in radiology reports. Variation exists across radiologists and practice settings. A standardized template may mitigate these inconsistencies.

Business and Practice Management Knowledge Deficiencies in Graduating Orthopedic Residents.

PubMed

Miller, D Joshua; Throckmorton, Thomas W; Azar, Frederick M; Beaty, James H; Canale, S Terry; Richardson, David R

2015-10-01

We conducted a study to determine the general level of knowledge that orthopedic residents have on business and practice management topics at graduation and to evaluate the level of knowledge that practicing orthopedic surgeons need in order to function effectively in a medical practice. Residency graduates from a single training program were asked to complete a survey that gathered demographic information and had surgeons rate their understanding of 9 general business and practice management skills and the importance of these skills in their current practice situation. The amount of necessary business knowledge they lacked at graduation was defined as a functional knowledge deficiency (FKD) and was calculated as the difference between the reported importance of a topic in current practice and the level of understanding of that topic at graduation (larger FKD indicates greater deficiency). Those in physician-managed practices reported significantly higher levels of understanding of economic analytical tools than those in nonphysician-managed practices. There were no other statistically significant differences among groups. Hospital-employed physicians had the lowest overall FKD (4.0), followed by those in academic practices (5.1) and private practices (5.9). Graduating orthopedic surgeons appear to be inadequately prepared to effectively manage business issues in their practices, as evidenced by the low overall knowledge levels and high FKDs.

Polish Adaptation of Wrist Evaluation Questionnaires.

PubMed

Czarnecki, Piotr; Wawrzyniak-Bielęda, Anna; Romanowski, Leszek

2015-01-01

Questionnaires evaluating hand and wrist function are a very useful tool allowing for objective and systematic recording of symptoms reported by the patients. Most questionnaires generally accepted in clinical practice are available in English and need to be appropriately adapted in translation and undergo subsequent validation before they can be used in another culture and language. The process of translation of the questionnaires was based on the generally accepted guidelines of the International Quality of Life Assessment Project (IQOLA). First, the questionnaires were translated from English into Polish by two independent translators. Then, a joint version of the translation was prepared collectively and translated back into English. Each stage was followed by a written report. The translated questionnaires were then evaluated by a group of patients. We selected 31 patients with wrist problems and asked them to complete the PRWE, Mayo, Michigan and DASH questionnaires twice at intervals of 3-10 days. The results were submitted for statistical analysis. We found a statistically significant (p<0.05) correlation for the two completions of the questionnaires. A comparison of the PRWE and Mayo questionnaires with the DASH questionnaire also showed a statistically significant correlation (p<0.05). Our results indicate that the cultural adaptation of the translated questionnaires was successful and that the questionnaires may be used in clinical practice.

Approaches to Art Therapy for Cancer Inpatients: Research and Practice Considerations

ERIC Educational Resources Information Center

Nainis, Nancy A.

2008-01-01

Common symptoms reported by cancer patients include pain, fatigue, breathlessness, insomnia, lack of appetite, and anxiety. A study conducted by an interdisciplinary research team (Nainis et al., 2006) demonstrated statistically significant reductions in these cancer symptoms with the use of traditional art therapy methods. The study found a…

Standardized UXO Technology Demonstration Site Blind Grid Record No. 904 (Sky Research, Inc.). EM61 MKII/Towed Array

DTIC Science & Technology

2008-09-01

DEMONSTRATOR’S FIELD PERSONNEL Geophysicist: Craig Hyslop Geophysicist: John Jacobsen Geophysicist: Rob Mehl 3.7 DEMONSTRATOR’S FIELD SURVEYING...Yuma Proving Ground Soil Survey Report, May 2003. 5. Practical Nonparametric Statistics, W.J. Conover, John Wiley & Sons, 1980 , pages 144 through

Community Pre-Retirement Training Program: Final Report and Statistical Summary.

ERIC Educational Resources Information Center

Wilson, Gary W.; Oerke, George

The Office of Continuing Education at Edison State Community College developed a community pre-retirement training curriculum, which was designed to make a flexible, practical, locally adaptable program available for use by corporations, chamber of commerce education committees, adult education programs, and public institutions. The objectives of…

Leadership development practices and hospital financial outcomes.

PubMed

Crowe, Daniel; Garman, Andrew N; Li, Chien-Ching; Helton, Jeff; Anderson, Matthew M; Butler, Peter

2017-08-01

Affordable Care Act legislation is requiring leaders in US health systems to adapt to new and very different approaches to improving operating performance. Research from other industries suggests leadership development can be a helpful component of organizational change strategies; however, there is currently very little healthcare-specific research available to guide design and deployment. The goal of this exploratory study is to examine potential relationships between specific leadership development practices and health system financial outcomes. Results from the National Center for Healthcare Leadership survey of leadership development practices were correlated with hospital and health system financial performance data from the 2013 Medicare Cost Reports. A general linear regression model, controlling for payer mix, case-mix index, and bed size, was used to assess possible relationships between leadership practices and three financial performance metrics: operating margin, days cash on hand, and debt to capitalization. Statistically significant associations were found between hospital-level operating margins and 5 of the 11 leadership practices as well as the composite score. Relationships at the health system level, however, were not statistically significant. Results provide preliminary evidence of an association between hospital financial performance and investments made in developing their leaders.

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

PubMed

Burdo, Joseph; O'Dwyer, Laura

2015-12-01

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

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

PubMed

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

2014-01-01

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

Awareness, practices, and barriers regarding smoking cessation treatment among physicians in Saudi Arabia.

PubMed

Jradi, Hoda

2017-01-01

Smoking cessation counseling and therapy provided by physicians play an important role in helping smokers quit. Awareness and practices of the clinical practice guidelines for tobacco dependence (in particular the 5A's: Ask, Assist, Assess, Advise, and Arrange) among physicians and perceived barriers for their implementation is needed to improve care for individuals who smoke/use tobacco products in Saudi Arabia. A cross-sectional self-administered survey was conducted among 124 general and family practitioners in primary health care clinics belonging to 2 major medical centers in Riyadh city, Saudi Arabia. Descriptive statistics were reported for all survey variables. Logistic regression was used to examine the predictors of physicians' use of the 5A's for smoking cessation counseling and therapy. Among the 216 contacted physicians, 124 responded (57.4%). The majority (63.7%) were males, between the ages of 40 and 49 years (52.4%), practicing full-time (95.2%), and had not received smoking cessation training during medical school education or residency training (68.6%). Approximately 85.5% reported some experience with the guidelines (heard, read, or used). Asking (71.8%) and advising (87.9%) were the most implemented for smoking cessation, while assisting (15.3%) and arranging for follow-up (17.7%) were the least implemented. Most (96.0%) did not prescribe pharmacotherapy and 53.2% reported documenting the patient's smoking status. Reported barriers were mostly lack of time (72.6%) and lack of training (66.9%). Awareness of the guidelines, physician's smoking status, perceived competence in ability to provide smoking cessation counseling and therapy, reporting the ineffectiveness of smoking cessation therapy as a barrier, and the perceived benefit of reducing patient's physical symptoms were independently statistically significant predictors of the implementation of the 5A's for smoking cessation therapy. This preliminary study showed that smoking cessation delivery, according to the clinical practice guidelines recommendation, in Saudi Arabia is inadequate. Barriers were identified regarding the delivery of smoking cessation therapy and counseling for the first time. Physician training is likely to improve compliance with implementing smoking cessation counseling and therapy.

A bibliometric analysis of statistical terms used in American Physical Therapy Association journals (2011-2012): evidence for educating physical therapists.

PubMed

Tilson, Julie K; Marshall, Katie; Tam, Jodi J; Fetters, Linda

2016-04-22

A primary barrier to the implementation of evidence based practice (EBP) in physical therapy is therapists' limited ability to understand and interpret statistics. Physical therapists demonstrate limited skills and report low self-efficacy for interpreting results of statistical procedures. While standards for physical therapist education include statistics, little empirical evidence is available to inform what should constitute such curricula. The purpose of this study was to conduct a census of the statistical terms and study designs used in physical therapy literature and to use the results to make recommendations for curricular development in physical therapist education. We conducted a bibliometric analysis of 14 peer-reviewed journals associated with the American Physical Therapy Association over 12 months (Oct 2011-Sept 2012). Trained raters recorded every statistical term appearing in identified systematic reviews, primary research reports, and case series and case reports. Investigator-reported study design was also recorded. Terms representing the same statistical test or concept were combined into a single, representative term. Cumulative percentage was used to identify the most common representative statistical terms. Common representative terms were organized into eight categories to inform curricular design. Of 485 articles reviewed, 391 met the inclusion criteria. These 391 articles used 532 different terms which were combined into 321 representative terms; 13.1 (sd = 8.0) terms per article. Eighty-one representative terms constituted 90% of all representative term occurrences. Of the remaining 240 representative terms, 105 (44%) were used in only one article. The most common study design was prospective cohort (32.5%). Physical therapy literature contains a large number of statistical terms and concepts for readers to navigate. However, in the year sampled, 81 representative terms accounted for 90% of all occurrences. These "common representative terms" can be used to inform curricula to promote physical therapists' skills, competency, and confidence in interpreting statistics in their professional literature. We make specific recommendations for curriculum development informed by our findings.

Australasian Resuscitation In Sepsis Evaluation trial statistical analysis plan.

PubMed

Delaney, Anthony; Peake, Sandra L; Bellomo, Rinaldo; Cameron, Peter; Holdgate, Anna; Howe, Belinda; Higgins, Alisa; Presneill, Jeffrey; Webb, Steve

2013-10-01

The Australasian Resuscitation In Sepsis Evaluation (ARISE) study is an international, multicentre, randomised, controlled trial designed to evaluate the effectiveness of early goal-directed therapy compared with standard care for patients presenting to the ED with severe sepsis. In keeping with current practice, and taking into considerations aspects of trial design and reporting specific to non-pharmacologic interventions, this document outlines the principles and methods for analysing and reporting the trial results. The document is prepared prior to completion of recruitment into the ARISE study, without knowledge of the results of the interim analysis conducted by the data safety and monitoring committee and prior to completion of the two related international studies. The statistical analysis plan was designed by the ARISE chief investigators, and reviewed and approved by the ARISE steering committee. The data collected by the research team as specified in the study protocol, and detailed in the study case report form were reviewed. Information related to baseline characteristics, characteristics of delivery of the trial interventions, details of resuscitation and other related therapies, and other relevant data are described with appropriate comparisons between groups. The primary, secondary and tertiary outcomes for the study are defined, with description of the planned statistical analyses. A statistical analysis plan was developed, along with a trial profile, mock-up tables and figures. A plan for presenting baseline characteristics, microbiological and antibiotic therapy, details of the interventions, processes of care and concomitant therapies, along with adverse events are described. The primary, secondary and tertiary outcomes are described along with identification of subgroups to be analysed. A statistical analysis plan for the ARISE study has been developed, and is available in the public domain, prior to the completion of recruitment into the study. This will minimise analytic bias and conforms to current best practice in conducting clinical trials. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

How much guidance is given in the operating room? Factors influencing faculty self-reports, resident perceptions, and faculty/resident agreement.

PubMed

Torbeck, Laura; Williams, Reed G; Choi, Jennifer; Schmitz, Connie C; Chipman, Jeffrey G; Dunnington, Gary L

2014-10-01

Guidance in the operating room impacts resident confidence and ability to function independently. The purpose of this study was to explore attending surgeon guidance practices in the operating room as reported by faculty members themselves and by junior and senior residents. This was an exploratory, cross-sectional survey research study involving 91 categorical residents and 82 clinical faculty members at two academic general surgery training programs. A series of analyses of variance along with descriptive statistics were performed to understand the impact of resident training year, program, and surgeon characteristics (sex and type of surgery performed routinely) on guidance practices. Resident level (junior versus senior) significantly impacted the amount of guidance given as reported by faculty and as perceived by residents. Within each program, junior residents perceived less guidance than faculty reported giving. For senior guidance practices, however, the differences between faculty and resident practices varied by program. In terms of the effects of surgeon practice type (mostly general versus mostly complex cases), residents at both institutions felt they were more supervised closely by the faculty who perform mostly complex cases. More autonomy is given to senior than to junior residents. Additionally, faculty report a greater amount of change in their guidance practices over the training period than residents perceive. Faculty and resident agreement about the need for guidance and for autonomy are important for achieving the goals of residency training. Copyright © 2014 Elsevier Inc. All rights reserved.

Three common misuses of P values

PubMed Central

Kim, Jeehyoung; Bang, Heejung

2016-01-01

“Significance” has a specific meaning in science, especially in statistics. The p-value as a measure of statistical significance (evidence against a null hypothesis) has long been used in statistical inference and has served as a key player in science and research. Despite its clear mathematical definition and original purpose, and being just one of the many statistical measures/criteria, its role has been over-emphasized along with hypothesis testing. Observing and reflecting on this practice, some journals have attempted to ban reporting of p-values, and the American Statistical Association (for the first time in its 177 year old history) released a statement on p-values in 2016. In this article, we intend to review the correct definition of the p-value as well as its common misuses, in the hope that our article is useful to clinicians and researchers. PMID:27695640

Young worker safety in construction: do family ties and workgroup size affect hazard exposures and safety practices?

PubMed

Rauscher, Kimberly J; Myers, Douglas J; Runyan, Carol W; Schulman, Michael

2012-01-01

Little is known about how social aspects of the work environment influence exposures or safety practices affecting young construction workers. Our objective was to investigate whether working on a construction site with a small number of workers (≤10 vs. 11-50) or having a family-firm connection (working in a family-owned firm or one in which a family member also works) impacts hazard exposures and safety practices. Participants included 187 North Carolina construction workers 14 to 17 years old who were surveyed about their jobs. We conducted stratified analyses using cross-tabulations and chi-square statistics to measure associations between workgroup size (i.e., the total number of workers on a jobsite) and family-firm connections (yes/no) and hazard exposures (e.g., saws) and safety practices (e.g., supervision). Having a family-firm connection was associated with fewer hazard exposures and greater safety practices. Youth who worked on jobsites with a larger workgroup (11-50 workers) reported more hazards but also more safety practices. Family-firm connections, in particular, may have a protective effect for youth in construction. Even though the statistical significance of our findings on workgroup size was limited in places, the pattern of differences found suggest that further research in this area is warranted.

A Survey of Knowledge, Attitude and Practice of Iranian Dentists and Pedodontists in Relation to Child Abuse.

PubMed

Jahanimoghadam, Fatemeh; Kalantari, Mahsa; Horri, Azadeh; Ahmadipour, Habibeh; Pourmorteza, Ehsan

2017-12-01

Since almost half of the child abuse cases affect the head and neck region, dentists have an important role in the diagnosis and report of oral and dental aspects of child abuse cases. The objective of the current study was to evaluate the knowledge, attitude and practice of the general dentists and pedodontists regarding child abuse and child neglect. This cross-sectional study was carried out on the participants of the 12 th congress of pedodontists of Iran. A self-administered questionnaire was used for evaluating their knowledge, attitude and practice toward child abuse. T-test and ANOVA were applied to analyze the data by SPSS software. p <0.05 was considered statistically significant. The mean score of knowledge, attitude and practice of the participants regarding child abuse was 10.24±2.68, 41.54±11.24 and 2.78±1.05, respectively. The knowledge of pedodontists was significantly higher than knowledge of general dentists. No statistically significant difference was observed in attitude and practice ( p > 0.05). Dentists had a moderate knowledge, poor attitude and moderate practice regarding child abuse. Considering this fact, improvements in child abuse education for undergraduate students and continuing post-graduate training in this field are recommended.

The relationship between organizational policies and practices and work limitations among hospital patient care workers.

PubMed

Sparer, Emily H; Boden, Leslie I; Sorensen, Glorian; Dennerlein, Jack T; Stoddard, Anne; Wagner, Gregory R; Nagler, Eve M; Hashimoto, Dean M; Hopcia, Karen; Sabbath, Erika L

2018-05-29

We examined relationships between organizational policies and practices (OPPs) (safety practices, ergonomic practices, and people-oriented culture) and work limitations in a sample of hospital workers. We used the 6-item Work Limitations Questionnaire (WLQ) to assess workers' perceptions of health-related work limitations. Self-reported OPPs and the WLQ were collected from workers in Boston, Massachusetts (n = 1277). We conducted random-intercept multi-level logistic regression models for each OPP using stepwise selection of covariates. As the unit-average ergonomic practice score increased by one, the odds of a worker reporting work limitations decreased by approximately 39% (P-value = 0.018), adjusted for job title, age, and body mass index. A similar relationship existed for people-oriented culture (P-value = 0.038). The association between safety practices and work limitations was similar, but not statistically significant. This study demonstrated the importance of workplace OPPs. OPPs that promote positive and supportive environments and that foster improvements in ergonomics may help reduce work limitations. © 2018 Wiley Periodicals, Inc.

The Attitudes and Behaviors of Anaesthesiology and Reanimation Specialists in Anaesthesia Care Applications Outside the Operating Room in Turkey: A Survey Study

PubMed Central

Yıldız, Mehmet; İyilikçi, Leyla; Duru, Seden; Hancı, Volkan

2014-01-01

Objective We aimed to investigate the attitudes and behaviors of anaesthesiologists in “non-operating room anaesthesia” applications, which can be described as anaesthesia applications performed outside the operating room, and their reflection on practice all over Turkey. Methods Our study was conducted between November 5, 2012 and January 7, 2013 with the approval of the Research Ethics Board. Survey data were obtained through distributing printed questionnaires to be completed either by hand or via the web. The questionnaire consisted of 38 questions. The data obtained were analyzed with the Statistical Package for Social Sciences (SPSS) program. Results A total of 500 anaesthesiologists replied to our survey; 93% of anaesthesia specialists reported that there was a request that the anaesthesia and anaesthesia outside the operating room was given in their institution. Among anaesthesiologists, 56% reported that there were other sections that can provide sedation other than the anaesthesiology department in their institutions. Anaesthesia care team members; equipment; anaesthetic techniques; monitoring methods; and hypnotic, analgesic, and antagonist agents had statistically significant differences according to the participants’ institutions. Equipment used in the anaesthesia practice outside the operating room, anaesthesia, and monitoring methods had statistically significant differences according to geographical distribution (p<0.05). Conclusion Outside the operating room, anaesthesia practices and security measures are compliant with the standards set by the guidelines, the key to the prevention of complications. In our study, the current status of anaesthetic procedures outside the operating room in our country have been analyzed. PMID:27366420

Scribe Impacts on Provider Experience, Operations, and Teaching in an Academic Emergency Medicine Practice

PubMed Central

Hess, Jeremy J.; Wallenstein, Joshua; Ackerman, Jeremy D.; Akhter, Murtaza; Ander, Douglas; Keadey, Matthew T.; Capes, James P.

2015-01-01

Introduction Physicians dedicate substantial time to documentation. Scribes are sometimes used to improve efficiency by performing documentation tasks, although their impacts have not been prospectively evaluated. Our objective was to assess a scribe program’s impact on emergency department (ED) throughput, physician time utilization, and job satisfaction in a large academic emergency medicine practice. Methods We evaluated the intervention using pre- and post-intervention surveys and administrative data. All site physicians were included. Pre- and post-intervention data were collected in four-month periods one year apart. Primary outcomes included changes in monthly average ED length of stay (LOS), provider-specific average relative value units (RVUs) per hour (raw and normalized to volume), self-reported estimates of time spent teaching, self-reported estimates of time spent documenting, and job satisfaction. We analyzed data using descriptive statistics and appropriate tests for paired pre-post differences in continuous, categorical, and ranked variables. Results Pre- and post-survey response rates were 76.1% and 69.0%, respectively. Most responded positively to the intervention, although 9.5% reported negative impressions. There was a 36% reduction (25%–50%; p<0.01) in time spent documenting and a 30% increase (11%–46%, p<0.01) in time spent in direct patient contact. No statistically significant changes were seen in job satisfaction or perception of time spent teaching. ED volume increased by 88 patients per day (32–146, p=0.04) pre- to post- and LOS was unchanged; rates of patients leaving against medical advice dropped, and rates of patients leaving without being seen increased. RVUs per hour increased 5.5% and per patient 5.3%; both were statistically significant. No statistically significant changes were seen in patients seen per hour. There was moderate correlation between changes in ED volume and changes in productivity metrics. Conclusion Scribes were well received in our practice. Documentation time was substantially reduced and redirected primarily to patient care. Despite an ED volume increase, LOS was maintained, with fewer patients leaving against medical advice but more leaving without being seen. RVUs per hour and per patient both increased. PMID:26587079

Changes in sexual behaviour and practice and HIV prevalence indicators among young people aged 15–24 years in Zambia: An in-depth analysis of the 2001–2002 and 2007 Zambia Demographic and Health Surveys

PubMed Central

Kembo, Joshua

2014-01-01

HIV and AIDS still pose a major public health problem to most countries in sub-Saharan Africa, Zambia included. The objective of the paper is to determine changes in selected sexual behaviour and practice and HIV prevalence indicators between 2001–2002 and 2007. We used the Demographic and Health Survey Indicators Database for the computation of the selected indicators. We further used STATA 10.0 to compute significance tests to test for statistical difference in the indicators. The results indicate some changes in sexual behaviour, as indicated by an increase in abstinence, use of condoms and the decrease in multiple partnerships. The overall percentage of abstinence among never-married young men and women aged 15–24 years in Zambia increased significantly by 15.2% (p = .000) and 5.9% (p = .001) respectively, between 2001–2002 and 2007. A statistically significant increase of 6.6% (p = .029) was observed in the percentage of young women who reported having used a condom during the last time they had had premarital sex. A statistically significant decrease of 11.0% (p = .000) and 1.4% (p = .000) was observed among young men and women, respectively, who reported having multiple partners in the preceding 12 months. The factorial decomposition using multivariate analysis reveals that the indicators which contributed to the statistically significant 2.6% decline in HIV prevalence among young women aged 15–24 years in Zambia include proportion reporting condom use during premarital sex (+6.6%), abstinence (+5.9%), sex before age 15 (– 4.5%), premarital sex (– 2.6%), sex before age 18 (– 2.4%) and proportion reporting multiple partnerships (– 1.4%). Remarkable strides have been achieved towards promoting responsible sexual behaviour and practice among young people in Zambia. Further research focusing on factors that predispose young women in Zambia to higher risk of infection from HIV is required. The results from this paper should be useful in the design of programmes to control the spread of HIV and AIDS, particularly among young people in Zambia and other sub-Saharan countries. PMID:24702245

Quantum and classical noise in practical quantum-cryptography systems based on polarization-entangled photons

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

Castelletto, S.; Degiovanni, I.P.; Rastello, M.L.

2003-02-01

Quantum-cryptography key distribution (QCKD) experiments have been recently reported using polarization-entangled photons. However, in any practical realization, quantum systems suffer from either unwanted or induced interactions with the environment and the quantum measurement system, showing up as quantum and, ultimately, statistical noise. In this paper, we investigate how an ideal polarization entanglement in spontaneous parametric down-conversion (SPDC) suffers quantum noise in its practical implementation as a secure quantum system, yielding errors in the transmitted bit sequence. Since all SPDC-based QCKD schemes rely on the measurement of coincidence to assert the bit transmission between the two parties, we bundle up themore » overall quantum and statistical noise in an exhaustive model to calculate the accidental coincidences. This model predicts the quantum-bit error rate and the sifted key and allows comparisons between different security criteria of the hitherto proposed QCKD protocols, resulting in an objective assessment of performances and advantages of different systems.« less

Effects of patient safety culture interventions on incident reporting in general practice: a cluster randomised trial

PubMed Central

Verbakel, Natasha J; Langelaan, Maaike; Verheij, Theo JM; Wagner, Cordula; Zwart, Dorien LM

2015-01-01

Background A constructive safety culture is essential for the successful implementation of patient safety improvements. Aim To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. Design and setting A three-arm cluster randomised trial was conducted in a mixed method study, studying the effect of administering a patient safety culture questionnaire (intervention I), the questionnaire complemented with a practice-based workshop (intervention II) and no intervention (control) in 30 general practices in the Netherlands. Method The primary outcome, the number of reported incidents, was measured with a questionnaire at baseline and a year after. Analysis was performed using a negative binomial model. Secondary outcomes were quality and safety indicators and safety culture. Mixed effects linear regression was used to analyse the culture questionnaires. Results The number of incidents increased in both intervention groups, to 82 and 224 in intervention I and II respectively. Adjusted for baseline number of incidents, practice size and accreditation status, the study showed that practices that additionally participated in the workshop reported 42 (95% confidence interval [CI] = 9.81 to 177.50) times more incidents compared to the control group. Practices that only completed the questionnaire reported 5 (95% CI = 1.17 to 25.49) times more incidents. There were no statistically significant differences in staff perception of patient safety culture at follow-up between the three study groups. Conclusion Educating staff and facilitating discussion about patient safety culture in their own practice leads to increased reporting of incidents. It is beneficial to invest in a team-wise effort to improve patient safety. PMID:25918337

International practices in the provision of teratology information: a survey of international teratogen information programmes and comparisons with the North American model.

PubMed

Hancock, Rebecca L; Ungar, Wendy J; Einarson, Adrienne; Koren, Gideon

2010-10-01

Teratology Information Services (TIS) provide health care professionals and the public with information regarding the safety and/or risk of exposures during pregnancy and lactation, mainly via telephone consultations. An international comparison of clinical practices at TIS has never been conducted. The survey objective was to compare international TIS to North American TIS, with an aim to identify strengths and challenges that can lead to service improvement. Twenty-two international TIS were approached for participation during an international conference. TIS were surveyed on information in six categories: services, staffing, operations, data collection, knowledge transfer activities and additional information. Data were summarized using descriptive statistics. Statistical tests were conducted using SPSS®. Sixteen TIS from 12 countries participated. Survey results were compared with previously reported results from a similar survey of North American TIS (16 US, two Canadian). TIS exist in a variety of departments and settings, but most commonly are in university hospitals. Pregnant women were the most commonly counselled group worldwide. International TIS spent significantly more time fielding inquiries regarding medications, while North American TIS had a wider variety of inquiry categories. All TIS could improve budget tracking. Overall, service practices and goals were similar, although international TIS conducted more follow-up with service users than North American TIS. This report offers TIS the first ever opportunity to compare practices. Increased dialogue between TIS encourages sharing of best practices and improves the ability of these important public health programmes to support women and health care providers. © 2010 Blackwell Publishing Ltd.

Transfusion practice in Helsinki University Central Hospital: an analysis of diagnosis-related groups (DRG).

PubMed

Syrjälä, M T; Kytöniemi, I; Mikkolainen, K; Ranimo, J; Lauharanta, J

2001-12-01

Transfusion data combined with data automatically recorded in hospital databases provides an outstanding tool for blood utilization reporting. When the reporting is performed with an online analytical processing (OLAP) tool, real time reporting can be provided to blood subscribers. When this data is combined with a common patient classification system, Diagnosis-Related Groups (DRG), it is possible to produce statistical results, that are similar in different institutions and may provide a means for international transfusion bench-marking and cost comparison. We use a DRG classification to describe the transfusion practice in Helsinki University Central Hospital. The key indicators include the percentage of transfused patients, the number of transfused units and costs in different DRG groups, as well as transfusion rates per DRG weighted treatment episodes. Ninety-three per cent of all transfusions could be classified into different DRGs. The largest blood-using DRG group was acute adult leukaemia (DRG 473), which accounted for 10.4% of all transfusion costs. The 13 largest blood consuming DRGs accounted for half the total costs in 1998. Currently, there is a lack of an internationally accepted standardized way to report institutional or national transfusion practices. DRG-based transfusion reporting might serve as a means for transfusion benchmarking and thus aid studies of variations in transfusion practice.

Early termination of breast-feeding in periurban Santo Domingo, Dominican Republic: mothers' community perceptions and personal practices.

PubMed

McLennan, J D

2001-06-01

The objectives of this study were to determine: 1) whether mothers' perceptions of typical community practice for breast-feeding duration influence their personal practices and 2) whether the mothers' reports of community reasons for terminating breast-feeding identify barriers not elicited through self-report. The study was conducted in 1997 in a sample of poor neighborhoods in a periurban district of Santo Domingo, the capital of the Dominican Republic. A representative sample of 220 mothers from these neighborhoods was interviewed with a structured questionnaire. While the duration of breast-feeding was similar for self-report and for mothers' perceptions of typical community practice, there was no statistically significant correlation between these two variables. "Mother-driven" reasons for early termination of breast-feeding, such as "fear of loss of figure or of breast shape" and "not wanting to breast-feed," were frequently perceived as community reasons but rarely given as personal reasons. Personal reasons were predominately "child-driven," including "the child not wanting the breast," or reasons beyond the mother's control such as having "insufficient" milk. Maternal report of community reasons for early termination may be a useful way to identify factors that would not otherwise be revealed on self-report. These additional reasons may guide health promotion efforts aimed at increasing breast-feeding duration.

Confidence intervals for effect sizes: compliance and clinical significance in the Journal of Consulting and clinical Psychology.

PubMed

Odgaard, Eric C; Fowler, Robert L

2010-06-01

In 2005, the Journal of Consulting and Clinical Psychology (JCCP) became the first American Psychological Association (APA) journal to require statistical measures of clinical significance, plus effect sizes (ESs) and associated confidence intervals (CIs), for primary outcomes (La Greca, 2005). As this represents the single largest editorial effort to improve statistical reporting practices in any APA journal in at least a decade, in this article we investigate the efficacy of that change. All intervention studies published in JCCP in 2003, 2004, 2007, and 2008 were reviewed. Each article was coded for method of clinical significance, type of ES, and type of associated CI, broken down by statistical test (F, t, chi-square, r/R(2), and multivariate modeling). By 2008, clinical significance compliance was 75% (up from 31%), with 94% of studies reporting some measure of ES (reporting improved for individual statistical tests ranging from eta(2) = .05 to .17, with reasonable CIs). Reporting of CIs for ESs also improved, although only to 40%. Also, the vast majority of reported CIs used approximations, which become progressively less accurate for smaller sample sizes and larger ESs (cf. Algina & Kessleman, 2003). Changes are near asymptote for ESs and clinical significance, but CIs lag behind. As CIs for ESs are required for primary outcomes, we show how to compute CIs for the vast majority of ESs reported in JCCP, with an example of how to use CIs for ESs as a method to assess clinical significance.

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.

On Time Performance Pressure

NASA Technical Reports Server (NTRS)

Connell, Linda; Wichner, David; Jakey, Abegael

2013-01-01

Within many operations, the pressures for on-time performance are high. Each month, on-time statistics are reported to the Department of Transportation and made public. There is a natural tendency for employees under pressure to do their best to meet these objectives. As a result, pressure to get the job done within the allotted time may cause personnel to deviate from procedures and policies. Additionally, inadequate or unavailable resources may drive employees to work around standard processes that are seen as barriers. However, bypassing practices to enable on-time performance may affect more than the statistics. ASRS reports often highlight on-time performance pressures which may result in impact across all workgroups in an attempt to achieve on-time performance. Reporters often provide in-depth insights into their experiences which can be used by industry to identify and focus on the implementation of systemic fixes.

Nurse's Awareness on Ethico-legal Aspects of Nursing Profession.

PubMed

Paudel Subedi, Krishna Kumari; Timalsina, Kalpana; Bhele, Raja Laxmi

2018-03-13

Nursing practice amicably includes practical efficacy and ethics. Now a days legal and ethical problems associated with client care are arising day by day. Therefore, nurses should have adequate understanding of basic legal concepts and issues relevant to nursing profession in order to protect the rights of the clients and the nurses. A cross sectional descriptive design was adopted for the study. 142 nurses were included by using purposive sampling technique. Data was collected with self-administered structured questionnaire. Descriptive statistics was used to reveal demographic information. Kruskal Wallis and Mann Whitney test were used to find out association of selected demographic variables and ethico legal aspects of nursing. Majority of participants were belonging to 20-29 years of age. More than half nurses had complete bachelor's degree and had less than 10 year's experiences. Majority of participants reported that they did not encounter any legal issues in their professional life till date. Similarly, majority of participants had average level knowledge and equate level of practice. Years of experiences and education level did not affect in knowledge level and existing practice related to ethico legal aspect of nursing. There was no significant relationship between level of knowledge and existing practice. Nurses have average knowledge and practice on ethico legal aspects. There is positive relationship between knowledge and practice though it is not statistically significant.

Trend analysis of dental practice rent and mortgage expenses: 1989-1995.

PubMed

Brown, L J; Lazar, V

1999-03-01

The authors analyzed trends for rent and mortgage, as reported by independent active private practitioners, for the period of 1989-1995. Rent and mortgage were analyzed overall and by different characteristics. In the ADA's annual "Survey of Dental Practice," dentists reported gross billings and net incomes, as well as itemized practice expenses. The authors tabulated survey responses over time to develop trends and compare rent and mortgage expenses for each year. If trends over time were not exhibited, the authors combined multiple years of data to develop more reliable statistics. Approximately three-fourths of independent active private practitioners reported rent but no mortgage expenses. The percentages of practitioners who reported rent or mortgage was stable over time. The percentage reporting rent only as an expense increased with the number of dentists in the practice, the age of the reporting dentist and the number of office locations. In contrast, the opposite was true for dentists reporting mortgage only as an expense. The authors found that office rental is more common than is office ownership and that mortgages as a percentage of gross billings and in dollar amounts were similar to rents. They also found that because the cost of office space as a percentage of gross billings decreased as the number of dentists in the practice increased, limited economies of scale may be present in the cost of dental office space. There is not a large financial advantage to ownership, so renting is likely to remain an important way to acquire office space. As only limited economies of scale exist in office space expenses, many group practices may choose to rent office space.

A proof of concept for epidemiological research using structured reporting with pulmonary embolism as a use case.

PubMed

Daniel, Pinto Dos Santos; Sonja, Scheibl; Gordon, Arnhold; Aline, Maehringer-Kunz; Christoph, Düber; Peter, Mildenberger; Roman, Kloeckner

2018-05-10

This paper studies the possibilities of an integrated IT-based workflow for epidemiological research in pulmonary embolism using freely available tools and structured reporting. We included a total of 521 consecutive cases which had been referred to the radiology department for computed tomography pulmonary angiography (CTPA) with suspected pulmonary embolism (PE). Free-text reports were transformed into structured reports using a freely available IHE-MRRT-compliant reporting platform. D-dimer values were retrieved from the hospitals laboratory results system. All information was stored in the platform's database and visualized using freely available tools. For further analysis, we directly accessed the platform's database with an advanced analytics tool (RapidMiner). We were able developed an integrated workflow for epidemiological statistics from reports obtained in clinical routine. The report data allowed for automated calculation of epidemiological parameters. Prevalence of pulmonary embolism was 27.6%. The mean age in patients with and without pulmonary embolism did not differ (62.8 years and 62.0 years, respectively, p=0.987). As expected, there was a significant difference in mean D-dimer values (10.13 mg/L FEU and 3.12 mg/L FEU, respectively, p<0.001). Structured reporting can make data obtained from clinical routine more accessible. Designing practical workflows is feasible using freely available tools and allows for the calculation of epidemiological statistics on a near real-time basis. Therefore, radiologists should push for the implementation of structured reporting in clinical routine. Advances in knowledge: Theoretical benefits of structured reporting have long been discussed, but practical implementation demonstrating those benefits has been lacking. Here we present a first experience providing proof that structured reporting will make data from clinical routine more accessible.

Quantitative Reporting Practices in Middle-Grades Research Journals: Lessons to Learn

ERIC Educational Resources Information Center

Capraro, Robert M.; Capraro, Mary Margaret

2009-01-01

This study examines two journals specific to the middles grades where original quantitative empirical articles are published, Research in Middle Level Education and Middle Grades Research Journal to determine what quantitative statistics are used, how they are used, and what study designs are used. Important for those who write for the…

Evaluation of a Text Compression Algorithm Against Computer-Aided Instruction (CAI) Material.

ERIC Educational Resources Information Center

Knight, Joseph M., Jr.

This report describes the initial evaluation of a text compression algorithm against computer assisted instruction (CAI) material. A review of some concepts related to statistical text compression is followed by a detailed description of a practical text compression algorithm. A simulation of the algorithm was programed and used to obtain…

Baseline Statistics for Evaluation of the Effective Practice Incentive Community. Final Report

ERIC Educational Resources Information Center

Cody, Scott; Wellington, Alison; Sullivan, Margaret; Knechtel, Virginia; Chaplin, Duncan

2009-01-01

In 2006 and 2007, the U.S. Department of Education awarded Teacher Incentive Fund (TIF) grants for the development of innovative strategies for teacher compensation. New Leaders for New Schools (NLNS), with five partner organizations--Memphis City Schools (MCS), the District of Columbia Public Schools (DCPS), Denver Public Schools, Prince…

Critical Examination of Candidates' Diversity Competence: Rigorous and Systematic Assessment of Candidates' Efficacy to Teach Diverse Student Populations

ERIC Educational Resources Information Center

Benton-Borghi, Beatrice Hope; Chang, Young Mi

2011-01-01

The National Center for Educational Statistics (NCES, 2010) continues to report substantial underachievement of diverse student populations in the nation's schools. After decades of focus on diversity and multicultural education, with integrating field and clinical practice, candidates continue to graduate without adequate knowledge, skills and…

Teachers' Intentions to Use National Literacy and Numeracy Assessment Data: A Pilot Study

ERIC Educational Resources Information Center

Pierce, Robyn; Chick, Helen

2011-01-01

In recent years the educational policy environment has emphasised data-driven change. This has increased the expectation for school personnel to use statistical information to inform their programs and to improve teaching practices. Such data include system reports of student achievement tests and socio-economic profiles provided to schools by…

Test and Evaluation of a Course Designed for Mobile Learning. ZIFF Papiere.

ERIC Educational Resources Information Center

Strohlein, Georg; Fritsch, Helmut

This report contains two parts: "Part I: Design and Implementation" (Georg Strohlein) and "Part II: Student Usage" (Helmut Fritsch). Part I describes the development and practical use of a short course on descriptive statistics designed for mobile learning (i.e., the situation when the learning person is mobile and utilizes…

Adoption Practice in Canada: Emerging Trends and Challenges.

ERIC Educational Resources Information Center

Sobol, Michael P.; Daly, Kerry

1995-01-01

Reports the results of the National Adoption Study of Canada (NAS), which is based on demographic adoption statistics and a survey of adoption agencies and practitioners. The NAS found that between 1981 and 1990 the number of adoptions decreased by 47% and that private adoptions are accounting for an ever-increasing proportion of infant…

Development and refinement of new statistical methods for enhanced syndromic surveillance during the 2012 Olympic and Paralympic Games.

PubMed

Morbey, Roger A; Elliot, Alex J; Charlett, Andre; Andrews, Nick; Verlander, Neville Q; Ibbotson, Sue; Smith, Gillian E

2015-06-01

Prior to the 2012 London Olympic and Paralympic Games, new statistical methods had to be developed for the enhanced syndromic surveillance during the Games. Different methods were developed depending on whether or not historical data were available. Practical solutions were needed to cope with the required daily reporting and data quality issues. During the Games, nearly 4800 signals were tested on average each day, generating statistical alarms that were assessed to provide information on areas of potential public health concern and reassurance that no major adverse incident had occurred. spjhi;21/2/159/FIG41460458213517577 F1 fig4-1460458213517577. © The Author(s) 2013.

Measuring primary care practice performance within an integrated delivery system: a case study.

PubMed

Stewart, Louis J; Greisler, David

2002-01-01

This article examines the use of an integrated performance measurement system to plan and control primary care service delivery within an integrated delivery system. We review a growing body of literature that focuses on the development and implementation of management reporting systems among healthcare providers. Our study extends the existing literature by examining the use of performance information generated by an integrated performance measurement system within a healthcare organization. We conduct our examination through a case study of the WMG Primary Care Medicine Group, the primary care medical group practice of WellSpan Health System. WellSpan Health System is an integrated delivery system that serves south central Pennsylvania and northern Maryland. Our study examines the linkage between WellSpan Health's strategic objectives and its primary care medicine group's integrated performance measurement system. The conceptual design of this integrated performance measurement system combines financial metrics with practice management and clinical operating metrics to provide a more complete picture of medical group performance. Our findings demonstrate that WellSpan Health was able to achieve superior financial results despite a weak linkage between its integrated performance measurement system and its strategic objectives. WellSpan Health achieved this objective for its primary care medicine group by linking clinical performance information to physician compensation and reporting practice management performance through the use of statistical process charts. They found that the combined mechanisms of integrated performance measurement and statistical process control charts improved organizational learning and communications between organizational stakeholders.

Probability as certainty: dichotomous thinking and the misuse of p values.

PubMed

Hoekstra, Rink; Finch, Sue; Kiers, Henk A L; Johnson, Addie

2006-12-01

Significance testing is widely used and often criticized. The Task Force on Statistical Inference of the American Psychological Association (TFSI, APA; Wilkinson & TFSI, 1999) addressed the use of significance testing and made recommendations that were incorporated in the fifth edition of the APA Publication Manual (APA, 2001). They emphasized the interpretation of significance testing and the importance of reporting confidence intervals and effect sizes. We examined whether 286 Psychonomic Bulletin & Review articles submitted before and after the publication of the TFSI recommendations by APA complied with these recommendations. Interpretation errors when using significance testing were still made frequently, and the new prescriptions were not yet followed on a large scale. Changing the practice of reporting statistics seems doomed to be a slow process.

Hand Washing Practices Among Emergency Medical Services Providers.

PubMed

Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan

2015-09-01

Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS) workers, respectively. We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale) and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003). Providers who brought their own sanitizer were more likely to clean their hands. Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing.

Hand Washing Practices Among Emergency Medical Services Providers

PubMed Central

Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan

2015-01-01

Introduction Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS) workers, respectively. Methods We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale) and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. Results There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003). Providers who brought their own sanitizer were more likely to clean their hands. Conclusion Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing. PMID:26587098

Correlation of oral hygiene practices, smoking and oral health conditions with self perceived halitosis amongst undergraduate dental students.

PubMed

Setia, Saniya; Pannu, Parampreet; Gambhir, Ramandeep Singh; Galhotra, Virat; Ahluwalia, Pooja; Sofat, Anjali

2014-01-01

The present study was undertaken to determine the prevalence of oral hygiene practices, smoking habits and halitosis among undergraduate dental students and correlating the oral hygiene practices, oral health conditions to the prevalence of self perceived oral malodour. A self-administered questionnaire was distributed among 277 male and female students. A questionnaire was developed to assess the self-reported perception of oral breath, awareness of bad breath, timing of bad breath, oral hygiene practices, caries and bleeding gums, dryness of the mouth, smoking and tongue coating. The results indicate female students had better oral hygiene practices. Significantly less self-reported oral bad breath (P = 0.007) was found in female dental students (40%) as compared to their male counterparts (58%). It was found that smoking and dryness of mouth had statistically significant correlation with halitosis (P = 0.026, P = 0.001). Presence of other oral conditions such as tongue coating and dental caries and bleeding gums also showed higher prevalence of halitosis in dental students. A direct correlation exists between oral hygiene practices and oral health conditions with halitosis. Females exhibited better oral hygiene practices and less prevalence of halitosis as compared to male students.

Orientation, Evaluation, and Integration of Part-Time Nursing Faculty.

PubMed

Carlson, Joanne S

2015-07-10

This study helps to quantify and describe orientation, evaluation, and integration practices pertaining to part-time clinical nursing faculty teaching in prelicensure nursing education programs. A researcher designed Web-based survey was used to collect information from a convenience sample of part-time clinical nursing faculty teaching in prelicensure nursing programs. Survey questions focused on the amount and type of orientation, evaluation, and integration practices. Descriptive statistics were used to analyze results. Respondents reported on average four hours of orientation, with close to half reporting no more than two hours. Evaluative feedback was received much more often from students than from full-time faculty. Most respondents reported receiving some degree of mentoring and that it was easy to get help from full-time faculty. Respondents reported being most informed about student evaluation procedures, grading, and the steps to take when students are not meeting course objectives, and less informed about changes to ongoing curriculum and policy.

Melanoma reporting to central cancer registries by US dermatologists: an analysis of the persistent knowledge and practice gap.

PubMed

Cartee, Todd V; Kini, Seema P; Chen, Suephy C

2011-11-01

Every state requires diagnosing physicians to report new cases of melanoma to its central cancer registry. Previous regional studies and anecdotal experience suggest that few dermatologists are cognizant of this obligation. This oversight could result in a large number of unreported melanomas annually and, in turn, US melanoma statistics that markedly underestimate the true incidence of the disease. We sought to quantify the percentage of dermatologists who are unaware of melanoma reporting requirements (the knowledge gap) and who are not reporting melanoma diagnoses (the practice gap). We also sought to delineate factors predictive of reporting knowledge and behavior. A survey was administered to attendees of the Cutaneous Oncology Symposium at the 2010 American Academy of Dermatology annual meeting. In all, 104 of 419 eligible attendees completed surveys (response rate 26%). Fifty percent of respondents do not believe they are required to report melanomas and 56% do not actively report their diagnoses to a registry. Practice duration of less than 10 years was significantly associated with both a knowledge gap (P = .047) and practice gap (P = .056). Similarly, dermatologists who diagnosed fewer than 10 melanomas per year were more likely to possess a knowledge gap (P = .096) and a practice gap (P = .087) than those who diagnosed more than 10. Limitations include small sample size and low response rate. A majority of dermatologists are not reporting melanomas they diagnose to a cancer registry, and half of those surveyed were not aware that diagnosing physicians are required to report melanoma. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Statistical analysis plan for the family-led rehabilitation after stroke in India (ATTEND) trial: A multicenter randomized controlled trial of a new model of stroke rehabilitation compared to usual care.

PubMed

Billot, Laurent; Lindley, Richard I; Harvey, Lisa A; Maulik, Pallab K; Hackett, Maree L; Murthy, Gudlavalleti Vs; Anderson, Craig S; Shamanna, Bindiganavale R; Jan, Stephen; Walker, Marion; Forster, Anne; Langhorne, Peter; Verma, Shweta J; Felix, Cynthia; Alim, Mohammed; Gandhi, Dorcas Bc; Pandian, Jeyaraj Durai

2017-02-01

Background In low- and middle-income countries, few patients receive organized rehabilitation after stroke, yet the burden of chronic diseases such as stroke is increasing in these countries. Affordable models of effective rehabilitation could have a major impact. The ATTEND trial is evaluating a family-led caregiver delivered rehabilitation program after stroke. Objective To publish the detailed statistical analysis plan for the ATTEND trial prior to trial unblinding. Methods Based upon the published registration and protocol, the blinded steering committee and management team, led by the trial statistician, have developed a statistical analysis plan. The plan has been informed by the chosen outcome measures, the data collection forms and knowledge of key baseline data. Results The resulting statistical analysis plan is consistent with best practice and will allow open and transparent reporting. Conclusions Publication of the trial statistical analysis plan reduces potential bias in trial reporting, and clearly outlines pre-specified analyses. Clinical Trial Registrations India CTRI/2013/04/003557; Australian New Zealand Clinical Trials Registry ACTRN1261000078752; Universal Trial Number U1111-1138-6707.

Nursing genetics and genomics: The International Society of Nurses in Genetics (ISONG) survey.

PubMed

Hickey, Kathleen T; Taylor, Jacquelyn Y; Barr, Taura L; Hauser, Nicole R; Jia, Haomiao; Riga, Teresa C; Katapodi, Maria

2018-04-01

The International Society of Nursing in Genetics (ISONG) fosters scientific and professional development in the discovery, interpretation, and application of genomic information in nursing research, education, and clinical practice. Assess genomic-related activities of ISONG members in research, education and practice, and competencies to serve as global leaders in genomics. Cross-sectional survey (21-items) assessing genomic-related training, knowledge, and practice. An email invitation included a link to the anonymous online survey. All ISONG members (n = 350 globally) were invited to partake. Descriptive statistics and Wilcoxon Rank Sum Test for between-group comparisons. Respondents (n = 231, 66%), were mostly Caucasian, female, with a master's degree or higher. Approximately 70% wanted to incorporate genomics in research, teaching, and practice. More than half reported high genomic competency, and over 95% reported that genomics is relevant the next 5 years. Findings provide a foundation for developing additional educational programs for an international nursing workforce in genomics. Copyright © 2018. Published by Elsevier Ltd.

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

PubMed Central

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

2014-01-01

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

Virtual school teacher's science efficacy beliefs: The effects of community of practice on science-teaching efficacy beliefs

NASA Astrophysics Data System (ADS)

Uzoff, Phuong Pham

The purpose of this study was to examine how much K-12 science teachers working in a virtual school experience a community of practice and how that experience affects personal science-teaching efficacy and science-teaching outcome expectancy. The study was rooted in theoretical frameworks from Lave and Wenger's (1991) community of practice and Bandura's (1977) self-efficacy beliefs. The researcher used three surveys to examine schoolteachers' experiences of a community of practice and science-teaching efficacy beliefs. The instrument combined Mangieri's (2008) virtual teacher demographic survey, Riggs and Enochs (1990) Science-teaching efficacy Beliefs Instrument-A (STEBI-A), and Cadiz, Sawyer, and Griffith's (2009) Experienced Community of Practice (eCoP) instrument. The results showed a significant linear statistical relationship between the science teachers' experiences of community of practice and personal science-teaching efficacy. In addition, the study found that there was also a significant linear statistical relationship between teachers' community of practice experiences and science-teaching outcome expectancy. The results from this study were in line with numerous studies that have found teachers who are involved in a community of practice report higher science-teaching efficacy beliefs (Akerson, Cullen, & Hanson, 2009; Fazio, 2009; Lakshmanan, Heath, Perlmutter, & Elder, 2011; Liu, Lee, & Lin, 2010; Sinclair, Naizer, & Ledbetter, 2010). The researcher concluded that school leaders, policymakers, and researchers should increase professional learning opportunities that are grounded in social constructivist theoretical frameworks in order to increase teachers' science efficacy.

Vaccine financing and billing in practices serving adult patients: A follow-up survey.

PubMed

Lindley, Megan C; Hurley, Laura P; Beaty, Brenda L; Allison, Mandy A; Crane, Lori A; Brtnikova, Michaela; Snow, Megan; Bridges, Carolyn B; Kempe, Allison

2018-02-14

Financial concerns are often cited by physicians as a barrier to administering routinely recommended vaccines to adults. The purpose of this study was to assess perceived payments and profit from administering recommended adult vaccines and vaccine purchasing practices among general internal medicine (GIM) and family medicine (FM) practices in the United States. We conducted an interviewer-administered survey from January-June 2014 of practices stratified by specialty (FM or GIM), affiliation (standalone or ≥ 2 practice sites), and level of financial decision-making (independent or larger system level) in FM and GIM practices that responded to a previous survey on adult vaccine financing and provided contact information for follow-up. Practice personnel identified as knowledgeable about vaccine financing and billing responded to questions about payments relative to vaccine purchase price and payment for vaccine administration, perceived profit on vaccination, claim denial, and utilization of various purchasing strategies for private vaccine stocks. Survey items on payment and perceived profit were assessed for various public and private payer types. Descriptive statistics were calculated and responses compared by physician specialty, practice affiliation, and level of financial decision-making. Of 242 practices approached, 43% (n = 104) completed the survey. Reported payment levels and perceived profit varied by payer type. Only for preferred provider organizations did a plurality of respondents report profiting on adult vaccination services. Over half of respondents reported losing money vaccinating adult Medicaid beneficiaries. One-quarter to one-third of respondents reported not knowing about Medicare Part D payment levels for vaccine purchase and vaccine administration, respectively. Few respondents reported negotiating with manufacturers or insurance plans on vaccine purchase prices or payments for vaccination. Practices vaccinating adults may benefit from education and technical assistance related to vaccine financing and billing and greater use of purchasing strategies to decrease upfront vaccine cost. Published by Elsevier Ltd.

Systematic survey of randomized trials evaluating the impact of alternative diagnostic strategies on patient-important outcomes.

PubMed

El Dib, Regina; Tikkinen, Kari A O; Akl, Elie A; Gomaa, Huda A; Mustafa, Reem A; Agarwal, Arnav; Carpenter, Christopher R; Zhang, Yuchen; Jorge, Eliane C; Almeida, Ricardo A M B; do Nascimento Junior, Paulo; Doles, Joao Vitor P; Mustafa, Ahmad A; Sadeghirad, Behnam; Lopes, Luciane C; Bergamaschi, Cristiane C; Suzumura, Erica A; Cardoso, Marília M A; Corrente, José Eduardo; Stone, Samuel B; Schunemann, Holger J; Guyatt, Gordon H

2017-04-01

To provide a perspective on the current practice of randomized clinical trials (RCTs) of diagnostic strategies focusing on patient-important outcomes. We conducted a comprehensive search of MEDLINE and included RCTs published in full-text reports that evaluated alternative diagnostic strategies. Of 56,912 unique citations, we sampled 7,500 and included 103 eligible RCTs, therefore suggesting that MEDLINE includes approximately 781 diagnostic RCTs. The 103 eligible trials reported on: mortality (n = 41; 39.8%); morbidities (n = 63; 61.2%); symptoms/quality of life/functional status (n = 14; 13.6%); and on composite end points (n = 10; 9.7%). Of the studies that reported statistically significant results (n = 12; 11.6%), we judged 7 (58.3%) as at low risk of bias with respect to missing outcome data and 4 (33.3%) as at low risk of bias regarding blinding. Of the 41 RCTs that reported on mortality, only one (2.4%) reported statistically significant results. Of 63 RCTs addressing morbidity outcomes, 11 (17.5%) reported statistically significant results, all of which reported relative effects of greater than 20%. RCTs of diagnostic tests are not uncommon, and sometimes suggest benefits on patient-important outcomes but often suffer from limitations in sample size and conduct. Copyright © 2017 Elsevier Inc. All rights reserved.

Yoga and heart rate variability: A comprehensive review of the literature

PubMed Central

Tyagi, Anupama; Cohen, Marc

2016-01-01

Heart rate variability (HRV) has been used as a proxy for health and fitness and indicator of autonomic regulation and therefore, appears well placed to assess the changes occurring with mind.-body practices that facilitate autonomic balance. While many studies suggest that yoga influences HRV, such studies have not been systematically reviewed. We aimed to systematically review all published papers that report on yoga practices and HRV. A comprehensive search of multiple databases was conducted and all studies that reported a measure of HRV associated with any yoga practice were included. Studies were categorized by the study design and type of yoga practice. A total of 59 studies were reviewed involving a total of 2358 participants. Most studies were performed in India on relatively small numbers of healthy male yoga practitioners during a single laboratory session. Of the reviewed studies, 15 were randomized controlled trials with 6 having a Jadad score of 3. The reviewed studies suggest that yoga can affect cardiac autonomic regulation with increased HRV and vagal dominance during yoga practices. Regular yoga practitioners were also found to have increased vagal tone at rest compared to non-yoga practitioners. It is premature to draw any firm conclusions about yoga and HRV as most studies were of poor quality, with small sample sizes and insufficient reporting of study design and statistical methods. Rigorous studies with detailed reporting of yoga practices and any corresponding changes in respiration are required to determine the effect of yoga on HRV. PMID:27512317

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

PubMed

Wekerle, Christine

2013-01-01

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

Importance of reporting segmental bowel preparation scores during colonoscopy in clinical practice

PubMed Central

Jain, Deepanshu; Momeni, Mojdeh; Krishnaiah, Mahesh; Anand, Sury; Singhal, Shashideep

2015-01-01

AIM: To evaluate the impact of reporting bowel preparation using Boston Bowel Preparation Scale (BBPS) in clinical practice. METHODS: The study was a prospective observational cohort study which enrolled subjects reporting for screening colonoscopy. All subjects received a gallon of polyethylene glycol as bowel preparation regimen. After colonoscopy the endoscopists determined quality of bowel preparation using BBPS. Segmental scores were combined to calculate composite BBPS. Site and size of the polyps detected was recorded. Pathology reports were reviewed to determine advanced adenoma detection rates (AADR). Segmental AADR’s were calculated and categorized based on the segmental BBPS to determine the differential impact of bowel prep on AADR. RESULTS: Three hundred and sixty subjects were enrolled in the study with a mean age of 59.2 years, 36.3% males and 63.8% females. Four subjects with incomplete colonoscopy due BBPS of 0 in any segment were excluded. Based on composite BBPS subjects were divided into 3 groups; Group-0 (poor bowel prep, BBPS 0-3) n = 26 (7.3%), Group-1 (Suboptimal bowel prep, BBPS 4-6) n = 121 (34%) and Group-2 (Adequate bowel prep, BBPS 7-9) n = 209 (58.7%). AADR showed a linear trend through Group-1 to 3; with an AADR of 3.8%, 14.8% and 16.7% respectively. Also seen was a linear increasing trend in segmental AADR with improvement in segmental BBPS. There was statistical significant difference between AADR among Group 0 and 2 (3.8% vs 16.7%, P < 0.05), Group 1 and 2 (14.8% vs 16.7%, P < 0.05) and Group 0 and 1 (3.8% vs 14.8%, P < 0.05). χ2 method was used to compute P value for determining statistical significance. CONCLUSION: Segmental AADRs correlate with segmental BBPS. It is thus valuable to report segmental BBPS in colonoscopy reports in clinical practice. PMID:25852286

Importance of reporting segmental bowel preparation scores during colonoscopy in clinical practice.

PubMed

Jain, Deepanshu; Momeni, Mojdeh; Krishnaiah, Mahesh; Anand, Sury; Singhal, Shashideep

2015-04-07

To evaluate the impact of reporting bowel preparation using Boston Bowel Preparation Scale (BBPS) in clinical practice. The study was a prospective observational cohort study which enrolled subjects reporting for screening colonoscopy. All subjects received a gallon of polyethylene glycol as bowel preparation regimen. After colonoscopy the endoscopists determined quality of bowel preparation using BBPS. Segmental scores were combined to calculate composite BBPS. Site and size of the polyps detected was recorded. Pathology reports were reviewed to determine advanced adenoma detection rates (AADR). Segmental AADR's were calculated and categorized based on the segmental BBPS to determine the differential impact of bowel prep on AADR. Three hundred and sixty subjects were enrolled in the study with a mean age of 59.2 years, 36.3% males and 63.8% females. Four subjects with incomplete colonoscopy due BBPS of 0 in any segment were excluded. Based on composite BBPS subjects were divided into 3 groups; Group-0 (poor bowel prep, BBPS 0-3) n = 26 (7.3%), Group-1 (Suboptimal bowel prep, BBPS 4-6) n = 121 (34%) and Group-2 (Adequate bowel prep, BBPS 7-9) n = 209 (58.7%). AADR showed a linear trend through Group-1 to 3; with an AADR of 3.8%, 14.8% and 16.7% respectively. Also seen was a linear increasing trend in segmental AADR with improvement in segmental BBPS. There was statistical significant difference between AADR among Group 0 and 2 (3.8% vs 16.7%, P < 0.05), Group 1 and 2 (14.8% vs 16.7%, P < 0.05) and Group 0 and 1 (3.8% vs 14.8%, P < 0.05). χ(2) method was used to compute P value for determining statistical significance. Segmental AADRs correlate with segmental BBPS. It is thus valuable to report segmental BBPS in colonoscopy reports in clinical practice.

Accidental death in autoerotic maneuvers.

PubMed

Focardi, Martina; Gualco, Barbara; Norelli, GianAristide

2008-03-01

The authors from the Florence Forensic Department present a case that demonstrates the paradigms attached to accidental deaths while performing autoerotic maneuvers. The incidents of such practices are underestimated and are only the tip of the iceberg since they do not represent the cases that are never reported due to successful practice. After analyzing the statistic data, the authors describe the case and discuss about the element that prove the accidental nature of the death and the importance of the correct application of forensic methodology at the scene and in the mortuary.

The spiritual and religious identities, beliefs, and practices of academic pediatricians in the United States.

PubMed

Catlin, Elizabeth Ann; Cadge, Wendy; Ecklund, Elaine Howard; Gage, Elizabeth A; Zollfrank, Angelika Annette

2008-12-01

Physicians' spiritual and religious identities, beliefs, and practices are beginning to be explored. The objective of this study was to gather descriptive information about personal religion and spirituality from a random sample of academic American pediatricians and to compare this information with similar data from the public. In 2005, a Web-based survey of a random sample of 208 pediatrician faculty from 13 academic centers ranked by the US News & World Report as "honor roll" hospitals was conducted. Surveys elicited information about personal beliefs and practices as well as their influence on decisions about patient care and clinical practice. Multiple questions were replicated from the General Social Survey to enable comparisons with the public. Descriptive statistics were generated, and logistic regression analyses were conducted on relevant variables. Nearly 88% of respondents were raised in a religious tradition, but just 67.2% claimed current religious identification. More than half (52.6%) reported praying privately; additional spiritual practices reported included relaxation techniques (38.8%), meditation (29.3%), sacred readings (26.7%), and yoga (19%). The majority of academic pediatricians (58.6%) believed that personal spiritual or religious beliefs influenced their interactions with patients/colleagues. These odds increased 5.1-fold when academic pediatricians attended religious services monthly or more (P < .05). Compared with the American public, a notably smaller proportion of academic pediatricians reported a personal religious identity. The majority believed spiritual and religious beliefs influenced their practice of pediatrics. Whether secular or faith-based belief systems measurably modify academic pediatric practice is unknown.

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

PubMed

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

2015-03-01

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

Practice activities of privately-practicing nurse practitioners: Results from an Australian survey.

PubMed

Currie, Jane; Chiarella, Mary; Buckley, Thomas

2018-03-01

To facilitate expansion of privately-practicing nurse practitioners in community and primary care settings, a legislative amendment in 2010 made privately-practicing nurse practitioners eligible to provide services subsidised through the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme. To evaluate their practice activities, a national survey of privately-practicing nurse practitioners in Australia was conducted, and data analysed using descriptive statistics and thematic analysis (n = 73). As part of their role, 96% (n = 70) participants reported undertaking direct patient care, 95% (n = 69) patient education and health promotion, 95% (n = 69) prescribed medications, 92% (n = 67) referred patients for diagnostic investigations, and 88% (n = 64) reported making a diagnosis. Over 50% of participants saw up to 15 patients daily, and 80% (n = 58) treated the same patients on a regular basis. Of the participants, 59% (n = 43) perceived that they worked to their full scope of practice. The mainstay of privately-practicing nurse practitioner services is provision of direct patient care in community and primary healthcare settings, suggesting they have emerging potential in addressing the ever-increasing demand for healthcare in Australia. © 2017 John Wiley & Sons Australia, Ltd.

A cross-sectional mixed methods study protocol to generate learning from patient safety incidents reported from general practice.

PubMed

Carson-Stevens, Andrew; Hibbert, Peter; Avery, Anthony; Butlin, Amy; Carter, Ben; Cooper, Alison; Evans, Huw Prosser; Gibson, Russell; Luff, Donna; Makeham, Meredith; McEnhill, Paul; Panesar, Sukhmeet S; Parry, Gareth; Rees, Philippa; Shiels, Emma; Sheikh, Aziz; Ward, Hope Olivia; Williams, Huw; Wood, Fiona; Donaldson, Liam; Edwards, Adrian

2015-12-01

Incident reports contain descriptions of errors and harms that occurred during clinical care delivery. Few observational studies have characterised incidents from general practice, and none of these have been from the England and Wales National Reporting and Learning System. This study aims to describe incidents reported from a general practice care setting. A general practice patient safety incident classification will be developed to characterise patient safety incidents. A weighted-random sample of 12,500 incidents describing no harm, low harm and moderate harm of patients, and all incidents describing severe harm and death of patients will be classified. Insights from exploratory descriptive statistics and thematic analysis will be combined to identify priority areas for future interventions. The need for ethical approval was waivered by the Aneurin Bevan University Health Board research risk review committee given the anonymised nature of data (ABHB R&D Ref number: SA/410/13). The authors will submit the results of the study to relevant journals and undertake national and international oral presentations to researchers, clinicians and policymakers. 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/

Smoking behavior and patient education practices of oncology nurses in six countries.

PubMed

Lally, Robin M; Chalmers, Karen I; Johnson, Judith; Kojima, Misako; Endo, Emiko; Suzuki, Shizue; Lai, Yeur-Hur; Yang, Young-Hee; Degner, Lesley; Anderson, Elsie; Molassiotis, Alexander

2008-09-01

Worldwide, tobacco is the leading cause of preventable death, resulting in approximately 5 million deaths annually. Nurses are keenly positioned to work toward reducing tobacco-related illness and deaths. Therefore, guided by the health belief model, the purpose of this study was to explore the smoking behavior, beliefs, smoking cessation education practices, and existing smoking policies at the institutions of a sample of practicing oncology nurses in Canada, Japan, Korea, Taiwan, United Kingdom, and the United States. A 27-item structured survey, designed for this study in English and translated and reverse translated by the Asian countries, was distributed to a convenience sample of nurses attending oncology meetings in each country. Totally 759 surveys were completed and analyzed using descriptive statistics. Principle findings indicate that 4.5% of these nurses currently smoke, although 23.3% reported smoking previously. While many nurses (74%) reported frequently assessing the smoking status of patients, only 50% reported discussing cessation with their patients that smoke. Although the majority (80%) reported feeling comfortable with asking their patients about smoking, only 23% felt it was the nurse's role. The findings indicate that while internationally oncology nurses recognize the importance of smoking cessation, significant room for improvement exists in translating this into practice.

Physician Practice Information: The Practice Expenses and Characteristics of Sleep Medicine as Compared with Other AMA-Recognized Medical Specialties

PubMed Central

Blehart, Caroline

2009-01-01

Summary: This report introduces the Physician Practice Information (PPI) Survey and its findings. Background information on the PPI Survey is explained, as is the Survey's importance to the field of sleep medicine. Statistics reported by the Survey regarding Practice Expenses per Hour (PE/HR) for various specialties are analyzed in comparison with those reported specifically for sleep medicine. The similarities and differences between sleep medicine and all other medical specialties surveyed in terms of practice characteristics are also discussed. Analysis of PE/HR data found that sleep medicine payroll practice expenses are closest to those of obstetrics/gynecology, likely due to the employment of technologists in both fields. Regarding supplies and equipment expenses, sleep medicine is most similar to radiology, cardiology, and spine surgery, probably due to the use of disposable medical supplies. In terms of total PE/HR (less separately billable), sleep medicine is most like obstetrics/gynecology, orthopedic surgery, and otolaryngology. The full cause of this is undeterminable from the PPI Survey. Some areas of dissimilarity in regard to the practice characteristics of sleep physicians and all physicians surveyed across all specialties were found. Most of these fell in the area of “practice size and function of non-physician personnel.” Overall, the results of this section of the PPI Survey show that sleep medicine is practiced in a manner similar to that of the various specialty fields of all physicians surveyed across all specialties but still maintains some unique practice characteristics. Citation: Blehart C. Physician practice information: the practice expenses and characteristics of sleep medicine as compared with other AMA-recognized medical specialties. J Clin Sleep Med 2009;5(6):E1-E11.

Academic Librarians' Practices and Perceptions on Web-Based Instruction for Academic Library Patrons as Adult Learners

ERIC Educational Resources Information Center

Taylor, Deborah Michelle

2016-01-01

Academic librarians are encouraged to provide library services, resources, and instruction to all patrons, including the adult learner. Statistics reported that worldwide, adults are a growing student population in colleges and universities; however, the adult learner as an academic library patron is often neglected. Academic libraries can…

Black Boys Can Write: Challenging Dominant Framings of African American Adolescent Males in Literacy Research

ERIC Educational Resources Information Center

Haddix, Marcelle

2009-01-01

In this article, the author considers how dominant cultural framings of African American adolescent males intersect with literacy research, policy, and practice. The overrepresentation of statistical and policy reports that place African American males and their low academic performance in the center of the frame risks further reifying and…

Give or Take a Few? Comparing Measured and Self-Reported Height and Weight as Correlates of Social Physique Anxiety

ERIC Educational Resources Information Center

Gay, Jennifer; Monsma, Eva V.; Torres-McGehee, Toni

2009-01-01

Statistically controlling for physical size is common practice, especially in self-perception studies uncovering the etiology of maladaptive behaviors, such as eating disorders. For example, social physique anxiety (SPA)--apprehension about social evaluations while presenting oneself in front of others (Leary, 1992)--is a prominent correlate of…

Parenting and Socialization of Only Children in Urban China: An Example of Authoritative Parenting

ERIC Educational Resources Information Center

Lu, Hui Jing; Chang, Lei

2013-01-01

The authors report a semistructured interview of 328 urban Chinese parents regarding their parenting beliefs and practices with respect to their only children. Statistical analyses of the coded parental interviews and peer nomination data from the children show none of the traditional Chinese parenting or child behaviors that have been widely…

Prove It! Putting Together the Evidence-Based Practice Puzzle

ERIC Educational Resources Information Center

Little, Hannah Byrd

2015-01-01

Why is it important to prove that school libraries add value to the school program? The National Center for Education Statistics reports that 20 percent of U.S. public schools lack a full or part-time certified librarian (NCES 2013). In California the ratio of certified school librarians to students is 1:7,374 (California Department of Education…

Five Years Later: A Look at Building and Triangulating Evidence in a School Library

ERIC Educational Resources Information Center

Yutzey, Susan D.

2010-01-01

Participating in an evidence-based practice workshop in 2005 was a transforming experience for the author. She realized that the traditional statistics that she had painstakingly gathered and recorded for her annual report did not provide evidence of actual learning. Evidence acquired through assessment, both formative and summative, provides the…

Development and Validation of a Teaching Practice Scale (TISS) for Instructors of Introductory Statistics at the College Level

ERIC Educational Resources Information Center

Hassad, Rossi A.

2009-01-01

This study examined the teaching practices of 227 college instructors of introductory statistics (from the health and behavioral sciences). Using primarily multidimensional scaling (MDS) techniques, a two-dimensional, 10-item teaching practice scale, TISS (Teaching of Introductory Statistics Scale), was developed and validated. The two dimensions…

Career retention in the dental hygiene workforce in Texas.

PubMed

Johns, G H; Gutmann, M E; DeWald, J P; Nunn, M E

2001-01-01

The purpose of this study was to determine the factors that influence the retention and attrition of dental hygienists within the workforce in Texas. Respondents' perception of the role of employee benefits and practice of dental hygiene on career retention were explored. Demographic descriptors, including educational level, marital status, age, employment setting, and practice statuses, were also examined. A questionnaire modified from the American Dental Hygienists' Association Extension Study: Retention of Dental Hygienists in the Workforce Final Report, April 1992, was mailed to a systematic sample of licensed Texas dental hygienists in March 1999. Descriptive statistics were computed for dental hygienists currently in practice in Texas and those not in practice at the time of the survey. Differences in demographics, benefits, and attitudes between dental hygienists currently in practice in Texas and dental hygienists not in practice at the time of the survey were tested using independent t-tests for interval data and chi-squared tests for categorical data. All statistical analyses were conducted using the Statistical Package for Social Scientists (SPSS v. 9, Chicago, Illinois). A response rate of 68.1% was obtained. Results revealed the primary reasons for remaining in the practice of dental hygiene were salary, family responsibility, professional collaboration, and variety of work. The primary reasons for leaving dental hygiene practice were family responsibility, boredom, salary, and lack of benefits. Secondary and tertiary reasons stated for staying in clinical practice revealed additional factors including benefits, participation in decision-making, and a safe environment. Dental hygienists in clinical practice were more likely to be employed by a dentist in a single practice and see more patients per day, have a certificate or associate's degree, be unmarried, have fewer children, and be younger than dental hygienists not in practice. The findings suggest that dental hygienists in Texas who remain in the workforce are positively influenced primarily by salary. Dental hygienists in Texas who had left the workforce were primarily influenced to leave practice because of family responsibility. Boredom and lack of benefits were also important factors in deciding to leave clinical practice. Employers of dental hygienists need to be aware of these factors in the hiring process. In addition, dental hygiene educators should prepare students in interviewing techniques for better communication regarding retention factors.

Cardiac surgery report cards: comprehensive review and statistical critique.

PubMed

Shahian, D M; Normand, S L; Torchiana, D F; Lewis, S M; Pastore, J O; Kuntz, R E; Dreyer, P I

2001-12-01

Public report cards and confidential, collaborative peer education represent distinctly different approaches to cardiac surgery quality assessment and improvement. This review discusses the controversies regarding their methodology and relative effectiveness. Report cards have been the more commonly used approach, typically as a result of state legislation. They are based on the presumption that publication of outcomes effectively motivates providers, and that market forces will reward higher quality. Numerous studies have challenged the validity of these hypotheses. Furthermore, although states with report cards have reported significant decreases in risk-adjusted mortality, it is unclear whether this improvement resulted from public disclosure or, rather, from the development of internal quality programs by hospitals. An additional confounding factor is the nationwide decline in heart surgery mortality, including states without quality monitoring. Finally, report cards may engender negative behaviors such as high-risk case avoidance and "gaming" of the reporting system, especially if individual surgeon results are published. The alternative approach, continuous quality improvement, may provide an opportunity to enhance performance and reduce interprovider variability while avoiding the unintended negative consequences of report cards. This collaborative method, which uses exchange visits between programs and determination of best practice, has been highly effective in northern New England and in the Veterans Affairs Administration. However, despite their potential advantages, quality programs based solely on confidential continuous quality improvement do not address the issue of public accountability. For this reason, some states may continue to mandate report cards. In such instances, it is imperative that appropriate statistical techniques and report formats are used, and that professional organizations simultaneously implement continuous quality improvement programs. The statistical methodology underlying current report cards is flawed, and does not justify the degree of accuracy presented to the public. All existing risk-adjustment methods have substantial inherent imprecision, and this is compounded when the results of such patient-level models are aggregated and used inappropriately to assess provider performance. Specific problems include sample size differences, clustering of observations, multiple comparisons, and failure to account for the random component of interprovider variability. We advocate the use of hierarchical or multilevel statistical models to address these concerns, as well as report formats that emphasize the statistical uncertainty of the results.

Systematic review of practice guideline dissemination and implementation strategies for healthcare teams and team-based practice.

PubMed

Medves, Jennifer; Godfrey, Christina; Turner, Carly; Paterson, Margo; Harrison, Margaret; MacKenzie, Lindsay; Durando, Paola

2010-06-01

To synthesis the literature relevant to guideline dissemination and implementation strategies for healthcare teams and team-based practice. Systematic approach utilising Joanna Briggs Institute methods. Two reviewers screened all articles and where there was disagreement, a third reviewer determined inclusion. Initial search revealed 12,083 of which 88 met the inclusion criteria. Ten dissemination and implementation strategies identified with distribution of educational materials the most common. Studies were assessed for patient or practitioner outcomes and changes in practice, knowledge and economic outcomes. A descriptive analysis revealed multiple approaches using teams of healthcare providers were reported to have statistically significant results in knowledge, practice and/or outcomes for 72.7% of the studies. Team-based care using practice guidelines locally adapted can affect positively patient and provider outcomes. © 2010 The Authors. Journal Compilation © Blackwell Publishing Asia Pty Ltd.

Household Survey of Pesticide Practice, Deliberate Self-Harm, and Suicide in the Sundarban Region of West Bengal, India

PubMed Central

Banerjee, Sohini; Chowdhury, Arabinda Narayan; Schelling, Esther; Weiss, Mitchell G.

2013-01-01

The toxicological impact and intentional ingestion of pesticides are major public health concerns globally. This study aimed to estimate the extent of deliberate self-harm (DSH) and suicides (suicidal behaviour) and document pesticide practices in Namkhana block of the Sundarban region, India. A cross-sectional study was conducted in 1680 households (21 villages) following a mixed random and cluster design sampling. The survey questionnaire (Household Information on Pesticide Use and DSH) was developed by the research team to elicit qualitative and quantitative information. The Kappa statistic and McNemar's test were used to assess the level of agreement and association between respondents' and investigators' opinions about safe storage of pesticides. Over five years, 1680 households reported 181 incidents of suicidal behaviour. Conflict with family members was the most frequently reported reason for suicidal behaviour (53.6%). The Kappa statistic indicated poor agreement between respondents and investigators about safe storage of pesticides. The pesticide-related annual DSH rate was 158.1 (95% CI 126.2–195.5), and for suicide it was 73.4 (95% CI 52.2–100.3) per 100,000. Unsafe pesticide practice and psychosocial stressors are related to the high rates of suicidal behaviour. An intersectoral approach involving the local governments, agricultural department and the health sector would help to reduce the magnitude of this public health problem. PMID:24224181

Knowledge, awareness, and behaviors of endocrinologists and dentists for the relationship between diabetes and periodontitis.

PubMed

Lin, Hanxiao; Zhang, Hua; Yan, Yuxia; Liu, Duan; Zhang, Ruyi; Liu, Yeungyeung; Chen, Pei; Zhang, Jincai; Xuan, Dongying

2014-12-01

This study aimed to compare the opinions of dentists and endocrinologists regarding diabetes mellitus (DM) and periodontitis, and to investigate the possible effects on their practice. Cross-sectional data were collected from 297 endocrinologists and 134 dentists practicing in southern China using two separated questionnaires. Questions were close-ended or Likert-scaled. Statistical analyses were done by descriptive statistics, bivariate and binary logistic regression analysis. Compared with endocrinologists, dentists presented more favorable attitudes for the relationship of DM and periodontitis (P<0.001). 61.2% of dentists reported they would frequently refer patients with severe periodontitis for DM evaluation, while only 26.6% of endocrinologists reported they would frequently advise patients with DM to visit a dentist. Nearly all of the respondents (94.4%) agreed that the interdisciplinary collaboration should be strengthened. The logistic regression analysis exhibited that respondents with more favorable attitudes were more likely to advise a dental visit (P=0.003) or to screen for DM (P=0.006). Endocrinologists and dentists are not equally equipped with the knowledge about the relationship between DM and periodontitis, and there is a wide gap between their practice and the current evidence, especially for endocrinologists. It's urgent to take measures to develop the interdisciplinary education and collaboration among the health care providers. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Developing nurse leaders: a program enhancing staff nurse leadership skills and professionalism.

PubMed

Abraham, Pauline J

2011-01-01

This study aims to determine whether participation in the Nursing Leadership Perspectives Program (NLPP) at Mayo Clinic in Rochester, Minnesota, produced a change in leadership skills, increased professional activities, leadership promotion, and retention rates of participants. The NLPP is an educational program designed to enhance leadership skills and promote professionalism of registered nurses. The 6-month program provides participants with theoretical knowledge, core competencies, and opportunities to practice application of leadership skills. Outcome metrics were collected from registered nurses who completed the program (n = 15). Data analysis included descriptive and nonparametric methods. Participants reported statistically significant changes in their leadership skills after participation in the program (P = .007) on the Leadership Practices Inventory. Changes in professional behavior were also statistically significant as rated by the Nursing Activity Scale (P = .001). Participants demonstrated a change in leadership skills and professional behavior following the program.

Perceptions of business skill development by graduates of the University of Michigan Dental School.

PubMed

Barber, Michael; Wiesen, Robert; Arnold, Sara; Taichman, Russell S; Taichman, Linda Susan

2011-04-01

Many graduating dentists leave dental school feeling that they are not prepared to start and run a dental practice. The aim of this pilot study was to explore the knowledge and perceptions dental graduates have in the area of practice management. A twenty-item survey was mailed in the fall of 2008 to nearly half of the University of Michigan dental school alumni who had graduated between the years of 1997 and 2007. Respondents were asked about their demographics, practice characteristics, and perceptions of knowledge/experience regarding practice management skills at the present time as well as at graduation. Data were analyzed using descriptive and inferential statistics. The majority of respondents were general practitioners (84 percent) aged thirty to thirty-nine practicing between six and ten years with practice incomes reported to be greater than $300,000 per year (79 percent). Most dentists reported being either an owner or co-owner of the practice (57 percent), and 33 percent reported being an associate in the practice. Upon graduation, 7 percent of the respondents felt that they had a strong knowledge of accounting or human resource issues; this perception increased to 47 percent at the present time. Similarly, less than 6 percent of respondents felt they understood issues pertaining to dental insurance upon graduation; this perception increased to 68 percent after having spent time in the workforce. In contrast to the large increase in knowledge/experience in business aspects of dentistry that had accrued since graduation, most alumni reported only a 7 percent increase in their knowledge of the legal aspects of dental practice. Results from this study indicate that interventions are needed to increase graduating dentists' knowledge of practice management and close the gap between their knowledge and its application in real life. The majority of alumni believed there is a need to improve the curriculum focused on these aspects of dental practice.

A person based formula for allocating commissioning funds to general practices in England: development of a statistical model.

PubMed

Dixon, Jennifer; Smith, Peter; Gravelle, Hugh; Martin, Steve; Bardsley, Martin; Rice, Nigel; Georghiou, Theo; Dusheiko, Mark; Billings, John; Lorenzo, Michael De; Sanderson, Colin

2011-11-22

To develop a formula for allocating resources for commissioning hospital care to all general practices in England based on the health needs of the people registered in each practice Multivariate prospective statistical models were developed in which routinely collected electronic information from 2005-6 and 2006-7 on individuals and the areas in which they lived was used to predict their costs of hospital care in the next year, 2007-8. Data on individuals included all diagnoses recorded at any inpatient admission. Models were developed on a random sample of 5 million people and validated on a second random sample of 5 million people and a third sample of 5 million people drawn from a random sample of practices. All general practices in England as of 1 April 2007. All NHS inpatient admissions and outpatient attendances for individuals registered with a general practice on that date. All individuals registered with a general practice in England at 1 April 2007. Power of the statistical models to predict the costs of the individual patient or each practice's registered population for 2007-8 tested with a range of metrics (R(2) reported here). Comparisons of predicted costs in 2007-8 with actual costs incurred in the same year were calculated by individual and by practice. Models including person level information (age, sex, and ICD-10 codes diagnostic recorded) and a range of area level information (such as socioeconomic deprivation and supply of health facilities) were most predictive of costs. After accounting for person level variables, area level variables added little explanatory power. The best models for resource allocation could predict upwards of 77% of the variation in costs at practice level, and about 12% at the person level. With these models, the predicted costs of about a third of practices would exceed or undershoot the actual costs by 10% or more. Smaller practices were more likely to be in these groups. A model was developed that performed well by international standards, and could be used for allocations to practices for commissioning. The best formulas, however, could predict only about 12% of the variation in next year's costs of most inpatient and outpatient NHS care for each individual. Person-based diagnostic data significantly added to the predictive power of the models.

Principled Missing Data Treatments.

PubMed

Lang, Kyle M; Little, Todd D

2018-04-01

We review a number of issues regarding missing data treatments for intervention and prevention researchers. Many of the common missing data practices in prevention research are still, unfortunately, ill-advised (e.g., use of listwise and pairwise deletion, insufficient use of auxiliary variables). Our goal is to promote better practice in the handling of missing data. We review the current state of missing data methodology and recent missing data reporting in prevention research. We describe antiquated, ad hoc missing data treatments and discuss their limitations. We discuss two modern, principled missing data treatments: multiple imputation and full information maximum likelihood, and we offer practical tips on how to best employ these methods in prevention research. The principled missing data treatments that we discuss are couched in terms of how they improve causal and statistical inference in the prevention sciences. Our recommendations are firmly grounded in missing data theory and well-validated statistical principles for handling the missing data issues that are ubiquitous in biosocial and prevention research. We augment our broad survey of missing data analysis with references to more exhaustive resources.

Interpretation of lung cancer study outcomes.

PubMed

Cortinovis, Diego; Abbate, Marida; Bidoli, Paolo; Pelizzoni, Davide; Canova, Stefania

2015-11-01

Lung cancer is the leading cause of cancer death in developed countries. However, in the last few years we observed an important acceleration in drug development due to oncogenic driver tumors discovery. Sharing and putting together preclinical data from benchmark and data from clinical research is the scientific paradigm that allows real breakthrough in clinical practice in this field, but only a few targeted agents are worthy and practice changing. The clinical research and proper use of statistical methodology are the pillars to continue to achieve important goals like improvement of overall survival. A good medical oncologist should be able to critically read a scientific paper and move from the observed outcomes into clinical perspective. Despite clinical improvements, sometimes the union of promising targeted agents and optimistic expectations misrepresent the reality and the value of clinical research. In this article, we try to analyze the meaning of statistical assumptions from clinical trials, especially in lung cancer, through a critical review of the concept of value-based medicine. We also attempt to give the reader some practical tools to weigh scientific value of literature reports.

Socializing Identity Through Practice: A Mixed Methods Approach to Family Medicine Resident Perspectives on Uncertainty.

PubMed

Ledford, Christy J W; Cafferty, Lauren A; Seehusen, Dean A

2015-01-01

Uncertainty is a central theme in the practice of medicine and particularly primary care. This study explored how family medicine resident physicians react to uncertainty in their practice. This study incorporated a two-phase mixed methods approach, including semi-structured personal interviews (n=21) and longitudinal self-report surveys (n=21) with family medicine residents. Qualitative analysis showed that though residents described uncertainty as an implicit part of their identity, they still developed tactics to minimize or manage uncertainty in their practice. Residents described increasing comfort with uncertainty the longer they practiced and anticipated that growth continuing throughout their careers. Quantitative surveys showed that reactions to uncertainty were more positive over time; however, the difference was not statistically significant. Qualitative and quantitative results show that as family medicine residents practice medicine their perception of uncertainty changes. To reduce uncertainty, residents use relational information-seeking strategies. From a broader view of practice, residents describe uncertainty neutrally, asserting that uncertainty is simply part of the practice of family medicine.

Launching Effectiveness Research to Guide Practice in Neurosurgery: A National Institute Neurological Disorders and Stroke Workshop Report

PubMed Central

Walicke, Patricia; Abosch, Aviva; Asher, Anthony; Barker, Fred G.; Ghogawala, Zoher; Harbaugh, Robert; Jehi, Lara; Kestle, John; Koroshetz, Walter; Little, Roderick; Rubin, Donald; Valadka, Alex; Wisniewski, Stephen

2017-01-01

Abstract This workshop addressed challenges of clinical research in neurosurgery. Randomized controlled clinical trials (RCTs) have high internal validity, but often insufficiently generalize to real-world practice. Observational studies are inclusive but often lack sufficient rigor. The workshop considered possible solutions, such as (1) statistical methods for demonstrating causality using observational data; (2) characteristics required of a registry supporting effectiveness research; (3) trial designs combining advantages of observational studies and RCTs; and (4) equipoise, an identified challenge for RCTs. In the future, advances in information technology potentially could lead to creation of a massive database where clinical data from all neurosurgeons are integrated and analyzed, ending the separation of clinical research and practice and leading to a new “science of practice.” PMID:28362926

Correlation of oral hygiene practices, smoking and oral health conditions with self perceived halitosis amongst undergraduate dental students

PubMed Central

Setia, Saniya; Pannu, Parampreet; Gambhir, Ramandeep Singh; Galhotra, Virat; Ahluwalia, Pooja; Sofat, Anjali

2014-01-01

Objective: The present study was undertaken to determine the prevalence of oral hygiene practices, smoking habits and halitosis among undergraduate dental students and correlating the oral hygiene practices, oral health conditions to the prevalence of self perceived oral malodour. Materials and Methods: A self-administered questionnaire was distributed among 277 male and female students. A questionnaire was developed to assess the self-reported perception of oral breath, awareness of bad breath, timing of bad breath, oral hygiene practices, caries and bleeding gums, dryness of the mouth, smoking and tongue coating. Results: The results indicate female students had better oral hygiene practices. Significantly less self-reported oral bad breath (P = 0.007) was found in female dental students (40%) as compared to their male counterparts (58%). It was found that smoking and dryness of mouth had statistically significant correlation with halitosis (P = 0.026, P = 0.001). Presence of other oral conditions such as tongue coating and dental caries and bleeding gums also showed higher prevalence of halitosis in dental students. Conclusion: A direct correlation exists between oral hygiene practices and oral health conditions with halitosis. Females exhibited better oral hygiene practices and less prevalence of halitosis as compared to male students. PMID:24678201

Acute care nurses' perceptions of spirituality and spiritual care: an exploratory study in Singapore.

PubMed

Chew, Brendan Wk; Tiew, Lay Hwa; Creedy, Debra K

2016-09-01

To investigate acute care nurses' perceptions of spirituality and spiritual care and relationships with nurses' personal and professional characteristics. Spirituality and spiritual care are often neglected or absent in daily nursing practice. Nurses' perceptions of spirituality can be influenced by personal, professional and social factors and affect the provision of spiritual care. A cross-sectional, exploratory, nonexperimental design was used. All nursing staff (n = 1008) from a large acute care hospital in Singapore were invited to participate. Participants completed a demographic form and the Spiritual Care-Giving Scale. Completed surveys were received from 767 staff yielding a response rate of 76%. Descriptive statistics and General Linear Modelling were used to analyse data. Acute care nurses reported positive perceptions of spirituality and spiritual care. Religion, area of clinical practice and view of self as spiritual were associated with nurses' reported perspectives of spirituality and spiritual care. Nurses working in this acute care hospital in Singapore reported positive perceptions of spirituality and spiritual care. Respondents tended to equate religion with spirituality and were often unclear about what constituted spiritual care. They reported a sense of readiness to apply an interprofessional approach to spiritual care. However, positive perceptions of spirituality may not necessarily translate into practice. Spiritual care can improve health outcomes. Nurses' understanding of spirituality is essential for best practice. Interprofessional collaboration with clinicians, administrators, educators, chaplains, clergy and spiritual leaders can contribute to the development of practice guidelines and foster spiritual care by nurses. Further research is needed on the practical applications of spiritual care in nursing. © 2016 John Wiley & Sons Ltd.

How the Economy Influences Pedagogy: The Great Recession's Influence on Elementary Teaching Practices

ERIC Educational Resources Information Center

Sawyer, Amanda G.

2017-01-01

From 2007 to 2009, the United States experienced one of the greatest economic declines reported in the previous decades, known as the Great Recession (Bureau of Labor Statistics, 2012). While a great deal of media attention focused on the immediate financial effects of the recession, little discussion was made about the influence of this crisis…

Employment in Perspective: Women in the Labor Force. First Quarter 1988. Report 752.

ERIC Educational Resources Information Center

Bureau of Labor Statistics (DOL), Washington, DC.

A special survey on employer child-care practices conducted by the Bureau of Labor Statistics (BLS) in the summer of 1987 sampled 10,345 establishments with 10 or more employees selected from the BLS establishment universe file and classified by industry and size. The survey showed that over the last decade, the number of mothers in the labor…

Refinement of a Bias-Correction Procedure for the Weighted Likelihood Estimator of Ability. Research Report. ETS RR-07-23

ERIC Educational Resources Information Center

Zhang, Jinming; Lu, Ting

2007-01-01

In practical applications of item response theory (IRT), item parameters are usually estimated first from a calibration sample. After treating these estimates as fixed and known, ability parameters are then estimated. However, the statistical inferences based on the estimated abilities can be misleading if the uncertainty of the item parameter…

How can my research paper be useful for future meta-analyses on forest restoration practices?

Treesearch

Enrique Andivia; Pedro Villar‑Salvador; Juan A. Oliet; Jaime Puertolas; R. Kasten Dumroese

2018-01-01

Statistical meta-analysis is a powerful and useful tool to quantitatively synthesize the information conveyed in published studies on a particular topic. It allows identifying and quantifying overall patterns and exploring causes of variation. The inclusion of published works in meta-analyses requires, however, a minimum quality standard of the reported data and...

Academic Advising, Remedial Courses, and Legislative Mandates: An Exploration of Academic Advising in Florida Community Colleges with Optional Developmental Education

ERIC Educational Resources Information Center

Woods, Chenoa S.; Richard, Keith; Park, Toby; Tandberg, David; Hu, Shouping; Jones, Tamara Bertrand

2017-01-01

In this article we report on our exploration of academic advising practices at 19 community colleges in the Florida College System after the implementation of Senate Bill 1720. This bill made developmental education optional for many students and mandated that colleges provide academic advising for all new students. Descriptive statistics of…

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

PubMed

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

2017-02-01

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

The use of equipment and training practices and the prevalence of owner-reported ridden behaviour problems in UK leisure horses.

PubMed

Hockenhull, J; Creighton, E

2013-01-01

UK leisure horses are owned primarily for riding. Ridden behaviour problems may compromise the use of the horse in this role and lead to harsh redress or relinquishment of the horse. Despite the consequences of these problems little is known about their prevalence or the working lives of UK leisure horses. To generate data on the work undertaken by leisure horses, the equipment and training practices used with them and prevalence of ridden behaviour problems. An internet survey was used to generate horse-level data from a convenience sample of leisure horse carers. Respondents were asked to report on their practices in the week prior to the survey's completion to minimise recall bias. The survey was online for one year to allow for seasonal variation in practices. Data were collected on the tack and equipment used on the horse, the regularity that professional services (e.g. farriers) were used, type of training employed and frequency the owner reported that horse displayed 15 ridden behaviour problems. The survey generated data on 1326 individual horses. Data describing practices relating to the horse's working life are presented. Ridden behaviour problems were reported in 91% of horses in the week preceding data collection. Descriptive data on the working lives of UK leisure horses provides valuable baseline statistics for this largest section of the UK horse population. High prevalence of owner-reported ridden behaviour problems represents a concern in such leisure horses and may indicate significant rider safety and horse welfare concerns. © 2012 EVJ Ltd.

Use of routine interventions in vaginal labor and birth: findings from the Maternity Experiences Survey.

PubMed

Chalmers, Beverley; Kaczorowski, Janusz; Levitt, Cheryl; Dzakpasu, Susie; O'Brien, Beverley; Lee, Lily; Boscoe, Madeline; Young, David

2009-03-01

Intervention rates in maternity practices vary considerably across Canadian provinces and territories. The objective of this study was to describe the use of routine interventions and practices in labor and birth as reported by women in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System. Rates of interventions and practices are considered in the light of current evidence and both Canadian and international recommendations. A sample of 8,244 estimated eligible women was identified from a randomly selected sample of recently born infants drawn from the May 2006 Canadian Census and stratified primarily by province and territory. Birth mothers living with their infants at the time of interview were invited to participate in a computer-assisted telephone interview conducted by Statistics Canada on behalf of the Public Health Agency of Canada. Interviews averaged 45 minutes long and were completed when infants were between 5 and 10 months old (9-14 mo in the territories). Completed responses were obtained from 6,421 women (78%). Women frequently reported electronic fetal monitoring, a health care practitioner starting or speeding up their labor (or trying to do so), epidural anesthesia, episiotomy, and a supine position for birth. Some women also reported pubic or perineal shaves, enemas, and pushing on the top of their abdomen. Several practices and interventions were commonly reported in labor and birth in Canada, although evidence and Canadian and international guidelines recommend against their routine use. Practices not recommended for use at all, such as shaving, were also reported.

Association between workplace and housing conditions and use of pesticide safety practices and personal protective equipment among North Carolina farmworkers in 2010.

PubMed

Levesque, D L; Arif, A A; Shen, J

2012-04-01

There are inconsistencies about the effects of farmworker housing and workplace conditions and use of self-protective behavior practices and personal protective equipment (PPE). To investigate the association between workplace and housing conditions and farmworker use of pesticide safety practices and PPE. This study was conducted in 4 counties in North Carolina, USA, from July to October, 2010, during the agricultural growing season. Farmworkers working in agriculture aged 18 to 62 (n = 187) were administered a structured questionnaire to collect self-reported measures on housing and workplace conditions. Use of pesticide safety and PPE were examined by asking questions about wearing gloves, wearing socks, and wearing a hat. Chi-square and multiple logistic regression analyses were used for statistical analyses. Farmworkers reporting availability of enough hot and cold water for bathing and doing laundry were 13.6 times more likely to use pesticide safety practices (adjusted OR: 13.6, 95% CI: 1.4-135.4), whereas, those who reported that soap for handwashing was always or usually available while doing agricultural work were 7.8 times more likely to use pesticide safety practices (adjusted OR: 7.8, 95% CI: 3.3-18.5). Farmworkers that reported access to water to wash their hands with while performing agricultural work were more likely to use PPE (adjusted OR: 3.4, 95% CI: 1.3-9.2). Some migrant farmworker labor camps are not supplying acceptable housing conditions such as 1 handwashing sink per 6 people (n = 10, 5.4%). Use of pesticide safety practices and PPE is greater when farmers provide decontamination supplies. Improvement of housing and workplace conditions are crucial to increase use of pesticide safety practices and PPE.

Statistics Graduate Teaching Assistants' Beliefs, Practices and Preparation for Teaching Introductory Statistics

ERIC Educational Resources Information Center

Justice, Nicola; Zieffler, Andrew; Garfield, Joan

2017-01-01

Graduate teaching assistants (GTAs) are responsible for the instruction of many statistics courses offered at the university level, yet little is known about these students' preparation for teaching, their beliefs about how introductory statistics should be taught, or the pedagogical practices of the courses they teach. An online survey to examine…

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

PubMed

Harrington, Peter de Boves

2018-01-02

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

Outlier Removal and the Relation with Reporting Errors and Quality of Psychological Research

PubMed Central

Bakker, Marjan; Wicherts, Jelte M.

2014-01-01

Background The removal of outliers to acquire a significant result is a questionable research practice that appears to be commonly used in psychology. In this study, we investigated whether the removal of outliers in psychology papers is related to weaker evidence (against the null hypothesis of no effect), a higher prevalence of reporting errors, and smaller sample sizes in these papers compared to papers in the same journals that did not report the exclusion of outliers from the analyses. Methods and Findings We retrieved a total of 2667 statistical results of null hypothesis significance tests from 153 articles in main psychology journals, and compared results from articles in which outliers were removed (N = 92) with results from articles that reported no exclusion of outliers (N = 61). We preregistered our hypotheses and methods and analyzed the data at the level of articles. Results show no significant difference between the two types of articles in median p value, sample sizes, or prevalence of all reporting errors, large reporting errors, and reporting errors that concerned the statistical significance. However, we did find a discrepancy between the reported degrees of freedom of t tests and the reported sample size in 41% of articles that did not report removal of any data values. This suggests common failure to report data exclusions (or missingness) in psychological articles. Conclusions We failed to find that the removal of outliers from the analysis in psychological articles was related to weaker evidence (against the null hypothesis of no effect), sample size, or the prevalence of errors. However, our control sample might be contaminated due to nondisclosure of excluded values in articles that did not report exclusion of outliers. Results therefore highlight the importance of more transparent reporting of statistical analyses. PMID:25072606

The American Indian and Alaska Native Dentist Workforce in the United States

PubMed Central

Mertz, Elizabeth; Wides, Cynthia; Gates, Paul

2017-01-01

Objectives The purpose of this paper is to describe the American Indian/Alaska Native (AI/AN) dentist workforce, the general practice patterns of these providers, and their contributions to oral health care for AI/AN and underserved patients. Methods A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 34.0% response rate for self-reported AI/AN dentists. Data were weighted for selection and response bias to be nationally representative. Descriptive and multivariable statistics were computed to provide a workforce profile. Comparisons to Census data and published information on dental students and dentists were used to examine practice patterns. Results The AI/AN dentist workforce (weighted n=442) is very diverse with 55 reported individual tribal affiliations. Tribal heritage was provided by 96.4% of AI/AN dentists (n=426), and of these, 93.9% (n=400) reported an affiliation with only one tribe. The largest share of AI/AN dentists were born in the U.S. (98.2%, n=434), married (75.6%, n=333), and had dependent children under age 18 (52.0%, n=222). Only 0.9% (n=4) of AI/AN dentists spoke a traditional AI/AN language in patient care, while 10.6% (n=46) were raised on tribal land or reservation. Initial practice in the Indian Health Service was reported by 15.8% of AI/AN dentists while 16.2% report currently practicing in a safety-net setting, and 42.0% report working in a practice that primarily serves underserved patients. Conclusions AI/AN dentists provide a disproportionate share of care for AI/AN populations, yet the number of AI/AN dentists would need to increase 7.4 fold in order to meet population parity. PMID:27922723

Knowledge, practice and utilization of dental services among pregnant women in the north of Jordan.

PubMed

Malkawi, Zain A; Tubaishat, Reem S

2014-05-01

The aim of this study was to evaluate women's oral hygiene knowledge, practice, and use of dental services during pregnancy in the north of Jordan. Voluntary sample of 154 pregnant women of 18 to 40 years old were invited to participate in the study. They were asked to read a self-designated questionnaire and a cover letter which explained the purpose of the study. The questionnaire addressed self-reported demographics, knowledge, practice and use of dental services during pregnancy. Data were statistically analyzed using Chi-square test to determine statistically significant differences across knowledge, practice and use of dental services during pregnancy. The sample included 29.3% aged 20 to 24 years old; 33.1% having bachelor degree; and 66.9% were housewives. The majority of study sample 68.2% knew they need dental consultation during pregnancy; however, 39.5% received dental consultation during pregnancy. Majority 62.4% brushed their teeth regularly; however, 73.2% does not use auxiliary dental hygiene devices. Majority 44.5% visited dentist, when they feel pain. Statistically significant association were found between educational level and knowledge about need to dental consultation during pregnancy (p = 0.012); educational level and knowledge about link between pregnancy and periodontal diseases (p = 0.01); and economic status and use of auxiliary dental hygiene devices during pregnancy (p = 0.040). Pregnant women brushed their teeth regularly and visited dentist occasionally. Income was significantly associated with increase use of auxiliary dental hygiene devices. Educational level was significantly associated with mothers' knowledge about the need for consultation and possible link between pregnancy and periodontal diseases.

An investigation into dental digital radiography in dental practices in West Kent following the introduction of the 2006 NHS General Dental Services contract.

PubMed

Mauthe, Peter W; Eaton, Kenneth A

2011-04-01

The primary aims of the study were to investigate the use of digital radiography within primary dental care practices in the West Kent Primary Care Trust (PCT) area and general dental practitioners' (GDPs) self-reported change in radiographic prescribing patterns following the introduction of the nGDS contract in 2006. Data were gathered via a piloted, self-completed questionnaire, and circulated to all GDPs listed on the National Health Service (NHS) Choices website as practising in the West Kent PCT area. There were three mailings and follow-up telephone calls. The resulting data were entered into a statistical software database and, where relevant, statistically tested, using the chi-square test and Pearson correlation coefficient. Of 223 GDPs, 168 (75%) responded. There were 163 usable questionnaires. The respondents represented 85% of the general dental practices in West Kent. Eighty (49%) respondents were using digital intra-oral radiography. Of those who used digital radiography, 44 (55%) reported that they used phosphor plate systems and 36 (45%) that they used direct digital sensors. Eighty-three (51%) had a panoramic machine in their practice, 46 of whom (55%) were using digital systems; of these, 32 (67%) were using a direct digital system. Seventy-one GDPs reported that they worked exclusively or mainly in private practice. Forty (56%) of these 'mainly private' GDPs reported that they used digital radiographic systems, whereas only 40 (44%) of the 89 'mainly NHS' GDPs reported using digital radio-graphic systems. On average, mainly private GDPs made the transition to a digital radiographic system six months before mainly NHS GDPs. Of those who provided NHS dentistry before and after April 2006, only 18 (14%) reported taking fewer radiographs and seven (6%) taking more. In February 2010, of the West Kent GDPs who responded to the questionnaire, just under 50% used digital radio graphy. Mainly private GDPs were more likely to use digital radiography than their mainly NHS counterparts. A link between digital radiography and increased prescription of radiographs was not specifically apparent from this study. There was no evidence that West Kent GDPs were taking fewer radiographs than they did prior to the introduction of the new GDS contract in April 2006. Research is needed to investigate whether the uptake of digital radiography by GDPs in the rest of the country is similar to that in West Kent.

Central line-associated blood stream infections in pediatric ICUs: Longitudinal trends and compliance with bundle strategies

PubMed Central

Edwards, Jeffrey D; Herzig, Carolyn TA; Liu, Hangsheng; Pogorzelska-Maziarz, Monika; Zachariah, Philip; Dick, Andrew W; Saiman, Lisa; Stone, Patricia W; Furuya, E Yoko

2015-01-01

Background Knowing the temporal trend central line-associated bloodstream infection (CLABSI) rates among U.S. pediatric intensive care units (PICU), the current extent of CL bundle compliance, and the impact of compliance on rates is necessary to understand what has been accomplished and can be improved in CLABSI prevention. Methods Longitudinal study of PICUs in National Healthcare Safety Network hospitals and a cross-sectional survey of directors/managers of infection prevention & control departments regarding PICU CLABSI prevention practices, including self-reported compliance with elements of central line bundles. Associations between 2011/12 PICU CLABSI rates and infection prevention practices were examined. Results Reported CLABSI rates decreased during the study period, from 5.8 per 1000 line days in 2006 to 1.4 in 2011/12 (P<0.001). While 73% of PICUs had policies for all central line prevention practices, only 35% of those with policies reported ≥95% compliance. PICUs with ≥95% compliance with central line infection prevention policies had lower reported CLABSI rates, but this association was statistically insignificant. Conclusions There was a non-significant trend in decreasing CLABSI rates as PICUs improved bundle policy compliance. Given that few PICUs reported full compliance with these policies, PICUs increasing their efforts to comply with these policies may help reduce CLABSI rates. PMID:25952048

Psychopathology and Parenting Practices of Parents of Preschool Children with Behavior Problems

PubMed Central

Harvey, Elizabeth; Stoessel, Brian; Herbert, Sharonne

2012-01-01

SYNOPSIS Objective This study investigated associations among different types of parental psychopathology and several specific parenting practices. Design Mothers (n = 182) and fathers (n = 126) of preschool-aged children with behavior problems completed questionnaires assessing parental psychopathology and parenting practices, and participated in observed parent-child interactions. Results Maternal depression, anxiety, substance abuse, and several different personality disorder traits were related to maternal negativity, laxness, and lack of warmth. Paranoid, schizoid, schizotypal, and borderline personality disorder symptoms predicted mothers’ parenting practices, even when statistically controlling for other types of psychopathology. For fathers, those same symptoms, dependent and avoidant symptoms, and substance abuse symptoms were associated with self-reported lax parenting. Evidence emerged that psychopathology in one parent was associated with less overreactivity in the other parent. Conclusions Many aspects of parents’ psychological functioning play a role in determining specific parenting practices, including personality disorder symptoms. PMID:22737040

Statistics for stochastic modeling of volume reduction, hydrograph extension, and water-quality treatment by structural stormwater runoff best management practices (BMPs)

USGS Publications Warehouse

Granato, Gregory E.

2014-01-01

The U.S. Geological Survey (USGS) developed the Stochastic Empirical Loading and Dilution Model (SELDM) in cooperation with the Federal Highway Administration (FHWA) to indicate the risk for stormwater concentrations, flows, and loads to be above user-selected water-quality goals and the potential effectiveness of mitigation measures to reduce such risks. SELDM models the potential effect of mitigation measures by using Monte Carlo methods with statistics that approximate the net effects of structural and nonstructural best management practices (BMPs). In this report, structural BMPs are defined as the components of the drainage pathway between the source of runoff and a stormwater discharge location that affect the volume, timing, or quality of runoff. SELDM uses a simple stochastic statistical model of BMP performance to develop planning-level estimates of runoff-event characteristics. This statistical approach can be used to represent a single BMP or an assemblage of BMPs. The SELDM BMP-treatment module has provisions for stochastic modeling of three stormwater treatments: volume reduction, hydrograph extension, and water-quality treatment. In SELDM, these three treatment variables are modeled by using the trapezoidal distribution and the rank correlation with the associated highway-runoff variables. This report describes methods for calculating the trapezoidal-distribution statistics and rank correlation coefficients for stochastic modeling of volume reduction, hydrograph extension, and water-quality treatment by structural stormwater BMPs and provides the calculated values for these variables. This report also provides robust methods for estimating the minimum irreducible concentration (MIC), which is the lowest expected effluent concentration from a particular BMP site or a class of BMPs. These statistics are different from the statistics commonly used to characterize or compare BMPs. They are designed to provide a stochastic transfer function to approximate the quantity, duration, and quality of BMP effluent given the associated inflow values for a population of storm events. A database application and several spreadsheet tools are included in the digital media accompanying this report for further documentation of methods and for future use. In this study, analyses were done with data extracted from a modified copy of the January 2012 version of International Stormwater Best Management Practices Database, designated herein as the January 2012a version. Statistics for volume reduction, hydrograph extension, and water-quality treatment were developed with selected data. Sufficient data were available to estimate statistics for 5 to 10 BMP categories by using data from 40 to more than 165 monitoring sites. Water-quality treatment statistics were developed for 13 runoff-quality constituents commonly measured in highway and urban runoff studies including turbidity, sediment and solids; nutrients; total metals; organic carbon; and fecal coliforms. The medians of the best-fit statistics for each category were selected to construct generalized cumulative distribution functions for the three treatment variables. For volume reduction and hydrograph extension, interpretation of available data indicates that selection of a Spearman’s rho value that is the average of the median and maximum values for the BMP category may help generate realistic simulation results in SELDM. The median rho value may be selected to help generate realistic simulation results for water-quality treatment variables. MIC statistics were developed for 12 runoff-quality constituents commonly measured in highway and urban runoff studies by using data from 11 BMP categories and more than 167 monitoring sites. Four statistical techniques were applied for estimating MIC values with monitoring data from each site. These techniques produce a range of lower-bound estimates for each site. Four MIC estimators are proposed as alternatives for selecting a value from among the estimates from multiple sites. Correlation analysis indicates that the MIC estimates from multiple sites were weakly correlated with the geometric mean of inflow values, which indicates that there may be a qualitative or semiquantitative link between the inflow quality and the MIC. Correlations probably are weak because the MIC is influenced by the inflow water quality and the capability of each individual BMP site to reduce inflow concentrations.

Graphical Presentation of Patient-Treatment Interaction Elucidated by Continuous Biomarkers. Current Practice and Scope for Improvement.

PubMed

Shen, Yu-Ming; Le, Lien D; Wilson, Rory; Mansmann, Ulrich

2017-01-09

Biomarkers providing evidence for patient-treatment interaction are key in the development and practice of personalized medicine. Knowledge that a patient with a specific feature - as demonstrated through a biomarker - would have an advantage under a given treatment vs. a competing treatment can aid immensely in medical decision-making. Statistical strategies to establish evidence of continuous biomarkers are complex and their formal results are thus not easy to communicate. Good graphical representations would help to translate such findings for use in the clinical community. Although general guidelines on how to present figures in clinical reports are available, there remains little guidance for figures elucidating the role of continuous biomarkers in patient-treatment interaction (CBPTI). To combat the current lack of comprehensive reviews or adequate guides on graphical presentation within this topic, our study proposes presentation principles for CBPTI plots. In order to understand current practice, we review the development of CBPTI methodology and how CBPTI plots are currently used in clinical research. The quality of a CBPTI plot is determined by how well the presentation provides key information for clinical decision-making. Several criteria for a good CBPTI plot are proposed, including general principles of visual display, use of units presenting absolute outcome measures, appropriate quantification of statistical uncertainty, correct display of benchmarks, and informative content for answering clinical questions especially on the quantitative advantage for an individual patient with regard to a specific treatment. We examined the development of CBPTI methodology from the years 2000 - 2014, and reviewed how CBPTI plots were currently used in clinical research in six major clinical journals from 2013 - 2014 using the principle of theoretical saturation. Each CBPTI plot found was assessed for appropriateness of its presentation and clinical utility. In our review, a total of seven methodological papers and five clinical reports used CBPTI plots which we categorized into four types: those that distinguish the outcome effect for each treatment group; those that show the outcome differences between treatment groups (by either partitioning all individuals into subpopulations or modelling the functional form of the interaction); those that evaluate the proportion of population impact of the biomarker; and those that show the classification accuracy of the biomarker. The current practice of utilizing CBPTI plots in clinical reports suffers from methodological shortcomings: the lack of presentation of statistical uncertainty, the outcome measure scaled by relative unit instead of absolute unit, incorrect use of benchmarks, and being non-informative in answering clinical questions. There is considerable scope for improvement in the graphical representation of CBPTI in clinical reports. The current challenge is to develop instruments for high-quality graphical plots which not only convey quantitative concepts to readers with limited statistical knowledge, but also facilitate medical decision-making.

The Practicality of Statistical Physics Handout Based on KKNI and the Constructivist Approach

NASA Astrophysics Data System (ADS)

Sari, S. Y.; Afrizon, R.

2018-04-01

Statistical physics lecture shows that: 1) the performance of lecturers, social climate, students’ competence and soft skills needed at work are in enough category, 2) students feel difficulties in following the lectures of statistical physics because it is abstract, 3) 40.72% of students needs more understanding in the form of repetition, practice questions and structured tasks, and 4) the depth of statistical physics material needs to be improved gradually and structured. This indicates that learning materials in accordance of The Indonesian National Qualification Framework or Kerangka Kualifikasi Nasional Indonesia (KKNI) with the appropriate learning approach are needed to help lecturers and students in lectures. The author has designed statistical physics handouts which have very valid criteria (90.89%) according to expert judgment. In addition, the practical level of handouts designed also needs to be considered in order to be easy to use, interesting and efficient in lectures. The purpose of this research is to know the practical level of statistical physics handout based on KKNI and a constructivist approach. This research is a part of research and development with 4-D model developed by Thiagarajan. This research activity has reached part of development test at Development stage. Data collection took place by using a questionnaire distributed to lecturers and students. Data analysis using descriptive data analysis techniques in the form of percentage. The analysis of the questionnaire shows that the handout of statistical physics has very practical criteria. The conclusion of this study is statistical physics handouts based on the KKNI and constructivist approach have been practically used in lectures.

Measuring the statistical validity of summary meta‐analysis and meta‐regression results for use in clinical practice

PubMed Central

Riley, Richard D.

2017-01-01

An important question for clinicians appraising a meta‐analysis is: are the findings likely to be valid in their own practice—does the reported effect accurately represent the effect that would occur in their own clinical population? To this end we advance the concept of statistical validity—where the parameter being estimated equals the corresponding parameter for a new independent study. Using a simple (‘leave‐one‐out’) cross‐validation technique, we demonstrate how we may test meta‐analysis estimates for statistical validity using a new validation statistic, Vn, and derive its distribution. We compare this with the usual approach of investigating heterogeneity in meta‐analyses and demonstrate the link between statistical validity and homogeneity. Using a simulation study, the properties of Vn and the Q statistic are compared for univariate random effects meta‐analysis and a tailored meta‐regression model, where information from the setting (included as model covariates) is used to calibrate the summary estimate to the setting of application. Their properties are found to be similar when there are 50 studies or more, but for fewer studies Vn has greater power but a higher type 1 error rate than Q. The power and type 1 error rate of Vn are also shown to depend on the within‐study variance, between‐study variance, study sample size, and the number of studies in the meta‐analysis. Finally, we apply Vn to two published meta‐analyses and conclude that it usefully augments standard methods when deciding upon the likely validity of summary meta‐analysis estimates in clinical practice. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. PMID:28620945

A review of CDC's Web-based Injury Statistics Query and Reporting System (WISQARS™): Planning for the future of injury surveillance✩

PubMed Central

Ballesteros, Michael F.; Webb, Kevin; McClure, Roderick J.

2017-01-01

Introduction The Centers for Disease Control and Prevention (CDC) developed the Web-based Injury Statistics Query and Reporting System (WISQARSTM) to meet the data needs of injury practitioners. In 2015, CDC completed a Portfolio Review of this system to inform its future development. Methods Evaluation questions addressed utilization, technology and innovation, data sources, and tools and training. Data were collected through environmental scans, a review of peer-reviewed and grey literature, a web search, and stakeholder interviews. Results Review findings led to specific recommendations for each evaluation question. Response CDC reviewed each recommendation and initiated several enhancements that will improve the ability of injury prevention practitioners to leverage these data, better make sense of query results, and incorporate findings and key messages into prevention practices. PMID:28454867

An integrated educational model for continuing nurse education.

PubMed

Duff, Beverley; Gardner, Glenn; Osborne, Sonya

2014-01-01

This paper reports on the development and evaluation of an integrated clinical learning model to inform ongoing education for surgical nurses. The research aim was to evaluate the effectiveness of implementing a Respiratory Skills Update (ReSKU) education program, in the context of organisational utility, on improving surgical nurses' practice in the area of respiratory assessment. Continuous development and integration of technological innovations and research in the healthcare environment mandate the need for continuing education for nurses. Despite an increased worldwide emphasis on this, there is scant empirical evidence of program effectiveness. A quasi experimental pre test, post test non-equivalent control group design evaluated the impact of the ReSKU program on surgical nurses' clinical practice. The 2008 study was conducted in a 400 bed regional referral public hospital and was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies. The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group's reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales. The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful reflection, was a powerful educational strategy to enhance competency and capability in clinicians. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Psychoactive Drugs in Plastic Surgery

PubMed Central

Davison, Steven P.; Hayes, Kylie D.

2017-01-01

Background: Psychoactive drug use is on the rise in the United States, with plastic surgery patients a potentially susceptible group. This study aimed to determine the incidence of cosmetic and reconstructive patients in our practice taking psychoactive drugs and to compare those values with the national average. Furthermore, we discuss the patient safety concerns when patients withhold their medical history information over the course of their treatment. Methods: Urban private plastic practice patients who underwent surgery in a closed practice from 2009 to 2016 were divided into cosmetic and reconstructive cohorts. Review for drug use was medical scripts, history, and Surescripts drug reporting. Extracted information includes age, race, procedure, psychoactive medications, and whether or not they stated a mental health diagnosis on their medical history forms. Only patients with complete records were included. Results: A total of 830 patients were included in statistical analysis. Due to minimal cohort number, 70 men were excluded, as there were no comparative national data. Our analysis found that 33.6% cosmetic patients and 46.3% reconstructive patients used at least one psychoactive drug. Conclusion: There is a statistically significant difference between psychoactive drug use at our practice compared with the general population and a significantly larger percentage of reconstructive patients taking drugs compared with the cosmetic cohort. PMID:28458985

Use of Tests of Statistical Significance and Other Analytic Choices in a School Psychology Journal: Review of Practices and Suggested Alternatives.

ERIC Educational Resources Information Center

Snyder, Patricia A.; Thompson, Bruce

The use of tests of statistical significance was explored, first by reviewing some criticisms of contemporary practice in the use of statistical tests as reflected in a series of articles in the "American Psychologist" and in the appointment of a "Task Force on Statistical Inference" by the American Psychological Association…

What influences the choice of assessment methods in health technology assessments? Statistical analysis of international health technology assessments from 1989 to 2002.

PubMed

Draborg, Eva; Andersen, Christian Kronborg

2006-01-01

Health technology assessment (HTA) has been used as input in decision making worldwide for more than 25 years. However, no uniform definition of HTA or agreement on assessment methods exists, leaving open the question of what influences the choice of assessment methods in HTAs. The objective of this study is to analyze statistically a possible relationship between methods of assessment used in practical HTAs, type of assessed technology, type of assessors, and year of publication. A sample of 433 HTAs published by eleven leading institutions or agencies in nine countries was reviewed and analyzed by multiple logistic regression. The study shows that outsourcing of HTA reports to external partners is associated with a higher likelihood of using assessment methods, such as meta-analysis, surveys, economic evaluations, and randomized controlled trials; and with a lower likelihood of using assessment methods, such as literature reviews and "other methods". The year of publication was statistically related to the inclusion of economic evaluations and shows a decreasing likelihood during the year span. The type of assessed technology was related to economic evaluations with a decreasing likelihood, to surveys, and to "other methods" with a decreasing likelihood when pharmaceuticals were the assessed type of technology. During the period from 1989 to 2002, no major developments in assessment methods used in practical HTAs were shown statistically in a sample of 433 HTAs worldwide. Outsourcing to external assessors has a statistically significant influence on choice of assessment methods.

Oncology Nurses' Attitudes Toward the Edmonton Symptom Assessment System: Results From a Large Cancer Care Ontario Study.

PubMed

Green, Esther; Yuen, Dora; Chasen, Martin; Amernic, Heidi; Shabestari, Omid; Brundage, Michael; Krzyzanowska, Monika K; Klinger, Christopher; Ismail, Zahra; Pereira, José

2017-01-01

To examine oncology nurses' attitudes toward and reported use of the Edmonton Symptom Assessment System (ESAS) and to determine whether the length of work experience and presence of oncology certification are associated with their attitudes and reported usage.
. Exploratory, mixed-methods study employing a questionnaire approach.
. 14 regional cancer centers (RCCs) in Ontario, Canada.
. Oncology nurses who took part in a larger province-wide study that surveyed 960 interdisciplinary providers in oncology care settings at all of Ontario's 14 RCCs.
. Oncology nurses' attitudes and use of ESAS were measured using a 21-item investigator-developed questionnaire. Descriptive statistics and Kendall's tau-b or tau-c test were used for data analyses. Qualitative responses were analyzed using content analysis.
. Attitudes toward and self-reported use of standardized symptom screening and ESAS.
. More than half of the participants agreed that ESAS improves symptom screening, most said they would encourage their patients to complete ESAS, and most felt that managing symptoms is within their scope of practice and clinical responsibilities. Qualitative comments provided additional information elucidating the quantitative responses. Statistical analyses revealed that oncology nurses who have 10 years or less of work experience were more likely to agree that the use of standardized, valid instruments to screen for and assess symptoms should be considered best practice, ESAS improves symptom screening, and ESAS enables them to better manage patients' symptoms. No statistically significant difference was found between oncology-certified RNs and noncertified RNs on attitudes or reported use of ESAS.
. Implementing a population-based symptom screening approach is a major undertaking. The current study found that oncology nurses recognize the value of standardized screening, as demonstrated by their attitudes toward ESAS.
. Oncology nurses are integral to providing high-quality person-centered care. Using standardized approaches that enable patients to self-report symptoms and understanding barriers and enablers to optimal use of patient-reported outcome tools can improve the quality of patient care.

The association between students taking elective courses in chiropractic technique and their anticipated chiropractic technique choices in future practice.

PubMed

Wanlass, Paul W; Sikorski, David M; Kizhakkeveettil, Anupama; Tobias, Gene S

2018-03-12

To assess students' opinions of the potential influence of taking elective courses in chiropractic techniques and their future practice preferences. An anonymous, voluntary survey was conducted among graduating students from a doctor of chiropractic program. The survey included questions regarding the chiropractic technique elective courses they had completed and the potential influence of these courses on their chiropractic technique choices in future practice. Surveys were pretested for face validity, and data were analyzed using descriptive and inferential statistics. Of the 56 surveys distributed, 46 were completed, for a response rate of 82%. More than half of the students reported having taken at least 1 elective course in diversified technique (80%), Cox technique (76%), Activator Methods (70%), or sacro-occipital technique (63%). Less than half of the respondents reported taking technique elective courses in Gonstead or Thompson techniques. More than half of the students stated they were more likely to use Activator (72%), Thompson (68%), diversified (57%), or Cox (54%) techniques in their future practice after taking an elective course in that technique. Females stated that they were more likely to use Activator Methods ( p = .006) in future practice. Chiropractic technique elective courses in the doctor of chiropractic curriculum may influence students' choices of future practice chiropractic technique.

The large sample size fallacy.

PubMed

Lantz, Björn

2013-06-01

Significance in the statistical sense has little to do with significance in the common practical sense. Statistical significance is a necessary but not a sufficient condition for practical significance. Hence, results that are extremely statistically significant may be highly nonsignificant in practice. The degree of practical significance is generally determined by the size of the observed effect, not the p-value. The results of studies based on large samples are often characterized by extreme statistical significance despite small or even trivial effect sizes. Interpreting such results as significant in practice without further analysis is referred to as the large sample size fallacy in this article. The aim of this article is to explore the relevance of the large sample size fallacy in contemporary nursing research. Relatively few nursing articles display explicit measures of observed effect sizes or include a qualitative discussion of observed effect sizes. Statistical significance is often treated as an end in itself. Effect sizes should generally be calculated and presented along with p-values for statistically significant results, and observed effect sizes should be discussed qualitatively through direct and explicit comparisons with the effects in related literature. © 2012 Nordic College of Caring Science.

Waterpipe Tobacco Smoking Among Dental Practitioners: Prevalence and Health Perceptions

PubMed Central

Dar-Odeh, Najla; Alnazzawi, Ahmad; Shoqair, Noora; Al-Shayyab, Mohammad H.; Abu-Hammad, Osama

2016-01-01

BACKGROUND Waterpipe tobacco smoking prevalence, practice, and the associated health perceptions among dental practitioners have not been previously reported. This study aims to determine the prevalence of waterpipe smoking among dental practitioners and to evaluate their awareness of health hazards of waterpipe smoking, particularly the adverse effects on oral health. METHODS This was a cross-sectional questionnaire-based survey among dental practitioners. Surveyed dental practitioners practiced dentistry in the holy city of Al-Madinah Al-Munawarah, a city in the Central-Western Region of Saudi Arabia, and the study was conducted during March 2015. The questionnaire consisted of questions on demographic data, history and practices of tobacco use, and perceptions toward the health hazards of smoking. Dentists were approached at their work places and invited to participate. Descriptive statistics were used to describe the sample’s demographic and smoking characteristics, while cross-tabulation and chi-square test were used to determine the statistical significance of association between the groups (P ≤ 0.05). RESULTS One hundred dental practitioners participated in the survey, with 55 males and 45 females. Twenty-six percent indicated that they were waterpipe smokers. Male gender and cigarette smoking were the only factors to be significantly associated with waterpipe smoking (P = 0.008 and P = 0.000, respectively). Most participants stated that waterpipe smoking is harmful to health, and the most commonly reported health hazard was respiratory disease, which was reported by 81% of participants. CONCLUSIONS Prevalence of waterpipe smoking among dental practitioners is comparable to adult populations but lower than younger populations of university students. Health awareness of dental practitioners regarding waterpipe smoking was judged to be insufficient. PMID:27695374

Assessment of the knowledge of United Arab Emirates dentists of Child Maltreatment, protection and safeguarding.

PubMed

Al Hajeri, H; Al Halabi, M; Kowash, M; Khamis, A H; Welbury, R; Hussein, I

2018-06-01

Child safeguarding is society's responsibility. Dentists are uniquely positioned to recognise Child Abuse and Neglect (CAN) in dental practice and the wider society. The United Arab Emirates (UAE) introduced a child protection law in 2016. We aimed to assess the awareness of UAE dentists of child maltreatment, protection and safeguarding. Study Design A cross-sectional survey. We surveyed 381 UAE dentists about the knowledge and practice of CAN and safeguarding issues using a self-administered anonymous questionnaire. Statistical analysis was carried out using Chi-square, t-test, ANOVA and Pearson's correlation test and statistical significance was set as p <0.05. Over 39 % (n=152) of the responders suspected CAN; male dentists suspected more CAN than females (p=0.015). Orthodontists, paediatric dentists (p<0.001) and female dentists (p=0.001) were more knowledgeable about diagnosing CAN. Paediatric dentists attended more CAN-related postgraduate training (p<0.001) than other specialties. Over 90% (n=346) believed that CAN should be addressed, 58.1% (n=224) and 54.1% (n=206) had CAN undergraduate and postgraduate training respectively but 53.5% (n=204) were unaware of local child protection guidelines. Dentists barriers to child protection reporting were; fear of family violence (59.6%, n=227), lack of knowledge of referral process (60.2%, n=228) and lack of diagnosis certainty (54.9%, n=206). UAE dentists qualified in Western and Asian countries had fewer barriers for child protection reporting (p=0.022) than the Arab and Gulf Cooperation Council qualified dentists. A large minority of UAE dentists suspected CAN. Factors influencing child protection reporting were identified. Dentists' gender, specialty, and country of qualification affected their knowledge of CAN and practice of safeguarding. Child protection training is recommended.

Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database.

PubMed

Cooper, Jennifer; Edwards, Adrian; Williams, Huw; Sheikh, Aziz; Parry, Gareth; Hibbert, Peter; Butlin, Amy; Donaldson, Liam; Carson-Stevens, Andrew

2017-09-01

A culture of blame and fear of retribution are recognized barriers to reporting patient safety incidents. The extent of blame attribution in safety incident reports, which may reflect the underlying safety culture of health care systems, is unknown. This study set out to explore the nature of blame in family practice safety incident reports. We characterized a random sample of family practice patient safety incident reports from the England and Wales National Reporting and Learning System. Reports were analyzed according to prespecified classification systems to describe the incident type, contributory factors, outcomes, and severity of harm. We developed a taxonomy of blame attribution, and we then used descriptive statistical analyses to identify the proportions of blame types and to explore associations between incident characteristics and one type of blame. Health care professionals making family practice incident reports attributed blame to a person in 45% of cases (n = 975 of 2,148; 95% CI, 43%-47%). In 36% of cases, those who reported the incidents attributed fault to another person, whereas 2% of those reporting acknowledged personal responsibility. Blame was commonly associated with incidents where a complaint was anticipated. The high frequency of blame in these safety, incident reports may reflect a health care culture that leads to blame and retribution, rather than to identifying areas for learning and improvement, and a failure to appreciate the contribution of system factors in others' behavior. Successful improvement in patient safety through the analysis of incident reports is unlikely without achieving a blame-free culture. © 2017 Annals of Family Medicine, Inc.

Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database

PubMed Central

Cooper, Jennifer; Edwards, Adrian; Williams, Huw; Sheikh, Aziz; Parry, Gareth; Hibbert, Peter; Butlin, Amy; Donaldson, Liam; Carson-Stevens, Andrew

2017-01-01

PURPOSE A culture of blame and fear of retribution are recognized barriers to reporting patient safety incidents. The extent of blame attribution in safety incident reports, which may reflect the underlying safety culture of health care systems, is unknown. This study set out to explore the nature of blame in family practice safety incident reports. METHODS We characterized a random sample of family practice patient safety incident reports from the England and Wales National Reporting and Learning System. Reports were analyzed according to prespecified classification systems to describe the incident type, contributory factors, outcomes, and severity of harm. We developed a taxonomy of blame attribution, and we then used descriptive statistical analyses to identify the proportions of blame types and to explore associations between incident characteristics and one type of blame. RESULTS Health care professionals making family practice incident reports attributed blame to a person in 45% of cases (n = 975 of 2,148; 95% CI, 43%–47%). In 36% of cases, those who reported the incidents attributed fault to another person, whereas 2% of those reporting acknowledged personal responsibility. Blame was commonly associated with incidents where a complaint was anticipated. CONCLUSIONS The high frequency of blame in these safety, incident reports may reflect a health care culture that leads to blame and retribution, rather than to identifying areas for learning and improvement, and a failure to appreciate the contribution of system factors in others’ behavior. Successful improvement in patient safety through the analysis of incident reports is unlikely without achieving a blame-free culture. PMID:28893816

Experience and perception of sexual harassment during the clinical practice of korean nursing students.

PubMed

Lee, Sun-Kyoung; Song, Ju-Eun; Kim, Sue

2011-09-01

The purpose of this study was to identify the experience and perception of sexual harassment during the clinical practice of Korean nursing students. The descriptive study was conducted using a self-report questionnaire from December 2009 to January 2010. Participants were 542 nursing students recruited from 12 nursing colleges in Korea, who had finished 1,000 hours of clinical practice which is the minimum requirement for graduation. Data were analyzed by descriptive statistics. Ninety-seven participants (17.9%) reported that they experienced sexual harassment during clinical practice and 36 participants (6.7%) answered whether it was a sexual harassment or not. When sexual harassment was asked by the specific 18 items in the sexual harassment checklist, 52.0% (n = 282) of participants reported that they experienced at least 1 item among 18 items of sexual harassment. Sexual harassments were frequently made by the persons in their 40s (41.2%), men (97.9%) and patients (96.9%) and in the psychiatric wards (67.0%). Many respondents recognized that sexual harassment during clinical practice was caused by abnormal sexual desire of a pervert (34.5%) or men's sexual impulse (26.2%). Also, sexual harassment was perceived as a serious problem (19.4%) and education was necessary for prevention (88.3%). Education program is needed to prevent sexual harassment and enhance the gender sensitivity of nursing students, who are in the high-risk group of sexual harassment during clinical practice. This will in turn contribute to a safe educational environment for clinical practice. Copyright © 2011. Published by Elsevier B.V.

Selecting the "Best" Factor Structure and Moving Measurement Validation Forward: An Illustration.

PubMed

Schmitt, Thomas A; Sass, Daniel A; Chappelle, Wayne; Thompson, William

2018-04-09

Despite the broad literature base on factor analysis best practices, research seeking to evaluate a measure's psychometric properties frequently fails to consider or follow these recommendations. This leads to incorrect factor structures, numerous and often overly complex competing factor models and, perhaps most harmful, biased model results. Our goal is to demonstrate a practical and actionable process for factor analysis through (a) an overview of six statistical and psychometric issues and approaches to be aware of, investigate, and report when engaging in factor structure validation, along with a flowchart for recommended procedures to understand latent factor structures; (b) demonstrating these issues to provide a summary of the updated Posttraumatic Stress Disorder Checklist (PCL-5) factor models and a rationale for validation; and (c) conducting a comprehensive statistical and psychometric validation of the PCL-5 factor structure to demonstrate all the issues we described earlier. Considering previous research, the PCL-5 was evaluated using a sample of 1,403 U.S. Air Force remotely piloted aircraft operators with high levels of battlefield exposure. Previously proposed PCL-5 factor structures were not supported by the data, but instead a bifactor model is arguably more statistically appropriate.

Appointment-keeping behavior of Medicaid-enrolled pediatric dental patients in eastern Iowa.

PubMed

Iben, P; Kanellis, M J; Warren, J

2000-01-01

The purpose of this prospective study was to assess the appointment-keeping behavior of Medicaid-enrolled pediatric dental patients in three Eastern Iowa practices. During the month of October 1998, a tally was kept of all patient appointments at a private pediatric dental office, a public health dental clinic, and a university-based pediatric dentistry clinic. Patients were categorized as either Medicaid or non-Medicaid. Appointment behavior categories were defined as: On time; Failure; Late-notice Cancellation (less than 24 hours notice); and Tardy (greater than 10 minutes). The data was entered in SPSS and analyzed using the chi square statistic. Statistical significance was P < 0.05. A total of 1,406 appointments were recorded for all three sites. Overall, patients on Iowa Medicaid had higher appointment failure, late-notice cancellation, and tardiness rates than non-Medicaid patients at all three clinics. However, these differences were only statistically significant for the private office and the university-based clinic. Failed appointment rates for Medicaid patients were much higher at the private office (38%) than at the other two sites. Consistent with anecdotal reports from dentists, Medicaid patients had higher rates of broken appointments than did non-Medicaid patients, particularly in a private practice setting.

Use of Social Narratives as an Evidence-Based Practice to Support Employment of Young Adults with Autism Spectrum Disorders: A Practitioner's Guide

ERIC Educational Resources Information Center

Thomas, Jamie; Nix, Susan

2017-01-01

The statistical data reports that current unemployment rates for young adults with an Autism Spectrum Disorder (ASD) in the United States is bleak. In 2004, Hurlbutt and Chalmers noted that difficulties obtaining and keeping employment are many times connected to issues involving social interactions and communication skills rather than performing…

UAV Swarm Operational Risk Assessment System

DTIC Science & Technology

2015-09-01

a SIPRNET connection. For practicality in development of this prototype, the interface was created using the MATLAB GUI language . By design, the use ...and Budget, Paperwork Reduction Project (0704-0188) Washington DC 20503. 1. AGENCY USE ONLY (Leave blank) 2. REPORT DATE September 2015 3...discrete-event simulation of UAV swarm attacks using ExtendSim, statistical analysis of the simulation data using Minitab, and a graphical user interface

Report on the ''ESO Python Boot Camp — Pilot Version''

NASA Astrophysics Data System (ADS)

Dias, B.; Milli, J.

2017-03-01

The Python programming language is becoming very popular within the astronomical community. Python is a high-level language with multiple applications including database management, handling FITS images and tables, statistical analysis, and more advanced topics. Python is a very powerful tool both for astronomical publications and for observatory operations. Since the best way to learn a new programming language is through practice, we therefore organised a two-day hands-on workshop to share expertise among ESO colleagues. We report here the outcome and feedback from this pilot event.

A review of published analyses of case-cohort studies and recommendations for future reporting.

PubMed

Sharp, Stephen J; Poulaliou, Manon; Thompson, Simon G; White, Ian R; Wood, Angela M

2014-01-01

The case-cohort study design combines the advantages of a cohort study with the efficiency of a nested case-control study. However, unlike more standard observational study designs, there are currently no guidelines for reporting results from case-cohort studies. Our aim was to review recent practice in reporting these studies, and develop recommendations for the future. By searching papers published in 24 major medical and epidemiological journals between January 2010 and March 2013 using PubMed, Scopus and Web of Knowledge, we identified 32 papers reporting case-cohort studies. The median subcohort sampling fraction was 4.1% (interquartile range 3.7% to 9.1%). The papers varied in their approaches to describing the numbers of individuals in the original cohort and the subcohort, presenting descriptive data, and in the level of detail provided about the statistical methods used, so it was not always possible to be sure that appropriate analyses had been conducted. Based on the findings of our review, we make recommendations about reporting of the study design, subcohort definition, numbers of participants, descriptive information and statistical methods, which could be used alongside existing STROBE guidelines for reporting observational studies.

An evaluation of knowledge, attitude, and practice of adverse drug reaction reporting among prescribers at a tertiary care hospital.

PubMed

Desai, Chetna K; Iyer, Geetha; Panchal, Jigar; Shah, Samidh; Dikshit, R K

2011-10-01

Spontaneous reporting is an important tool in pharmacovigilance. However, its success depends on cooperative and motivated prescribers. Under-reporting of adverse drug reactions (ADRs) by prescribers is a common problem. The present study was undertaken to evaluate the knowledge, attitude, and practices (KAP) regarding ADR reporting among prescribers at the Civil Hospital, Ahmedabad, to get an insight into the causes of under-reporting of ADRs. A pretested KAP questionnaire comprising of 15 questions (knowledge 6, attitude 5, and practice 4) was administered to 436 prescribers. The questionnaires were assessed for their completeness (maximum score 20) and the type of responses regarding ADR reporting. Microsoft Excel worksheet (Microsoft Office 2007) and Chi-Square test were used for statistical analysis. A total of 260 (61%) prescribers completed the questionnaire (mean score of completion 18.04). The response rate of resident doctors (70.7%) was better than consultants (34.5%) (P < 0.001). ADR reporting was considered important by 97.3% of the respondents; primarily for improving patient safety (28.8%) and identifying new ADRs (24.6%). A majority of the respondents opined that they would like to report serious ADRs (56%). However, only 15% of the prescribers had reported ADRs previously. The reasons cited for this were lack of information on where (70%) and how (68%) to report and the lack of access to reporting forms (49.2%). Preferred methods for reporting were e-mail (56%) and personal communication (42%). The prescribers are aware of the ADRs and the importance of their reporting. However, under reporting and lack of knowledge about the reporting system are clearly evident. Creating awareness about ADR reporting and devising means to make it easy and convenient may aid in improving spontaneous reporting.

[Sedentary behaviour 13-years-olds and its association with selected health behaviours, parenting practices and body mass].

PubMed

Jodkowska, Maria; Tabak, Izabela; Oblacińska, Anna; Stalmach, Magdalena

2013-01-01

1. To estimate the time spent in sedentary behaviour (watching TV, using the computer, doing homework). 2. To assess the link between the total time spent on watching TV, using the computer, doing homework and dietary habits, physical activity, parental practices and body mass. Cross-sectional study was conducted in Poland in 2008 among 13-year olds (n=600). They self-reported their time of TV viewing, computer use and homework. Their dietary behaviours, physical activity (MVPA) and parenting practices were also self-reported. Height and weight were measured by school nurses. Descriptive statistics and correlation were used in this analysis. The mean time spent watching television in school days was 2.3 hours for girls and 2.2 for boys. Boys spent significantly more time using the computer than girls - respectively 1.8 and 1.5 hours, while girls took longer doing homework - respectively 1.7 and 1.3 hours. Mean screen time was about 4 hours in school days and about 6 hours during weekend, statistically longer for boys in weekdays. Screen time was positively associated with intake of sweets, chips, soft drinks, "fast food" and meals consumption during TV, and negatively with regularity of meals and parental supervision. There was no correlation between screen time with physical activity and body mass. Sedentary behaviours and physical activity are not competing behaviours in Polish teenagers, but their relationship with unhealthy dietary patterns may lead to development of obesity. Good parental practices, both mother's and father's supervision seems to be crucial for screen time limitation in their children. Parents should become aware that relevant lifestyle monitoring of their children is a crucial element of health education in prevention of civilization diseases. This is a task for both healthcare workers and educational staff.

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

Psychotherapy in Contemporary Psychiatric Practice

PubMed Central

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

2015-01-01

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

Knowledge, skills and attitudes of hospital pharmacists in the use of information technology and electronic tools to support clinical practice: A Brazilian survey

PubMed Central

Vasconcelos, Hemerson Bruno da Silva; Woods, David John

2017-01-01

This study aimed to identify the knowledge, skills and attitudes of Brazilian hospital pharmacists in the use of information technology and electronic tools to support clinical practice. Methods: A questionnaire was sent by email to clinical pharmacists working public and private hospitals in Brazil. The instrument was validated using the method of Polit and Beck to determine the content validity index. Data (n = 348) were analyzed using descriptive statistics, Pearson's Chi-square test and Gamma correlation tests. Results: Pharmacists had 1–4 electronic devices for personal use, mainly smartphones (84.8%; n = 295) and laptops (81.6%; n = 284). At work, pharmacists had access to a computer (89.4%; n = 311), mostly connected to the internet (83.9%; n = 292). They felt competent (very capable/capable) searching for a web page/web site on a specific subject (100%; n = 348), downloading files (99.7%; n = 347), using spreadsheets (90.2%; n = 314), searching using MeSH terms in PubMed (97.4%; n = 339) and general searching for articles in bibliographic databases (such as Medline/PubMed: 93.4%; n = 325). Pharmacists did not feel competent in using statistical analysis software (somewhat capable/incapable: 78.4%; n = 273). Most pharmacists reported that they had not received formal education to perform most of these actions except searching using MeSH terms. Access to bibliographic databases was available in Brazilian hospitals, however, most pharmacists (78.7%; n = 274) reported daily use of a non-specific search engine such as Google. This result may reflect the lack of formal knowledge and training in the use of bibliographic databases and difficulty with the English language. The need to expand knowledge about information search tools was recognized by most pharmacists in clinical practice in Brazil, especially those with less time dedicated exclusively to clinical activity (Chi-square, p = 0.006). Conclusion: These results will assist in defining minimal competencies for the training of pharmacists in the field of information technology to support clinical practice. Knowledge and skill gaps are evident in the use of bibliographic databases, spreadsheets and statistical tools. PMID:29272292

Knowledge, skills and attitudes of hospital pharmacists in the use of information technology and electronic tools to support clinical practice: A Brazilian survey.

PubMed

Néri, Eugenie Desirèe Rabelo; Meira, Assuero Silva; Vasconcelos, Hemerson Bruno da Silva; Woods, David John; Fonteles, Marta Maria de França

2017-01-01

This study aimed to identify the knowledge, skills and attitudes of Brazilian hospital pharmacists in the use of information technology and electronic tools to support clinical practice. A questionnaire was sent by email to clinical pharmacists working public and private hospitals in Brazil. The instrument was validated using the method of Polit and Beck to determine the content validity index. Data (n = 348) were analyzed using descriptive statistics, Pearson's Chi-square test and Gamma correlation tests. Pharmacists had 1-4 electronic devices for personal use, mainly smartphones (84.8%; n = 295) and laptops (81.6%; n = 284). At work, pharmacists had access to a computer (89.4%; n = 311), mostly connected to the internet (83.9%; n = 292). They felt competent (very capable/capable) searching for a web page/web site on a specific subject (100%; n = 348), downloading files (99.7%; n = 347), using spreadsheets (90.2%; n = 314), searching using MeSH terms in PubMed (97.4%; n = 339) and general searching for articles in bibliographic databases (such as Medline/PubMed: 93.4%; n = 325). Pharmacists did not feel competent in using statistical analysis software (somewhat capable/incapable: 78.4%; n = 273). Most pharmacists reported that they had not received formal education to perform most of these actions except searching using MeSH terms. Access to bibliographic databases was available in Brazilian hospitals, however, most pharmacists (78.7%; n = 274) reported daily use of a non-specific search engine such as Google. This result may reflect the lack of formal knowledge and training in the use of bibliographic databases and difficulty with the English language. The need to expand knowledge about information search tools was recognized by most pharmacists in clinical practice in Brazil, especially those with less time dedicated exclusively to clinical activity (Chi-square, p = 0.006). These results will assist in defining minimal competencies for the training of pharmacists in the field of information technology to support clinical practice. Knowledge and skill gaps are evident in the use of bibliographic databases, spreadsheets and statistical tools.

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

ERIC Educational Resources Information Center

Crissinger, Bryan R.

2015-01-01

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

Attitudes and practices of school-aged girls towards menstruation.

PubMed

Jarrah, Samiha Suhail; Kamel, Andaleeb Abu

2012-06-01

The purpose of this study was to (i) investigate attitude and menstruation-related practices in Jordanian school-aged girls; (ii) identify the influence of premenstrual preparation on girls' attitude and menstruation-related practices. A descriptive cross-sectional design was used. Data was collected from a convenience sample of 490 school-age girls (12-18 years) from different districts in Jordan. Self-report instruments [Menstrual Attitude Questionnaire (MAQ), and Menstrual Practices Questionnaires (MPQ)] were used to assess the study variables. Descriptive statistics, correlation and chi-square tests were used to analyze the data. It was found that menstrual attitude and practices were positively correlated. Poor attitude toward menstruation and low menstrual practices were significantly associated with inadequate premenstrual preparation. There is a need to prepare girls for menstruation before menarche. The role of the schools and teachers should be reinforced through formal and well planned reproductive health educators for girls and their mothers. © 2012 Blackwell Publishing Asia Pty Ltd.

CE: Original Research: Does Certification in Vascular Access Matter? An Analysis of the PICC1 Survey.

PubMed

Chopra, Vineet; Kuhn, Latoya; Vaughn, Valerie; Ratz, David; Winter, Suzanne; Moureau, Nancy; Meyer, Britt; Krein, Sarah

2017-12-01

: Background: Although certification by an accredited agency is often a practice prerequisite in health care, it is not required of vascular access specialists who insert peripherally inserted central catheters (PICCs). Whether certification is associated with differences in practice among inserters is unknown. The purpose of this study was to gather information regarding whether certified and noncertified PICC inserters differ with respect to their practices and views about PICC use. We conducted a national survey of vascular access specialists, identifying certified PICC inserters as those who had received board certification from the Association for Vascular Access, the Infusion Nurses Society, or both. The 76-item survey asked about PICC policies and procedures at respondents' facilities, use of insertion technologies, device management, management of complications, perceptions about PICC use, and relationships with other health care providers. Additional data about respondents, including years in practice and primary practice settings, were also gathered. Bivariable comparisons were made using χ tests; two-sided α with P ≤ 0.05 was considered statistically significant. Of the 1,450 respondents in the final sample, 1,007 (69%) said they were certified inserters and 443 (31%) said they were not. Significantly higher percentages of certified than noncertified inserters reported having practiced for five or more years (78% versus 54%) and having placed 1,000 or more PICCs (58% versus 32%). Significantly more certified than noncertified inserters also reported being the vascular access lead for their facility (56% versus 44%). Reported practice patterns for insertion, care, and management of PICCs varied based on certification status. Some evidence-based practices (such as the use of ultrasound to measure catheter-to-vein ratios) were more often reported by certified inserters, while others (such as the use of maximal sterile barriers during PICC insertion) were not. Asked about their perceptions of PICC use at their institution, certified inserters reported higher percentages of inappropriate insertion and removal than noncertified inserters. Certified PICC inserters appear to be a distinct group of vascular access specialists. A better understanding of how and why practices differ between certified and noncertified inserters is necessary to ensuring safer, high-quality patient care.

Use of missing data methods in longitudinal studies: the persistence of bad practices in developmental psychology.

PubMed

Jelicić, Helena; Phelps, Erin; Lerner, Richard M

2009-07-01

Developmental science rests on describing, explaining, and optimizing intraindividual changes and, hence, empirically requires longitudinal research. Problems of missing data arise in most longitudinal studies, thus creating challenges for interpreting the substance and structure of intraindividual change. Using a sample of reports of longitudinal studies obtained from three flagship developmental journals-Child Development, Developmental Psychology, and Journal of Research on Adolescence-we examined the number of longitudinal studies reporting missing data and the missing data techniques used. Of the 100 longitudinal studies sampled, 57 either reported having missing data or had discrepancies in sample sizes reported for different analyses. The majority of these studies (82%) used missing data techniques that are statistically problematic (either listwise deletion or pairwise deletion) and not among the methods recommended by statisticians (i.e., the direct maximum likelihood method and the multiple imputation method). Implications of these results for developmental theory and application, and the need for understanding the consequences of using statistically inappropriate missing data techniques with actual longitudinal data sets, are discussed.

Fingerprint identification: advances since the 2009 National Research Council report

PubMed Central

Champod, Christophe

2015-01-01

This paper will discuss the major developments in the area of fingerprint identification that followed the publication of the National Research Council (NRC, of the US National Academies of Sciences) report in 2009 entitled: Strengthening Forensic Science in the United States: A Path Forward. The report portrayed an image of a field of expertise used for decades without the necessary scientific research-based underpinning. The advances since the report and the needs in selected areas of fingerprinting will be detailed. It includes the measurement of the accuracy, reliability, repeatability and reproducibility of the conclusions offered by fingerprint experts. The paper will also pay attention to the development of statistical models allowing assessment of fingerprint comparisons. As a corollary of these developments, the next challenge is to reconcile a traditional practice dominated by deterministic conclusions with the probabilistic logic of any statistical model. There is a call for greater candour and fingerprint experts will need to communicate differently on the strengths and limitations of their findings. Their testimony will have to go beyond the blunt assertion of the uniqueness of fingerprints or the opinion delivered ispe dixit. PMID:26101284

An Early Feeding Practices Intervention for Obesity Prevention.

PubMed

Daniels, Lynne Allison; Mallan, Kimberley Margaret; Nicholson, Jan Maree; Thorpe, Karen; Nambiar, Smita; Mauch, Chelsea Emma; Magarey, Anthea

2015-07-01

Report long-term outcomes of the NOURISH randomized controlled trial (RCT), which evaluated a universal intervention commencing in infancy to provide anticipatory guidance to first-time mothers on "protective" complementary feeding practices that were hypothesized to reduce childhood obesity risk. The NOURISH RCT enrolled 698 mothers (mean age 30.1 years, SD = 5.3) with healthy term infants (51% female). Mothers were randomly allocated to usual care or to attend two 6-session, 12-week group education modules. Outcomes were assessed 5 times: baseline (infants 4.3 months); 6 months after module 1 (infants 14 months); 6 months after module 2 (infants 2 years) and at 3.5 and 5 years of age. Maternal feeding practices were self-reported using validated questionnaires. BMI Z-score was calculated from measured child height and weight. Linear mixed models evaluated intervention (group) effect across time. Retention at age 5 years was 61%. Across ages 2 to 5 years, intervention mothers reported less frequent use of nonresponsive feeding practices on 6 of 9 scales. At 5 years, they also reported more appropriate responses to food refusal on 7 of 12 items (Ps ≤ .05). No statistically significant group effect was noted for anthropometric outcomes (BMI Z-score: P = .06) or the prevalence of overweight/obesity (control 13.3% vs intervention 11.4%, P = .66). Anticipatory guidance on complementary feeding resulted in first-time mothers reporting increased use of protective feeding practices. These intervention effects were sustained up to 5 years of age and were paralleled by a nonsignificant trend for lower child BMI Z-scores at all postintervention assessment points. Copyright © 2015 by the American Academy of Pediatrics.

Pregnancy After Bariatric Surgery: National Survey of Obstetrician's Comfort, Knowledge, and Practice Patterns.

PubMed

Smid, Marcela C; Dotters-Katz, Sarah K; Mcelwain, Cora-Ann; Volckmann, Eric T; Schulkin, Jay; Stuebe, Alison M

2017-09-01

The objective of this study is to survey a nationally representative sample of obstetricians regarding comfort, knowledge, and practice patterns of caring for pregnant women after bariatric surgery. We conducted an online survey of US obstetricians and describe obstetrician's demographics, practice settings, and practice patterns. We assessed respondent's knowledge and recommended practices. We compared provider knowledge by years since completing residency, scope of practice (generalist or specialist), and practice setting (academic setting or other). Statistical significance was set at p < 0.05. A total of 106 completed the survey (response rate of 54%). Respondents had a median age of 47 and median 17 years in practice. Sixty-two percent were generalists. Nearly all of the respondents (94%) had some experience with caring for pregnant women after bariatric surgery and 83% reported feeling "very comfortable" (48%) or "somewhat comfortable" (35%) providing care for this population. Most (74%) were aware of increased risk of small for gestational age after surgery. Only 13% were able to correctly identify all recommended nutritional labs and 20% reported that they "did not know" which labs are recommended. There were no differences in comfort, experience, knowledge, and practice patterns by physician characteristics and practice settings. While most obstetricians are aware of perinatal risks after bariatric surgery, a substantial percentage of obstetricians are unaware of recommended practices regarding nutrition and nutritional monitoring. As bariatric surgery becomes increasingly prevalent among reproductive age women, educational interventions to increase obstetricians' knowledge of optimal care of pregnant women after bariatric surgery are urgently needed.

Dealing with missing standard deviation and mean values in meta-analysis of continuous outcomes: a systematic review.

PubMed

Weir, Christopher J; Butcher, Isabella; Assi, Valentina; Lewis, Stephanie C; Murray, Gordon D; Langhorne, Peter; Brady, Marian C

2018-03-07

Rigorous, informative meta-analyses rely on availability of appropriate summary statistics or individual participant data. For continuous outcomes, especially those with naturally skewed distributions, summary information on the mean or variability often goes unreported. While full reporting of original trial data is the ideal, we sought to identify methods for handling unreported mean or variability summary statistics in meta-analysis. We undertook two systematic literature reviews to identify methodological approaches used to deal with missing mean or variability summary statistics. Five electronic databases were searched, in addition to the Cochrane Colloquium abstract books and the Cochrane Statistics Methods Group mailing list archive. We also conducted cited reference searching and emailed topic experts to identify recent methodological developments. Details recorded included the description of the method, the information required to implement the method, any underlying assumptions and whether the method could be readily applied in standard statistical software. We provided a summary description of the methods identified, illustrating selected methods in example meta-analysis scenarios. For missing standard deviations (SDs), following screening of 503 articles, fifteen methods were identified in addition to those reported in a previous review. These included Bayesian hierarchical modelling at the meta-analysis level; summary statistic level imputation based on observed SD values from other trials in the meta-analysis; a practical approximation based on the range; and algebraic estimation of the SD based on other summary statistics. Following screening of 1124 articles for methods estimating the mean, one approximate Bayesian computation approach and three papers based on alternative summary statistics were identified. Illustrative meta-analyses showed that when replacing a missing SD the approximation using the range minimised loss of precision and generally performed better than omitting trials. When estimating missing means, a formula using the median, lower quartile and upper quartile performed best in preserving the precision of the meta-analysis findings, although in some scenarios, omitting trials gave superior results. Methods based on summary statistics (minimum, maximum, lower quartile, upper quartile, median) reported in the literature facilitate more comprehensive inclusion of randomised controlled trials with missing mean or variability summary statistics within meta-analyses.

Does Length of Developmental Behavioral Pediatrics Training Matter?

PubMed

Stein, Ruth E K; Storfer-Isser, Amy; Kerker, Bonnie D; Garner, Andrew; Szilagyi, Moira; Hoagwood, Kimberly E; O'Connor, Karen G; Green, Cori M; Horwitz, Sarah McCue

Since 1997 pediatric residencies have been required to provide a 4-week block rotation in developmental and behavioral pediatrics (DBP), but it is not known whether this has altered the care and management of children by practicing pediatricians. The objective of this study was to compare the self-reported practice patterns of pediatricians who were trained with 4 or more weeks of DBP with the practice patterns of those who were trained for <4 weeks. We used self-reported practices from the American Academy of Pediatrics Periodic Survey 85. Pediatricians were asked whether they never, sometimes, or usually inquired about and screened for, and whether they treated/managed/comanaged attention deficit hyperactivity disorder, depression, anxiety, behavior problems and learning problems. They were also asked about a series of barriers to care. Analyses were weighted to account for low response rates. Those with more DBP training were significantly more likely to treat/manage/co-manage depression, anxiety, behavior problems and learning problems, but were still doing so less than one third of the time. There were no differences in the care of patients with attention deficit hyperactivity disorder or in screening or inquiring about mental health conditions. Those with more training were more likely to perceive somewhat fewer barriers and to report more specific familiarity with some Diagnostic and Statistical Manual of Mental Disorders criteria and some treatment modalities. Longer length of training is associated with more treatment, but significant deficits in self-reported practice remain, leaving much room for additional improvement in the training of clinicians in DBP. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Over-the-counter treatments and perineal hygiene in postmenopausal women.

PubMed

Erekson, Elisabeth A; Martin, Deanna K; Brousseau, E Christine; Yip, Sallis O; Fried, Terri R

2014-03-01

The objective of this descriptive study was to quantify the personal hygiene habits/practices of, as well as the over-the-counter (OTC) products used by, postmenopausal women. Specifically, we were interested in any product that would contact the vulva or vagina. We performed a cross-sectional study of postmenopausal women seeking routine gynecologic care. We developed a questionnaire on their personal hygiene habits/practices and the OTC products that they use that would contact the vulva or vagina. We recruited postmenopausal women seeking gynecologic care from two separate gynecology practices. Descriptive statistics were performed as appropriate to characterize the frequency of reported treatments and practices. The questionnaire on OTC treatments and perineal hygiene was completed by 114 postmenopausal women. Fifty-eight women (50.9%) reported using at least one OTC vulvovaginal treatment in the last 3 months, including barrier treatments, topical anesthetics, powders, and antifungals. Women often used more than one OTC product. Thirty-seven women (32.5%) reported the use of two or more OTC products. Powders were used by 34 women (29.8%). Talcum powder was the most commonly used powder (26 of 34; 76.5%). Nine postmenopausal women (7.9%) reported douching in the last 3 months. We found that more than half of postmenopausal women seeking gynecologic care have used an OTC product for vulvovaginal symptoms in the last 3 months and that one third of women use two or more products. Because the use of OTC products is very common, our study highlights the need for a detailed history inquiry about OTC product use and perineal hygiene practices.

Capability beliefs on, and use of evidence-based practice among four health professional and student groups in geriatric care: A cross sectional study

PubMed Central

2018-01-01

Implementation of evidence-based practice (EBP) is a complex task. This study, conducted in an acute geriatric setting, aims to compare self-reported capability beliefs on EBP between health professionals and students, and to compare the use of EBP between health professional groups. Occupational therapists, physicians, physiotherapists and registered nurses with three or more months’ employment, and all students from the occupational therapy, medical, physiotherapy and nursing programs, who had conducted workplace learning at the department, were invited. Data on capability beliefs and use of EBP were collected using the Evidence-based Practice Capabilities Beliefs Scale assessing six activities of EBP: formulate questions; search databases; search other sources; appraise research reports; participate in implementation in practice; and participate in evaluation. Descriptive and inferential statistics were used. Capability beliefs on EBP: The health professionals (n = 101; response rate 80%) reported high on search other sources but less on appraise research reports. The students (n = 124; response rate 73%) reported high on all EBP activities. The health professionals reported significantly higher on search other sources than the students. The students reported significantly higher on formulate questions and appraise research reports than the health professionals. No significant differences were identified between the health professional groups or between the student groups. Use of EBP: Health professionals reported wide-ranging use from several times each month to once every six months. The physicians reported significantly more frequent use than registered nurses and occupational therapists. Health professionals supervising students reported more frequent use of appraise research reports than the non-supervising group. There is a need for improving the use of EBP, particularly among registered nurses and occupational therapists. Supervision of students might enhance the motivation among staff to increase the use of EBP and students’ high EBP capability beliefs might inspire staff in this matter. PMID:29444179

Reporting of Positive Results in Randomized Controlled Trials of Mindfulness-Based Mental Health Interventions.

PubMed

Coronado-Montoya, Stephanie; Levis, Alexander W; Kwakkenbos, Linda; Steele, Russell J; Turner, Erick H; Thombs, Brett D

2016-01-01

A large proportion of mindfulness-based therapy trials report statistically significant results, even in the context of very low statistical power. The objective of the present study was to characterize the reporting of "positive" results in randomized controlled trials of mindfulness-based therapy. We also assessed mindfulness-based therapy trial registrations for indications of possible reporting bias and reviewed recent systematic reviews and meta-analyses to determine whether reporting biases were identified. CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS databases were searched for randomized controlled trials of mindfulness-based therapy. The number of positive trials was described and compared to the number that might be expected if mindfulness-based therapy were similarly effective compared to individual therapy for depression. Trial registries were searched for mindfulness-based therapy registrations. CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS were also searched for mindfulness-based therapy systematic reviews and meta-analyses. 108 (87%) of 124 published trials reported ≥1 positive outcome in the abstract, and 109 (88%) concluded that mindfulness-based therapy was effective, 1.6 times greater than the expected number of positive trials based on effect size d = 0.55 (expected number positive trials = 65.7). Of 21 trial registrations, 13 (62%) remained unpublished 30 months post-trial completion. No trial registrations adequately specified a single primary outcome measure with time of assessment. None of 36 systematic reviews and meta-analyses concluded that effect estimates were overestimated due to reporting biases. The proportion of mindfulness-based therapy trials with statistically significant results may overstate what would occur in practice.

Efficacy and Physicochemical Evaluation of an Optimized Semisolid Formulation of Povidone Iodine Proposed by Extreme Vertices Statistical Design; a Practical Approach

PubMed Central

Lotfipour, Farzaneh; Valizadeh, Hadi; Shademan, Shahin; Monajjemzadeh, Farnaz

2015-01-01

One of the most significant issues in pharmaceutical industries, prior to commercialization of a pharmaceutical preparation is the "preformulation" stage. However, far too attention has been paid to verification of the software assisted statistical designs in preformulation studies. The main aim of this study was to report a step by step preformulation approach for a semisolid preparation based on a statistical mixture design and to verify the predictions made by the software with an in-vitro efficacy bioassay test. Extreme vertices mixture design (4 factors, 4 levels) was applied for preformulation of a semisolid Povidone Iodine preparation as Water removable ointment using different PolyEthylenGlycoles. Software Assisted (Minitab) analysis was then performed using four practically assessed response values including; Available iodine, viscosity (N index and yield value) and water absorption capacity. Subsequently mixture analysis was performed and finally, an optimized formulation was proposed. The efficacy of this formulation was bio-assayed using microbial tests in-vitro and MIC values were calculated for Escherichia coli, pseudomonaaeruginosa, staphylococcus aureus and Candida albicans. Results indicated the acceptable conformity of the measured responses. Thus, it can be concluded that the proposed design had an adequate power to predict the responses in practice. Stability studies, proved no significant change during the one year study for the optimized formulation. Efficacy was eligible on all tested species and in the case of staphylococcus aureus; the prepared semisolid formulation was even more effective. PMID:26664368

Issues with data and analyses: Errors, underlying themes, and potential solutions

PubMed Central

Allison, David B.

2018-01-01

Some aspects of science, taken at the broadest level, are universal in empirical research. These include collecting, analyzing, and reporting data. In each of these aspects, errors can and do occur. In this work, we first discuss the importance of focusing on statistical and data errors to continually improve the practice of science. We then describe underlying themes of the types of errors and postulate contributing factors. To do so, we describe a case series of relatively severe data and statistical errors coupled with surveys of some types of errors to better characterize the magnitude, frequency, and trends. Having examined these errors, we then discuss the consequences of specific errors or classes of errors. Finally, given the extracted themes, we discuss methodological, cultural, and system-level approaches to reducing the frequency of commonly observed errors. These approaches will plausibly contribute to the self-critical, self-correcting, ever-evolving practice of science, and ultimately to furthering knowledge. PMID:29531079

International employment in clinical practice: influencing factors for the dental hygienist.

PubMed

Abbott, A; Barrow, S-Y; Lopresti, F; Hittelman, E

2005-02-01

To assess demographics, job characteristics, geographical regions, resources and commitment, which influence dental hygienists seeking international clinical practice employment opportunities. Questionnaires were mailed to a convenience sample of members of the Dental Hygienists' Association of the City of New York. Statistical analyses were conducted and frequency distributions and relationships between variables were calculated. Seventy-two percent of respondents reported that they are or may be interested in working overseas. Italy and Spain (67%) were the regions of most interest. Salary (65%) was cited as the most influencing factor in selection, whereas non-compliance with the equivalency to Occupational Safety and Health Administration standards (74%) was the most frequently perceived barrier. Multiple language fluency was statistically significant (0.003) regarding interest in overseas employment. Policy makers, employers and educators need to be aware of these findings should recruitment be a possibility to render urgently needed oral hygiene care in regions where there is a perceived shortage of dental hygienists.

Prevalence and Frequency of Heterosexual Anal Intercourse Among Young People: A Systematic Review and Meta-analysis.

PubMed

Owen, Branwen N; Brock, Patrick M; Butler, Ailsa R; Pickles, Michael; Brisson, Marc; Baggaley, Rebecca F; Boily, Marie-Claude

2015-07-01

We aim to assess if heterosexual anal intercourse (AI) is commonly practiced and how frequently it is practiced by young people. We searched PubMed for articles published 1975 to July 2014 reporting data on the proportion of young people (mean age <25) practicing heterosexual AI (AI prevalence) and on number of AI acts (AI frequency). Stratified random-effects meta-analysis and meta-regression were used to produce summary estimates and assess the influence of participant and study characteristics on AI prevalence. Eighty-three and thirteen of the 136 included articles reported data on lifetime AI prevalence and monthly AI frequency, respectively. Estimates were heterogenous. Overall summary estimates of lifetime AI prevalence were 22 % (95 % confidence interval 20-24) among sexually active young people, with no statistically significant differences by gender, continent or age. Prevalence increased significantly with confidentiality of interview method and, among males and in Europe, by survey year. Prevalence did not significantly differ by recall period. An estimated 3-24 % of all reported sex acts were AI. Reported heterosexual AI is common but variable among young people worldwide. To fully understand its impact on STI spread, more and better quality data on frequency of unprotected AI, and trends over time are required.

Changes in physiotherapy students' knowledge and perceptions of EBP from first year to graduation: a mixed methods study.

PubMed

McEvoy, Maureen P; Lewis, Lucy K; Luker, Julie

2018-05-11

Dedicated Evidence-Based Practice (EBP) courses are often included in health professional education programs. It is important to understand the effectiveness of this training. This study investigated EBP outcomes in entry-level physiotherapy students from baseline to completion of all EBP training (graduation). Mixed methods with an explanatory sequential design. Physiotherapy students completed two psychometrically-tested health professional EBP instruments at baseline and graduation. The Evidence-Based Practice Profile questionnaire collected self-reported data (Terminology, Confidence, Practice, Relevance, Sympathy), and the Knowledge of Research Evidence Competencies instrument collected objective data (Actual Knowledge). Focus groups with students were conducted at graduation to gain a deeper understanding of the factors impacting changes in students' EBP knowledge, attitudes, behaviour and competency. Descriptive statistics, paired t-tests, 95% CI and effect sizes (ES) were used to examine changes in outcome scores from baseline to graduation. Transcribed focus group data were analysed following a qualitative descriptive approach with thematic analysis. A second stage of merged data analysis for mixed methods studies was undertaken using side-by-side comparisons to explore quantitatively assessed EBP measures with participants' personal perceptions. Data were analysed from 56 participants who completed both instruments at baseline and graduation, and from 21 focus group participants. Large ES were reported across most outcomes: Relevance (ES 2.29, p ≤ 0.001), Practice (1.8, p ≤ 0.001), Confidence (1.67, p ≤ 0.001), Terminology (3.13, p ≤ 0.001) and Actual Knowledge (4.3, p ≤ 0.001). A medium ES was found for Sympathy (0.49, p = 0.008). Qualitative and quantitative findings mostly aligned but for statistical terminology, participants' self-reported understanding was disparate with focus group reported experiences. Qualitative findings highlighted the importance of providing relevant context and positive role models for students during EBP training. Following EBP training across an entry-level physiotherapy program, there were qualitative and significant quantitative changes in participants' knowledge and perceptions of EBP. The qualitative and quantitative findings were mainly well-aligned with the exception of the Terminology domain, where the qualitative findings did not support the strength of the effect reported quantitatively. The findings of this study have implications for the timing and content of EBP curricula in entry-level health professional programs.

Comparing Tobacco Use Knowledge, Attitudes and Practices between Engineering Students at a Public and Islamic Azad University in Shiraz, Iran 2011.

PubMed

Askarian, Mehrdad; Kouchak, Farideh; Youssef, Moussa; Romito, Laura M

2013-10-01

To compare the level of knowledge, the attitudes, and practices with regards to tobacco use between Iranian students at a public (PBU) and Islamic Azad (IAU) university. A cross-sectional design was used in this study. As the number of students at the IAU were three times greater than that of the PBU, we selected 150 students from the PBU and 450 students from the IAU using simple random sampling. A 57-item survey instrument was utilized for this study. The collected data were recorded by SPSS version 15 software and then it underwent statistical analysis using descriptive statistics and ANOVA to compare the difference between means of knowledge, attitude and practice scores. Logistic regression analysis was conducted to identify variables that have an independent association with students smoking and to describe possible variations in these relationships. The P value level for statistical significance was set at 0.05. From participants, 46.8% were females, 10% of 327 students reported being daily smokers; of these, 84% were from the IAU. Totally, among the 107 smokers, 61 (57%) and 29 (27.1%) were water pipe and cigarettes smokers, respectively. Ninety-three IAU students (21.7%) and 30 PBU students (20.7%) reported smoking during the past 30 days. The mean of the knowledge items between the students of IAU was lower than PBU students. Female gender, smoking in the home, and allowing visitors to smoke in the home were significant predictors of smoking in the past 30 days in PBU, respectively. In IAU, female gender, smoking by friends, and health status were predictors for smoking in the past 30 days. Future studies should assess the factors affecting smoking initiation, as well as effective techniques for the prevention of smoking initiation and substance abuse in Iranian adolescents and young adults.

[Development of the legal abortion situation at the gynecologic hospital of Karl-Marx-University, Leipzig from 1.1.1960 to 30.6.1972].

PubMed

Schulz, S; Henning, G

1973-07-13

Statistics on legal abortions at the Women's Clinic, Karl Marx University, Leipzig, East Germany, are reported. Between 1960-June 30, 1972, there were 3955 abortions and 53,972 births. Of these, 1368 abortions and 1831 births occurred in 1972; a similar large increase in abortions has been reported from other socialist countries. Average age of patients was 30.6 years in 1960, 27.7 years in 1972. In 1960, 83.1% of patients were married, but only 66.4% in 1972. Average hospital stay was 10.3 days in 1960, 3.7 days in 1972. Complications were seen in 32.5% of cases in 1960, and in 8.3% in 1972. Statistics for each year, 1960-1972, are given, and the implications of this information for medical practice and social policy are discussed.

Sample size in psychological research over the past 30 years.

PubMed

Marszalek, Jacob M; Barber, Carolyn; Kohlhart, Julie; Holmes, Cooper B

2011-04-01

The American Psychological Association (APA) Task Force on Statistical Inference was formed in 1996 in response to a growing body of research demonstrating methodological issues that threatened the credibility of psychological research, and made recommendations to address them. One issue was the small, even dramatically inadequate, size of samples used in studies published by leading journals. The present study assessed the progress made since the Task Force's final report in 1999. Sample sizes reported in four leading APA journals in 1955, 1977, 1995, and 2006 were compared using nonparametric statistics, while data from the last two waves were fit to a hierarchical generalized linear growth model for more in-depth analysis. Overall, results indicate that the recommendations for increasing sample sizes have not been integrated in core psychological research, although results slightly vary by field. This and other implications are discussed in the context of current methodological critique and practice.

Physicians' Current Practices and Opportunities for DNA Banking of Dying Patients With Cancer

PubMed Central

Quillin, John M.; Bodurtha, Joann N.; Siminoff, Laura A.; Smith, Thomas J.

2011-01-01

Purpose: The availability of genetic tests for cancer susceptibility is increasing. Current tests, however, have limited clinical sensitivity. Even when clinically valid tests are available, the genetic counseling and informed consent process might not be feasible for dying patients with cancer. DNA banking preserves the opportunity for future research or clinical testing and may provide critical opportunities for surviving relatives. This study explored the current practices and potential for DNA banking for cancer susceptibility among oncologists specializing in palliative care. Methods: Palliative care oncologists actively providing clinical care for dying patients with cancer were recruited for an online survey. Descriptive statistics for DNA banking practices, perceived qualification to recommend banking, and potential predictors were assessed. Results: Data were collected from 49 physicians (37% recruitment rate). Eighty percent reported assessing at least some patients for genetic cancer susceptibility in the past 12 months. No participants reported banking DNA for patients in the past 12 months. Only 5% reported feeling at least somewhat qualified to order DNA banking. A Web-based risk assessment tool and genetic counselor on staff were perceived as the most helpful potential resources. Conclusion: Despite its potential, DNA banking is not being used by palliative care oncologists. PMID:21886501

Nationally Certified School Psychologists' use and reported barriers to using evidence-based interventions in schools: the influence of graduate program training and education.

PubMed

Hicks, Taylor B; Shahidullah, Jeffrey D; Carlson, John S; Palejwala, Mohammed H

2014-12-01

The purpose of this study was to empirically investigate Nationally Certified School Psychologists' (NCSP) training in and use of evidence-based interventions (EBIs) for child behavior concerns as well as their reported implementation barriers. A modified Tailored Design Method (TDM; Dillman, Smyth, & Christian, 2009) using up to four mail-based participant contacts was used to obtain survey data (72% usable response rate; n = 392) from a randomly selected national sample of 548 currently practicing NCSPs. Lack of time was rated as the most serious barrier to behavioral EBI implementation, followed by a lack of necessary resources, and financial constraints. Nearly three-quarters (71%) of respondents reported a perceived inadequacy of graduate program training in behavioral EBIs, with a statistically significant difference found between respondents who attended American Psychological Association (APA)-accredited/National Association of School Psychologists (NASP)-approved programs and those who did not. These findings highlight the significant barriers school psychologists encounter when attempting to implement behavioral EBIs within applied practice, as well as the importance of graduate program training in implementation science. Implications for training, practice, and research are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Direct access: factors that affect physical therapist practice in the state of Ohio.

PubMed

McCallum, Christine A; DiAngelis, Tom

2012-05-01

Direct access to physical therapist services is permitted by law in the majority of states and across all practice settings. Ohio enacted such legislation in 2004; however, it was unknown how direct access had affected actual clinical practice. The purpose of this study was to describe physical therapist and physical therapist practice environment factors that affect direct access practice. A 2-phase, mixed-method descriptive study was conducted. In the first phase, focus group interviews with 32 purposively selected physical therapists were completed, which resulted in 8 themes for an electronically distributed questionnaire. In the second phase, survey questionnaires were distributed to physical therapists with an e-mail address on file with the Ohio licensing board. An adjusted return rate of 23% was achieved. Data were analyzed for descriptive statistics. A constant comparative method assessed open-ended questions for common themes and patterns. Thirty-one percent of the respondents reported using direct access in physical therapist practice; however, 80% reported they would practice direct access if provided the opportunity. Physical therapists who practiced direct access were more likely to be in practice 6 years or more and hold advanced degrees beyond the entry level, were American Physical Therapy Association members, and had supportive management and organizational practice policies. The direct access physical therapist practice was generally a locally owned suburban private practice or a school-based clinic that saw approximately 6% to 10% of its patients by direct access. The majority of patients treated were adults with musculoskeletal or neuromuscular impairments. Nonresponse from e-mail may be associated with sample frame bias. Implementation of a direct access physical therapist practice model is evident in Ohio. Factors related to reimbursement and organizational policy appear to impede the process.

A person based formula for allocating commissioning funds to general practices in England: development of a statistical model

PubMed Central

Smith, Peter; Gravelle, Hugh; Martin, Steve; Bardsley, Martin; Rice, Nigel; Georghiou, Theo; Dusheiko, Mark; Billings, John; Lorenzo, Michael De; Sanderson, Colin

2011-01-01

Objectives To develop a formula for allocating resources for commissioning hospital care to all general practices in England based on the health needs of the people registered in each practice Design Multivariate prospective statistical models were developed in which routinely collected electronic information from 2005-6 and 2006-7 on individuals and the areas in which they lived was used to predict their costs of hospital care in the next year, 2007-8. Data on individuals included all diagnoses recorded at any inpatient admission. Models were developed on a random sample of 5 million people and validated on a second random sample of 5 million people and a third sample of 5 million people drawn from a random sample of practices. Setting All general practices in England as of 1 April 2007. All NHS inpatient admissions and outpatient attendances for individuals registered with a general practice on that date. Subjects All individuals registered with a general practice in England at 1 April 2007. Main outcome measures Power of the statistical models to predict the costs of the individual patient or each practice’s registered population for 2007-8 tested with a range of metrics (R2 reported here). Comparisons of predicted costs in 2007-8 with actual costs incurred in the same year were calculated by individual and by practice. Results Models including person level information (age, sex, and ICD-10 codes diagnostic recorded) and a range of area level information (such as socioeconomic deprivation and supply of health facilities) were most predictive of costs. After accounting for person level variables, area level variables added little explanatory power. The best models for resource allocation could predict upwards of 77% of the variation in costs at practice level, and about 12% at the person level. With these models, the predicted costs of about a third of practices would exceed or undershoot the actual costs by 10% or more. Smaller practices were more likely to be in these groups. Conclusions A model was developed that performed well by international standards, and could be used for allocations to practices for commissioning. The best formulas, however, could predict only about 12% of the variation in next year’s costs of most inpatient and outpatient NHS care for each individual. Person-based diagnostic data significantly added to the predictive power of the models. PMID:22110252

[Effect of weather on odontogenic abscesses].

PubMed

Nissen, G; Schmidseder, R

1978-11-01

An increased frequency of odontogenous abcesses was observed on certain days in the course of routine clinical practice. We therefore investigated the possibility of a statistically significant weather-related odontogenous soft-tissue purulence originating from chronic apical periodontitis. Medical reports of patients treated between 1970 and 1977 were used. Our study indicated that the frequency of odontogenous abcesses was significantly higher with cyclonic weather conditions, i.e., weather with low barometric pressure.

Using Visual Displays to Communicate Risk of Cancer to Women From Diverse Race/Ethnic Backgrounds

PubMed Central

Wong, Sabrina T.; Pérez-Stable, Eliseo J.; Kim, Sue E.; Gregorich, Steven E.; Sawaya, George F.; Walsh, Judith M. E.; Washington, A. Eugene; Kaplan, Celia P.

2012-01-01

Objective This study evaluated how well women from diverse race/ethnic groups were able to take a quantitative cancer risk statistic verbally provided to them and report it in a visual format. Methods Cross-sectional survey was administered in English, Spanish or Chinese, to women aged 50 to 80 (n=1,160), recruited from primary care practices. The survey contained breast, colorectal or cervical cancer questions regarding screening and prevention. Women were told cancer-specific lifetime risk then shown a visual display of risk and asked to indicate the specific lifetime risk. Correct indication of risk was the main outcome. Results Correct responses on icon arrays were 46% for breast, 55% for colon, and 44% for cervical; only 25% correctly responded to a magnifying glass graphic. Compared to Whites, African American and Latina women were significantly less likely to use the icon arrays correctly. Higher education and higher numeracy were associated with correct responses. Lower education was associated with lower numeracy. Conclusions Race/Ethnic differences were associated with women’s ability to take a quantitative cancer risk statistic verbally provided to them and report it in a visual format. Practice Implications Systematically considering the complexity of intersecting factors such as race/ethnicity, educational level, poverty, and numeracy in most health communications is needed. (200) PMID:22244322

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

PubMed

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

2017-02-01

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

New U.S. Geological Survey Method for the Assessment of Reserve Growth

USGS Publications Warehouse

Klett, Timothy R.; Attanasi, E.D.; Charpentier, Ronald R.; Cook, Troy A.; Freeman, P.A.; Gautier, Donald L.; Le, Phuong A.; Ryder, Robert T.; Schenk, Christopher J.; Tennyson, Marilyn E.; Verma, Mahendra K.

2011-01-01

Reserve growth is defined as the estimated increases in quantities of crude oil, natural gas, and natural gas liquids that have the potential to be added to remaining reserves in discovered accumulations through extension, revision, improved recovery efficiency, and additions of new pools or reservoirs. A new U.S. Geological Survey method was developed to assess the reserve-growth potential of technically recoverable crude oil and natural gas to be added to reserves under proven technology currently in practice within the trend or play, or which reasonably can be extrapolated from geologically similar trends or plays. This method currently is in use to assess potential additions to reserves in discovered fields of the United States. The new approach involves (1) individual analysis of selected large accumulations that contribute most to reserve growth, and (2) conventional statistical modeling of reserve growth in remaining accumulations. This report will focus on the individual accumulation analysis. In the past, the U.S. Geological Survey estimated reserve growth by statistical methods using historical recoverable-quantity data. Those statistical methods were based on growth rates averaged by the number of years since accumulation discovery. Accumulations in mature petroleum provinces with volumetrically significant reserve growth, however, bias statistical models of the data; therefore, accumulations with significant reserve growth are best analyzed separately from those with less significant reserve growth. Large (greater than 500 million barrels) and older (with respect to year of discovery) oil accumulations increase in size at greater rates late in their development history in contrast to more recently discovered accumulations that achieve most growth early in their development history. Such differences greatly affect the statistical methods commonly used to forecast reserve growth. The individual accumulation-analysis method involves estimating the in-place petroleum quantity and its uncertainty, as well as the estimated (forecasted) recoverability and its respective uncertainty. These variables are assigned probabilistic distributions and are combined statistically to provide probabilistic estimates of ultimate recoverable quantities. Cumulative production and remaining reserves are then subtracted from the estimated ultimate recoverable quantities to provide potential reserve growth. In practice, results of the two methods are aggregated to various scales, the highest of which includes an entire country or the world total. The aggregated results are reported along with the statistically appropriate uncertainties.

Best practices for veterinary toxicologic clinical pathology, with emphasis on the pharmaceutical and biotechnology industries.

PubMed

Tomlinson, Lindsay; Boone, Laura I; Ramaiah, Lila; Penraat, Kelley A; von Beust, Barbara R; Ameri, Mehrdad; Poitout-Belissent, Florence M; Weingand, Kurt; Workman, Heather C; Aulbach, Adam D; Meyer, Dennis J; Brown, Diane E; MacNeill, Amy L; Bolliger, Anne Provencher; Bounous, Denise I

2013-09-01

The purpose of this paper by the Regulatory Affairs Committee (RAC) of the American Society for Veterinary Clinical Pathology (ASVCP) is to review the current regulatory guidances (eg, guidelines) and published recommendations for best practices in veterinary toxicologic clinical pathology, particularly in the pharmaceutical and biotechnology industries, and to utilize the combined experience of ASVCP RAC to provide updated recommendations. Discussion points include (1) instrumentation, validation, and sample collection, (2) routine laboratory variables, (3) cytologic laboratory variables, (4) data interpretation and reporting (including peer review, reference intervals and statistics), and (5) roles and responsibilities of clinical pathologists and laboratory personnel. Revision and improvement of current practices should be in alignment with evolving regulatory guidance documents, new technology, and expanding understanding and utility of clinical pathology. These recommendations provide a contemporary guide for the refinement of veterinary toxicologic clinical pathology best practices. © 2013 American Society for Veterinary Clinical Pathology.

Surgeons' physical discomfort and symptoms during robotic surgery: a comprehensive ergonomic survey study.

PubMed

Lee, G I; Lee, M R; Green, I; Allaf, M; Marohn, M R

2017-04-01

It is commonly believed that robotic surgery systems provide surgeons with an ergonomically sound work environment; however, the actual experience of surgeons practicing robotic surgery (RS) has not been thoroughly researched. In this ergonomics survey study, we investigated surgeons' physical symptom reports and their association with factors including demographics, specialties, and robotic systems. Four hundred and thirty-two surgeons regularly practicing RS completed this comprehensive survey comprising 20 questions in four categories: demographics, systems, ergonomics, and physical symptoms. Chi-square and multinomial logistic regression analyses were used for statistical analysis. Two hundred and thirty-six surgeons (56.1 %) reported physical symptoms or discomfort. Among those symptoms, neck stiffness, finger, and eye fatigues were the most common. With the newest robot, eye symptom rate was considerably reduced, while neck and finger symptoms did not improve significantly. A high rate of lower back stiffness was correlated with higher annual robotic case volume, and eye symptoms were more common with longer years practicing robotic surgery (p < 0.05). The symptom report rate from urology surgeons was significantly higher than other specialties (p < 0.05). Noticeably, surgeons with higher confidence and helpfulness levels with their ergonomic settings reported lower symptom report rates. Symptoms were not correlated with age and gender. Although RS provides relatively better ergonomics, this study demonstrates that 56.1 % of regularly practicing robotic surgeons still experience related physical symptoms or discomfort. In addition to system improvement, surgeon education in optimizing the ergonomic settings may be necessary to maximize the ergonomic benefits in RS.

Introducing StatHand: A Cross-Platform Mobile Application to Support Students' Statistical Decision Making.

PubMed

Allen, Peter J; Roberts, Lynne D; Baughman, Frank D; Loxton, Natalie J; Van Rooy, Dirk; Rock, Adam J; Finlay, James

2016-01-01

Although essential to professional competence in psychology, quantitative research methods are a known area of weakness for many undergraduate psychology students. Students find selecting appropriate statistical tests and procedures for different types of research questions, hypotheses and data types particularly challenging, and these skills are not often practiced in class. Decision trees (a type of graphic organizer) are known to facilitate this decision making process, but extant trees have a number of limitations. Furthermore, emerging research suggests that mobile technologies offer many possibilities for facilitating learning. It is within this context that we have developed StatHand, a free cross-platform application designed to support students' statistical decision making. Developed with the support of the Australian Government Office for Learning and Teaching, StatHand guides users through a series of simple, annotated questions to help them identify a statistical test or procedure appropriate to their circumstances. It further offers the guidance necessary to run these tests and procedures, then interpret and report their results. In this Technology Report we will overview the rationale behind StatHand, before describing the feature set of the application. We will then provide guidelines for integrating StatHand into the research methods curriculum, before concluding by outlining our road map for the ongoing development and evaluation of StatHand.

Statistical Methods and Tools for Uxo Characterization (SERDP Final Technical Report)

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

Pulsipher, Brent A.; Gilbert, Richard O.; Wilson, John E.

2004-11-15

The Strategic Environmental Research and Development Program (SERDP) issued a statement of need for FY01 titled Statistical Sampling for Unexploded Ordnance (UXO) Site Characterization that solicited proposals to develop statistically valid sampling protocols for cost-effective, practical, and reliable investigation of sites contaminated with UXO; protocols that could be validated through subsequent field demonstrations. The SERDP goal was the development of a sampling strategy for which a fraction of the site is initially surveyed by geophysical detectors to confidently identify clean areas and subsections (target areas, TAs) that had elevated densities of anomalous geophysical detector readings that could indicate the presencemore » of UXO. More detailed surveys could then be conducted to search the identified TAs for UXO. SERDP funded three projects: those proposed by the Pacific Northwest National Laboratory (PNNL) (SERDP Project No. UXO 1199), Sandia National Laboratory (SNL), and Oak Ridge National Laboratory (ORNL). The projects were closely coordinated to minimize duplication of effort and facilitate use of shared algorithms where feasible. This final report for PNNL Project 1199 describes the methods developed by PNNL to address SERDP's statement-of-need for the development of statistically-based geophysical survey methods for sites where 100% surveys are unattainable or cost prohibitive.« less

Control charts for monitoring accumulating adverse event count frequencies from single and multiple blinded trials.

PubMed

Gould, A Lawrence

2016-12-30

Conventional practice monitors accumulating information about drug safety in terms of the numbers of adverse events reported from trials in a drug development program. Estimates of between-treatment adverse event risk differences can be obtained readily from unblinded trials with adjustment for differences among trials using conventional statistical methods. Recent regulatory guidelines require monitoring the cumulative frequency of adverse event reports to identify possible between-treatment adverse event risk differences without unblinding ongoing trials. Conventional statistical methods for assessing between-treatment adverse event risks cannot be applied when the trials are blinded. However, CUSUM charts can be used to monitor the accumulation of adverse event occurrences. CUSUM charts for monitoring adverse event occurrence in a Bayesian paradigm are based on assumptions about the process generating the adverse event counts in a trial as expressed by informative prior distributions. This article describes the construction of control charts for monitoring adverse event occurrence based on statistical models for the processes, characterizes their statistical properties, and describes how to construct useful prior distributions. Application of the approach to two adverse events of interest in a real trial gave nearly identical results for binomial and Poisson observed event count likelihoods. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

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

PubMed

Fry, Margaret; Attawet, Jutharat

2018-03-01

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

Mobile phone text messaging to improve knowledge and practice of diabetic foot care in a developing country: Feasibility and outcomes.

PubMed

Hassan, Zeinab M

2017-06-01

To test the feasibility and effectiveness of using mobile phone text messaging to reinforce learning and the practice of diabetic foot care in a developing country. Ongoing learning reinforcement (2-3 times weekly) by text messaging followed an informal class on diabetic foot care in a community clinic setting. Subjects with cell phone access and no history of diabetic foot wounds or current wounds were recruited for participation (N = 225). Foot examinations and pretesting by survey occurred just before patients departed the clinic; the posttest survey and a final foot examination occurred 12 weeks later. The survey included basic demographic items along with items to measure knowledge and current foot care practices. One sample t tests (raw scores) and Wilcoxon signed-rank tests compared knowledge and practice before and after intervention. Initially, a majority of the sample (76%) reported poor levels of foot care. After 12 weeks <1% reported poor foot care practices. Statistical testing showed significant gains in knowledge (by score and level) and nearly unanimous compliance with daily foot examination. Mobile phone text messaging is an economical, feasible, and effective method for educators to improve diabetic self-care, even in a developing country. © 2017 John Wiley & Sons Australia, Ltd.

School food policies and practices: a state-wide survey of secondary school principals.

PubMed

French, Simone A; Story, Mary; Fulkerson, Jayne A

2002-12-01

To describe food-related policies and practices in secondary schools in Minnesota. Mailed anonymous survey including questions about the secondary school food environment and food-related practices and policies. Members of a statewide professional organization for secondary school principals (n = 610; response rate: 463/610 = 75%). Of the 463 surveys returned, 336 met the eligibility criteria (current position was either principal or assistant principal and school included at least one of the grades of 9 through 12). Descriptive statistics examined the prevalence of specific policies and practices. Chi2 analysis examined associations between policies and practices and school variables. Among principals, 65% believed it was important to have a nutrition policy for the high school; however, only 32% reported a policy at their school. Principals reported positive attitudes about providing a healthful school food environment, but 98% of the schools had soft drink vending machines and 77% had contracts with soft drink companies. Food sold at school fundraisers was most often candy, fruit, and cookies. Dietetics professionals who work in secondary school settings should collaborate with other key school staff members and parents to develop and implement a comprehensive school nutrition policy. Such a policy could foster a school food environment that is supportive of healthful food choices among youth.

How the mass media report social statistics: a case study concerning research on end-of-life decisions.

PubMed

Seale, Clive

2010-09-01

The issue of whether it is right to be concerned about the accuracy with which mass media report social scientific research is explored through a detailed case study of media reporting of two surveys of UK doctors' end-of-life decision-making. Data include press releases, emails and field notes taken during periods of media interest supplemented by a collection of print and broadcast media reports. The case study contributes to existing knowledge about the ways in which mass media establish, exaggerate and otherwise distort the meaning of statistical findings. Journalists ignored findings that did not fit into existing media interest in the 'assisted dying' story and were subject to pressure from interest groups concerned to promote their own interpretations and viewpoints. Rogue statistics mutated as they were set loose from their original research report context and were 'laundered' as they passed from one media report to another. Yet media accounts of the research, fuelling an already heated public debate about ethical issues in end-of-life care, arguably acted as a conduit for introducing new considerations into this debate, such as the role played by sedation at the end of life, the extent to which euthanasia is practiced outside the law, and the extent of medical opposition to the legalisation of assisted dying. The expectation that accuracy and comprehensiveness should be the sole criteria for judging journalists' reports is, finally, considered to be unrealistic and it is argued that social scientists need to understand and adapted to the conditions under which mass media reporting operates if they are to succeed in introducing the findings of social research into public debates. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Embedding Evidence-based Practice Education into a Post-graduate Physiotherapy Program: Eight Years of pre-Post Course Evaluations.

PubMed

Perraton, L; Machotka, Z; Grimmer, K; Gibbs, C; Mahar, C; Kennedy, K

2017-04-01

Little has been published about the effectiveness of training postgraduate physiotherapy coursework students in research methods and evidence-based practice (EBP) theory. Graduate qualities in most universities include lifelong learning. Inclusion of EBP in post-graduate coursework students' training is one way for students to develop the knowledge and skills needed to implement current best evidence in their clinical practice after graduation, thereby facilitating lifelong learning. This paper reports on change in confidence and anxiety in knowledge of statistical terminology and concepts related to research design and EBP in eight consecutive years of post-graduate physiotherapy students at one Australian university. Pre-survey/post-survey instruments were administered to students in an intensive 3-week post-graduate course, which taught health research methods, biostatistics and EBP. This course was embedded into a post-graduate physiotherapy programme from 2007 to 2014. The organization and delivery of the course was based on best pedagogical evidence for effectively teaching adult physiotherapists. The course was first delivered each year in the programme, and no other course was delivered concurrently. There were significant improvements in confidence, significantly decreased anxiety and improvements in knowledge of statistical terminology and concepts related to research design and EBP, at course completion. Age, gender and country of origin were not confounders on learning outcomes, although there was a (non-significant) trend that years of practice negatively impacted on learning outcomes (p = 0.09). There was a greater improvement in confidence in statistical terminology than in concepts related to research design and EBP. An intensive teaching programme in health research methods and biostatistics and EBP, based on best practice adult physiotherapy learning principles, is effective immediately post-course, in decreasing anxiety and increasing confidence in the terminology used in research methods and EBP. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Gender, symptom experience, and use of complementary and alternative medicine practices among cancer survivors in the U.S. cancer population.

PubMed

Fouladbakhsh, Judith M; Stommel, Manfred

2010-01-01

To identify relationships among gender, physical and psychological symptoms (pain, insomnia, fatigue, and depression), and use of specific complementary and alternative medicine (CAM) practices among survivors in the U.S. cancer population. Secondary analysis of the 2002 National Health Interview Survey (NHIS). The CAM Healthcare Model, an extension of the Behavioral Model for Health Services Use, guided the study. United States. 2,262 adults (aged 18 years and older) diagnosed with cancer representing more than 14.3 million cancer survivors in the United States . NHIS interview data on use of CAM practices (diet, yoga, tai chi, qigong, meditation, guided imagery, relaxation, and deep breathing) were examined in relationship to gender and symptoms. Analysis was conducted using Stata 9.2 software for population estimation. Binary logistic regression, the primary statistical model employed in the analysis, focused on between-subject differences in practice use. Dichotomous outcome variables included use of at least one CAM practice and use of specific individual CAM practices. Independent variables included gender, age, education, race, provider contact, cancer diagnosis, pain, insomnia, fatigue, depression, and health status. CAM practice use was more prevalent among female, middle-aged, Caucasian, and well-educated subjects. Pain, depression, and insomnia were strong predictors of practice use, with differences noted by gender and practice type. CAM practices are widely used in the U.S. cancer population, especially among women. Symptom experience influences likelihood of use, with increased odds when men report symptoms. Study findings inform oncology nurses on the benefits of integrating self-care CAM practices in relationship to gender into the symptom management care plan for cancer survivors. Findings reported in this study will help guide future CAM practice intervention studies.

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

PubMed

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

2018-04-01

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

Knowledge translation and implementation in spinal cord injury: a systematic review.

PubMed

Noonan, V K; Wolfe, D L; Thorogood, N P; Park, S E; Hsieh, J T; Eng, J J

2014-08-01

To conduct a systematic review examining the effectiveness of knowledge translation (KT) interventions in changing clinical practice and patient outcomes. MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO were searched for studies published from January 1980 to July 2012 that reported and evaluated an implemented KT intervention in spinal cord injury (SCI) care. We reviewed and summarized results from studies that documented the implemented KT intervention, its impact on changing clinician behavior and patient outcomes as well as the facilitators and barriers encountered during the implementation. A total of 13 articles featuring 10 studies were selected and abstracted from 4650 identified articles. KT interventions included developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice. The methods (or drivers) to facilitate the implementation included organizing training sessions for clinical staff, introducing computerized reminders and involving organizational leaders. The methodological quality of studies was mostly poor. Only 3 out of 10 studies evaluated the success of the implementation using statistical analyses, and all 3 reported significant behavior change. Out of the 10 studies, 6 evaluated the effect of the implementation on patient outcomes using statistical analyses, with 4 reporting significant improvements. The commonly cited facilitators and barriers were communication and resources, respectively. The field of KT in SCI is in its infancy with only a few relevant publications. However, there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. Future studies should ensure rigorous study methods are used to evaluate KT interventions.

[The use of diagnoses related to tobacco use in the Czech Republic].

PubMed

Zvolský, Miroslav; Nechanská, Blanka; Králíková, Eva

2012-01-01

According to the International Statistical Classification of Diseases and Related Health Problems 10th Revision, tobacco dependence is coded by group F17 - Mental and behavioral disorders due to use of tobacco. There are other codes for diagnoses and conditions associated with tobacco use. The aim of our analysis was to determine how often these codes are reported in clinical practice. We observed the incidence of diagnoses F17, P04.2, Z72.0 or T65.2 in years 2002-2011 in hospitalized patients and the F17 diagnosis in patients of psychiatric health facilities. According to data from the Institute of Health Information and Statistics of the Czech Republic diagnoses indicating smoking patients were reported in 1.5% of hospitalized patients in 2011, although the prevalence of smoking in the population is around 30% in last 15 years. Smoking-related diagnoses were reported in 2.1% of cases in Internal medicine departments. Codes F17, T65.2 and Z72.0 occurred as an accessory diagnose in vascular brain disease in 1.8% of hospitalizations and for respiratory tract neoplasms (dg. C32-C34) it was 7.1% of hospitalizations. These results demonstrate the underestimation of the importance of smoking and its relationship to clinical disciplines. Although it is one of the most common diseases in the population with a direct relation to fatal diseases of civilization, the information on its incidence is not used in clinical practice.

Sedation provider practice variation: a survey analysis of pediatric emergency subspecialists and fellows.

PubMed

Shavit, Itai; Leder, Marc; Cohen, Daniel M

2010-10-01

Pediatric emergency physicians use various techniques and medications when performing procedural sedation and analgesia. The goals of our study were to assess US pediatric emergency medicine subspecialists and fellows (PEMSSFs) for individual practice variation and to evaluate (1) the use of supplemental oxygen and capnography monitoring and (2) adverse sedation events (ADSEs). A Web-based tool was used to survey and analyze data collected from a selected group of PEMSSFs, regarding their responses to 5 common sedation case scenarios, use of supplemental oxygen and capnography monitoring, and ADSEs. Logistic regression analysis was used to examine the association between medication strategy and various levels of professional experience. Two hundred one surveys were received. One hundred ninety-five of these were eligible for the study: 140 from specialists and 55 from fellows. Respondents used multiple combinations of pharmaceutical agents to the scenarios presented. For some scenarios, statistical association was found between medication selection strategy and longer professional experience. Sixty percent of respondents do not routinely provide oxygen supplementation. Despite current guidelines supporting the routine use of capnography monitoring, 45% of respondents never use it. Adverse sedation event was reported in 17 cases; all patients were discharged with no further complications. A statistical association was found between years of practitioner experience and the likelihood of reporting an ADSE (P < 0.018). This group of PEMSSFs reported a wide spectrum of medication sedation strategies, dichotomous approaches to the use of oxygen supplementation and capnography monitoring, and a low rate of ADSEs.

Fitness to practise in pharmacy: a study of impairment in professional practice.

PubMed

Mohammad, Annim; Hanrahan, Jane R; Sainsbury, Erica; Chaar, Betty B

2012-04-01

To explore the opinions and knowledge of Australian pharmacists about impairment in the profession, and their awareness of new legislation regarding impairment and mandatory reporting. Pharmacy practice in Australia. Pharmacists' opinions and knowledge were explored using a purposively designed, de-identified survey distributed by an intermediate mailing house to randomly selected pharmacists registered with the Pharmacy Board. Descriptive statistics and thematic analyses were conducted on the data. KEY OUTCOME MEASURES: This being an explorative study, we analysed various items using standard statistical methods and qualitative thematic analysis for responses to open-ended questions. Responses from 370 registered pharmacists were obtained. Of these, nearly 60% were not confident in their knowledge of legislation relating to impairment. The vast majority stated they would consider reporting an impaired colleague in principle, but only after consulting the colleague. Older pharmacists demonstrated increased awareness of new legislation; this was accompanied however, by a marked decrease in confidence regarding knowledge about impairment. Thematic analysis of the qualitative data revealed four main themes: (1) perception of impairment and support systems available (2) stigma related to implications of impairment and whistle-blowing (3) factors affecting reporting of impairment and (4) management of impairment. Australian pharmacists in this study recognised the importance of the issue of impairment, but appeared to lack confidence and/or awareness of legislative requirements regarding impairment in the profession. There is a need for educative programs and accessible, profession-specific rehabilitative programs to be instigated for management of impairment in the profession of pharmacy in Australia.

Metrological traceability in education: A practical online system for measuring and managing middle school mathematics instruction

NASA Astrophysics Data System (ADS)

Torres Irribarra, D.; Freund, R.; Fisher, W.; Wilson, M.

2015-02-01

Computer-based, online assessments modelled, designed, and evaluated for adaptively administered invariant measurement are uniquely suited to defining and maintaining traceability to standardized units in education. An assessment of this kind is embedded in the Assessing Data Modeling and Statistical Reasoning (ADM) middle school mathematics curriculum. Diagnostic information about middle school students' learning of statistics and modeling is provided via computer-based formative assessments for seven constructs that comprise a learning progression for statistics and modeling from late elementary through the middle school grades. The seven constructs are: Data Display, Meta-Representational Competence, Conceptions of Statistics, Chance, Modeling Variability, Theory of Measurement, and Informal Inference. The end product is a web-delivered system built with Ruby on Rails for use by curriculum development teams working with classroom teachers in designing, developing, and delivering formative assessments. The online accessible system allows teachers to accurately diagnose students' unique comprehension and learning needs in a common language of real-time assessment, logging, analysis, feedback, and reporting.

Good pharmacovigilance practices: technology enabled.

PubMed

Nelson, Robert C; Palsulich, Bruce; Gogolak, Victor

2002-01-01

The assessment of spontaneous reports is most effective it is conducted within a defined and rigorous process. The framework for good pharmacovigilance process (GPVP) is proposed as a subset of good postmarketing surveillance process (GPMSP), a functional structure for both a public health and corporate risk management strategy. GPVP has good practices that implement each step within a defined process. These practices are designed to efficiently and effectively detect and alert the drug safety professional to new and potentially important information on drug-associated adverse reactions. These practices are enabled by applied technology designed specifically for the review and assessment of spontaneous reports. Specific practices include rules-based triage, active query prompts for severe organ insults, contextual single case evaluation, statistical proportionality and correlational checks, case-series analyses, and templates for signal work-up and interpretation. These practices and the overall GPVP are supported by state-of-the-art web-based systems with powerful analytical engines, workflow and audit trials to allow validated systems support for valid drug safety signalling efforts. It is also important to understand that a process has a defined set of steps and any one cannot stand independently. Specifically, advanced use of technical alerting methods in isolation can mislead and allow one to misunderstand priorities and relative value. In the end, pharmacovigilance is a clinical art and a component process to the science of pharmacoepidemiology and risk management.

Perceived financial incentives, HMO market penetration, and physicians' practice styles and satisfaction.

PubMed

Hadley, J; Mitchell, J M; Sulmasy, D P; Bloche, M G

1999-04-01

To estimate the effects of physicians' personal financial incentives and other measures of involvement with HMOs on three measures of satisfaction and practice style: overall practice satisfaction, the extent to which prior expectations about professional autonomy and the ability to practice good-quality medicine are met, and several specific measures of practice style. A telephone survey conducted in 1997 of 1,549 physicians who were located in the 75 largest Metropolitan Statistical Areas in 1991. Eligible physicians were under age 52, had between 8 and 17 years of post-residency practice experience, and spent at least 20 hours per week in patient care. The response rate was 74 percent. Multivariate binomial and multinomial ordered logistic regression models were estimated. Independent variables included physicians' self-reported financial incentives, measured by the extent to which their overall financial arrangements created an incentive to either reduce or increase services to patients, the level of HMO penetration in the market, employment setting, medical specialty, exposure to managed care while in medical training, and selected personal characteristics. About 15 percent of survey respondents reported a moderate or strong incentive to reduce services; 70 percent reported a neutral incentive; and 15 percent reported an incentive to increase services. Compared to physicians with a neutral incentive, physicians with an incentive to reduce services were from 1.5 to 3.5 times more likely to be very dissatisfied with their practices and were 0.2 to 0.5 times as likely to report that their expectations regarding professional autonomy and ability to practice good-quality medicine were met. They were also 0.2 to 0.6 times as likely to report having the freedom to care for patients the way they would like along several specific measures of practice style, such as sufficient time with patients, ability to hospitalize, ability to order tests and procedures, and ability to make referrals. These effects were generally reinforced by practicing in an area with a high level of HMO penetration and were offset to some extent by having had exposure to HMOs and the practice of cost-effective medicine while in medical training. Although financial incentives to reduce services are not widespread, there is a legitimate reason to be concerned about possible adverse affects on the quality of care. More research is needed to investigate directly whether changes in patients' health are affected by their physicians' financial incentives.

Perceived financial incentives, HMO market penetration, and physicians' practice styles and satisfaction.

PubMed Central

Hadley, J; Mitchell, J M; Sulmasy, D P; Bloche, M G

1999-01-01

OBJECTIVE: To estimate the effects of physicians' personal financial incentives and other measures of involvement with HMOs on three measures of satisfaction and practice style: overall practice satisfaction, the extent to which prior expectations about professional autonomy and the ability to practice good-quality medicine are met, and several specific measures of practice style. DATA SOURCES: A telephone survey conducted in 1997 of 1,549 physicians who were located in the 75 largest Metropolitan Statistical Areas in 1991. Eligible physicians were under age 52, had between 8 and 17 years of post-residency practice experience, and spent at least 20 hours per week in patient care. The response rate was 74 percent. STUDY DESIGN: Multivariate binomial and multinomial ordered logistic regression models were estimated. Independent variables included physicians' self-reported financial incentives, measured by the extent to which their overall financial arrangements created an incentive to either reduce or increase services to patients, the level of HMO penetration in the market, employment setting, medical specialty, exposure to managed care while in medical training, and selected personal characteristics. PRINCIPAL FINDINGS: About 15 percent of survey respondents reported a moderate or strong incentive to reduce services; 70 percent reported a neutral incentive; and 15 percent reported an incentive to increase services. Compared to physicians with a neutral incentive, physicians with an incentive to reduce services were from 1.5 to 3.5 times more likely to be very dissatisfied with their practices and were 0.2 to 0.5 times as likely to report that their expectations regarding professional autonomy and ability to practice good-quality medicine were met. They were also 0.2 to 0.6 times as likely to report having the freedom to care for patients the way they would like along several specific measures of practice style, such as sufficient time with patients, ability to hospitalize, ability to order tests and procedures, and ability to make referrals. These effects were generally reinforced by practicing in an area with a high level of HMO penetration and were offset to some extent by having had exposure to HMOs and the practice of cost-effective medicine while in medical training. CONCLUSIONS: Although financial incentives to reduce services are not widespread, there is a legitimate reason to be concerned about possible adverse affects on the quality of care. More research is needed to investigate directly whether changes in patients' health are affected by their physicians' financial incentives. PMID:10199677

Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania.

PubMed

Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Ndossi, Godwin D; Osei, Eric J A; Sidibe, Mintou Fall; Boupha, Boungnong

2011-12-13

Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs). This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140), Laos (136), Senegal (100) and Tanzania (121). Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. The survey achieved a 75% response rate (372/497) across Ghana (107/140), Laos (136/136), Senegal (51/100) and Tanzania (78/121). Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13%) or self-reported performing all five clinical practices according to established evidence (2%). Statistically significant factors associated with higher knowledge within each country included: 1) training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73); and 2) ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70). Statistically significant factors associated with better clinical practices within each country include: 1) reading scientific journals from their own country (OR 1.67, 95% CI 1.10-2.54); 2) working with researchers to improve their clinical practice or quality of working life (OR 1.44, 95% CI 1.04-1.98); 3) training on malaria prevention since their last degree (OR 1.68, 95% CI 1.17-2.39); and 4) easy access to the internet (OR 1.52, 95% CI 1.08-2.14). Improving healthcare providers' knowledge and practices is an untapped opportunity for expanding ITN utilization and preventing malaria. This study points to several strategies that may help bridge the gap between what is known from research evidence and the knowledge and practices of healthcare providers. Training on acquiring systematic reviews and facilitating internet access may be particularly helpful.

Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania

PubMed Central

2011-01-01

Background Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs). Methods This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140), Laos (136), Senegal (100) and Tanzania (121). Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. Results The survey achieved a 75% response rate (372/497) across Ghana (107/140), Laos (136/136), Senegal (51/100) and Tanzania (78/121). Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13%) or self-reported performing all five clinical practices according to established evidence (2%). Statistically significant factors associated with higher knowledge within each country included: 1) training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73); and 2) ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70). Statistically significant factors associated with better clinical practices within each country include: 1) reading scientific journals from their own country (OR 1.67, 95% CI 1.10-2.54); 2) working with researchers to improve their clinical practice or quality of working life (OR 1.44, 95% CI 1.04-1.98); 3) training on malaria prevention since their last degree (OR 1.68, 95% CI 1.17-2.39); and 4) easy access to the internet (OR 1.52, 95% CI 1.08-2.14). Conclusions Improving healthcare providers' knowledge and practices is an untapped opportunity for expanding ITN utilization and preventing malaria. This study points to several strategies that may help bridge the gap between what is known from research evidence and the knowledge and practices of healthcare providers. Training on acquiring systematic reviews and facilitating internet access may be particularly helpful. PMID:22165841

Comparing early signs and basic symptoms as methods for predicting psychotic relapse in clinical practice.

PubMed

Eisner, Emily; Drake, Richard; Lobban, Fiona; Bucci, Sandra; Emsley, Richard; Barrowclough, Christine

2018-02-01

Early signs interventions show promise but could be further developed. A recent review suggested that 'basic symptoms' should be added to conventional early signs to improve relapse prediction. This study builds on preliminary evidence that basic symptoms predict relapse and aimed to: 1. examine which phenomena participants report prior to relapse and how they describe them; 2. determine the best way of identifying pre-relapse basic symptoms; 3. assess current practice by comparing self- and casenote-reported pre-relapse experiences. Participants with non-affective psychosis were recruited from UK mental health services. In-depth interviews (n=23), verbal checklists of basic symptoms (n=23) and casenote extracts (n=208) were analysed using directed content analysis and non-parametric statistical tests. Three-quarters of interviewees reported basic symptoms and all reported conventional early signs and 'other' pre-relapse experiences. Interviewees provided rich descriptions of basic symptoms. Verbal checklist interviews asking specifically about basic symptoms identified these experiences more readily than open questions during in-depth interviews. Only 5% of casenotes recorded basic symptoms; interviewees were 16 times more likely to report basic symptoms than their casenotes did. The majority of interviewees self-reported pre-relapse basic symptoms when asked specifically about these experiences but very few casenotes reported these symptoms. Basic symptoms may be potent predictors of relapse that clinicians miss. A self-report measure would aid monitoring of basic symptoms in routine clinical practice and would facilitate a prospective investigation comparing basic symptoms and conventional early signs as predictors of relapse. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Agreement between parent and child report on parental practices regarding dietary, physical activity and sedentary behaviours: the ENERGY cross-sectional survey.

PubMed

Rebholz, Cornelia E; Chinapaw, Mai J M; van Stralen, Maartje M; Bere, Elling; Bringolf, Bettina; De Bourdeaudhuij, Ilse; Jan, Nataša; Kovacs, Eva; Maes, Lea; Manios, Yannis; Moreno, Luis; Singh, Amika S; Brug, Johannes; te Velde, Saskia J

2014-09-05

Parents and their parenting practices play an important role in shaping their children's environment and energy-balance related behaviours (EBRBs). Measurement of parenting practices can be parent- or child-informed, however not much is known about agreement between parent and child perspectives. This study aimed to assess agreement between parent and child reports on parental practices regarding EBRBs across different countries in Europe and to identify correlates of agreement. Within the ENERGY-project, a cross-sectional survey was conducted among 10-12 year old children and their parents in eight European countries. Both children and parents filled in a questionnaire on 14 parental practices regarding five different EBRBs (i.e. soft drink, fruit juice and breakfast consumption, sports activity and watching TV) and socio-demographic characteristics. Children's anthropometric measurements were taken at school. We calculated percentages of agreement between children and their parents and weighted kappa statistics (for ordinal variables) per practice and country and assessed factors associated with agreement using multilevel linear regression. Reports of 6425 children and their parents were available for analysis. Overall mean agreement between parent and child reports was 43% and varied little among countries. The lowest agreement was found for questions assessing joint parent-child activities, such as sports (27%; Kappa (κ) = 0.14) or watching TV (30%; κ = 0.17), and for parental allowance of the child to have soft drinks (32%; κ = 0.24) or fruit juices (32%; κ = 0.19), or to watch TV (27%; κ = 0.17). Having breakfast products available at home or having a TV in the child's bedroom were the only practices with moderate to good agreement (>60%; κ = 0.06 and 0.77, respectively). In general, agreement was lower for boys, younger children, younger parents, parents with less than 14 years of education, single parents, parents with a higher self-reported body mass index and parents who perceived their child to be underweight. Parents and children perceive parental practices regarding dietary, physical activity and sedentary behaviours differently in all parts of Europe, with considerable variation across specific practices and countries. Therefore, future studies should assess both, parents and children's view on parental practices.

Cognitive function in early clinical phase huntington disease after rivastigmine treatment.

PubMed

Sešok, Sanja; Bolle, Nika; Kobal, Jan; Bucik, Valentin; Vodušek, David B

2014-09-01

In Huntington disease (HD) patients receiving rivastigmine treatment improvement of behavioral symptoms and of cognitive function (assessed with screening diagnostic instruments) has been reported. The aim of the present study was to verify such improvement in cognitive function by cognitive function assessment with a detailed neuropsychological battery covering all relevant cognitive systems expected to be impaired in early phase HD. Eighteen (18) HD patients entered the study and were randomly allocated to the rivastigmine and placebo group. All subjects underwent neuropsychological assessment at baseline. Follow-up neuropsychological assessment was applied after 6 months of rivastigmine or placebo treatment. Eighteen (18) healthy controls entered the study to control for practice effect and underwent neuropsychological assessment at baseline and after 6 months, without treatment. The neuropsychological battery consisted of assessment tools that are sensitive to cognitive impairment seen in early phase HD: CTMT, SDMT, Stroop (attention and information control), RFFT, TOL, Verbal fluency (executive functioning), CVLT-II, RCFT (learning and memory). Effect of rivastigmine and possible effect of practice was assessed using the mixed ANOVA model. No statistically significant effect of rivastigmine treatment on cognitive function in HD patients was detected. There was no evidence for practice or placebo effect. Detailed neuropsychological assessment did not confirm previously reported effect of rivastigmine treatment on cognitive function in HD patients. The limitations of our study are, in particular, small sample size and the lack of a single measure of relevant cognitive functioning in HD patients. Instead of focusing solely on statistical significance, a clinical relevance study is proposed to clarify the issue of rivastigmine effects in HD.

Historical Origins of Statistical Testing Practices: The Treatment of Fisher versus Neyman-Pearson Views in Textbooks.

ERIC Educational Resources Information Center

Huberty, Carl J.

1993-01-01

Twenty-eight books published from 1910 to 1949, 19 books published from 1990 to 1992, and 5 multiple edition books were reviewed to examine the presentations of statistical testing, particularly coverage of the p-value and fixed-alpha approaches. Statistical testing itself is not at fault, but some textbook presentations, testing practices, and…

Best Practices in Teaching Statistics and Research Methods in the Behavioral Sciences [with CD-ROM

ERIC Educational Resources Information Center

Dunn, Dana S., Ed.; Smith, Randolph A., Ed.; Beins, Barney, Ed.

2007-01-01

This book provides a showcase for "best practices" in teaching statistics and research methods in two- and four-year colleges and universities. A helpful resource for teaching introductory, intermediate, and advanced statistics and/or methods, the book features coverage of: (1) ways to integrate these courses; (2) how to promote ethical conduct;…

Standardized seawater rearing of chinook salmon smolts to evaluate hatchery practices showed low statistical power

USGS Publications Warehouse

Palmisano, Aldo N.; Elder, N.E.

2001-01-01

We examined, under standardized conditions, seawater survival of chinook salmon Oncorhynchus tshawytscha at the smolt stage to evaluate the experimental hatchery practices applied to their rearing. The experimental rearing practices included rearing fish at different densities; attempting to control bacterial kidney disease with broodstock segregation, erythromycin injection, and an experimental diet; rearing fish on different water sources; and freeze branding the fish. After application of experimental rearing practices in hatcheries, smolts were transported to a rearing facility for about 2-3 months of seawater rearing. Of 16 experiments, 4 yielded statistically significant differences in seawater survival. In general we found that high variability among replicates, plus the low numbers of replicates available, resulted in low statistical power. We recommend including four or five replicates and using ?? = 0.10 in 1-tailed tests of hatchery experiments to try to increase the statistical power to 0.80.

The American Indian and Alaska Native dentist workforce in the United States.

PubMed

Mertz, Elizabeth; Wides, Cynthia; Gates, Paul

2017-03-01

The purpose of this article is to describe the American Indian/Alaska Native (AI/AN) dentist workforce, the general practice patterns of these providers, and their contributions to oral health care for AI/AN and underserved patients. A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 34 percent response rate for self-reported AI/AN dentists. Data were weighted for selection and response bias to be nationally representative. Descriptive and multivariable statistics were computed to provide a workforce profile. Comparisons to Census data and published information on dental students and dentists were used to examine practice patterns. The AI/AN dentist workforce (weighted n = 442) is very diverse with 55 reported individual tribal affiliations. Tribal heritage was provided by 95.7 percent of AI/AN dentists (n = 423), and of these, 93.9 percent (n = 400) reported an affiliation with only one tribe. The largest share of AI/AN dentists were born in the United States (98.2 percent, n = 434), married (75.6 percent, n = 333), and had dependent children under age 18 (52.0 percent, n = 222). Only 0.9 percent (n = 4) of AI/AN dentists spoke a traditional AI/AN language in patient care, while 10.6 percent (n = 46) were raised on tribal land or reservation. Initial practice in the Indian Health Service was reported by 15.8 percent of AI/AN dentists while 16.2 percent report currently practicing in a safety-net setting, and 42.0 percent report working in a practice that primarily serves underserved patients. AI/AN dentists provide a disproportionate share of care for AI/AN populations, yet the number of AI/AN dentists would need to increase 7.4-fold in order to meet population parity. © 2016 American Association of Public Health Dentistry.

Decision support methods for the detection of adverse events in post-marketing data.

PubMed

Hauben, M; Bate, A

2009-04-01

Spontaneous reporting is a crucial component of post-marketing drug safety surveillance despite its significant limitations. The size and complexity of some spontaneous reporting system databases represent a challenge for drug safety professionals who traditionally have relied heavily on the scientific and clinical acumen of the prepared mind. Computer algorithms that calculate statistical measures of reporting frequency for huge numbers of drug-event combinations are increasingly used to support pharamcovigilance analysts screening large spontaneous reporting system databases. After an overview of pharmacovigilance and spontaneous reporting systems, we discuss the theory and application of contemporary computer algorithms in regular use, those under development, and the practical considerations involved in the implementation of computer algorithms within a comprehensive and holistic drug safety signal detection program.

Translating evidence to practice in the health professions: a randomized trial of Twitter vs Facebook.

PubMed

Tunnecliff, Jacqueline; Weiner, John; Gaida, James E; Keating, Jennifer L; Morgan, Prue; Ilic, Dragan; Clearihan, Lyn; Davies, David; Sadasivan, Sivalal; Mohanty, Patitapaban; Ganesh, Shankar; Reynolds, John; Maloney, Stephen

2017-03-01

Our objective was to compare the change in research informed knowledge of health professionals and their intended practice following exposure to research information delivered by either Twitter or Facebook. This open label comparative design study randomized health professional clinicians to receive "practice points" on tendinopathy management via Twitter or Facebook. Evaluated outcomes included knowledge change and self-reported changes to clinical practice. Four hundred and ninety-four participants were randomized to 1 of 2 groups and 317 responders analyzed. Both groups demonstrated improvements in knowledge and reported changes to clinical practice. There was no statistical difference between groups for the outcomes of knowledge change (P = .728), changes to clinical practice (P = .11) or the increased use of research information (P = .89). Practice points were shared more by the Twitter group (P < .001); attrition was lower in the Facebook group (P < .001). Research information delivered by either Twitter or Facebook can improve clinician knowledge and promote behavior change. No differences in these outcomes were observed between the Twitter and Facebook groups. Brief social media posts are as effective as longer posts for improving knowledge and promoting behavior change. Twitter may be more useful in publicizing information and Facebook for encouraging course completion. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

An Investigation into How Measures of Student Teacher Performance that Indicate Developmentally Informed Practice Are Related to a Measure of Overall Student Teaching Proficiency at a Private Northwest Comprehensive University

ERIC Educational Resources Information Center

Buchanan, Thomas D.

2011-01-01

Indicators of the proficiency of teacher candidates at applying knowledge of child development to teaching and learning were examined to see if they predict the overall success of the candidates full-time student teaching. The assessment instrument, the Full-Time Student Teaching Summary Report (FSTSR), was found statistically reliable and…

A review of nosocomial Salmonella outbreaks: infection control interventions found effective.

PubMed

Lee, M B; Greig, J D

2013-03-01

To review nosocomial salmonellosis outbreaks to identify: mode of transmission; morbidity and mortality patterns; and recommendations for control and prevention. Documented nosocomial salmonellosis outbreaks in hospitals published from January 1995 to November 2011, written in the English language, were systematically reviewed. The study methodology incorporated steps from the PRISMA statement for a high quality review process. Computer-aided searches of Scopus, CAB Global Health and CINAHL(®), the Cumulative Index to Nursing and Allied Health Literature were completed to identify relevant outbreak reports written in English. To validate the electronic search methodology, bibliographies and reference lists of relevant review articles were hand-searched. Public health and government websites were searched for nosocomial salmonellosis. Fifty-two relevant reports were identified. The most frequently reported routes of transmission were food 31/52 (59.6%) and person-to-person transmission 7/52 (13.5%). Actions taken during the outbreak to control transmission included improvements to: 1) infection control practices (41.8% of actions); isolation or cohorting patients, hand hygiene practices, and enhancing cleaning and disinfection in patient care areas; and 2) food handling practices (24.4% of actions); reviewing food preparation practices, enhancing cleaning and sanitation of the kitchen, and controlling food temperatures. Investigators made recommendations retrospectively in outbreak reports to provide direction to health centees but these recommendations were not statistically evaluated for effectiveness. More emphasis should be placed on improving food handling practices, such as training food workers, monitoring food temperatures, and not using raw foods of animal origin, to prevent nosocomial salmonellosis outbreaks in hospitals because almost 60% of the outbreaks were foodborne. Copyright © 2013 The Royal Institute of Public Health. All rights reserved.

Health and safety matters! Associations between organizational practices and personal support workers' life and work stress in Ontario, Canada.

PubMed

Zeytinoglu, Isik U; Denton, Margaret; Brookman, Catherine; Davies, Sharon; Sayin, Firat K

2017-06-21

The home and community care sector is one of the fastest growing sectors globally and most prominently in mature industrialized countries. Personal support workers (PSWs) are the largest occupational group in the sector. This paper focuses on the emotional health of PSWs working in the home and community care sector in Ontario, Canada. The purpose of this paper is to present evidence on the associations between PSWs' life and work stress and organizational practices of full-time and guaranteed hours, and PSWs' perceptions of support at work and preference for hours. Data come from our 2015 survey of 1543 PSWs. Dependent variables are life and work stress. Independent variables are: objective organizational practices of full-time and guaranteed hours, and subjective organizational practices of perceived support at work, and preferred hours of work. Descriptive statistics, correlations and ordinary least square regression analyses with collinearity tests are conducted. Organizational practices of employing PSWs in full-time or guaranteed hours are not associated with their life and work stress. However, those who perceive support from their organizations are also the ones reporting lower life and work stress. In addition, those PSWs perceiving support from their supervisor report lower work stress. PSWs would like to work in their preferred hours, and those who prefer to work more hours report lower life and work stress, and conversely, those who prefer to work less hours report life and work stress. For PSWs in home and community care, perceived support from their organizations and supervisors, and employment in preferred hours are important factors related to their life and work stress.

The quality of assessments for childhood psychopathology within a regional medical center.

PubMed

Sattler, Adam F; Leffler, Jarrod M; Harrison, Nicole L; Bieber, Ewa D; Kosmach, Joseph J; Sim, Leslie A; Whiteside, Stephen P H

2018-05-17

Accurate assessment is essential to implementing effective mental health treatment; however, little research has explored child clinicians' assessment practices in applied settings. The current study thus examines practitioners' use of evidence-based assessment (EBA) instruments (i.e., self-report measures and structured interviews), specificity of identified diagnoses (i.e., use of specific diagnostic labels vs. nonstandardized labels, not otherwise specified [NOS] diagnoses, and adjustment disorder diagnoses), and documentation of Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR, American Psychiatric Association, 2000) criteria. Use of these practices was evaluated via analysis of documentation contained within a regional medical center's medical records. This analysis was limited to 2,499 session notes from patient appointments associated with psychiatric disorders newly diagnosed during 2013. In total, session notes were linked to 694 children aged 7 to 17. Results indicated that EBA use was low overall, although self-report measures were utilized relatively frequently versus structured interviews. Diagnostic specificity was also low overall and clinicians rarely documented full diagnostic criteria; however, EBA use was associated with increased diagnostic specificity. Further, clinicians practicing in psychological, psychiatric, and primary care settings were more likely to use self-report measures as compared to those practicing in an integrated behavioral health social work setting. In addition, structured interviews were most likely to be utilized by clinicians practicing in a psychological services setting. Finally, clinicians were more likely to use self-report measures when the identified primary concern was a mood disorder or attention-deficit/hyperactivity disorder (ADHD). Based on these results, we provide suggestions and references to resources for clinicians seeking to improve the quality of their assessments via implementation of EBA. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Good research practices for comparative effectiveness research: defining, reporting and interpreting nonrandomized studies of treatment effects using secondary data sources: the ISPOR Good Research Practices for Retrospective Database Analysis Task Force Report--Part I.

PubMed

Berger, Marc L; Mamdani, Muhammad; Atkins, David; Johnson, Michael L

2009-01-01

Health insurers, physicians, and patients worldwide need information on the comparative effectiveness and safety of prescription drugs in routine care. Nonrandomized studies of treatment effects using secondary databases may supplement the evidence based from randomized clinical trials and prospective observational studies. Recognizing the challenges to conducting valid retrospective epidemiologic and health services research studies, a Task Force was formed to develop a guidance document on state of the art approaches to frame research questions and report findings for these studies. The Task Force was commissioned and a Chair was selected by the International Society for Pharmacoeconomics and Outcomes Research Board of Directors in October 2007. This Report, the first of three reported in this issue of the journal, addressed issues of framing the research question and reporting and interpreting findings. The Task Force Report proposes four primary characteristics-relevance, specificity, novelty, and feasibility while defining the research question. Recommendations included: the practice of a priori specification of the research question; transparency of prespecified analytical plans, provision of justifications for any subsequent changes in analytical plan, and reporting the results of prespecified plans as well as results from significant modifications, structured abstracts to report findings with scientific neutrality; and reasoned interpretations of findings to help inform policy decisions. Comparative effectiveness research in the form of nonrandomized studies using secondary databases can be designed with rigorous elements and conducted with sophisticated statistical methods to improve causal inference of treatment effects. Standardized reporting and careful interpretation of results can aid policy and decision-making.

[Gender-sensitive epidemiological data analysis: methodological aspects and empirical outcomes. Illustrated by a health reporting example].

PubMed

Jahn, I; Foraita, R

2008-01-01

In Germany gender-sensitive approaches are part of guidelines for good epidemiological practice as well as health reporting. They are increasingly claimed to realize the gender mainstreaming strategy in research funding by the federation and federal states. This paper focuses on methodological aspects of data analysis, as an empirical data example of which serves the health report of Bremen, a population-based cross-sectional study. Health reporting requires analysis and reporting methods that are able to discover sex/gender issues of questions, on the one hand, and consider how results can adequately be communicated, on the other hand. The core question is: Which consequences do a different inclusion of the category sex in different statistical analyses for identification of potential target groups have on the results? As evaluation methods logistic regressions as well as a two-stage procedure were exploratively conducted. This procedure combines graphical models with CHAID decision trees and allows for visualising complex results. Both methods are analysed by stratification as well as adjusted by sex/gender and compared with each other. As a result, only stratified analyses are able to detect differences between the sexes and within the sex/gender groups as long as one cannot resort to previous knowledge. Adjusted analyses can detect sex/gender differences only if interaction terms have been included in the model. Results are discussed from a statistical-epidemiological perspective as well as in the context of health reporting. As a conclusion, the question, if a statistical method is gender-sensitive, can only be answered by having concrete research questions and known conditions. Often, an appropriate statistic procedure can be chosen after conducting a separate analysis for women and men. Future gender studies deserve innovative study designs as well as conceptual distinctiveness with regard to the biological and the sociocultural elements of the category sex/gender.

Streamflow Statistics for the Narraguagus River at Cherryfield, Maine

USGS Publications Warehouse

Dudley, Robert W.; Nielsen, Joseph P.

2000-01-01

Streamflow data have been collected for the Narraguagus River from 1948 to the present (2000) at the U.S. Geological Survey (USGS) streamgaging station at Cherryfield, Maine. This report describes a study done by the USGS to determine streamflow statistics using the streamflow record at the Narraguagus River station for use in total water use management plans implemented by State and Federal agencies. Because the effect of changes in irrigation practices from 1993 to the present on streamflow in the Narraguagus basin is unknown and potentially significant, streamflow data after December 1992 were not used in the determination of the streamflow statistics. For the period 1948- 92, monthly median streamflows range from 93.0 ft3/s (August) to 1,000 ft3/s (April). The median streamflow for the selected period of record for all days (1948-92) is 302 ft3/s.

The value of 100% retrospective peer review in a forensic pathology practice.

PubMed

Obenson, Ken; Wright, Claire M

2013-11-01

Peer review in forensic pathology practice has become an important cornerstone of continuous quality improvement. Although there are several components to an effective and transparent peer review process, one of the most essential is the review of completed reports. The autopsy report may be reviewed prospectively (report reviewed before sign out) or retrospectively (report reviewed after sign out). Prospective reviews are more likely to be performed on criminal or criminally suspicious cases, pediatric and SIDS deaths and high profile cases. Retrospective reviews on the other hand are performed on a proportion of all other signed-out routine medico-legal cases. The actual percentage varies by jurisdiction since there are no agreed minimum standards. Manpower and workload factors appear to be critical to determining what percentage of cases are reviewed retrospectively. The objective of this report is to present a mechanism by which a 100% retrospective review policy has been implemented, how it integrates with quality management protocols, the outcomes of the reviews and what challenges remain to improve compliance with key quality indicators especially turn around time (TAT) statistics. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Conservative sharp wound debridement: an overview of Canadian education, practice, risk, and policy.

PubMed

Rodd-Nielsen, Elise; Harris, Connie L

2013-01-01

The purpose of this study was to describe the education, policy, practice, and risk management strategies of nurses performing conservative sharp wound debridement (CSWD) in Canada, prior to the release of the Canadian Association for Enterostomal Therapy Evidence-Based Recommendations for Conservative Sharp Wound Debridement. Data collection was based on a nonrandomized, nonexperimental study design and reported using descriptive statistics. Invitations for health care professionals to participate in a CSWD scan were sent to 4315 people via e-mail through the membership lists of 2 Canadian voluntary professional wound care associations. Skip logic screened out respondents who had no experience in CSWD (n = 57). The total number of professionals who participated was 487. A 26-question electronic scan addressed demographics, education, policy, practice, and risk/quality issues related to CSWD. A comment section was included for some questions. A selected subsample of 397 nurses was chosen from the original total of 487 respondents. Nonnurse respondents were excluded due to the low total number of participants in each of these other professional categories. Nurses perform CSWD in all types of care settings in Canada from outpost nursing stations to hospital wards, homes, and long-term care facilities. The wound education preparation reported varied. The most frequently reported formal wound care education was a 2-day course (59%; n = 220), followed by an enterostomal therapy course (42%; n = 155) and the International Interdisciplinary Wound Care Course (26%; n = 98), with overlapping preparation evident. Eleven percent of respondents (n = 47) reported having taken no formal wound course, and 7% (n = 27) taught themselves to perform CSWD. Twenty-eight percent of nurses (n = 112) were unclear about whether CSWD was within their scope of practice or replied that it was not, and 69% (n = 273) did not know if there was provincial legislation that restricted their practice of CSWD. Forty-eight percent of nurses (n = 181) reported that their institutions do not have policies on CSWD, and 9% (n = 35) did not know. Adverse events associated with CSWD were reported by 196 respondents, with minor bleeding reported most frequently (98% n = 192) by those who answered the question. The education, policy, practice, and risk management of nurses practicing CSWD could benefit from development and dissemination of a set of National Standards and Competencies for this high-risk wound intervention.

The quality improvement attitude survey: Development and preliminary psychometric characteristics.

PubMed

Dunagan, Pamela B

2017-12-01

To report the development of a tool to measure nurse's attitudes about quality improvement in their practice setting and to examine preliminary psychometric characteristics of the Quality Improvement Nursing Attitude Scale. Human factors such as nursing attitudes of complacency have been identified as root causes of sentinel events. Attitudes of nurses concerning use of Quality and Safety Education for nurse's competencies can be most challenging to teach and to change. No tool has been developed measuring attitudes of nurses concerning their role in quality improvement. A descriptive study design with preliminary psychometric evaluation was used to examine the preliminary psychometric characteristics of the Quality Improvement Nursing Attitude Scale. Registered bedside clinical nurses comprised the sample for the study (n = 57). Quantitative data were analysed using descriptive statistics and Cronbach's alpha reliability. Total score and individual item statistics were evaluated. Two open-ended items were used to collect statements about nurses' feelings regarding their experience in quality improvement efforts. Strong support for the internal consistency reliability and face validity of the Quality Improvement Nursing Attitude Scale was found. Total scale scores were high indicating nurse participants valued Quality and Safety Education for Nurse competencies in practice. However, item-level statistics indicated nurses felt powerless when other nurses deviate from care standards. Additionally, the sample indicated they did not consistently report patient safety issues and did not have a feeling of value in efforts to improve care. Findings suggested organisational culture fosters nurses' reporting safety issues and feeling valued in efforts to improve care. Participants' narrative comments and item analysis revealed the need to generate new items for the Quality Improvement Nursing Attitude Scale focused on nurses' perception of their importance in quality and safety and their power to enact principles. The Quality Improvement Nursing Attitude Scale-Revised edition was designed to help in understanding nurses' attitudes and values. It can be used to further explore broad concepts of quality improvement efforts. © 2017 John Wiley & Sons Ltd.

Critical care nurses' knowledge and practice of delirium assessment.

PubMed

Rowley-Conwy, Gabby

2017-04-13

The aim of this study was to examine perceived barriers to assessment of delirium for critical care nurses, and the impact of education on their knowledge and practice. Delirium is a significant problem in critical care, leading to increased morbidity and mortality. Many authors have found variations in assessment by critical care nurses, but there has been limited analysis of the reasons for this. Education on the topic improves knowledge and practice, but the best approach has not been examined. A questionnaire survey design. A self-reported questionnaire was distributed to critical care nurses (n=31) at a district general hospital. Data were analysed with descriptive statistics. Knowledge and practice were variable, but correlation was seen between nursing band and years of experience with better scores. Any type of education led to significantly improved scores. Several barriers to assessment were found, with the most common being lack of knowledge and difficulty in assessing intubated patients. It is essential to improve practice in delirium assessment and management. Education is vital to improve the knowledge and practice of critical care nurses regarding delirium.

SRTR center-specific reporting tools: Posttransplant outcomes.

PubMed

Dickinson, D M; Shearon, T H; O'Keefe, J; Wong, H-H; Berg, C L; Rosendale, J D; Delmonico, F L; Webb, R L; Wolfe, R A

2006-01-01

Measuring and monitoring performance--be it waiting list and posttransplant outcomes by a transplant center, or organ donation success by an organ procurement organization and its partnering hospitals--is an important component of ensuring good care for people with end-stage organ failure. Many parties have an interest in examining these outcomes, from patients and their families to payers such as insurance companies or the Centers for Medicare and Medicaid Services; from primary caregivers providing patient counseling to government agencies charged with protecting patients. The Scientific Registry of Transplant Recipients produces regular, public reports on the performance of transplant centers and organ procurement organizations. This article explains the statistical tools used to prepare these reports, with a focus on graft survival and patient survival rates of transplant centers--especially the methods used to fairly and usefully compare outcomes of centers that serve different populations. The article concludes with a practical application of these statistics--their use in screening transplant center performance to identify centers that may need remedial action by the OPTN/UNOS Membership and Professional Standards Committee.

Non-response to sad mood induction: implications for emotion research.

PubMed

Rottenberg, Jonathan; Kovacs, Maria; Yaroslavsky, Ilya

2018-05-01

Experimental induction of sad mood states is a mainstay of laboratory research on affect and cognition, mood regulation, and mood disorders. Typically, the success of such mood manipulations is reported as a statistically significant pre- to post-induction change in the self-rated intensity of the target affect. The present commentary was motivated by an unexpected finding in one of our studies concerning the response rate to a well-validated sad mood induction. Using the customary statistical approach, we found a significant mean increase in self-rated sadness intensity with a moderate effect size, verifying the "success" of the mood induction. However, that "success" masked that, between one-fifth and about one-third of our samples (adolescents who had histories of childhood-onset major depressive disorder and healthy controls) reported absolutely no sadness in response to the mood induction procedure. We consider implications of our experience for emotion research by (1) commenting upon the typically overlooked phenomenon of nonresponse, (2) suggesting changes in reporting practices regarding mood induction success, and (3) outlining future directions to help scientists determine why some subjects do not respond to experimental mood induction.

Quality of reporting web-based and non-web-based survey studies: What authors, reviewers and consumers should consider.

PubMed

Turk, Tarek; Elhady, Mohamed Tamer; Rashed, Sherwet; Abdelkhalek, Mariam; Nasef, Somia Ahmed; Khallaf, Ashraf Mohamed; Mohammed, Abdelrahman Tarek; Attia, Andrew Wassef; Adhikari, Purushottam; Amin, Mohamed Alsabbahi; Hirayama, Kenji; Huy, Nguyen Tien

2018-01-01

Several influential aspects of survey research have been under-investigated and there is a lack of guidance on reporting survey studies, especially web-based projects. In this review, we aim to investigate the reporting practices and quality of both web- and non-web-based survey studies to enhance the quality of reporting medical evidence that is derived from survey studies and to maximize the efficiency of its consumption. Reporting practices and quality of 100 random web- and 100 random non-web-based articles published from 2004 to 2016 were assessed using the SUrvey Reporting GuidelinE (SURGE). The CHERRIES guideline was also used to assess the reporting quality of Web-based studies. Our results revealed a potential gap in the reporting of many necessary checklist items in both web-based and non-web-based survey studies including development, description and testing of the questionnaire, the advertisement and administration of the questionnaire, sample representativeness and response rates, incentives, informed consent, and methods of statistical analysis. Our findings confirm the presence of major discrepancies in reporting results of survey-based studies. This can be attributed to the lack of availability of updated universal checklists for quality of reporting standards. We have summarized our findings in a table that may serve as a roadmap for future guidelines and checklists, which will hopefully include all types and all aspects of survey research.

Adherence to best practice consensus guidelines for implant-based breast reconstruction: Results from the iBRA national practice questionnaire survey.

PubMed

Mylvaganam, Senthurun; Conroy, Elizabeth J; Williamson, Paula R; Barnes, Nicola L P; Cutress, Ramsey I; Gardiner, Matthew D; Jain, Abhilash; Skillman, Joanna M; Thrush, Steven; Whisker, Lisa J; Blazeby, Jane M; Potter, Shelley; Holcombe, Christopher

2018-05-01

The 2008 National Mastectomy and Breast Reconstruction Audit demonstrated marked variation in the practice and outcomes of breast reconstruction in the UK. To standardise practice and improve outcomes for patients, the British professional associations developed best-practice guidelines with specific guidance for newer mesh-assisted implant-based techniques. We explored the degree of uptake of best-practice guidelines within units performing implant-based reconstruction (IBBR) as the first phase of the implant Breast Reconstruction Evaluation (iBRA) study. A questionnaire developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Simple summary statistics were calculated for each survey item to assess compliance with current best-practice guidelines. 81 units from 79 NHS Trusts completed the questionnaire. Marked variation was observed in adherence to guidelines, especially those relating to clinical governance and infection prevention strategies. Less than half (n = 28, 47%) of units obtained local clinical governance board approval prior to offering new mesh-based techniques and prospective audit of the clinical, cosmetic and patient-reported outcomes of surgery was infrequent. Most units screened for methicillin-resistant staphylococcus aureus prior to surgery but fewer than 1 in 3 screened for methicillin-sensitive strains. Laminar-flow theatres (recommended for IBBR) were not widely-available with less than 1 in 5 units having regular access. Peri-operative antibiotics were widely-used, but the type and duration were highly-variable. The iBRA national practice questionnaire has demonstrated variation in reported practice and adherence to IBBR guidelines. High-quality evidence is urgently required to inform best practice. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

PubMed

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

2017-02-01

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

Teaching efficacy of nurses in clinical practice education: A cross-sectional study.

PubMed

Kim, Eun-Kyeung; Shin, Sujin

2017-07-01

Clinical nurses play a vital role in clinical practice education; thus, it is necessary to help clinical nurses have teaching efficacy through the development and application of systematic education programs. To identify nurses' teaching efficacy for clinical education and analyze the influencing factors of teaching efficacy. The study used a cross-sectional design. We used a convenience sample of 263 nurses from two hospitals. Teaching efficacy, general characteristics, and perception of clinical practice education were collected via self-reported questionnaires. Teaching efficacy was measured using Hwang's (2006) questionnaire, while perception of clinical practice education was measured using the Clinical Nurse Teacher Survey developed by Nishioka et al. (2014). Participants completed the questionnaire directly. The collected data were then analyzed using descriptive statistics, t-tests, ANOVAs, and multiple regression analysis with PASW Statistics 18.0. The mean total score of teaching efficacy was 72.5 (range 21-105). The leadership for students subscale had the highest score (3.56±0.59). The factors influencing teaching efficacy were length of clinical career (β=0.26, p<0.001) and perceptions of work satisfaction (β=0.20, p=.005), clinical supervisory relationship (β=0.18, p=.010), and nursing at the hospital ward (β=0.13, p=.029). Altogether, these variables explained 28% of the variance in teaching efficacy in nurses. Based on these results, nursing educators might need to develop greater confidence in their knowledge and enhance control of their teaching strategies. Nursing schools and hospitals might need to provide greater support and educational opportunities to nurse clinical practice instructors. Furthermore, constructing a system of cooperation between these colleges and educational hospitals, developing programs to enhance teaching efficacy, and identifying the clinical instructor's role are all necessary to promote clinical practice education. Copyright © 2017. Published by Elsevier Ltd.

An Interprofessional Evaluation of Health Literacy Communication Practices of Physicians, Pharmacists, and Nurses at Public Hospitals in Penang, Malaysia.

PubMed

Rajah, Retha; Hassali, Mohamed Azmi; Lim, Ching-Jou

2018-04-01

Health care practitioners carry a tremendous responsibility to differentiate the varying need of information and customized communication according to a patient's health literacy (HL) level. To assess and compare the HL communication practices among physicians, pharmacists, and nurses serving at public hospitals in Penang, Malaysia. A pretested, self-administered questionnaire was used to collect data from study participants of 6 public hospitals using stratified sampling. Descriptive and inferential statistics used to analyze the data with level of significance was set at P < 0.05. Of 600 distributed questionnaires, 526 (87.6%) were adequately filled and returned. Almost 19.0% (n = 98) of the respondents admitted that they did not frequently use simple language and avoid medical jargon during communication with patients. Only about half of the respondents reported frequently using other HL communication practices that include handing out education material to patients (52.2%, n = 275), asking the patient to repeat information (58.9%, n = 310), and asking patients' caregivers to be present during explanation (57.4%, n = 302). Comparatively, drawing pictures to ease patients' understanding (40.1%, n = 211) was the less-frequently practiced HL communication techniques. Health practitioners in the age group >41 years ( P = 0.046), serving 10 years and more ( P = 0.03) and those who have heard the term or concept of HL ( P = 0.004) have statistically significantly higher mean score of HL communication practices than other groups. The gap in the HL communication practices among physicians, pharmacists, and nurses warrants educational intervention, and standardized HL communication techniques guidelines are needed in the near future.

Spatial-temporal clustering of companion animal enteric syndrome: detection and investigation through the use of electronic medical records from participating private practices.

PubMed

Anholt, R M; Berezowski, J; Robertson, C; Stephen, C

2015-09-01

There is interest in the potential of companion animal surveillance to provide data to improve pet health and to provide early warning of environmental hazards to people. We implemented a companion animal surveillance system in Calgary, Alberta and the surrounding communities. Informatics technologies automatically extracted electronic medical records from participating veterinary practices and identified cases of enteric syndrome in the warehoused records. The data were analysed using time-series analyses and a retrospective space-time permutation scan statistic. We identified a seasonal pattern of reports of occurrences of enteric syndromes in companion animals and four statistically significant clusters of enteric syndrome cases. The cases within each cluster were examined and information about the animals involved (species, age, sex), their vaccination history, possible exposure or risk behaviour history, information about disease severity, and the aetiological diagnosis was collected. We then assessed whether the cases within the cluster were unusual and if they represented an animal or public health threat. There was often insufficient information recorded in the medical record to characterize the clusters by aetiology or exposures. Space-time analysis of companion animal enteric syndrome cases found evidence of clustering. Collection of more epidemiologically relevant data would enhance the utility of practice-based companion animal surveillance.

Practices and opinions on nitrous oxide/oxygen sedation from dentists licensed to perform relative analgesia in Brazil

PubMed Central

2012-01-01

Background Relative analgesia (RA), defined as the use of inhalation sedation with nitrous oxide and oxygen, is one of the most common pharmacological behavior management techniques used to provide sedation and analgesia for dental patients. This study aimed to assess RA licensed Brazilian dentists’ practices and opinions about nitrous oxide/oxygen sedation in the dental setting. Methods A cross sectional national survey was conducted with 281 dentists who were certified to perform RA, using an electronically mailed self-administered questionnaire containing closed questions about their practices and opinions regarding RA. Practice and opinion were individually analyzed by descriptive statistics. Non-parametric tests assessed the relationships between RA practice and independent variables. To test the interplay between practices and opinions, a k-means clusters analysis was used to divide the group for statistical comparisons. Results The response rate was 45.2%. Women made up 64.6% of the respondents, the mean age was 39.1 years (SD = 9.8), and the mean time since graduation in dentistry was 16 years (SD = 9.7). Seventy-seven percent of respondents reported the use of RA in clinical practice, most of them ‘sometimes’ (53.5%), and focusing more on adult patients. Patients with certain physical or mental deficiencies were indications associated with RA practice. ‘Equipment acquisition’ (p < 0.001) and ‘living in Southeast and South regions’ (p < 0.02) were also associated with RA practice. The scores for dentists’ opinions ranged from 15 to 41 points (mean 29.2, SD = 5.6), based on nine items scored from 1 to 5. Two clusters representing more favorable (n = 65) and less favorable (n = 55) opinions were established. Dentists who were women (p = 0.04), practiced RA in dental settings (p < 0.01) or practiced it frequently (p < 0.001), had more favorable opinions about RA. Conclusion Most of the RA licensed Brazilian dentists interviewed currently use RA. Current practice of RA and frequency of use determined the degree of favorable opinion about this inhalation sedation among this group of respondents. PMID:22808942

A content validated questionnaire for assessment of self reported venous blood sampling practices

PubMed Central

2012-01-01

Background Venous blood sampling is a common procedure in health care. It is strictly regulated by national and international guidelines. Deviations from guidelines due to human mistakes can cause patient harm. Validated questionnaires for health care personnel can be used to assess preventable "near misses"--i.e. potential errors and nonconformities during venous blood sampling practices that could transform into adverse events. However, no validated questionnaire that assesses nonconformities in venous blood sampling has previously been presented. The aim was to test a recently developed questionnaire in self reported venous blood sampling practices for validity and reliability. Findings We developed a questionnaire to assess deviations from best practices during venous blood sampling. The questionnaire contained questions about patient identification, test request management, test tube labeling, test tube handling, information search procedures and frequencies of error reporting. For content validity, the questionnaire was confirmed by experts on questionnaires and venous blood sampling. For reliability, test-retest statistics were used on the questionnaire answered twice. The final venous blood sampling questionnaire included 19 questions out of which 9 had in total 34 underlying items. It was found to have content validity. The test-retest analysis demonstrated that the items were generally stable. In total, 82% of the items fulfilled the reliability acceptance criteria. Conclusions The questionnaire could be used for assessment of "near miss" practices that could jeopardize patient safety and gives several benefits instead of assessing rare adverse events only. The higher frequencies of "near miss" practices allows for quantitative analysis of the effect of corrective interventions and to benchmark preanalytical quality not only at the laboratory/hospital level but also at the health care unit/hospital ward. PMID:22260505

A content validated questionnaire for assessment of self reported venous blood sampling practices.

PubMed

Bölenius, Karin; Brulin, Christine; Grankvist, Kjell; Lindkvist, Marie; Söderberg, Johan

2012-01-19

Venous blood sampling is a common procedure in health care. It is strictly regulated by national and international guidelines. Deviations from guidelines due to human mistakes can cause patient harm. Validated questionnaires for health care personnel can be used to assess preventable "near misses"--i.e. potential errors and nonconformities during venous blood sampling practices that could transform into adverse events. However, no validated questionnaire that assesses nonconformities in venous blood sampling has previously been presented. The aim was to test a recently developed questionnaire in self reported venous blood sampling practices for validity and reliability. We developed a questionnaire to assess deviations from best practices during venous blood sampling. The questionnaire contained questions about patient identification, test request management, test tube labeling, test tube handling, information search procedures and frequencies of error reporting. For content validity, the questionnaire was confirmed by experts on questionnaires and venous blood sampling. For reliability, test-retest statistics were used on the questionnaire answered twice. The final venous blood sampling questionnaire included 19 questions out of which 9 had in total 34 underlying items. It was found to have content validity. The test-retest analysis demonstrated that the items were generally stable. In total, 82% of the items fulfilled the reliability acceptance criteria. The questionnaire could be used for assessment of "near miss" practices that could jeopardize patient safety and gives several benefits instead of assessing rare adverse events only. The higher frequencies of "near miss" practices allows for quantitative analysis of the effect of corrective interventions and to benchmark preanalytical quality not only at the laboratory/hospital level but also at the health care unit/hospital ward.

Self-reported practices among traditional birth attendants surveyed in western Kenya: a descriptive study.

PubMed

Bucher, Sherri; Konana, Olive; Liechty, Edward; Garces, Ana; Gisore, Peter; Marete, Irene; Tenge, Constance; Shipala, Evelyn; Wright, Linda; Esamai, Fabian

2016-08-12

The high rate of home deliveries conducted by unskilled birth attendants in resource-limited settings is an important global health issue because it is believed to be a significant contributing factor to maternal and newborn mortality. Given the large number of deliveries that are managed by unskilled or traditional birth attendants outside of health facilities, and the fact that there is on-going discussion regarding the role of traditional birth attendants in the maternal newborn health (MNH) service continuum, we sought to ascertain the practices of traditional birth attendants in our catchment area. The findings of this descriptive study might help inform conversations regarding the roles that traditional birth attendants can play in maternal-newborn health care. A structured questionnaire was used in a survey that included one hundred unskilled birth attendants in western Kenya. Descriptive statistics were employed. Inappropriate or outdated practices were reported in relation to some obstetric complications and newborn care. Encouraging results were reported with regard to positive relationships that traditional birth attendants have with their local health facilities. Furthermore, high rates of referral to health facilities was reported for many common obstetric emergencies and similar rates for reporting of pregnancy outcomes to village elders and chiefs. Potentially harmful or outdated practices with regard to maternal and newborn care among traditional birth attendants in western Kenya were revealed by this study. There were high rates of traditional birth attendant referrals of pregnant mothers with obstetric complications to health facilities. Policy makers may consider re-educating and re-defining the roles and responsibilities of traditional birth attendants in maternal and neonatal health care based on the findings of this survey.

Attitudes Toward Research During Residency: A Survey of Canadian Residents in Obstetrics and Gynecology.

PubMed

Clancy, Aisling A; Posner, Glenn

2015-01-01

Obstetrics and Gynecology (Ob/Gyn) residency programs in Canada mandate participation in scholarly research activity, yet there remains a lack of literature on trainees' opinions regarding its value, feasibility, and perceived effect on future practice. An understanding of resident attitudes toward research during residency is essential in effectively engaging trainees and fostering a robust research community in the field. We sought to identify factors reported to influence involvement in resident research, including perceived barriers. Anonymous data were collected via an online survey distributed to all residents enrolled in accredited Ob/Gyn residency programs throughout Canada. The 10-minute, previously piloted questionnaire covered questions related to demographic information, research experience, career goals, current research activities, opinions on research environment, and opinions regarding the effect of research on future practice. Descriptive statistics were used to describe demographics, research background, and current research activities. Categorical variables were compared using the chi-square analysis and continuous variables were compared using the Mann-Whitney rank sum tests. A total of 175 residents completed the survey; 61% agreed/strongly agreed that they participate in research solely because it is mandated by their program, 22% felt that their training environment did not promote research, 19% disagreed/strongly disagreed that research is a positive experience, while 70% agreed/strongly agreed that they would prefer to complete another educational activity other than a research project. Time constraints owing to residency duties, time constraints owing to personal reasons, and lack of statistical knowledge were reported as barriers to research involvement by 97%, 90%, and 74% of trainees, respectively. Residents with graduate degrees were less likely to report lack of training on research design as a moderate/extreme barrier (7% vs 32%, p = 0.007). There exists considerable disparity in enthusiasm for scholarly research activity among Ob/Gyn residents. Curricular development should focus on addressing resident-reported barriers, including the provision of protected time for research and access to statistical support and education, particularly for residents without graduate degrees. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2010-06-01

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

Current Practices in Lumbar Surgery Perioperative Rehabilitation: A Scoping Review.

PubMed

Marchand, Andrée-Anne; O'Shaughnessy, Julie; Châtillon, Claude-Édouard; Sorra, Karin; Descarreaux, Martin

The objective of this review was to identify current practices and relevant patient-reported and objective outcome measures with regard to rehabilitation protocols directed at the lumbar spine in perioperative procedure settings in order to inform clinical practice and future research. A literature search was performed in MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), the Cochrane Central Register of Controlled Trials, PEDro (Physiotherapy Evidence Database), and PubMed using terms relevant to surgical interventions, rehabilitation, and the lumbar spine. Twenty-nine studies met the inclusion criteria, and 28 investigated postoperative forms of rehabilitation. Patient-reported outcomes typically used were pain and disability, although a wide range of objective measures based on physical capacities were often reported. Rehabilitation programs, for the most part, included some form of strengthening exercises alone or in combination with stabilization exercises, aerobic conditioning, stretching, or education. Despite most studies reporting statistically significant results between intervention groups, considering clinically significant improvement within intervention groups yielded a different portrait. A wide range of objective and subjective outcomes is used to document changes after active rehabilitation. Program components include both active and assisted interventions combined with various means of education and discussion. Multimodal rehabilitation protocols after lumbar surgery may be used to improve patient-reported and objective outcome measures such as pain, disability, and physical function. Further research should be conducted on the effects of preoperative rehabilitation programs. Copyright © 2016. Published by Elsevier Inc.

Filipino-American Nurses' Knowledge, Perceptions, Beliefs and Practice of Genetics and Genomics.

PubMed

Saligan, Leorey N; Rivera, Reynaldo R

2014-01-01

There is limited information on the knowledge, perceptions, beliefs, and practice, about genetics and genomics among Filipino-American nurses. The National Coalition of Ethnic Minority Organizations (NCEMNA), in which the Philippine Nurses Association of America (PNAA) is a member organization, conducted an online survey to describe the genomic knowledge, perceptions, beliefs, and practice of minority nurses. This study reports on responses from Filipino-American survey participants, which is a subset analysis of the larger NCEMNA survey. The purpose of this study was to explore the knowledge, perceptions, beliefs, practice and genomic education of Filipino-American nurses. An online survey of 112 Filipino-American nurses was conducted to describe the knowledge, perceptions, beliefs, and practice of genetics/genomics. Survey responses were analyzed using descriptive statistics. Most (94%) Filipino-American nurses wanted to learn more about genetics. Although 41% of the respondents indicated good understanding of genetics of common diseases, 60% had not attended any related continuing education courses since RN licensure, and 73% reported unavailability of genetic courses to take. The majority (83%) of PNAA respondents indicated that they would attend genetics/genomics awareness training if it was offered by their national organization during their annual conference, and 86% reported that the national organization should have a visible role in genetics/genomics initiatives in their community. Filipino-American nurses wanted to learn more about genetics and were willing to attend genetics/genomics trainings if offered by PNAA. The study findings can assist PNAA in planning future educational programs that incorporates genetics and genomics information.

A robust bayesian estimate of the concordance correlation coefficient.

PubMed

Feng, Dai; Baumgartner, Richard; Svetnik, Vladimir

2015-01-01

A need for assessment of agreement arises in many situations including statistical biomarker qualification or assay or method validation. Concordance correlation coefficient (CCC) is one of the most popular scaled indices reported in evaluation of agreement. Robust methods for CCC estimation currently present an important statistical challenge. Here, we propose a novel Bayesian method of robust estimation of CCC based on multivariate Student's t-distribution and compare it with its alternatives. Furthermore, we extend the method to practically relevant settings, enabling incorporation of confounding covariates and replications. The superiority of the new approach is demonstrated using simulation as well as real datasets from biomarker application in electroencephalography (EEG). This biomarker is relevant in neuroscience for development of treatments for insomnia.

On Fitting Generalized Linear Mixed-effects Models for Binary Responses using Different Statistical Packages

PubMed Central

Zhang, Hui; Lu, Naiji; Feng, Changyong; Thurston, Sally W.; Xia, Yinglin; Tu, Xin M.

2011-01-01

Summary The generalized linear mixed-effects model (GLMM) is a popular paradigm to extend models for cross-sectional data to a longitudinal setting. When applied to modeling binary responses, different software packages and even different procedures within a package may give quite different results. In this report, we describe the statistical approaches that underlie these different procedures and discuss their strengths and weaknesses when applied to fit correlated binary responses. We then illustrate these considerations by applying these procedures implemented in some popular software packages to simulated and real study data. Our simulation results indicate a lack of reliability for most of the procedures considered, which carries significant implications for applying such popular software packages in practice. PMID:21671252

Toward inclusive science education: University scientists' views of students,instructional practices, and the nature of science

NASA Astrophysics Data System (ADS)

Bianchini, Julie A.; Whitney, David J.; Breton, Therese D.; Hilton-Brown, Bryan A.

2002-01-01

This study examined the perceptions and self-reported practices of 18 scientists participating in a yearlong seminar series designed to explore issues of gender and ethnicity in science. Scientists and seminar were part of the Promoting Women and Scientific Literacy project, a curriculum transformation and professional development initiative undertaken by science, science education, and women's studies faculty at their university. Researchers treated participating scientists as critical friends able to bring clarity to and raise questions about conceptions of inclusion in science education. Through questionnaires and semistructured interviews, we explored their (a) rationales for differential student success in undergraduate science education; (b) self-reports of ways they structure, teach, and assess courses to promote inclusion; and (c) views of androcentric and ethnocentric bias in science. Statistical analysis of questionnaires yielded few differences in scientists' views and reported practices by sex or across time. Qualitative analysis of interviews offered insight into how scientists can help address the problem of women and ethnic minorities in science education; constraints encountered in attempts to implement pedagogical and curricular innovations; and areas of consensus and debate across scientists and science studies scholars' descriptions of science. From our findings, we provided recommendations for other professional developers working with scientists to promote excellence and equity in undergraduate science education.

Physician assistants and their intent to retire.

PubMed

Coombs, Jennifer; Hooker, Roderick S; Brunisholz, Kim

2013-07-01

To determine predictors of physician assistants (PAs) to retire or to permanently leave clinical practice. The intent was to create a measure of retention and attrition for purposes of forecasting PA supply. All PAs 55 years or older who were nationally certified in 2011 were surveyed. Statistical analysis included descriptive measures utilizing means, standard deviations, range, and proportions for all survey questions. Univariable analysis using χ² test for the categorical variables determined gender differences in participants' intent to retire. A studentized t test analysis for continuous variables was used to compare differences across genders. The estimated time interval until retirement was calculated using reported values from participants and then subtracting their projected retirement age from current age. The same calculation was used for estimating PA career length from date of graduation to retirement. For all analyses, a P value < .05 was considered statistically significant. A total of 12,005 were eligible and surveyed online; 4767 responded (38%). The mean age was 60 years and the years in clinical practice was 25. When asked to predict a retirement date or age, the mean duration of working beyond age 55 years was 12 years (range 5 to 21). Most respondents reported being confident they were on track to retire with an adequate income. The significant differences that emerged were that men were more confident than women in preparing to retire, having enough money for medical expenses, and being able to live comfortably in retirement. Men more than women stated that, if forced to retire, they were more confident in the preparation to do so. PAs 55 years and older report they are likely to delay retirement from practice until age 67 years, on average. Women were less confident than men in retirement preparation. This age prediction expands career projections and refines forecasting models for the profession. Correlations based on expectation-action chain of events should be developed by periodically measuring how often intent and reality coalesce.

Finite-data-size study on practical universal blind quantum computation

NASA Astrophysics Data System (ADS)

Zhao, Qiang; Li, Qiong

2018-07-01

The universal blind quantum computation with weak coherent pulses protocol is a practical scheme to allow a client to delegate a computation to a remote server while the computation hidden. However, in the practical protocol, a finite data size will influence the preparation efficiency in the remote blind qubit state preparation (RBSP). In this paper, a modified RBSP protocol with two decoy states is studied in the finite data size. The issue of its statistical fluctuations is analyzed thoroughly. The theoretical analysis and simulation results show that two-decoy-state case with statistical fluctuation is closer to the asymptotic case than the one-decoy-state case with statistical fluctuation. Particularly, the two-decoy-state protocol can achieve a longer communication distance than the one-decoy-state case in this statistical fluctuation situation.

Counternarcotic Efforts in the Southern Cone: Chile

DTIC Science & Technology

1990-06-30

deportation is simply not practical . Statistics of cocaine coming into Chile by "ant smuggling" do not exist. Carabineros mentions that according to...existing evidence is contradictory. A recent report ordered by the Ministry of Foreign 10 Affairs does not support the allegation that Chile is being used...Gugliotta and Jeff Leen, Kings of Cocaine (New York: Harper and Row, 1989) p.23. 11 industry based in Chile and controlled by a few refiners who bought

Statistical Modeling of Bivariate Data.

DTIC Science & Technology

1982-08-01

Technical S. PERFORMING ORG. REPORT NUMBER 7. AUTNOR(a) S. CONTRACT OR GRANT NUMBER(e) Terry Joe Woodfield DAAG29-80-C-0070 S. PERFORMING ORGANIZATION NAME...proaramming has caused it to be a widely practiced form of program construction. The idea behind this approach is to carefully organize a program so that it...flows smoothly from one computation to the next without haphazard placement of loops and branches. There are , J a variety of ways to organize a program

[Preventive therapy with cast removable partial dentures].

PubMed

Staegemann, G

1977-09-01

Starting from tertiary prevention, the author quotes statistical reports of their clinical successfulness. The classification into groups of changes of success according to E. Köhler (fig. 3) permits to give practice-oriented recommendations for therapy (fig. 4-6). The various possibilities of designing the sublingual bar and its attachment (fig. 7 and 8) are interpreted. Finally, the author gives advice on mouth and prosthesis hygiene and on the mode of wear with regard to their importance in inflammations.

The Krigifier: A Procedure for Generating Pseudorandom Nonlinear Objective Functions for Computational Experimentation

NASA Technical Reports Server (NTRS)

Trosset, Michael W.

1999-01-01

Comprehensive computational experiments to assess the performance of algorithms for numerical optimization require (among other things) a practical procedure for generating pseudorandom nonlinear objective functions. We propose a procedure that is based on the convenient fiction that objective functions are realizations of stochastic processes. This report details the calculations necessary to implement our procedure for the case of certain stationary Gaussian processes and presents a specific implementation in the statistical programming language S-PLUS.

Validity of a measure to assess healthy eating and physical activity policies and practices in Australian childcare services.

PubMed

Dodds, Pennie; Wyse, Rebecca; Jones, Jannah; Wolfenden, Luke; Lecathelinais, Christophe; Williams, Amanda; Yoong, Sze Lin; Finch, Meghan; Nathan, Nicole; Gillham, Karen; Wiggers, John

2014-06-09

Childcare services represent a valuable obesity prevention opportunity, providing access to a large portion of children at a vital point in their development. Few rigorously validated measures exist to measure healthy eating and physical activity policies and practices in this setting, and no such measures exist that are specific to the childcare setting in Australia. This was a cross sectional study, comparing two measures (pen and paper survey and observation) of healthy eating and physical activity policies and practices in childcare services. Research assistants attended consenting childcare services (n = 42) across the Hunter region of New South Wales, Australia and observed practices for one day. Nominated Supervisors and Room Leaders of the service also completed a pen and paper survey during the day of observation. Kappa statistics and proportion agreement were calculated for a total of 43 items relating to healthy eating and physical activity policies and practices. Agreement ranged from 38%-100%. Fifty one percent of items showed agreement of greater than or equal to 80%. Items assessing the frequency with which staff joined in active play with children reported the lowest percent agreement, while items assessing availability of beverages such as juice, milk and cordial, as well as the provision of foods such as popcorn, pretzels and sweet biscuits, reported the highest percent agreement. Kappa scores ranged from -0.06 (poor agreement) to 1 (perfect agreement). Of the 43 items assessed, 27 were found to have moderate or greater agreement. The study found that Nominated Supervisors and Room Leaders were able to accurately report on a number of healthy eating and physical activity policies and practices. Items assessing healthy eating practices tended to have higher kappa scores than those assessing physical activity related policies or practices. The tool represents a useful instrument for public health researchers and policy makers working in this setting.

Does Practice Make Perfect? The Relationship Between Self-Reported Treatment Homework Completion and Parental Skill Acquisition and Child Behaviors.

PubMed

Stokes, Jocelyn O; Jent, Jason F; Weinstein, Allison; Davis, Eileen M; Brown, Tasha M; Cruz, Laura; Wavering, Hannah

2016-07-01

The purpose of the current study was to examine whether the rate and type of parent-reported homework completion is associated with parent-report of child behavior outcomes, number of sessions to master parental skills as measured by therapist observation, and length of treatment in Parent-child Interaction Therapy (PCIT). Sixty-two parent-child dyads (primary caregiver: Mage=36.35years, female 95.20%, 81.60% White, 59.57% Hispanic; child Mage=4.22years; child gender male 64.50%) who completed PCIT were included in the study. A within-subjects hierarchical regression statistical design was used to examine the impact of parent report of homework completion on treatment processes and outcomes. A higher rate of self-reported homework completion was predictive of parental mastery of skill acquisition in fewer sessions and treatment completion in fewer sessions. Parent report of homework completion rate was not related to changes in child disruptive behavior after controlling for child behavior at baseline. Current study findings reinforce the importance of having parents regularly practice PCIT skills outside of session in order to decrease treatment length and facilitate the acquisition of parenting skills, which may reduce family burdens associated with attending a weekly treatment. Copyright © 2016. Published by Elsevier Ltd.

Illustrating the practice of statistics

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

Hamada, Christina A; Hamada, Michael S

2009-01-01

The practice of statistics involves analyzing data and planning data collection schemes to answer scientific questions. Issues often arise with the data that must be dealt with and can lead to new procedures. In analyzing data, these issues can sometimes be addressed through the statistical models that are developed. Simulation can also be helpful in evaluating a new procedure. Moreover, simulation coupled with optimization can be used to plan a data collection scheme. The practice of statistics as just described is much more than just using a statistical package. In analyzing the data, it involves understanding the scientific problem andmore » incorporating the scientist's knowledge. In modeling the data, it involves understanding how the data were collected and accounting for limitations of the data where possible. Moreover, the modeling is likely to be iterative by considering a series of models and evaluating the fit of these models. Designing a data collection scheme involves understanding the scientist's goal and staying within hislher budget in terms of time and the available resources. Consequently, a practicing statistician is faced with such tasks and requires skills and tools to do them quickly. We have written this article for students to provide a glimpse of the practice of statistics. To illustrate the practice of statistics, we consider a problem motivated by some precipitation data that our relative, Masaru Hamada, collected some years ago. We describe his rain gauge observational study in Section 2. We describe modeling and an initial analysis of the precipitation data in Section 3. In Section 4, we consider alternative analyses that address potential issues with the precipitation data. In Section 5, we consider the impact of incorporating additional infonnation. We design a data collection scheme to illustrate the use of simulation and optimization in Section 6. We conclude this article in Section 7 with a discussion.« less

Bayesian inference for psychology. Part II: Example applications with JASP.

PubMed

Wagenmakers, Eric-Jan; Love, Jonathon; Marsman, Maarten; Jamil, Tahira; Ly, Alexander; Verhagen, Josine; Selker, Ravi; Gronau, Quentin F; Dropmann, Damian; Boutin, Bruno; Meerhoff, Frans; Knight, Patrick; Raj, Akash; van Kesteren, Erik-Jan; van Doorn, Johnny; Šmíra, Martin; Epskamp, Sacha; Etz, Alexander; Matzke, Dora; de Jong, Tim; van den Bergh, Don; Sarafoglou, Alexandra; Steingroever, Helen; Derks, Koen; Rouder, Jeffrey N; Morey, Richard D

2018-02-01

Bayesian hypothesis testing presents an attractive alternative to p value hypothesis testing. Part I of this series outlined several advantages of Bayesian hypothesis testing, including the ability to quantify evidence and the ability to monitor and update this evidence as data come in, without the need to know the intention with which the data were collected. Despite these and other practical advantages, Bayesian hypothesis tests are still reported relatively rarely. An important impediment to the widespread adoption of Bayesian tests is arguably the lack of user-friendly software for the run-of-the-mill statistical problems that confront psychologists for the analysis of almost every experiment: the t-test, ANOVA, correlation, regression, and contingency tables. In Part II of this series we introduce JASP ( http://www.jasp-stats.org ), an open-source, cross-platform, user-friendly graphical software package that allows users to carry out Bayesian hypothesis tests for standard statistical problems. JASP is based in part on the Bayesian analyses implemented in Morey and Rouder's BayesFactor package for R. Armed with JASP, the practical advantages of Bayesian hypothesis testing are only a mouse click away.

The protective effects of acute cardiovascular exercise on the interference of procedural memory.

PubMed

Jo, J S; Chen, J; Riechman, S; Roig, M; Wright, D L

2018-04-10

Numerous studies have reported a positive impact of acute exercise for procedural skill memory. Previous work has revealed this effect, but these findings are confounded by a potential contribution of a night of sleep to the reported exercise-mediated reduction in interference. Thus, it remains unclear if exposure to a brief bout of exercise can provide protection to a newly acquired motor memory. The primary objective of the present study was to examine if a single bout of moderate-intensity cardiovascular exercise after practice of a novel motor sequence reduces the susceptibility to retroactive interference. To address this shortcoming, 17 individuals in a control condition practiced a novel motor sequence that was followed by test after a 6-h wake-filled interval. A separate group of 17 individuals experienced practice with an interfering motor sequence 45 min after practice with the original sequence and were then administered test trials 6 h later. One additional group of 12 participants was exposed to an acute bout of exercise immediately after practice with the original motor sequence but prior to practice with the interfering motor sequence and the subsequent test. In comparison with the control condition, increased response times were revealed during the 6-h test for the individuals that were exposed to interference. The introduction of an acute bout of exercise between the practice of the two motor sequences produced a reduction in interference from practice with the second task at the time of test, however, this effect was not statistically significant. These data reinforce the hypothesis that while there may be a contribution from exercise to post-practice consolidation of procedural skills which is independent of sleep, sleep may interact with exercise to strengthen the effects of the latter on procedural memory.

The policy and practices of New South Wales drug treatment providers in responding to the possession of illicit substances on premises.

PubMed

Stirling, Robert; Day, Carolyn

2016-09-01

Responding to possession of illicit substances on the premises of drug treatment services is a complex issue. Providers are challenged by balancing duty-of-care and staff safety while attempting to provide a therapeutic environment. This study assessed the current policy and practice of non-government drug treatment services in New South Wales, Australia in responding to possession of illicit substances on their premises. Non-government drug treatment services were invited to participate in a survey that aimed to elicit information about existing policy and practices and how often it occurred. Analysis explored the differences between services that had a written policy and those that did not against service setting, accreditation status, reporting of an illicit drug possession in the last 12 months and having a sharps disposal unit. Fifty-one responses were included in the analysis, 29 (57%) of which reported having a policy and/or procedure. There was no statistically discernible difference between inpatient and outpatient settings, accreditation status of services or availability of a sharps disposal unit on the premises. However, services that reported a possession incident in the previous 12 months were more likely to report having a written policy than those that did not (37% vs. 12%; odds ratio: 4.75, 95% confidence interval 1.32-17.11, P = 0.014). The policy and practice in these settings vary greatly, with many services reporting no documented policy to guide staff. The findings suggest the need to develop organisational policy to support service providers in responding to possession of illicit substances on premises. [Stirling R, Day C. The policy and practices of New South Wales drug treatment providers in responding to the possession of illicit substances on premises. Drug Alcohol Rev 2016;35:644-649]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Knowledge translation and implementation in spinal cord injury: a systematic review

PubMed Central

Noonan, VK; Wolfe, DL; Thorogood, NP; Park, SE; Hsieh, JT; Eng, JJ

2015-01-01

Objective To conduct a systematic review examining the effectiveness of knowledge translation (KT) interventions in changing clinical practice and patient outcomes. Methods MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO were searched for studies published from January 1980 to July 2012 that reported and evaluated an implemented KT intervention in spinal cord injury (SCI) care. We reviewed and summarized results from studies that documented the implemented KT intervention, its impact on changing clinician behavior and patient outcomes as well as the facilitators and barriers encountered during the implementation. Results A total of 13 articles featuring 10 studies were selected and abstracted from 4650 identified articles. KT interventions included developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice. The methods (or drivers) to facilitate the implementation included organizing training sessions for clinical staff, introducing computerized reminders and involving organizational leaders. The methodological quality of studies was mostly poor. Only 3 out of 10 studies evaluated the success of the implementation using statistical analyses, and all 3 reported significant behavior change. Out of the 10 studies, 6 evaluated the effect of the implementation on patient outcomes using statistical analyses, with 4 reporting significant improvements. The commonly cited facilitators and barriers were communication and resources, respectively. Conclusion The field of KT in SCI is in its infancy with only a few relevant publications. However, there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. Future studies should ensure rigorous study methods are used to evaluate KT interventions. PMID:24796445

Diabetes mellitus type II as a risk factor for depression: a lower than expected risk in a general practice setting.

PubMed

Aarts, S; van den Akker, M; van Boxtel, M P J; Jolles, J; Winkens, B; Metsemakers, J F M

2009-01-01

The aim of the present study was to determine whether a diagnosis of diabetes mellitus (DM) in a primary setting is associated with an increased risk of subsequent depression. A retrospective cohort design was used based on the Registration Network Family Practice (RNH) database. Patients diagnosed with diabetes mellitus at or after the age of 40 and who were diagnosed between 01-01-1980 and 01-01-2007 (N = 6,140), were compared with age-matched controls from a reference group (N = 18,416) without a history of diabetes. Both groups were followed for an emerging first diagnosis of depression (and/or depressive feelings) until January 1, 2008. 2.0% of the people diagnosed with diabetes mellitus developed a depressive disorder, compared to 1.6% of the reference group. After statistical correction for confounding factors diabetes mellitus was associated with an increased risk of developing subsequent depression (HR 1.26; 95% CI: 1.12-1.42) and/or depressive feelings (HR 1.33; 95% CI: 1.18-1.46). After statistical adjustment practice identification code, age and depression preceding diabetes, were significantly related to a diagnosis of depression. Patients with diabetes mellitus are more likely to develop subsequent depression than persons without a history of diabetes. Results from this large longitudinal study based on a general practice population indicate that this association is weaker than previously found in cross-sectional research using self-report surveys. Several explanations for this dissimilarity are discussed

Sexual Victimization and Subsequent Police Reporting by Gender Identity Among Lesbian, Gay, Bisexual, Transgender, and Queer Adults.

PubMed

Langenderfer-Magruder, Lisa; Walls, N Eugene; Kattari, Shanna K; Whitfield, Darren L; Ramos, Daniel

2016-01-01

Prevalence of sexual victimization among lesbian, gay, bisexual, transgender, and queer (LGBTQ) persons is frequently found to be higher than the prevalence reported by their heterosexual peers. Transgender individuals are often included solely as part of larger LGBTQ research samples, potentially obfuscating differences between sexual orientation and gender identity. In this study, the authors examined sexual assault/rape in a large convenience sample of LGBTQ adults (N = 1,124) by respondents' gender identity (cisgender, transgender) to determine whether differences exist in lifetime prevalence of sexual assault/rape and subsequent police reporting. Findings indicate transgender individuals report having experienced sexual assault/rape more than twice as frequently as cisgender LGBQ individuals. Authors found no statistically significant difference in reporting sexual violence to police. Implications for research and practice are discussed.

The Heuristics of Statistical Argumentation: Scaffolding at the Postsecondary Level

ERIC Educational Resources Information Center

Pardue, Teneal Messer

2017-01-01

Language plays a key role in statistics and, by extension, in statistics education. Enculturating students into the practice of statistics requires preparing them to communicate results of data analysis. Statistical argumentation is one way of providing structure to facilitate discourse in the statistics classroom. In this study, a teaching…

A Practical Guide to Check the Consistency of Item Response Patterns in Clinical Research Through Person-Fit Statistics: Examples and a Computer Program.

PubMed

Meijer, Rob R; Niessen, A Susan M; Tendeiro, Jorge N

2016-02-01

Although there are many studies devoted to person-fit statistics to detect inconsistent item score patterns, most studies are difficult to understand for nonspecialists. The aim of this tutorial is to explain the principles of these statistics for researchers and clinicians who are interested in applying these statistics. In particular, we first explain how invalid test scores can be detected using person-fit statistics; second, we provide the reader practical examples of existing studies that used person-fit statistics to detect and to interpret inconsistent item score patterns; and third, we discuss a new R-package that can be used to identify and interpret inconsistent score patterns. © The Author(s) 2015.

Documenting Elementary Teachers' Sustainability of Instructional Practices: A Mixed Method Case Study

NASA Astrophysics Data System (ADS)

Cotner, Bridget A.

School reform programs focus on making educational changes; however, research on interventions past the funded implementation phase to determine what was sustained is rarely done (Beery, Senter, Cheadle, Greenwald, Pearson, et al., 2005). This study adds to the research on sustainability by determining what instructional practices, if any, of the Teaching SMARTRTM professional development program that was implemented from 2005--2008 in elementary schools with teachers in grades third through eighth were continued, discontinued, or adapted five years post-implementation (in 2013). Specifically, this study sought to answer the following questions: What do teachers who participated in Teaching SMARTRTM and district administrators share about the sustainability of Teaching SMARTRTM practices in 2013? What teaching strategies do teachers who participated in the program (2005--2008) use in their science classrooms five years postimplementation (2013)? What perceptions about the roles of females in science, technology, engineering, and mathematics (STEM) do teachers who participated in the program (2005--2008) have five years later (2013)? And, What classroom management techniques do the teachers who participated in the program (2005--2008) use five years post implementation (2013)? A mixed method approach was used to answer these questions. Quantitative teacher survey data from 23 teachers who participated in 2008 and 2013 were analyzed in SAS v. 9.3. Descriptive statistics were reported and paired t-tests were conducted to determine mean differences by survey factors identified from an exploratory factor analysis, principal axis factoring, and parallel analysis conducted with teacher survey baseline data (2005). Individual teacher change scores (2008 and 2013) for identified factors were computed using the Reliable Change Index statistic. Qualitative data consisted of interviews with two district administrators and three teachers who responded to the survey in both years (2008 and 2013). Additionally, a classroom observation was conducted with one of the interviewed teachers in 2013. Qualitative analyses were conducted following the constant comparative method and were facilitated by ATLAS.ti v. 6.2, a qualitative analysis software program. Qualitative findings identified themes at the district level that influenced teachers' use of Teaching SMARTRTM strategies. All the themes were classified as obstacles to sustainability: economic downturn, turnover of teachers and lack of hiring, new reform policies, such as Race to the Top, Student Success Act, Common Core State Standards, and mandated blocks of time for specific content. Results from the survey data showed no statistically significant difference through time in perceived instructional practices except for a perceived decrease in the use of hands-on instructional activities from 2008 to 2013. Analyses conducted at the individual teacher level found change scores were statistically significant for a few teachers, but overall, teachers reported similarly on the teacher survey at both time points. This sustainability study revealed the lack of facilitating factors to support the continuation of reform practices; however, teachers identified strategies to continue to implement some of the reform practices through time in spite of a number of system-wide obstacles. This sustainability study adds to the literature by documenting obstacles to sustainability in this specific context, which overlap with what is known in the literature. Additionally, the strategies teachers identified to overcome some of the obstacles to implement reform practices and the recommendations by district level administrators add to the literature on how stakeholders may support sustainability of reform through time.

Parental Perceptions and Practices toward Childhood Asthma

PubMed Central

Nofal, Abdullah; Heena, Humariya

2016-01-01

Introduction. Parental perceptions and practices are important for improving the asthma outcomes in children; indeed, evidence shows that parents of asthmatic children harbor considerable misperceptions of the disease. Objective. To investigate the perceptions and practices of parents toward asthma and its management in Saudi children. Methods. Using a self-administered questionnaire, a two-stage cross-sectional survey of parents of children aged between 3 and 15 years, was conducted from schools located in Riyadh province in central Saudi Arabia. Results. During the study interval, 2000 parents were asked to participate in the study; 1450 parents responded, of whom 600 (41.4%) reported that their children had asthma, dyspnea, or chest allergy (recurrent wheezing or coughing), while 478 (32.9%) of the parents reported that their children were diagnosed earlier with asthma by a physician. Therefore, the final statistical analyses were performed with 600 participants. Furthermore, 321 (53.5%) respondents believed that asthma is solely a hereditary disease. Interestingly, 361 (60.3%) were concerned about side effects of inhaled corticosteroids and 192 (32%) about the development of dependency on asthma medications. Almost 76% of parents had previously visited a pediatric emergency department during an asthma attack. Conclusions. Parents had misperceptions regarding asthma and exhibited ineffective practices in its management. Therefore, improving asthma care and compliance requires added parental education. PMID:27843948

Investigating the exercise-prescription practices of nurses working in inpatient mental health settings.

PubMed

Stanton, Robert; Happell, Brenda; Reaburn, Peter

2015-04-01

Nurses working in mental health are well positioned to prescribe exercise to people with mental illness. However, little is known regarding their exercise-prescription practices. We examined the self-reported physical activity and exercise-prescription practices of nurses working in inpatient mental health facilities. Thirty-four nurses completed the Exercise in Mental Illness Questionnaire - Health Practitioner Version. Non-parametric bivariate statistics revealed no relationship between nurses' self-reported physical activity participation and the frequency of exercise prescription for people with mental illness. Exercise-prescription parameters used by nurses are consistent with those recommended for both the general population and for people with mental illness. A substantial number of barriers to effective exercise prescription, including lack of training, systemic issues (such as prioritization and lack of time), and lack of consumer motivation, impact on the prescription of exercise for people with mental illness. Addressing the barriers to exercise prescription could improve the proportion of nurses who routinely prescribe exercise. Collaboration with exercise professionals, such as accredited exercise physiologists or physiotherapists, might improve knowledge of evidence-based exercise-prescription practices for people with mental illness, thereby improving both physical and mental health outcomes for this vulnerable population. © 2015 Australian College of Mental Health Nurses Inc.

Outcomes and opportunities: a nurse-led model of chronic disease management in Australian general practice.

PubMed

Eley, Diann S; Patterson, Elizabeth; Young, Jacqui; Fahey, Paul P; Del Mar, Chris B; Hegney, Desley G; Synnott, Robyn L; Mahomed, Rosemary; Baker, Peter G; Scuffham, Paul A

2013-01-01

The Australian government's commitment to health service reform has placed general practice at the centre of its agenda to manage chronic disease. Concerns about the capacity of GPs to meet the growing chronic disease burden has stimulated the implementation and testing of new models of care that better utilise practice nurses (PN). This paper reports on a mixed-methods study nested within a larger study that trialled the feasibility and acceptability of a new model of nurse-led chronic disease management in three general practices. Patients over 18 years of age with type 2 diabetes, hypertension or stable ischaemic heart disease were randomised into PN-led or usual GP-led care. Primary outcomes were self-reported quality of life and perceptions of the model's feasibility and acceptability from the perspective of patients and GPs. Over the 12-month study quality of life decreased but the trend between groups was not statistically different. Qualitative data indicate that the PN-led model was acceptable and feasible to GPs and patients. It is possible to extend the scope of PN care to lead the routine clinical management of patients' stable chronic diseases. All GPs identified significant advantages to the model and elected to continue with the PN-led care after our study concluded.

Approaches for the Evaluation of the National Cancer Institute's Summer Curriculum in Cancer Prevention: lessons from the all-Ireland NCI cancer consortium.

PubMed

Otero, Isabel V; Williams, Makeda; Harford, Joe B

2012-06-01

The NCI Summer Curriculum in Cancer Prevention (SCCP) has provided interdisciplinary training in cancer prevention and control to cancer health-care professionals, including nurses, physicians, and scientists, since 1986. It has trained over 1,200 participants, 256 of them from Ireland and Northern Ireland through two summer courses: a 4-week course on Principles and Practice of Cancer Prevention and Control (PP) and 1-week on Molecular Prevention (MP). This report is our attempt to measure achievements and level of satisfaction among alumni from the island of Ireland upon return to their home institution. A questionnaire was developed to assess this. Our analysis found statistically significant differences in the types of accomplishments reported among respondents of the MP and PP courses as well as statistically significant differences in their level of satisfaction. More data are needed to better explain the differences observed as well as level of resources available to alumni upon their return home.

Oil and gas company policy regarding the concept of sustainable development (water resources)

NASA Astrophysics Data System (ADS)

Matyugina, E. G.; Pogharnitskaya, O. V.; Grinkevich, L. S.; Belozerova, D. S.; Strelnikova, A. B.

2016-03-01

The paper considers oil and gas companies implementing the strategy of sustainable development. Being vital to the national economy, oil and gas companies have a significant impact on the environment. Having analyzed the statistical data, the authors state that the leading Russian oil and gas companies contribute to the industry dynamics and conduct eco-friendly production practices. The environmental component is reported to be integrated in production, HR, information and other company policies, which results in “greening” both economic cooperation and place of production. The authors report the inverse relation between production dynamics and significance of the impact on water resources.

An Assessment of the Effectiveness of Air Force Risk Management Practices in Program Acquisition Using Survey Instrument Analysis

DTIC Science & Technology

2015-06-18

Engineering Effectiveness Survey. CMU/SEI-2012-SR-009. Carnegie Mellon University. November 2012. Field, Andy. Discovering Statistics Using SPSS , 3rd...enough into the survey to begin answering questions on risk practices. All of the data statistical analysis will be performed using SPSS . Prior to...probabilistically using distributions for likelihood and impact. Statistical methods like Monte Carlo can more comprehensively evaluate the cost and

Impact of integrated gastrointestinal nematode management training for U.S. goat and sheep producers.

PubMed

Whitley, N C; Oh, S-H; Lee, S J; Schoenian, S; Kaplan, R M; Storey, B; Terrill, T H; Mobini, S; Burke, J M; Miller, J E; Perdue, M A

2014-03-01

The objective of this study was to determine the impact of integrated parasite management (IPM) training, including FAMACHA(©) eyelid color scoring, on the ability of U.S. sheep and goat producers to control gastrointestinal nematodes (GIN) on their farms. A survey was developed and provided to over 2000 producers trained from 2004 to 2008 in IPM with questions involving farm size (number of sheep/goats), location (U.S. state), impact of training on parasite control efforts and parasite problems on farm, and IPM practices used. Responses were divided into U.S. Census regions of the U.S. Descriptive statistics and logistic regression were used to describe results. Most of the 729 respondents were from the southern region of the U.S. (54.3%) and were small-scale producers (50 or less animals; 64.8%). Nearly all of the respondents (95.1%) agreed that IPM workshop attendance made a difference in their ability to control and monitor parasitism in their herd or flock and employed IPM practices to control GIN (96.3%). The most popular practices respondents used were rotational grazing (71.2%), genetic selection (choosing a parasite resistant breed and/or culling susceptible animals; 52.7%), grain supplementation on pasture to improve nutrition (44.0%), and increased height of plants being grazed (41.8%). Although reporting using a practice decreased (P<0.05) the likelihood of reporting fewer problems, for each 1-point increase in the number of practices which producers employed to control internal parasitism in their herd or flock, they were 16% more likely to report fewer GIN problems (P<0.05). Approximately 75% of respondents indicated an economic benefit of IPM on their farm (P<0.05), and those reporting savings of over $80 were more likely to report fewer problems (P<0.05) with parasites after the training while those reporting no economic benefit were less likely to report fewer problems with GIN (P<0.001). Overall, IPM training resulted in positive impacts for producers responding to the survey and should continue. Copyright © 2013 Elsevier B.V. All rights reserved.

Current practice trends in allergy: results of a united states survey of otolaryngologists, allergist-immunologists, and primary care physicians.

PubMed

Ryan, Matthew W; Marple, Bradley F; Leatherman, Bryan; Mims, J Whit; Fornadley, John; Veling, Maria; Lin, Sandra Y

2014-10-01

Clinical practices for the diagnosis and treatment of allergic disease evolve over time in response to a variety of forces. The techniques used by various physician specialties are not clearly defined and may vary from published descriptions or recommendations in the literature. This work is a Web-based survey enrolling 250 U.S. physicians in the following specialties: otolaryngology (ENT), allergy-immunology (A/I), and primary care (PCP). Respondents reported that skin-prick testing is the most common diagnostic testing method, followed by in vitro specific immunoglobulin E (IgE) testing. ENTs were more likely to use intradermal testing compared to other specialties (p = 0.0003 vs A/I; p < 0.0001 vs PCP). Respondents reported a wide distribution in number of allergens tested, regardless of testing method (range, 11 to >60). Significant use of home immunotherapy injections (defined as >10% of immunotherapy patients) ranged from 27% to 36% of physicians, with no statistically significant difference noted based upon specialty. PCPs reported greater use of sublingual immunotherapy (PCP, 68%; A/I, 45%; otolaryngology, 35%; A/I vs PCP, p = 0.005; ENT vs PCP p < 0.001)). A variety of allergy testing and treatment methods are employed by U.S. physicians, with some differences noted based upon specialty. Home immunotherapy continues to be employed in allergy practices, and sublingual immunotherapy is a common form of delivery, especially in primary care practices. © 2014 ARS-AAOA, LLC.

Survey of safety practices among hospital laboratories in Oromia Regional State, Ethiopia.

PubMed

Sewunet, Tsegaye; Kebede, Wakjira; Wondafrash, Beyene; Workalemau, Bereket; Abebe, Gemeda

2014-10-01

Unsafe working practices, working environments, disposable waste products, and chemicals in clinical laboratories contribute to infectious and non-infectious hazards. Staffs, the community, and patients are less safe. Furthermore, such practices compromise the quality of laboratory services. We conducted a study to describe safety practices in public hospital laboratories of Oromia Regional State, Ethiopia. Randomly selected ten public hospital laboratories in Oromia Regional State were studied from Oct 2011- Feb 2012. Self-administered structured questionnaire and observation checklists were used for data collection. The respondents were heads of the laboratories, senior technicians, and safety officers. The questionnaire addressed biosafety label, microbial hazards, chemical hazards, physical/mechanical hazards, personal protective equipment, first aid kits and waste disposal system. The data was analyzed using descriptive analysis with SPSS version16 statistical software. All of the respondents reported none of the hospital laboratories were labeled with the appropriate safety label and safety symbols. These respondents also reported they may contain organisms grouped under risk group IV in the absence of microbiological safety cabinets. Overall, the respondents reported that there were poor safety regulations or standards in their laboratories. There were higher risks of microbial, chemical and physical/mechanical hazards. Laboratory safety in public hospitals of Oromia Regional State is below the standard. The laboratory workers are at high risk of combined physical, chemical and microbial hazards. Prompt recognition of the problem and immediate action is mandatory to ensure safe working environment in health laboratories.

Assessing the knowledge to practice gap: The asthma practices of community pharmacists

PubMed Central

Guirguis, Lisa M.

2017-01-01

Background: Community pharmacists are well positioned to identify patients with poorly controlled asthma and trained to optimize asthma therapy. Yet, over 90% of patients with asthma live with uncontrolled disease. We sought to understand the current state of asthma management in practice in Alberta and explore the potential use of the Chat, Check and Chart (CCC) model to enhance pharmacists’ care for patients with asthma. Methods: An 18-question survey was used to examine pharmacists’ monitoring of asthma control and prior use of the CCC tools. Descriptive statistics were used to characterize the response rate, sample demographics, asthma management and CCC use. Survey validity and reliability were established. Results: One hundred randomly selected pharmacists completed the online survey with a 40% (100/250) response rate. A third of responding pharmacists reported talking to most patients about asthma symptoms and medication, with a greater focus on talking with patients on new prescriptions over those with ongoing therapies. Fewer than 1 in 10 pharmacists routinely talked to most patients about asthma action plans (AAPs). The majority of pharmacists (76%) were familiar with the CCC model, and 83% of those reported that the CCC model influenced their practice anywhere from somewhat (45%) to a great deal (38%). Both scales had good reliability, and factor analysis provided support for scale validity. Conclusions: There was considerable variability in pharmacists’ activities in monitoring asthma. Pharmacists rarely used AAPs. The CCC model had a high level of self-reported familiarity, use and influence among pharmacists. PMID:29317938

An Analysis of News Media Coverage of Complementary and Alternative Medicine

PubMed Central

Bonevski, Billie; Wilson, Amanda; Henry, David A.

2008-01-01

Background To examine the accuracy and adequacy of lay media news stories about complementary and alternative medicines and therapies. Methodology/Principal Findings A descriptive analysis of news stories about complementary and alternative medicine (CAM) in the Australian media using a national medical news monitoring website, mediadoctor.org.au. Each story was rated against 10 criteria by two individuals. Consensus scores of 222 news articles reporting therapeutic claims about complementary medicines posted on mediadoctor.org.au between 1 January 2004 and 1 September 2007 were calculated. The overall rating score for 222 CAM articles was 50% (95% CI 47% to 53%). There was a statistically significant (F = 3.68, p = 0.006) difference in cumulative mean scores according to type of therapy: biologically based practices (54%, 95% CI 50% to 58%); manipulative body based practices (46%, 95% CI 39% to 54%), whole medical systems (45%, 95% CI 32% to 58%), mind body medicine (41%, 95% CI 31% to 50%) and energy medicine (33%, 95% CI 11% to 55%). There was a statistically significant difference in cumulative mean scores (F = 3.72, p = 0.0001) according to the clinical outcome of interest with stories about cancer treatments (62%, 95% CI 54% to 70%) scoring highest and stories about treatments for children's behavioural and mental health concerns scoring lowest (31%, 95% CI 19% to 43%). Significant differences were also found in scores between media outlets. Conclusions/Significance There is substantial variability in news reporting practices about CAM. Overall, although they may be improving, the scores remain generally low. It appears that much of the information the public receives about CAM is inaccurate or incomplete. PMID:18545688

Survey of brachytherapy practice in the United States: a report of the Clinical Research Committee of the American Endocurietherapy Society.

PubMed

Nag, S; Owen, J B; Farnan, N; Pajak, T F; Martinez, A; Porter, A; Blasko, J; Harrison, L B

1995-01-01

To obtain reliable data on the extent of the brachytherapy practice in the United States by conducting a comprehensive survey of all facilities. The Clinical Research Committee of the AES surveyed all 1321 radiation oncology facilities identified in the Patterns of Care Study (PCS) of the American College of Radiology (ACR). Multiple mailings and follow-up were made to obtain a high response rate. Survey responders and nonresponders were compared using chi-square tests. Summary statistics were reported. Of the 1321 facilities, 1054 responded (80%). Hospital-based and larger facilities had a statistically significant higher rate of response. Brachytherapy was being performed at 819 facilities (the median number of procedures = 21-50). Two hundred and two facilities did no brachytherapy. The common isotopes used were 137Cs (705 facilities), 192Ir (585 facilities), 125I (236 facilities), and 131I (194 facilities). The common brachytherapy techniques used were intracavitary (751 facilities), interstitial (536 facilities), intraluminal (310 facilities), and plaques (148 facilities). Remote afterloaded brachytherapy was used at 205 centers as follows: high dose rate (HDR) (164), medium dose rate (MDR) (5), and low dose rate (LDR) (36). Computerized dosimetry was most commonly used (790 facilities), followed by Patterson-Parker (104 facilities) and Quimby (72 facilities). The common sites treated were cervix (701 facilities), endometrium (565 facilities), head and neck (354 facilities), and lung (344 facilities). Data regarding brachytherapy practice has been obtained from a large percentage (80%) of all facilities in the United States. The majority (78-81%) of radiation oncology facilities perform brachytherapy; however, its use is restricted to gynecological implants in many of these centers. The results from this survey will be used to develop a pattern of care study and data registry in brachytherapy.

Analyzing quality of colorectal cancer care through registry statistics: a small community hospital example.

PubMed

Hopewood, Ian

2011-01-01

As the quantity of elderly Americans requiring oncologic care grows, and as cancer treatment and medicine become more advanced, assessing quality of cancer care becomes a necessary and advantageous practice for any facility.' Such analysis is especially practical in small community hospitals, which may not have the resources of their larger academic counterparts to ensure that the care being provided is current and competitive in terms of both technique and outcome. This study is a comparison of the colorectal cancer care at one such center, Falmouth Community Hospital (FCH)--located in Falmouth, Massachusetts, about an hour and a half away from the nearest metropolitan center--to the care provided at a major nearby Boston Tertiary Center (BTC) and at teaching and research facilities across New England and the United States. The metrics used to measure performance encompass both outcome (survival rate data) as well as technique, including quality of surgery (number of lymph nodes removed) and the administration of adjuvant treatments, chemotherapy, and radiation therapy, as per national guidelines. All data for comparison between FCH and BTC were culled from those hospitals' tumor registries. Data for the comparison between FCH and national tertiary/referral centers were taken from the American College of Surgeons' Commission on Cancer, namely National Cancer Data Base (NCDB) statistics, Hospital Benchmark Reports and Practice Profile Reports. The results showed that, while patients at FCH were diagnosed at both a higher age and at a more advanced stage of colorectal cancer than their BTC counterparts, FCH stands up favorably to BTC and other large centers in terms of the metrics referenced above. Quality assessment such as the analysis conducted here can be used at other community facilities to spotlight, and ultimately eliminate, deficiencies in cancer programs.

Effectiveness of an Online Educational Module in Improving Evidence-Based Practice Skills of Practicing Registered Nurses.

PubMed

Moore, Lora

2017-10-01

Implementation of evidence-based practice (EBP) at the bedside has been difficult to achieve. Significant gaps between current research and actual practice have been identified and must be addressed in effort to increase utilization of EBP. The purpose of this study was to evaluate the efficacy of an online EBP educational intervention and to examine the relationship between educational preparation and years of nursing experience on nurses' practice, attitudes, and knowledge and skills of EBP. An experimental pretest-posttest design study with three randomized groups utilizing the EBPQ instrument was conducted. No significant differences were noted in EBPQ subscale scores of practice, attitude, or knowledge and skills from pre- to posttest. In addition, no statistical difference in EBPQ subscale scores regarding educational preparation or years of experience were noted. While nurses report positive attitudes toward EBP, their perceptions of practice and knowledge and skills score much lower. Educational interventions are needed for practicing nurses to overcome this knowledge deficit to successfully implement EBP. However, the use of online, independent, computer-based learning modules, while cost-efficient and offer several benefits when educating nurses, may not necessarily be the most effective method for teaching EBP knowledge and skills to practicing nurses. © 2017 Sigma Theta Tau International.

Statistical learning algorithms for identifying contrasting tillage practices with landsat thematic mapper data

USDA-ARS?s Scientific Manuscript database

Tillage management practices have direct impact on water holding capacity, evaporation, carbon sequestration, and water quality. This study examines the feasibility of two statistical learning algorithms, such as Least Square Support Vector Machine (LSSVM) and Relevance Vector Machine (RVM), for cla...

Christian Educators' Use of Prayer to Cope with Stress.

PubMed

LaBarbera, Robin; Hetzel, June

2016-08-01

Teachers experience significant work-related stress, and research asserts that they show greater mental health symptoms associated with this stress as compared to many other professions. Psychological distress among educators has been reported in the literature to be twice that of the general population. In other lines of research examining religious practices such as prayer, researchers have documented the overall positive impact of prayer on one's mental health. This study identified sources of stress for an international sample of 916 Christian educators, and the use of religious practices such as prayer, to determine whether prayer served as a coping strategy for their work-related stress. A mixed methods approach was used to measure three key variables: sources of stress, spiritual practices, and job satisfaction. Qualitative findings were used to analyze participants' sources of stress, and quantitative findings were used to measure their practice of spiritual disciplines and job satisfaction. A statistically significant relationship was found between frequency of prayer and job satisfaction, providing support for the initial hypothesis.

National Board Certification and Developmentally Appropriate Practices: Perceptions of Impact.

PubMed

McKenzie, Ellen Nancy

2013-04-01

The study investigated a relationship between National Board certification and perceived use of developmentally appropriate practices (DAP). A self-developed survey, the Early-childhood Teacher Inventory of Practices, was e-mailed to participants. Participants included 246 non-National Board-certified (non-NBCT) and 135 National Board-certified (NBCT) early childhood teachers. Descriptives were reported for age, years of teaching experience, grade level currently teaching, ethnicity, degree type, certification type, and degree level. Inferential statistics were used to understand the differences between perceived use of DAP. NBCTs scored significantly higher than non-NBCTs in three of the four target areas and on the total of the scale. Pearson product-moment corelations were used to determine a relationship between years of experience or level of education and NBCTs' perceived use of DAP. Years of experience were significantly related, but level of education was not. The findings indicate that NBCT teachers perceive they incorporate more developmentally appropriate practices into their teaching than do non-NBCT teachers.

National Board Certification and Developmentally Appropriate Practices: Perceptions of Impact

PubMed Central

McKenzie, Ellen Nancy

2013-01-01

The study investigated a relationship between National Board certification and perceived use of developmentally appropriate practices (DAP). A self-developed survey, the Early-childhood Teacher Inventory of Practices, was e-mailed to participants. Participants included 246 non-National Board-certified (non-NBCT) and 135 National Board-certified (NBCT) early childhood teachers. Descriptives were reported for age, years of teaching experience, grade level currently teaching, ethnicity, degree type, certification type, and degree level. Inferential statistics were used to understand the differences between perceived use of DAP. NBCTs scored significantly higher than non-NBCTs in three of the four target areas and on the total of the scale. Pearson product-moment corelations were used to determine a relationship between years of experience or level of education and NBCTs’ perceived use of DAP. Years of experience were significantly related, but level of education was not. The findings indicate that NBCT teachers perceive they incorporate more developmentally appropriate practices into their teaching than do non-NBCT teachers. PMID:23626399

The influence of journal submission guidelines on authors' reporting of statistics and use of open research practices

PubMed Central

Cumming, Geoff; Fresc, Luca; Boedker, Ingrid; Tressoldi, Patrizio

2017-01-01

From January 2014, Psychological Science introduced new submission guidelines that encouraged the use of effect sizes, estimation, and meta-analysis (the “new statistics”), required extra detail of methods, and offered badges for use of open science practices. We investigated the use of these practices in empirical articles published by Psychological Science and, for comparison, by the Journal of Experimental Psychology: General, during the period of January 2013 to December 2015. The use of null hypothesis significance testing (NHST) was extremely high at all times and in both journals. In Psychological Science, the use of confidence intervals increased markedly overall, from 28% of articles in 2013 to 70% in 2015, as did the availability of open data (3 to 39%) and open materials (7 to 31%). The other journal showed smaller or much smaller changes. Our findings suggest that journal-specific submission guidelines may encourage desirable changes in authors’ practices. PMID:28414751

Enhancing nurses' ethical practice: development of a clinical ethics program.

PubMed

McDaniel, C

1998-06-01

There is increasing attention paid to ethics under managed care; however, few clinical-based ethics programs are reported. This paper reports the assessment and outcomes of one such program. A quasi-experimental research design with t-tests is used to assess the outcome differences between participants and control groups. There are twenty nurses in each; they are assessed for comparability. Differences are predicted on two outcomes using reliable and valid measures: nurses' time with their patients in ethics discussions, and nurses' opinions regarding their clinical ethics environments. Results reveal a statistically significant difference (p <.05) between the two groups, with modest positive change in the participants. Additional exploratory analyses are reported on variables influential in health care services.

How Educators Conceptualize and Teach Reflective Practice: A Survey of North American Pediatric Medical Educators.

PubMed

Butani, Lavjay; Bannister, Susan L; Rubin, Allison; Forbes, Karen L

2017-04-01

The objectives of this study were to explore pediatric undergraduate medical educators' understanding of reflective practice, the barriers they face in teaching this, the curricular activities they use, and the value they assign to reflective practice. Nine survey questions were sent to members of the Council on Medical Student Education in Pediatrics, an international pediatric undergraduate medical educator group. Quantitative data were analyzed using descriptive statistics. Open-ended responses were analyzed qualitatively through an iterative process to establish themes representing understanding of reflective practice and barriers in teaching this. Respondents representing 56% of all North American schools answered at least 1 survey question. Qualitative analysis of understanding of reflection revealed 11 themes spanning all components of reflective practice, albeit with a narrow view on triggers for reflection and a lower emphasis on understanding the why of things and on perspective-taking. The most frequent barriers in teaching this were the lack of skilled educators and limited time. Most respondents valued reflective skills but few reported confidence in their ability to teach reflection. Several curricular activities were used to teach reflection, the most common being narrative writing. Pediatric undergraduate medical educators value reflection and endorse its teaching. However, many do not have a complete understanding of the construct and few report confidence in teaching this. Implementing longitudinal curricula in reflective practice may require a culture change; opportunities exist for faculty development about the meaning and value of reflective practice and how best to teach this. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Influence of Body Weight on Patients' Satisfaction with Ambulatory Care

PubMed Central

Wee, Christina C; Phillips, Russell S; Cook, E Francis; Haas, Jennifer S; Puopolo, Ann Louise; Brennan, Troyen A; Burstin, Helen R

2002-01-01

Patients with obesity experience psychosocial consequences because of their weight and report physician bias. We examined whether obesity is associated with lower patient satisfaction with ambulatory care among 2,858 patients seen at 11 academically affiliated primary care practices in Boston. Compared with normal weight patients (body mass index [BMI], 19.0 to 24.9 kg/M2), overweight (BMI, 25.0 to 29.9 kg/M2) and obese patients (BMI ≥30 kg/M2) reported lower overall satisfaction scores at their most recent visit; the scores were 85.5, 85.0, and 82.6 out a possible 100, respectively (P = .05). After adjustment for potential confounders including illness burden, obese patients reported lower scores but the difference was not statistically significant (mean difference, 1.23 [95% confidence interval −0.67 to 3.12]). Patient satisfaction with their usual provider and their practice did not vary by BMI group. Obesity is associated with only modest decreases in satisfaction scores with the most recent visit, which were explained largely by higher illness burden among obese patients. PMID:11841531

Exploratory factor analysis in Rehabilitation Psychology: a content analysis.

PubMed

Roberson, Richard B; Elliott, Timothy R; Chang, Jessica E; Hill, Jessica N

2014-11-01

Our objective was to examine the use and quality of exploratory factor analysis (EFA) in articles published in Rehabilitation Psychology. Trained raters examined 66 separate exploratory factor analyses in 47 articles published between 1999 and April 2014. The raters recorded the aim of the EFAs, the distributional statistics, sample size, factor retention method(s), extraction and rotation method(s), and whether the pattern coefficients, structure coefficients, and the matrix of association were reported. The primary use of the EFAs was scale development, but the most widely used extraction and rotation method was principle component analysis, with varimax rotation. When determining how many factors to retain, multiple methods (e.g., scree plot, parallel analysis) were used most often. Many articles did not report enough information to allow for the duplication of their results. EFA relies on authors' choices (e.g., factor retention rules extraction, rotation methods), and few articles adhered to all of the best practices. The current findings are compared to other empirical investigations into the use of EFA in published research. Recommendations for improving EFA reporting practices in rehabilitation psychology research are provided.

Current and future health care professionals attitudes toward and knowledge of statistics: How confidence influences learning.

PubMed

Baghi, Heibatollah; Kornides, Melanie L

2013-01-01

Health care professionals require some understanding of statistics to successfully implement evidence based practice. Developing competency in statistical reasoning is necessary for students training in health care administration, research, and clinical care. Recently, the interest in healthcare professional's attitudes toward statistics has increased substantially due to evidence that these attitudes can hinder professionalism developing an understanding of statistical concepts. In this study, we analyzed pre- and post-instruction attitudes towards and knowledge of statistics obtained from health science graduate students, including nurses and nurse practitioners, enrolled in an introductory graduate course in statistics (n = 165). Results show that the students already held generally positive attitudes toward statistics at the beginning of course. However, these attitudes-along with the students' statistical proficiency-improved after 10 weeks of instruction. The results have implications for curriculum design and delivery methods as well as for health professionals' effective use of statistics in critically evaluating and utilizing research in their practices.

Current and future health care professionals attitudes toward and knowledge of statistics: How confidence influences learning

PubMed Central

Baghi, Heibatollah; Kornides, Melanie L.

2014-01-01

Background Health care professionals require some understanding of statistics to successfully implement evidence based practice. Developing competency in statistical reasoning is necessary for students training in health care administration, research, and clinical care. Recently, the interest in healthcare professional's attitudes toward statistics has increased substantially due to evidence that these attitudes can hinder professionalism developing an understanding of statistical concepts. Methods In this study, we analyzed pre- and post-instruction attitudes towards and knowledge of statistics obtained from health science graduate students, including nurses and nurse practitioners, enrolled in an introductory graduate course in statistics (n = 165). Results and Conclusions Results show that the students already held generally positive attitudes toward statistics at the beginning of course. However, these attitudes—along with the students’ statistical proficiency—improved after 10 weeks of instruction. The results have implications for curriculum design and delivery methods as well as for health professionals’ effective use of statistics in critically evaluating and utilizing research in their practices. PMID:25419256

A systematic review of the quality of statistical methods employed for analysing quality of life data in cancer randomised controlled trials.

PubMed

Hamel, Jean-Francois; Saulnier, Patrick; Pe, Madeline; Zikos, Efstathios; Musoro, Jammbe; Coens, Corneel; Bottomley, Andrew

2017-09-01

Over the last decades, Health-related Quality of Life (HRQoL) end-points have become an important outcome of the randomised controlled trials (RCTs). HRQoL methodology in RCTs has improved following international consensus recommendations. However, no international recommendations exist concerning the statistical analysis of such data. The aim of our study was to identify and characterise the quality of the statistical methods commonly used for analysing HRQoL data in cancer RCTs. Building on our recently published systematic review, we analysed a total of 33 published RCTs studying the HRQoL methods reported in RCTs since 1991. We focussed on the ability of the methods to deal with the three major problems commonly encountered when analysing HRQoL data: their multidimensional and longitudinal structure and the commonly high rate of missing data. All studies reported HRQoL being assessed repeatedly over time for a period ranging from 2 to 36 months. Missing data were common, with compliance rates ranging from 45% to 90%. From the 33 studies considered, 12 different statistical methods were identified. Twenty-nine studies analysed each of the questionnaire sub-dimensions without type I error adjustment. Thirteen studies repeated the HRQoL analysis at each assessment time again without type I error adjustment. Only 8 studies used methods suitable for repeated measurements. Our findings show a lack of consistency in statistical methods for analysing HRQoL data. Problems related to multiple comparisons were rarely considered leading to a high risk of false positive results. It is therefore critical that international recommendations for improving such statistical practices are developed. Copyright © 2017. Published by Elsevier Ltd.

Management of orthodontic emergencies in primary care - self-reported confidence of general dental practitioners.

PubMed

Popat, H; Thomas, K; Farnell, D J J

2016-07-08

Objective To determine general dental practitioners' (GDPs) confidence in managing orthodontic emergencies.Design Cross-sectional study.Setting Primary dental care.Subjects and methods An online survey was distributed to dentists practicing in Wales. The survey collected basic demographic information and included descriptions of ten common orthodontic emergency scenarios.Main outcome measure Respondents' self-reported confidence in managing the orthodontic emergency scenarios on a 5-point Likert scale. Differences between the Likert responses and the demographic variables were investigated using chi-squared tests.Results The median number of orthodontic emergencies encountered by respondents over the previous six months was 1. Overall, the self-reported confidence of respondents was high with 7 of the 10 scenarios presented scoring a median of 4 indicating that GDPs were 'confident' in their management. Statistical analysis revealed that GDPs who saw more orthodontic emergencies in the previous six months were more confident when managing the presented scenarios. Other variables such as age, gender, geographic location of practice and number of years practising dentistry were not associated with self-reported confidence.Conclusions Despite GDPs encountering very few orthodontic emergencies in primary care, they appear to be confident in dealing with commonly arising orthodontic emergency situations.

Applications of statistics to medical science (1) Fundamental concepts.

PubMed

Watanabe, Hiroshi

2011-01-01

The conceptual framework of statistical tests and statistical inferences are discussed, and the epidemiological background of statistics is briefly reviewed. This study is one of a series in which we survey the basics of statistics and practical methods used in medical statistics. Arguments related to actual statistical analysis procedures will be made in subsequent papers.

A randomized study of two methods of teaching perineal massage: effects on practice rates, episiotomy rates, and lacerations.

PubMed

Mynaugh, P A

1991-09-01

This study examined the effects of two methods of teaching perineal massage on the rates of practice of perineal massage, of episiotomy, and of lacerations in primiparas at birth. Couples in 20 randomly selected sections of four prenatal class series received routine printed and verbal instruction and a 12-minute video demonstration of perineal massage, or only the routine printed and verbal instruction. Women reported their practice rates in daily diary records, which were mailed to the researcher weekly. Hospital records provided delivery data. Of the 83 women, 23 (28%) practiced perineal massage: 16 (35.6%) in the experimental group, 7 (18.4%) controls. Even though the rate of practice almost doubled among experimental group women, the videotape instruction method was statistically nonsignificant. Episiotomy and laceration rates were not affected by teaching method. More severe lacerations occurred among the experimental group; however, the control group had almost four times as many severe (21%) as minor (5.3%) lacerations. The experimental group had twice as many severe (28.9%) as minor (13.3%) lacerations. These results were also nonsignificant.

Factors Affecting the Perception of Importance and Practice of Patient Safety Management among Hospital Employees in Korea.

PubMed

Kim, In-Sook; Park, MiJeong; Park, Mi-Young; Yoo, Hana; Choi, Jihea

2013-03-01

The study was undertaken to identify factors affecting perception of the importance and practice of patient safety management (PSM) among hospital employees in Korea. This study was conducted using a descriptive design and a self-report questionnaire. Two hundred and eighty employees were recruited from three hospitals using a convenience sampling method. Measures were perception of the importance, practice, and characteristics of PSM. Data were analyzed using descriptive statistics including t test, one-way analysis of variance, Pearson's correlation analysis, and multiple regression. Factors affecting perception of the importance of PSM were whether hospital employees were in contact with patients while on duty, weekly working hours, education on PSM, and perceived adequacy of PSM system construction. Factors affecting the practice of PSM were perceived adequacy of work load, perceived adequacy of PSM system construction and perception of its importance. The findings of this study indicate a need for developing strategies to improve perception of the importance and practice of PSM among all hospital employees, and provide a reference for future experimental studies. Copyright © 2013. Published by Elsevier B.V.

Statistical Significance vs. Practical Significance: An Exploration through Health Education

ERIC Educational Resources Information Center

Rosen, Brittany L.; DeMaria, Andrea L.

2012-01-01

The purpose of this paper is to examine the differences between statistical and practical significance, including strengths and criticisms of both methods, as well as provide information surrounding the application of various effect sizes and confidence intervals within health education research. Provided are recommendations, explanations and…

Teaching Primary School Mathematics and Statistics: Evidence-Based Practice

ERIC Educational Resources Information Center

Averill, Robin; Harvey, Roger

2010-01-01

Here is the only reference book you will ever need for teaching primary school mathematics and statistics. It is full of exciting and engaging snapshots of excellent classroom practice relevant to "The New Zealand Curriculum" and national mathematics standards. There are many fascinating examples of investigative learning experiences,…

Green initiative impact on stock prices: A quantitative study of the clean energy industry

NASA Astrophysics Data System (ADS)

Jurisich, John M.

The purpose of this quantitative ex post facto research study was to explore the relationship between green initiative expense disclosures and stock prices of 46 NASDAQ listed Clean Edge Green Energy global companies from 2007 to 2010. The independent variables were sales and marketing, environmental, customer and supplier, community, and corporate governance practices that were correlated with the dependent variable in the study of stock prices. Expense disclosures were examined in an effort to measure the impact of green initiative programs and to expose the interrelationships between green initiative expense disclosures and fluctuations of stock prices. The data for the research was secondary data from existing annual reports. A statistically significant relationship was revealed between environmental practices and changes in stock prices. The study results also provided substantial evidence for leadership and managerial decision making to reduce or increase green initiative practices to maximize shareholder wealth of their respective organizations.

Practical guide to understanding Comparative Effectiveness Research (CER).

PubMed

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

2013-12-01

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

Connecting Students to Mental Health Care: Pilot Findings from an Engagement Program for School Nurses

PubMed Central

Kim, Rachel E.; Becker, Kimberly D.; Stephan, Sharon H.; Hakimian, Serop; Apocada, Dee; Escudero, Pia V.; Chorpita, Bruce F.

2015-01-01

Schools function as the major provider of mental health services (MHS) for youth, but can struggle with engaging them in services. School nurses are well-positioned to facilitate referrals for MHS. This pilot study examined the feasibility, acceptability, and preliminary efficacy of an engagement protocol (EP) designed to enhance school nurses’ utilization of evidence-based engagement practices when referring youth to MHS. Participants were six school nurses and twenty-five adolescents in a large, urban school district. School nurses reported positive attitudes towards the EP, suggesting that they found it feasible and acceptable. Though there were small increases in school nurses’ use of engagement practices and in adolescents’ readiness for services following training, due to limited sample size, differences were not statistically significant. Still, pilot results suggest preliminary efficacy of training school nurses to strategically implement evidence-based engagement practices to increase adolescents’ engagement in MHS. PMID:26251671

Prevalence and determinants of risky sexual practice in Ethiopia: Systematic review and Meta-analysis.

PubMed

Muche, Achenef Asmamaw; Kassa, Getachew Mullu; Berhe, Abadi Kidanemariam; Fekadu, Gedefaw Abeje

2017-09-06

Risky sexual practice is a major public health problem in Ethiopia. There are various studies on the prevalence and determinants of risky sexual practice in different regions of the country but there is no study which shows the national estimate of risky sexual practices in Ethiopia. Therefore, this review was conducted to estimate the national pooled prevalence of risky sexual practice and its risk factors in Ethiopia. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed to review published and unpublished studies in Ethiopia. The databases used were; PubMed, Google Scholar, CINAHL and African Journals Online. Search terms were; risky sexual behavior, risky sexual practice, unprotected sex, multiple sexual partner, early sexual initiation, and/or Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for critical appraisal. The meta-analysis was conducted using Review Manager software. Descriptive information of studies was presented in narrative form and quantitative results were presented in forest plots. The Cochran Q test and I 2 test statistics were used to test heterogeneity across studies. The pooled estimate prevalence and the odd ratios with 95% confidence intervals were computed by a random effect model. A total of 31 studies with 43,695 participants were included in the meta-analysis. The pooled prevalence of risky sexual practice was 42.80% (95% CI: 35.64%, 49.96%). Being male (OR: 1.69; 95% CI: 1.21, 2.37), substance use (OR: 3.42; 95% CI: 1.41, 8.31), peer pressure (OR: 3.41; 95% CI: 1.69, 6.87) and watching pornography (OR: 3.6; 95% CI: 2.21, 5.86) were factors associated with an increase in risky sexual practices. The prevalence of risky sexual practices is high in Ethiopia. Being male, substance use, peer pressure and viewing pornographic materials were found to be associated with risky sexual practices. Therefore, life skills training is recommended to reduce peer pressure among individuals. Interventions should be designed to reduce substance use and viewing pornography.

Hormone replacement therapy is associated with gastro-oesophageal reflux disease: a retrospective cohort study.

PubMed

Close, Helen; Mason, James M; Wilson, Douglas; Hungin, A Pali S

2012-05-29

Oestrogen and progestogen have the potential to influence gastro-intestinal motility; both are key components of hormone replacement therapy (HRT). Results of observational studies in women taking HRT rely on self-reporting of gastro-oesophageal symptoms and the aetiology of gastro-oesophageal reflux disease (GORD) remains unclear. This study investigated the association between HRT and GORD in menopausal women using validated general practice records. 51,182 menopausal women were identified using the UK General Practice Research Database between 1995-2004. Of these, 8,831 were matched with and without hormone use. Odds ratios (ORs) were calculated for GORD and proton-pump inhibitor (PPI) use in hormone and non-hormone users, adjusting for age, co-morbidities, and co-pharmacy. In unadjusted analysis, all forms of hormone use (oestrogen-only, tibolone, combined HRT and progestogen) were statistically significantly associated with GORD. In adjusted models, this association remained statistically significant for oestrogen-only treatment (OR 1.49; 1.18-1.89). Unadjusted analysis showed a statistically significant association between PPI use and oestrogen-only and combined HRT treatment. When adjusted for covariates, oestrogen-only treatment was significant (OR 1.34; 95% CI 1.03-1.74). Findings from the adjusted model demonstrated the greater use of PPI by progestogen users (OR 1.50; 1.01-2.22). This first large cohort study of the association between GORD and HRT found a statistically significant association between oestrogen-only hormone and GORD and PPI use. This should be further investigated using prospective follow-up to validate the strength of association and describe its clinical significance.

The transfer of analytical procedures.

PubMed

Ermer, J; Limberger, M; Lis, K; Wätzig, H

2013-11-01

Analytical method transfers are certainly among the most discussed topics in the GMP regulated sector. However, they are surprisingly little regulated in detail. General information is provided by USP, WHO, and ISPE in particular. Most recently, the EU emphasized the importance of analytical transfer by including it in their draft of the revised GMP Guideline. In this article, an overview and comparison of these guidelines is provided. The key to success for method transfers is the excellent communication between sending and receiving unit. In order to facilitate this communication, procedures, flow charts and checklists for responsibilities, success factors, transfer categories, the transfer plan and report, strategies in case of failed transfers, tables with acceptance limits are provided here, together with a comprehensive glossary. Potential pitfalls are described such that they can be avoided. In order to assure an efficient and sustainable transfer of analytical procedures, a practically relevant and scientifically sound evaluation with corresponding acceptance criteria is crucial. Various strategies and statistical tools such as significance tests, absolute acceptance criteria, and equivalence tests are thoroughly descibed and compared in detail giving examples. Significance tests should be avoided. The success criterion is not statistical significance, but rather analytical relevance. Depending on a risk assessment of the analytical procedure in question, statistical equivalence tests are recommended, because they include both, a practically relevant acceptance limit and a direct control of the statistical risks. However, for lower risk procedures, a simple comparison of the transfer performance parameters to absolute limits is also regarded as sufficient. Copyright © 2013 Elsevier B.V. All rights reserved.

Knowledge, Attitude and Practice of General Practitioners toward Complementary and Alternative Medicine: a Cross-Sectional Study.

PubMed

Barikani, Ameneh; Beheshti, Akram; Javadi, Maryam; Yasi, Marzieh

2015-08-01

Orientation of public and physicians to the complementary and alternative medicine (CAM) is one of the most prominent symbols of structural changes in the health service system. The aim of his study was a determination of knowledge, attitude, and practice of general practitioners in complementary and alternative medicine. This cross- sectional study was conducted in Qazvin, Iran in 2013. A self-administered questionnaire was used for collecting data including four information parts: population information, physicians' attitude and knowledge, methods of getting information and their function. A total of 228 physicians in Qazvin comprised the population of study according to the deputy of treatment's report of Qazvin University of Medical Sciences. A total of 150 physicians were selected randomly, and SPSS Statistical program was used to enter questionnaires' data. Results were analyzed as descriptive statistics and statistical analysis. Sixty percent of all responders were male. About sixty (59.4) percent of participating practitioners had worked less than 10 years.96.4 percent had a positive attitude towards complementary and alternative medicine. Knowledge of practitioners about traditional medicine in 11 percent was good, 36.3% and 52.7% had average and little information, respectively. 17.9% of practitioners offered their patients complementary and alternative medicine for treatment. Although there was little knowledge among practitioners about traditional medicine and complementary approaches, a significant percentage of them had attitude higher than the lower limit.

Statistical analysis plan for the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART). A randomized controlled trial

PubMed Central

Damiani, Lucas Petri; Berwanger, Otavio; Paisani, Denise; Laranjeira, Ligia Nasi; Suzumura, Erica Aranha; Amato, Marcelo Britto Passos; Carvalho, Carlos Roberto Ribeiro; Cavalcanti, Alexandre Biasi

2017-01-01

Background The Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART) is an international multicenter randomized pragmatic controlled trial with allocation concealment involving 120 intensive care units in Brazil, Argentina, Colombia, Italy, Poland, Portugal, Malaysia, Spain, and Uruguay. The primary objective of ART is to determine whether maximum stepwise alveolar recruitment associated with PEEP titration, adjusted according to the static compliance of the respiratory system (ART strategy), is able to increase 28-day survival in patients with acute respiratory distress syndrome compared to conventional treatment (ARDSNet strategy). Objective To describe the data management process and statistical analysis plan. Methods The statistical analysis plan was designed by the trial executive committee and reviewed and approved by the trial steering committee. We provide an overview of the trial design with a special focus on describing the primary (28-day survival) and secondary outcomes. We describe our data management process, data monitoring committee, interim analyses, and sample size calculation. We describe our planned statistical analyses for primary and secondary outcomes as well as pre-specified subgroup analyses. We also provide details for presenting results, including mock tables for baseline characteristics, adherence to the protocol and effect on clinical outcomes. Conclusion According to best trial practice, we report our statistical analysis plan and data management plan prior to locking the database and beginning analyses. We anticipate that this document will prevent analysis bias and enhance the utility of the reported results. Trial registration ClinicalTrials.gov number, NCT01374022. PMID:28977255

Quality Assurance Practices in Obstetric Care: A Survey of Hospitals in California.

PubMed

Lundsberg, Lisbet S; Lee, Henry C; Dueñas, Grace Villarin; Gregory, Kimberly D; Grossetta Nardini, Holly K; Pettker, Christian M; Illuzzi, Jessica L; Xu, Xiao

2018-02-01

To assess hospital practices in obstetric quality management activities and identify institutional characteristics associated with utilization of evidence-supported practices. Data for this study came from a statewide survey of obstetric hospitals in California regarding their organization and delivery of perinatal care. We analyzed responses from 185 hospitals that completed quality assurance sections of the survey to assess their practices in a broad spectrum of quality enhancement activities. The association between institutional characteristics and adoption of evidence-supported practices (ie, those supported by prior literature or recommended by professional organizations as beneficial for improving birth outcome or patient safety) was examined using bivariate analysis and appropriate statistical tests. Most hospitals regularly audited adherence to written protocols regarding critical areas of care; however, 77.7% and 16.8% reported not having written guidelines on diagnosis of labor arrest and management of abnormal fetal heart rate, respectively. Private nonprofit hospitals were more likely to have a written protocol for management of abnormal fetal heart rate (P=.002). One in 10 hospitals (9.7%) did not regularly review cases with significant morbidity or mortality, and only 69.0% regularly tracked indications for cesarean delivery. Moreover, 26.3%, 14.3%, and 8.7% of the hospitals reported never performing interprofessional simulations for eclampsia, shoulder dystocia, or postpartum hemorrhage, respectively. Teaching status was associated with more frequent simulations in these three areas (P≤.04 for all), while larger volume was associated with more frequent simulations for eclampsia (P=.04). Hospitals in California engage in a wide range of practices to assure or improve quality of obstetric care, but substantial variation in practice exists among hospitals. There is opportunity for improvement in adoption of evidence-supported practices.

Technology Integration Barriers: Urban School Mathematics Teachers Perspectives

NASA Astrophysics Data System (ADS)

Wachira, Patrick; Keengwe, Jared

2011-02-01

Despite the promise of technology in education, many practicing teachers face several challenges when trying to effectively integrate technology into their classroom instruction. Additionally, while national statistics cite a remarkable improvement in access to computer technology tools in schools, teacher surveys show consistent declines in the use and integration of computer technology to enhance student learning. This article reports on primary technology integration barriers that mathematics teachers identified when using technology in their classrooms. Suggestions to overcome some of these barriers are also provided.

The Characteristics, Experiences and Perceptions of Registered Massage Therapists in New Zealand: Results from a National Survey of Practitioners.

PubMed

Cottingham, Phillip; Adams, Jon; Vempati, Ram; Dunn, Jill; Sibbritt, David

2018-06-01

Massage therapy is widely recognized as offering many health benefits, with a growing number of studies finding it has value in stress management, pain reduction, and overcoming physical limitations. However, there are few studies of massage therapists practices and perceptions in New Zealand and internationally. This paper reports the findings from the first national survey examining the characteristics, perceptions, and experiences of New Zealand-based massage therapists on a range of aspects related to their role and practices. This study sought to ascertain the characteristics, experiences, and perceptions of massage therapists in New Zealand, particularly in the aspects of: integration of health care; attitudes and practices related to research; and evidence and attitudes to registration. Massage practice in New Zealand (nationwide survey). Members of Massage New Zealand (a massage practitioners association). Massage practitioners were surveyed online, using a 65-part questionnaire, on a range of characteristics of their practices and their attitudes to research, integration, and registration. Statistical analysis was performed using STATA. Statistical significance was set at 0.05. Four hundred massage therapists (MTs) were invited to participate and 115 responded, providing a response rate of 29%. MTs valued research (95%) and perceived that it had an impact for their practices (88%). Significant correlations were found for research value and: mean case-load ( p = .009) and level of academic qualification ( p = .004). The majority of MTs (79%) supported integration with conventional practitioners, and 83% referred clients to general practitioners, with 75% receiving referrals from general practitioners. Ninety-three percent of MTs supported registration, with 67% of those supporting statutory registration. Massage practitioners perceive that they make a significant contribution to health care, but area of practice, such as research, and referral and integration into mainstream health care require more in-depth investigation.

Results of Observational Studies: Analysis of Findings from the Nurses’ Health Study

PubMed Central

Tai, Vicky; Grey, Andrew; Bolland, Mark J.

2014-01-01

Background The role of observational studies in informing clinical practice is debated, and high profile examples of discrepancies between the results of observational studies and randomised controlled trials (RCTs) have intensified that debate. We systematically reviewed findings from the Nurses’ Health Study (NHS), one of the longest and largest observational studies, to assess the number and strength of the associations reported and to determine if they have been confirmed in RCTs. Methods We reviewed NHS publication abstracts from 1978–2012, extracted information on associations tested, and graded the strength of the reported effect sizes. We searched PubMed for RCTs or systematic reviews for 3 health outcomes commonly reported in NHS publications: breast cancer, ischaemic heart disease (IHD) and osteoporosis. NHS results were compared with RCT results and deemed concordant when the difference in effect sizes between studies was ≤0.15. Findings 2007 associations between health outcomes and independent variables were reported in 1053 abstracts. 58.0% (1165/2007) were statistically significant, and 22.2% (445/2007) were neutral (no association). Among the statistically significant results that reported a numeric odds ratio (OR) or relative risk (RR), 70.5% (706/1002) reported a weak association (OR/RR 0.5–2.0), 24.5% (246/1002) a moderate association (OR/RR 0.25–0.5 or 2.0–4.0) and 5.0% (50/1002) a strong association (OR/RR ≤0.25 or ≥4.0). 19 associations reported in NHS publications for breast cancer, IHD and osteoporosis have been tested in RCTs, and the concordance between NHS and RCT results was low (≤25%). Conclusions NHS publications contain a large number of analyses, the majority of which reported statistically significant but weak associations. Few of these associations have been tested in RCTs, and where they have, the agreement between NHS results and RCTs is poor. PMID:25330007

Outcomes of a Seven Practice Pilot in a Pay For Performance (P4P)-Based Program in Pennsylvania

PubMed Central

Johnson, Rhonda M.; Johnson, Twyla; Zimmerman, Sarah D.; Marsh, Gary M.; Garcia-Dominic, Oralia

2014-01-01

Objectives To examine how a targeted six-month interventions impacted Best Practice/Patient Outcomes for minority patients receiving primary care in physician practices participating in a pay-for-performance (P4P) program. Methods P4P Practices were invited to participate in a pilot intervention study designed to improve care for minority patients with hypertension, diabetes or pediatric asthma. Patient medical records were reviewed to assess how the interventions impacted (n=7 practices): Body mass index, diet and exercise, smoking, compliance with visits as recommended, blood pressure, sodium intake and weight management counseling, medication reconciliation, HbA1c testing, annual lipid profile, and anti-inflammatory medications. Results Significant improvements in various clinical quality measures were observed in all seven practices. Of the 19 specified interventions, 13 were statistically significant at α=0.05 level and 14 met the target proportion. This suggests that the best practice intervention had a significant impact on some of the health care processes in the physician practices. Conclusions The most impactful interventions were those related to face-to-face educational discussions, patient medical chart documentations rather than those pertaining to medication adherence. Improvements in measuring reporting and recording of data at post-intervention were also observed. PMID:25893158

On Conceptual Analysis as the Primary Qualitative Approach to Statistics Education Research in Psychology

ERIC Educational Resources Information Center

Petocz, Agnes; Newbery, Glenn

2010-01-01

Statistics education in psychology often falls disappointingly short of its goals. The increasing use of qualitative approaches in statistics education research has extended and enriched our understanding of statistical cognition processes, and thus facilitated improvements in statistical education and practices. Yet conceptual analysis, a…

A methodological approach for deriving regional crop rotations as basis for the assessment of the impact of agricultural strategies using soil erosion as example.

PubMed

Lorenz, Marco; Fürst, Christine; Thiel, Enrico

2013-09-01

Regarding increasing pressures by global societal and climate change, the assessment of the impact of land use and land management practices on land degradation and the related decrease in sustainable provision of ecosystem services gains increasing interest. Existing approaches to assess agricultural practices focus on the assessment of single crops or statistical data because spatially explicit information on practically applied crop rotations is mostly not available. This provokes considerable uncertainties in crop production models as regional specifics have to be neglected or cannot be considered in an appropriate way. In a case study in Saxony, we developed an approach to (i) derive representative regional crop rotations by combining different data sources and expert knowledge. This includes the integration of innovative crop sequences related to bio-energy production or organic farming and different soil tillage, soil management and soil protection techniques. Furthermore, (ii) we developed a regionalization approach for transferring crop rotations and related soil management strategies on the basis of statistical data and spatially explicit data taken from so called field blocks. These field blocks are the smallest spatial entity for which agricultural practices must be reported to apply for agricultural funding within the frame of the European Agricultural Fund for Rural Development (EAFRD) program. The information was finally integrated into the spatial decision support tool GISCAME to assess and visualize in spatially explicit manner the impact of alternative agricultural land use strategies on soil erosion risk and ecosystem services provision. Objective of this paper is to present the approach how to create spatially explicit information on agricultural management practices for a study area around Dresden, the capital of the German Federal State Saxony. Copyright © 2013 Elsevier Ltd. All rights reserved.

Interest and satisfaction of dentists in practicing periodontics: A survey based on treatment of gingival recession

PubMed Central

Grover, Vishakha; Kapoor, Anoop; Malhotra, Ranjan; Sachdeva, Sonia

2012-01-01

Background: Gingival recession is a common occurrence and patients often report to dental clinic with associated problems such as root surface hypersensitivity, esthetic concerns, cervical root abrasions, and root caries that make it a concern for patients. Based upon the fact that gingival recession is an enigma for clinicians because of multitude of etiological factors and plethora of treatment modalities present for its treatment, a survey was conducted to assess knowledge as well as opinion about most common etiology, classification, and preferred treatment of gingival recession and to evaluate the interest and satisfaction of dentists in practicing periodontics. Materials and Methods: Study design consisted of a cross-sectional online survey, conducted among dentists practicing in state of Punjab, India, in the month of April 2011. A structured online questionnaire consisting of 17 questions evaluating the interest of dentists in periodontics based on knowledge about gingival recession (most of them giving the possibility of multiple choices of answers) was sent to about 300 dentists. Pearson Chi-Square and Mann-Whitney U tests were used for statistical analysis of data collected. P ≤ 0.05 was considered as statistically significant and P ≤ 0.01 considered as highly significant. Results: A greater proportion of periodontists had better knowledge about etiology (P = 0.07), classification (P = 0.000), and treatment of gingival recession (P = 0.000). A greater number of periodontists opted for the surgical modalities to correct the defects produced by gingival recession as compared to non-periodontists and had better interest (P = 0.000) and satisfaction (P = 0.000) in practicing periodontics. Conclusion: The results elucidated that periodontists had better interest and satisfaction in practicing periodontics, and were more inclined towards surgical correction of gingival recession as compared to non-periodontists. PMID:23162580

Neonatal care - what do mothers in a rural Nigerian community know and practice?

PubMed

Nnebue, C C; Duru, C B; Uwakwe, K A; Ifeadike, C O; Anyanwu, B C; Adinnu, K M; Nwaneri, P O; Ufoh, I J

2016-09-16

Nigeria ranks among developing countries with poor neonatal health indices. This underscores the need for households and healthcare providers to understand the concept of newborn care and react appropriately and timely too. To determine the knowledge and practices of mothers in the Elele community regarding neonatal care. This was a community-based descriptive cross sectional study of 380 mothers who had a neonate. Mothers were selected using a multistage sampling technique. Data were collected by interview using a semi-structured questionnaire (with closed and open ended questions) and analyzed using a statistical package for social sciences version 22.0. Chi-square test was used to identify statistically significant associations among antenatal care clinic (ANC) attendance cum place of delivery and neonatal care practices. Ninety one (23.9%) of respondents were aware of at least four out of nine danger signs, while all reported wrapping their babies within 10 minutes after birth. Duration less than six hours from birth to first bath, feeding with or discarding of colostrum and timing of first breastfeeding within the first hour of birth were significantly associated with ANC attendance (p = 0.000, p = 0.002 and p = 0.000 respectively). Duration less than six hours to first bath, umbilical cord care and feeding with or discarding of colostrum were significantly associated with health facility delivery (p = 0.043, p = 0.026 and p = 0.003 respectively). Inadequate knowledge of newborn care among mothers was found, while non-ANC attendance and non-health facility delivery were associated with inappropriate neonatal care practices. We recommend comprehensive behavior change interventions, to promote proper neonatal care practices.

Interest and satisfaction of dentists in practicing periodontics: A survey based on treatment of gingival recession.

PubMed

Grover, Vishakha; Kapoor, Anoop; Malhotra, Ranjan; Sachdeva, Sonia

2012-07-01

Gingival recession is a common occurrence and patients often report to dental clinic with associated problems such as root surface hypersensitivity, esthetic concerns, cervical root abrasions, and root caries that make it a concern for patients. Based upon the fact that gingival recession is an enigma for clinicians because of multitude of etiological factors and plethora of treatment modalities present for its treatment, a survey was conducted to assess knowledge as well as opinion about most common etiology, classification, and preferred treatment of gingival recession and to evaluate the interest and satisfaction of dentists in practicing periodontics. Study design consisted of a cross-sectional online survey, conducted among dentists practicing in state of Punjab, India, in the month of April 2011. A structured online questionnaire consisting of 17 questions evaluating the interest of dentists in periodontics based on knowledge about gingival recession (most of them giving the possibility of multiple choices of answers) was sent to about 300 dentists. Pearson Chi-Square and Mann-Whitney U tests were used for statistical analysis of data collected. P ≤ 0.05 was considered as statistically significant and P ≤ 0.01 considered as highly significant. A greater proportion of periodontists had better knowledge about etiology (P = 0.07), classification (P = 0.000), and treatment of gingival recession (P = 0.000). A greater number of periodontists opted for the surgical modalities to correct the defects produced by gingival recession as compared to non-periodontists and had better interest (P = 0.000) and satisfaction (P = 0.000) in practicing periodontics. The results elucidated that periodontists had better interest and satisfaction in practicing periodontics, and were more inclined towards surgical correction of gingival recession as compared to non-periodontists.

Use of the Combined First-Trimester Screen in High- and Low-Risk Patient Populations After Introduction of Noninvasive Prenatal Testing.

PubMed

Larion, Sebastian; Warsof, Steven L; Romary, Letty; Mlynarczyk, Margaret; Peleg, David; Abuhamad, Alfred Z

2015-08-01

To report changes in the use of the combined first-trimester screen (FTS) in patients classified as high and low risk for fetal aneuploidy, including after introduction of noninvasive prenatal testing (NIPT). A prospectively collected database was reviewed to investigate changes in FTS use before and after American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 77 (Obstet Gynecol 2007; 109:217-227), which recommended that all patients be offered aneuploidy screening, and after NIPT introduction. High-risk patients were classified as 35 years or older at the estimated time of delivery or those with an abnormal prior screen, abnormal ultrasound findings, or family history of aneuploidy. Data were normalized per 100 morphologic ultrasound examinations to account for changes in patient number over time. Statistical significance was defined as P < .05. A total of 10,125 FTSs were recorded during the 88-month study period, including 2962 in high-risk patients and 7163 in low-risk patients. The total number of FTSs performed per 100 morphologic ultrasound examinations significantly increased after ACOG Practice Bulletin No. 77 and significantly decreased after NIPT introduction. In high-risk patients, the total number of FTSs performed per 100 morphologic ultrasound examinations significantly increased after ACOG Practice Bulletin No. 77 but significantly decreased after NIPT introduction. In contrast, in low-risk patients, the total number of FTSs performed per 100 morphologic ultrasound examinations significantly increased after ACOG Practice Bulletin No.77 but was not statistically different after NIPT introduction. American College of Obstetricians and Gynecologists Practice Bulletin No. 77 significantly increased patient use of FTS. The introduction of NIPT significantly decreased FTS use in the high-risk population but not in the low-risk population. © 2015 by the American Institute of Ultrasound in Medicine.

A synthesis of Vroom's model with other social theories: an application to nursing education.

PubMed

Gyurko, Charlene C

2011-07-01

In 2009, the National League for Nursing reported that there are over 3.4 million persons in the United States employed in nursing in the roles of Registered Nurses (RNs) and Advanced Practice Nurses (APRNs). In 2007, the Bureau of Labor Statistics also reported that in 2006, there were over 749,000 Licensed Practical Nurses (LPNs) working in the United States with a projected increase of 14% by 2016. Buerhaus et al, in 2009, stated that between 2016 and 2025, it is estimated that the U.S. will need over 260,000 registered nurses (RNs) Using the conceptual framework of Vroom's expectancy theory on motivation as well as theories addressing student and career development, this paper demonstrates a synthesis of Vroom's model with other educational theories and its application to nursing education, specifically the prediction of motivation to advance one's nursing education. By putting Vroom's theory into a context, Vroom's fairly simple model could help nurse educators predict the factors that make for success in midcareer educational advancement--and even possibly manipulate those factors to increase that success. In today's economy, that practical part seems too good to lose. Copyright © 2010 Elsevier Ltd. All rights reserved.

Latent profiles of elite Malaysian athletes' use of psychological skills and techniques and relations with mental toughness.

PubMed

Ponnusamy, Vellapandian; Lines, Robin L J; Zhang, Chun-Qing; Gucciardi, Daniel F

2018-01-01

The majority of past work on athletes' use of psychological skills and techniques (PSTs) has adopted a variable-centered approach in which the statistical relations among study variables are averaged across a sample. However, variable-centered-analyses exclude the possibility that PSTs may be used in tandem or combined in different ways across practice and competition settings. With this empirical gap in mind, the purposes of this study were to identify the number and type of profiles of elite athletes' use of PSTs, and examine differences between these clusters in terms of their self-reported mental toughness. In this cross-sectional survey study, 285 Malaysian elite athletes (170 males, 115 females) aged 15-44 years ( M = 18.89, SD = 4.49) completed measures of various PSTs and mental toughness. Latent profile analysis was employed to determine the type and number of profiles that best represent athletes' reports of their use of PSTs in practice and competition settings, and examine differences between these classes in terms of self-reported mental toughness. Our results revealed three profiles (low, moderate, high use) in both practice and competition settings that were distinguished primarily according to quantitative differences in the absolute levels of reported use across most of the PSTs assessed in practice and competition settings, which in turn, were differentially related with mental toughness. Specifically, higher use of PSTs was associated with higher levels of mental toughness. This study provides one of the first analyses of the different configurations of athletes' use of PSTs that typify unique subgroups of performers. An important next step is to examine the longitudinal (in) stability of such classes and therefore provide insight into the temporal dynamics of different configurations of athletes' use of PSTs.

Latent profiles of elite Malaysian athletes’ use of psychological skills and techniques and relations with mental toughness

PubMed Central

Lines, Robin L.J.

2018-01-01

Background The majority of past work on athletes’ use of psychological skills and techniques (PSTs) has adopted a variable-centered approach in which the statistical relations among study variables are averaged across a sample. However, variable-centered-analyses exclude the possibility that PSTs may be used in tandem or combined in different ways across practice and competition settings. With this empirical gap in mind, the purposes of this study were to identify the number and type of profiles of elite athletes’ use of PSTs, and examine differences between these clusters in terms of their self-reported mental toughness. Methods In this cross-sectional survey study, 285 Malaysian elite athletes (170 males, 115 females) aged 15–44 years (M = 18.89, SD = 4.49) completed measures of various PSTs and mental toughness. Latent profile analysis was employed to determine the type and number of profiles that best represent athletes’ reports of their use of PSTs in practice and competition settings, and examine differences between these classes in terms of self-reported mental toughness. Results Our results revealed three profiles (low, moderate, high use) in both practice and competition settings that were distinguished primarily according to quantitative differences in the absolute levels of reported use across most of the PSTs assessed in practice and competition settings, which in turn, were differentially related with mental toughness. Specifically, higher use of PSTs was associated with higher levels of mental toughness. Conclusion This study provides one of the first analyses of the different configurations of athletes’ use of PSTs that typify unique subgroups of performers. An important next step is to examine the longitudinal (in) stability of such classes and therefore provide insight into the temporal dynamics of different configurations of athletes’ use of PSTs. PMID:29780672

Common pitfalls in statistical analysis: Clinical versus statistical significance

PubMed Central

Ranganathan, Priya; Pramesh, C. S.; Buyse, Marc

2015-01-01

In clinical research, study results, which are statistically significant are often interpreted as being clinically important. While statistical significance indicates the reliability of the study results, clinical significance reflects its impact on clinical practice. The third article in this series exploring pitfalls in statistical analysis clarifies the importance of differentiating between statistical significance and clinical significance. PMID:26229754

National Association of Psychometrists: 2015 professional practices and salary survey of U.S. and Canadian psychometrists.

PubMed

Kippie, Amber; Ryan, Brittany J; McManemy, Heather; Escobar Medina, Maria R; Porter, Pamela M; Malek-Ahmadi, Michael

2018-05-11

The National Association of Psychometrists (NAP) conducted a salary survey to collect data regarding common practices and income of individuals employed as psychometrists. An email with a survey link was sent to NAP members and posted on the NAP website. There were 118 responses; most from the United States. Canadian data was excluded from compensation analysis due to imprecision in the survey/exchange rates. Most respondents reported full time employment. Respondents' educations were equally split between bachelor's and master's degrees. More than half reported hourly compensation. Most psychometrists see one patient a day and the most frequent age range was adults between 17-59 years old. Administration times ranged from 3-5 h, except in young pediatric populations. Two hours was the most commonly reported amount of time needed to score a test battery. The average hourly wage was $23.00 ± 4.96. Certified psychometrists reported higher average hourly wages (M = 24.57, SD = 4.73) compared to those who are not certified (M = 21.53, SD = 4.76). This difference was statistically significant (p < .001) with a medium effect size (d = .64). Results of the survey also showed a significant increase in income based on years of experience as a psychometrist. The current survey may be used as a baseline for further study of the income and practices of psychometrists in the United States and Canada.

An iPhone Application Intervention to Promote Surveillance Among Women with a BRCA Mutation: Pre-intervention Data.

PubMed

Cohen, Stephanie A; Scherr, Courtney Lynam; Nixon, Dawn M

2018-04-01

Women with BRCA mutations, at significantly increased risk for breast and ovarian cancer, do not consistently adhere to management guidelines due to lack of awareness and challenges tracking appointments. We developed an iPhone application (app) to help BRCA carriers manage their surveillance. We explored baseline awareness and adherence to surveillance guidelines and analytic data from 21 months of app use. Descriptive statistics were calculated on responses (N = 86) to a survey about surveillance awareness and practices. The majority were aware of breast surveillance guidelines, but only one third were aware of ovarian surveillance guidelines. In practice, the majority reported a clinical breast exam within 6 months, just over half reported a mammogram and breast MRI in the last year, and under half reported ovarian surveillance in the last year. Nearly 50% reported difficulty remembering appointments. Although only 69 received access codes, 284 unique users attempted to enter the app, which was visible in the iTunes store but only available to those with a study code. Evaluation of analytic data demonstrated user engagement with study participants accessing the app 427 times over the 21-month time period (range 2-57; mean = 6.28). Results indicate participants were more likely to know screening guidelines than practice them. There was interest in the app and users were engaged, suggesting app value. We will send a follow-up survey after 18 months of app use for additional evaluation and feedback.

Modelling multiple sources of dissemination bias in meta-analysis.

PubMed

Bowden, Jack; Jackson, Dan; Thompson, Simon G

2010-03-30

Asymmetry in the funnel plot for a meta-analysis suggests the presence of dissemination bias. This may be caused by publication bias through the decisions of journal editors, by selective reporting of research results by authors or by a combination of both. Typically, study results that are statistically significant or have larger estimated effect sizes are more likely to appear in the published literature, hence giving a biased picture of the evidence-base. Previous statistical approaches for addressing dissemination bias have assumed only a single selection mechanism. Here we consider a more realistic scenario in which multiple dissemination processes, involving both the publishing authors and journals, are operating. In practical applications, the methods can be used to provide sensitivity analyses for the potential effects of multiple dissemination biases operating in meta-analysis.

Fundamentals of Counting Statistics in Digital PCR: I Just Measured Two Target Copies-What Does It Mean?

PubMed

Tzonev, Svilen

2018-01-01

Current commercially available digital PCR (dPCR) systems and assays are capable of detecting individual target molecules with considerable reliability. As tests are developed and validated for use on clinical samples, the need to understand and develop robust statistical analysis routines increases. This chapter covers the fundamental processes and limitations of detecting and reporting on single molecule detection. We cover the basics of quantification of targets and sources of imprecision. We describe the basic test concepts: sensitivity, specificity, limit of blank, limit of detection, and limit of quantification in the context of dPCR. We provide basic guidelines how to determine those, how to choose and interpret the operating point, and what factors may influence overall test performance in practice.

On fitting generalized linear mixed-effects models for binary responses using different statistical packages.

PubMed

Zhang, Hui; Lu, Naiji; Feng, Changyong; Thurston, Sally W; Xia, Yinglin; Zhu, Liang; Tu, Xin M

2011-09-10

The generalized linear mixed-effects model (GLMM) is a popular paradigm to extend models for cross-sectional data to a longitudinal setting. When applied to modeling binary responses, different software packages and even different procedures within a package may give quite different results. In this report, we describe the statistical approaches that underlie these different procedures and discuss their strengths and weaknesses when applied to fit correlated binary responses. We then illustrate these considerations by applying these procedures implemented in some popular software packages to simulated and real study data. Our simulation results indicate a lack of reliability for most of the procedures considered, which carries significant implications for applying such popular software packages in practice. Copyright © 2011 John Wiley & Sons, Ltd.

State laws related to billing third parties for healthcare services at public STD clinics in the United States.

PubMed

Cramer, Ryan; Loosier, Penny S; Krasner, Andee; Kawatu, Jennifer

2018-02-07

Health departments (HDs) cite state laws as barriers to billing third parties for sexually transmitted disease (STD) services, but the association between legal/policy barriers and third party HD billing has not been examined. This study investigates the relationship between laws that may limit HDs' ability to bill, clinic perceptions of billing barriers, and billing practices. Two surveys (1) clinic managers [N=246], 2) STD program managers [N=63]) conducted via a multi-regional needs assessment of federally funded HD clinics' capacity to bill for STD services, billing/reimbursement practices, and perceived barriers were combined with an analysis of state laws regarding third party billing for STD services. Statistical analyses examined relationships between laws that may limit HDs' ability to bill, clinic perceptions, and billing practices. Clinic managers reported clinics were less likely to bill Medicaid and other third parties in jurisdictions with a state law limiting their ability to bill compared to respondents who billed neither or one payer (OR=0.31, CI=0.10,0.97) and cited practical concerns as a primary barrier to billing (OR=2.83 CI=1.50,5.37). STD program managers' reports that staff believed STD services should be free (OR=0.34, CI=0.13, 0.90) was associated with not billing (not sure versus no resistance to billing); confidentiality concerns was not a reported barrier to billing among either sample. Practical concerns and clinic staff beliefs that STD services should be free emerged as possible barriers to billing, and laws less so. Attempts to initiate HD billing for STD services may benefit from staff education as well as addressing perceived legal barriers and staff concerns.

Coupling Changing Student Demographics with Evidence-Based Leadership Practices: Leading Hispanic Friendly Learning Organizations

ERIC Educational Resources Information Center

Farmer, Tod Allen

2012-01-01

The study assessed the need for learning organizations to implement evidence-based policies and practices designed to enhance the academic and social success of Hispanic learners. Descriptive statistics and longitudinal data from the National Center for Educational Statistics (NCES) and the National Clearinghouse for English Language Acquisition…

Information Distribution Practices of Federal Statistical Agencies: The Census Bureau Example.

ERIC Educational Resources Information Center

Gey, Frederick C.

1993-01-01

Describes the current and historical distribution channels of the U.S. Bureau of the Census within a framework of distribution policies and practices for federal statistical information. The issues of reasonable distribution policies and the impact of technological change are discussed, and guidelines are offered. (Contains 26 references.) (EAM)

Variable approaches to genetic counseling for microarray regions of homozygosity associated with parental relatedness.

PubMed

Grote, Lauren; Myers, Melanie; Lovell, Anne; Saal, Howard; Sund, Kristen Lipscomb

2014-01-01

SNP microarrays are capable of detecting regions of homozygosity (ROH) which can suggest parental relatedness. This study was designed to describe pre- and post-test counseling practices of genetics professionals regarding ROH, explore perceived comfort and ethical concerns in the follow-up of such results, demonstrate awareness of laws surrounding duty to report consanguinity and incest, and allow respondents to share their personal experiences with results suggesting a parental relationship. A 35 question survey was administered to 240 genetic counselors and geneticists who had ordered or counseled for SNP microarray. The results are presented using descriptive statistics. There was variation in both pre- and post-test counseling practices of genetics professionals. Twenty-five percent of respondents reported pre-test counseling that ROH can indicate parental relatedness. The most commonly reported ethical concern was disclosure of findings suggesting parental relatedness to parents of the patient; only 48.4% reported disclosing parental relatedness when indicated. Fifty-seven percent felt comfortable receiving results suggesting parental consanguinity while 17% felt comfortable receiving results suggesting parental incest. Twenty percent of respondents were extremely/moderately familiar with the laws about duty to report incest. Personal experiences in post-test counseling included both parental acknowledgement and denial of relatedness. This study highlights the differences in genetics professionals' pre- and post-test counseling practices, comfort, and experiences surrounding parental relatedness suggested by SNP microarray results. It identifies a need for professional organizations to offer guidance to genetics professionals about how to respond to and counsel for molecular results suggesting parental consanguinity or incest. © 2013 Wiley Periodicals, Inc.

Commercial gaming devices for stroke upper limb rehabilitation: a survey of current practice.

PubMed

Thomson, Katie; Pollock, Alex; Bugge, Carol; Brady, Marian C

2016-08-01

Stroke upper limb impairment is associated with disability in activities of daily living. Gaming (Nintendo Wii) is being introduced to rehabilitation despite limited evidence regarding effectiveness. Little data exists on how gaming is implemented resulting in a lack of clinical information. We aimed to gather therapists' opinions on gaming. A survey was posted to therapists, identified from stroke services across Scotland. A second survey was posted to non-responders. Survey data were analysed using descriptive statistics and thematic coding. Surveys were sent to 127 therapists (70 stroke services) and returned by 88% (112/127). Gaming was used by 18% of therapists, 61% (68/112) stated they would use this intervention should equipment be available. The most commonly used device was Nintendo Wii (83% of therapists using gaming) for 30 min or less once or twice per week. Half of therapists (51%) reported observing at least one adverse event, such as fatigue, stiffness or pain. Gaming was reported to be enjoyable but therapists described barriers, which relate to time, space and cost. Gaming is used by almost a fifth of therapists. Adverse events were reported by 51% of therapists; this should be considered when recommending use and dosage. Implications for Rehabilitation Commercial gaming devices are reported to be used by 1/5th of therapists for stroke upper limb rehabilitation, 3/5ths would use gaming if available. Adverse events were reported by 51% of therapists; this should be considered when recommending use and dosage. Current use of gaming in practice may not be achieving intense and repetitive upper limb task-specific practice.

Comparison of food safety cognitions and self-reported food-handling behaviors with observed food safety behaviors of young adults.

PubMed

Abbot, J M; Byrd-Bredbenner, C; Schaffner, D; Bruhn, C M; Blalock, L

2009-04-01

Developing tailored and effective food safety education for young adults is critical given their future roles as caregivers likely to be preparing food for populations who may be at greater risk for foodborne disease (FBD). The objective of this study was to examine the relationship between food safety self-reported food-handling behaviors and cognitions of young adults to observed food-handling behaviors. Participants were 153 young adults (mean age 20.74+/-1.30 s.d.) attending a major American university. Each prepared a meal under observation in a controlled laboratory setting, permitted researchers to observe their home kitchen and completed an online survey assessing food safety knowledge, behavior and psychosocial measures. Descriptive statistics were generated for participants' self-reported food-handling behaviors, psychosocial characteristics, knowledge, food preparation observations and home kitchen observations. Determinants of compliance with safe food-handling procedures while preparing a meal and home food storage/rotation practices were identified using backward regression models. Participants engaged in less than half of the recommended safe food-handling practices evaluated and correctly answered only two-thirds of the food safety knowledge items. They reported positive food safety beliefs and high food safety self-efficacy. Self-reported compliance with cross-contamination prevention, disinfection procedures and knowledge of groups at greatest risk for FBD were the best measures for predicting compliance with established safe food-handling practices. Food safety education directed toward young adults should focus on increasing awareness of FBD and knowledge of proper cross-contamination prevention procedures to help promote better compliance with actual safe food handling.

Dosage Parameters in Pediatric Outcome Studies Reported in 9 Peer-Reviewed Occupational Therapy Journals from 2008 to 2014: A Content Analysis

PubMed Central

Gee, Bryan M.; Lloyd, Kimberly; Devine, Nancy; Tyrrell, Erin; Evans, Trisha; Hill, Rebekah; Dineen, Stacee; Magalogo, Kristin

2016-01-01

Occupational therapists determine the dosage when establishing the plan of care for their pediatric clients. A content analysis was conducted using 123 pediatric occupational therapy outcomes studies from 9 scholarly international occupational therapy journals. The parameters of dosage were calculated using descriptive statistics in order to obtain a representation of dosage available within the current collage of pediatric occupational therapy outcomes studies. The results revealed that most studies reported portions of dosage parameters within the published studies. The average findings for the subcomponents related to dosage were session length (minutes) M = 58.7, duration of plan of care (weeks) M = 12.1, session frequency (per week) M = 3.4, and total hours of therapy (hours) M = 18.1. This first attempt at describing and calculating dosage related to pediatric occupational therapy practice indicates that evidence is lacking within the published literature to adequately guide OT dosage decisions. Further research related to dosage in pediatric occupational therapy practice is needed. PMID:26949547

Tic-related school problems: impact on functioning, accommodations, and interventions.

PubMed

Packer, Leslie E

2005-11-01

Children with Tourette's syndrome (TS) are statistically overrepresented in special education classes; however, the extent to which tics contribute to such placement is unclear. In this article, the results of a survey of parents or guardians of 71 children and adolescents with TS are described within the broader context of discussing the impact of tics and educational practices. One half of the respondents reported moderate to significant tic-related academic impact, and 48% reported moderate to significant tic-related peer problems. Peer education and in-school counseling were generally not offered nor provided. In the minority of cases where behavioral interventions for tics were reported, contingent aversive consequences were reported to be ineffective or counterproductive, while positive reinforcement for modifying tics reportedly produced some successful results. The identification of research-validated academic accommodations and increased involvement of school psychologists are suggested as necessary and potentially helpful supports for students with TS and their teachers.

Boric acid for recurrent vulvovaginal candidiasis: the clinical evidence.

PubMed

Iavazzo, Christos; Gkegkes, Ioannis D; Zarkada, Ioanna M; Falagas, Matthew E

2011-08-01

Recurrent vulvovaginal candidiasis (VVC) remains a challenge to manage in clinical practice. Recent epidemiologic studies indicate that non-albicans Candida spp. are more resistant to conventional antifungal treatment with azoles and are considered as causative pathogens of vulvovaginal candidiasis. We searched PubMed and Scopus for studies that reported clinical evidence on the intravaginal use of boric acid for vulvovaginal candidiasis. We identified 14 studies (2 randomized clinical trials [RCTs], 9 case series, and 4 case reports) as eligible for inclusion in this review. Boric acid was compared with nystatin, terconazole, flucytosine, itraconazole, clotrimazole, ketoconazole, fluconazole, buconazole, and miconazole; as monotherapy, boric acid was studied in 7 studies. The mycologic cure rates varied from 40% to 100% in patients treated with boric acid; 4 of the 9 included case series reported statistically significant outcomes regarding cure (both mycologic and clinical) rates. None of the included studies reported statistically significant differences in recurrence rates. Regarding the adverse effects caused by boric acid use, vaginal burning sensation (<10% of cases), water discharge during treatment, and vaginal erythema were identified in 7 studies. Our findings suggest that boric acid is a safe, alternative, economic option for women with recurrent and chronic symptoms of vaginitis when conventional treatment fails because of the involvement of non-albicans Candida spp. or azole-resistant strains.

Impact of advanced laparoscopy courses on present surgical practice.

PubMed

Houck, Jared; Kopietz, Courtni M; Shah, Bhavin C; Goede, Matthew R; McBride, Corrigan L; Oleynikov, Dmitry

2013-01-01

The introduction of new surgical techniques has made training in laparoscopic procedures a necessity for the practicing surgeon, but acquisition of new surgical skills is a formidable task. This study was conducted to assess the impact of advanced laparoscopic workshops on caseload patterns of practicing surgeons. After we obtained institutional review board approval, a survey of practicing surgeons who participated in advanced laparoscopic courses was distributed; the results were analyzed for statistical significance. The courses were held at the University of Nebraska Medical Center between January 2002 and December 2010. Questionnaires were mailed, faxed, and e-mailed to surgeons. Of the 109 surgeons who participated in the advanced laparoscopy courses, 79 received surveys and 30 were excluded from the survey because of their affiliation with the University of Nebraska Medical Center. A total of 47 responses (59%) were received from 41 male and 6 female surgeons. The median response time from completion of the course to completion of the survey was 13.2 months (range, 6.8-19.1 months). The mean age of participating surgeons was 39.2 years (range, 29-51 years). The mean time since residency was 8.4 years (range, 0.8-21 years). Eleven surgeons had completed a minimal number of laparoscopic cases in residency (<50), 17 surgeons had completed a moderate number of laparoscopic procedures in residency (50-200), and 21 surgeons had completed a significant number of cases during residency (>200). Of the surgeons who responded, 94% were in private practice. Fifty-seven percent of the participating surgeons who responded reported a change in laparoscopic practice patterns after the courses. Of these surgeons, 24% had a limited residency laparoscopy exposure of <50 cases. Surgeons who were exposed to ≥50 laparoscopic cases during their residency showed a statistically significant increase in the number of laparoscopic procedures performed after their class compared with surgeons who did not receive ≥50 laparoscopic cases in residency (P = .03). In addition, regardless of the procedures learned in a specific class, surgeons with ≥50 laparoscopic cases in residency had a statistically significant increase in their laparoscopic colectomy and laparoscopic hernia procedure caseload (P < .01). However, there was no statistically significant difference in laparoscopic caseload between surgeons who had completed 50 to 200 laparoscopic residency cases and those who had completed greater than 200 laparoscopic residency cases (P = .31). Furthermore, the participant's age (P = .23), practice type (P = .61), and years in practice (P = .22) had no statistical significance with regard to the adoption of laparoscopic procedures after courses taken. This finding is congruent with the findings of other researchers. Future interest in advanced laparoscopy courses was noted in 70% of surgeons and was more pronounced in surgeons with ≥50 cases in residency. Advanced laparoscopic workshops provide an efficacious instrument in educating surgeons on minimally invasive surgical techniques. Participating surgeons significantly increased the number of course-specific procedures that they performed but also increased the number of other laparoscopic surgeries, suggesting that a certain proficiency in laparoscopic skills is translated to multiple surgical procedures. Laparoscopy experience of ≥50 cases during residency is a strong predictor of an increase in the number of advanced laparoscopic cases after attending courses.

Twice random, once mixed: applying mixed models to simultaneously analyze random effects of language and participants.

PubMed

Janssen, Dirk P

2012-03-01

Psychologists, psycholinguists, and other researchers using language stimuli have been struggling for more than 30 years with the problem of how to analyze experimental data that contain two crossed random effects (items and participants). The classical analysis of variance does not apply; alternatives have been proposed but have failed to catch on, and a statistically unsatisfactory procedure of using two approximations (known as F(1) and F(2)) has become the standard. A simple and elegant solution using mixed model analysis has been available for 15 years, and recent improvements in statistical software have made mixed models analysis widely available. The aim of this article is to increase the use of mixed models by giving a concise practical introduction and by giving clear directions for undertaking the analysis in the most popular statistical packages. The article also introduces the DJMIXED: add-on package for SPSS, which makes entering the models and reporting their results as straightforward as possible.

Vaginal douching practice: Frequency, associated factors and relationship with vulvovaginal symptoms.

PubMed

Yanikkerem, Emre; Yasayan, Aysegul

2016-04-01

To determine the frequency, associated factors and relationship with vulvovaginal symptoms and vaginal douching among Turkish women. The cross-sectional, analytical study was conducted at Merkez Efendi Hospital, Manisa, Turkey, from January to June 2014 using a questionnaire. Statistical analysis was carried out using SPSS 17. Of the total 343 women in the study, 91(26.5%) had reported vaginal douching in the preceding year. Statistically significant relationship was determined between the vaginal douching behaviour and couples who had low educationand low income levels, having unplanned pregnancy and had someone in their neighbourhood who douched (p< 0.05 each). The most common reason for using vaginal douching was reported to be cleanliness by 85(93.4%) women, prevention of genital infections 75(82.4%), cleaning after/before sexual intercourse 72(79%), during menstruation 49(54%), prevention of vaginal discharge 69(76%), decreasing of unpleasant odours 65(71.4%) and religious beliefs 46(50.5%). Self-reported history of vaginal infection was significantly more common for women who douched compared those who did not (p< 0.05). Healthcare providers should determine the reason and risky groups of women and educate the women to stop the vaginal douching behaviour and harmful effects of vaginal douching.

Examining the Environmental Effects of Athletic Training: Perceptions of Waste and the Use of Green Techniques.

PubMed

Potteiger, Kelly; Pitney, William A; Cappaert, Thomas A; Wolfe, Angela

2017-12-01

  Environmental sustainability is a critical concern in health care. Similar to other professions, the practice of athletic training necessitates the use of a large quantity of natural and manufactured resources.   To examine the perceptions of the waste produced by the practice of athletic training and the green practices currently used by athletic trainers (ATs) to combat this waste.   Mixed-methods study.   Field setting.   A total of 442 ATs completed the study. Sixteen individuals participated in the qualitative portion.   Data from sections 2 and 3 of the Athletic Training Environmental Impact Survey were analyzed. Focus groups and individual interviews were used to determine participants' views of waste and the efforts used to combat waste. Descriptive statistics were used to examine types of waste. Independent t tests, χ 2 tests, and 1-way analyses of variance were calculated to identify any differences between the knowledge and use of green techniques. Interviews and focus groups were transcribed verbatim and analyzed inductively.   Participants reported moderate knowledge of green techniques (3.18 ± 0.53 on a 5-point Likert scale). Fifty-eight percent (n = 260) of survey participants perceived that a substantial amount of waste was produced by the practice of athletic training. Ninety-two percent (n = 408) admitted they thought about the waste produced in their daily practice. The types of waste reported most frequently were plastics (n = 111, 29%), water (n = 88, 23%), and paper for administrative use (n = 81, 21%). Fifty-two percent (n = 234) agreed this waste directly affected the environment. The qualitative aspect of the study reinforced recognition of the large amount of waste produced by the practice of athletic training. Types of conservation practices used by ATs were also explored.   Participants reported concern regarding the waste produced by athletic training. The amount of waste varies depending on practice size and setting. Future researchers should use direct measures to determine the amount of waste created by the practice of athletic training.

Prediction during statistical learning, and implications for the implicit/explicit divide

PubMed Central

Dale, Rick; Duran, Nicholas D.; Morehead, J. Ryan

2012-01-01

Accounts of statistical learning, both implicit and explicit, often invoke predictive processes as central to learning, yet practically all experiments employ non-predictive measures during training. We argue that the common theoretical assumption of anticipation and prediction needs clearer, more direct evidence for it during learning. We offer a novel experimental context to explore prediction, and report results from a simple sequential learning task designed to promote predictive behaviors in participants as they responded to a short sequence of simple stimulus events. Predictive tendencies in participants were measured using their computer mouse, the trajectories of which served as a means of tapping into predictive behavior while participants were exposed to very short and simple sequences of events. A total of 143 participants were randomly assigned to stimulus sequences along a continuum of regularity. Analysis of computer-mouse trajectories revealed that (a) participants almost always anticipate events in some manner, (b) participants exhibit two stable patterns of behavior, either reacting to vs. predicting future events, (c) the extent to which participants predict relates to performance on a recall test, and (d) explicit reports of perceiving patterns in the brief sequence correlates with extent of prediction. We end with a discussion of implicit and explicit statistical learning and of the role prediction may play in both kinds of learning. PMID:22723817

An Overview of Interrater Agreement on Likert Scales for Researchers and Practitioners

PubMed Central

O'Neill, Thomas A.

2017-01-01

Applications of interrater agreement (IRA) statistics for Likert scales are plentiful in research and practice. IRA may be implicated in job analysis, performance appraisal, panel interviews, and any other approach to gathering systematic observations. Any rating system involving subject-matter experts can also benefit from IRA as a measure of consensus. Further, IRA is fundamental to aggregation in multilevel research, which is becoming increasingly common in order to address nesting. Although, several technical descriptions of a few specific IRA statistics exist, this paper aims to provide a tractable orientation to common IRA indices to support application. The introductory overview is written with the intent of facilitating contrasts among IRA statistics by critically reviewing equations, interpretations, strengths, and weaknesses. Statistics considered include rwg, rwg*, r′wg, rwg(p), average deviation (AD), awg, standard deviation (Swg), and the coefficient of variation (CVwg). Equations support quick calculation and contrasting of different agreement indices. The article also includes a “quick reference” table and three figures in order to help readers identify how IRA statistics differ and how interpretations of IRA will depend strongly on the statistic employed. A brief consideration of recommended practices involving statistical and practical cutoff standards is presented, and conclusions are offered in light of the current literature. PMID:28553257

A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation.

PubMed

Sand-Jecklin, Kari; Sherman, Jay

2014-10-01

To quantify quantitative outcomes of a practice change to a blended form of bedside nursing report. The literature identifies several benefits of bedside nursing shift report. However, published studies have not adequately quantified outcomes related to this process change, having either small or unreported sample sizes or not testing for statistical significance. Quasi-experimental pre- and postimplementation design. Seven medical-surgical units in a large university hospital implemented a blend of recorded and bedside nursing report. Outcomes monitored included patient and nursing satisfaction, patient falls, nursing overtime and medication errors. We found statistically significant improvements postimplementation in four patient survey items specifically impacted by the change to bedside report. Nursing perceptions of report were significantly improved in the areas of patient safety and involvement in care and nurse accountability postimplementation. However, there was a decline in nurse perception that report took a reasonable amount of time after bedside report implementation; contrary to these perceptions, there was no significant increase in nurse overtime. Patient falls at shift change decreased substantially after the implementation of bedside report. An intervening variable during the study period invalidated the comparison of medication errors pre- and postintervention. There was some indication from both patients and nurses that bedside report was not always consistently implemented. Several positive outcomes were documented in relation to the implementation of a blended bedside shift report, with few drawbacks. Nurse attitudes about report at the final data collection were more positive than at the initial postimplementation data collection. If properly implemented, nursing bedside report can result in improved patient and nursing satisfaction and patient safety outcomes. However, managers should involve staff nurses in the implementation process and continue to monitor consistency in report format as well as satisfaction with the process. © 2014 John Wiley & Sons Ltd.

Use of complementary and alternative medicine by patients with hematological diseases experience at a university hospital in northeast Mexico.

PubMed

Jaime-Pérez, José Carlos; Chapa-Rodríguez, Adrián; Rodríguez-Martínez, Marisol; Colunga-Pedraza, Perla Rocío; Marfil-Rivera, Luis Javier; Gómez-Almaguer, David

2012-01-01

Complementary and alternative medicine includes a diverse group of medical and healthcare systems, practices and products not considered part of conventional medicine. Although there is information on unconventional practices in oncological diseases, specific data regarding the use of complementary and alternative medicine by hematology patients is scarce. The aim of this study is to document the prevalence of this modality of unconventional therapy in patients with malignant and benign hematological diseases, particularly children with acute lymphoblastic leukemia. An observational study of adult patients and guardians of children with malignant or benign hematological diseases was carried out by applying a structured questionnaire detailing the use and results of the most prevalent complementary and alternative medicine practices. One hundred and twenty patients were included; 104 had malignant and 16 had benign hematological diseases. The use of complementary and alternative medicine was greater in benign diseases but the difference was not statistically significant (64.7% versus 41.7%; p-value = 0.08). Patients and guardians with high school or college educations used these alternative practices more than patients with less schooling (60.7% versus 54.7%; p-value = 0.032). The use of folk remedies was most prevalent followed by herbal preparations and spiritual healing. Sixty-four percent of patients that used these unconventional practices reported improvement in their symptoms and increased capacity to perform daily activities. No significant difference was documented between patients with malignant or benign hematological diseases using these alternative practices. The majority of complementary and alternative medicine users reported improvement of the disease or chemotherapy-related symptoms.

Financial management practices and attitudes of dental hygienists: a descriptive study.

PubMed

Russell, Katherine; Stramoski, Sandra

2011-01-01

The purpose of this study was to determine the financial management goals and practices of registered dental hygienists, their satisfaction with their current financial situations and their attitudes about savings, investments and retirement. A 40 question electronic survey was completed by 388 registered dental hygienists. The descriptive instrument assessed financial practices, attitudes, goals and beliefs, retirement mindset, savings habits, debt tendencies and demographic characteristics of respondents. Statistical analyses compared respondents' beliefs about their financial independence and security with their current financial practices. Analyses included: independent samples t-tests, chi-square analysis and ANOVA. Most dental hygienists believed themselves to be financially independent and reported satisfaction with their current financial situation. Significant relationships existed between respondents' satisfaction with their current financial situations and their financial attitudes and practices (saving regularly and having limited debt). Those who indicated they had personally saved for retirement were more likely to view these savings as their largest source of income during retirement, as opposed to Social Security benefits. A majority agreed that financial management education should be included in the dental hygiene curriculum, and that they would attend a continuing education course on the subject if offered. The results of this study suggest that hygienists have confidence in their ability to provide secure financial futures for themselves. Hygienists who practiced sound financial planning, such as adhering to monthly budgets, having wills, lowering debt and saving regularly, reported a higher level of financial security than those who did not. Most respondents expressed interest in receiving education about financial management through the dental hygiene curriculum and continuing education courses.

Improving undergraduate STEM education: The efficacy of discipline-based professional development.

PubMed

Manduca, Cathryn A; Iverson, Ellen R; Luxenberg, Michael; Macdonald, R Heather; McConnell, David A; Mogk, David W; Tewksbury, Barbara J

2017-02-01

We sought to determine whether instructional practices used by undergraduate faculty in the geosciences have shifted from traditional teacher-centered lecture toward student-engaged teaching practices and to evaluate whether the national professional development program On the Cutting Edge (hereinafter Cutting Edge) has been a contributing factor in this change. We surveyed geoscience faculty across the United States in 2004, 2009, and 2012 and asked about teaching practices as well as levels of engagement in education research, scientific research, and professional development related to teaching. We tested these self-reported survey results with direct observations of teaching using the Reformed Teaching Observation Protocol, and we conducted interviews to understand what aspects of Cutting Edge have supported change. Survey data show that teaching strategies involving active learning have become more common, that these practices are concentrated in faculty who invest in learning about teaching, and that faculty investment in learning about teaching has increased. Regression analysis shows that, after controlling for other key influences, faculty who have participated in Cutting Edge programs and who regularly use resources on the Cutting Edge website are statistically more likely to use active learning teaching strategies. Cutting Edge participants also report that learning about teaching, the availability of teaching resources, and interactions with peers have supported changes in their teaching practice. Our data suggest that even one-time participation in a workshop with peers can lead to improved teaching by supporting a combination of affective and cognitive learning outcomes.

Improving undergraduate STEM education: The efficacy of discipline-based professional development

PubMed Central

Manduca, Cathryn A.; Iverson, Ellen R.; Luxenberg, Michael; Macdonald, R. Heather; McConnell, David A.; Mogk, David W.; Tewksbury, Barbara J.

2017-01-01

We sought to determine whether instructional practices used by undergraduate faculty in the geosciences have shifted from traditional teacher-centered lecture toward student-engaged teaching practices and to evaluate whether the national professional development program On the Cutting Edge (hereinafter Cutting Edge) has been a contributing factor in this change. We surveyed geoscience faculty across the United States in 2004, 2009, and 2012 and asked about teaching practices as well as levels of engagement in education research, scientific research, and professional development related to teaching. We tested these self-reported survey results with direct observations of teaching using the Reformed Teaching Observation Protocol, and we conducted interviews to understand what aspects of Cutting Edge have supported change. Survey data show that teaching strategies involving active learning have become more common, that these practices are concentrated in faculty who invest in learning about teaching, and that faculty investment in learning about teaching has increased. Regression analysis shows that, after controlling for other key influences, faculty who have participated in Cutting Edge programs and who regularly use resources on the Cutting Edge website are statistically more likely to use active learning teaching strategies. Cutting Edge participants also report that learning about teaching, the availability of teaching resources, and interactions with peers have supported changes in their teaching practice. Our data suggest that even one-time participation in a workshop with peers can lead to improved teaching by supporting a combination of affective and cognitive learning outcomes. PMID:28246629

Physiotherapy triage assessment of patients referred for orthopaedic consultation - Long-term follow-up of health-related quality of life, pain-related disability and sick leave.

PubMed

Samsson, Karin S; Larsson, Maria E H

2015-02-01

The literature indicates that physiotherapy triage assessment can be efficient for patients referred for orthopaedic consultation, however long-term follow up of patient reported outcome measures are not available. To report a long-term evaluation of patient-reported health-related quality of life, pain-related disability, and sick leave after a physiotherapy triage assessment of patients referred for orthopaedic consultation compared with standard practice. Patients referred for orthopaedic consultation (n = 208) were randomised to physiotherapy triage assessment or standard practice. The randomised cohort was analysed on an intention-to-treat (ITT) basis. The patient reported outcome measures EuroQol VAS (self-reported health-state), EuroQol 5D-3L (EQ-5D) and Pain Disability Index (PDI) were assessed at baseline and after 3, 6 and 12 months. EQ VAS was analysed using a repeated measure ANOVA. PDI and EQ-5D were analysed using a marginal logistic regression model. Sick leave was analysed for the 12 months following consultation using a Mann-Whitney U-test. The patients rated a significantly better health-state at 3 after physiotherapy triage assessment [mean difference -5.7 (95% CI -11.1; -0.2); p = 0.04]. There were no other statistically significant differences in perceived health-related quality of life or pain related disability between the groups at any of the follow-ups, or sick leave. This study reports that the long-term follow up of the patient related outcome measures health-related quality of life, pain-related disability and sick leave after physiotherapy triage assessment did not differ from standard practice, indicating the possible benefits of implementation of this model of care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Community education on preterm birth. Does it change practice?

PubMed Central

Sprague, Ann; Stewart, Paula; Niday, Patricia; Nimrod, Carl; Walker, Robin

2002-01-01

OBJECTIVE: To evaluate how well physicians and other prenatal care providers educate women about early recognition of and appropriate response to the signs and symptoms of preterm labour (PTL). To assess use of antenatal steroids for babies born at less than 34 weeks' gestation. DESIGN: Before-after study using a population-based approach. SETTING: Health care providers' offices, hospitals, and prenatal classes in Ottawa, Ont. PARTICIPANTS: Prenatal care providers, women in hospital after giving birth, prenatal class participants. INTERVENTIONS: Prenatal care providers received information and educational materials on PTL and preterm birth (PTB). They passed this information on to pregnant women at their 18- to 20-week prenatal visits. Teachers of prenatal classes gave the same information in early-series classes. Clinical practice guidelines were developed, and hospital staff received education on appropriate response to PTL. MAIN OUTCOME MEASURES: Use of educational materials and steroid treatment. RESULTS: Statistically significant increases were seen in the numbers of care providers who had educational material about PTL and PTB, who reported giving the educational material to all women, and who reported discussing signs and symptoms of PTL and PTB with all women; women who reported that their care providers talked with them about PTL and PTB, and women delivering preterm (< 34 weeks) babies who received steroids. CONCLUSION: Providing knowledge and standardized educational materials to health care providers can help improve preventive practice for PTL and educate women about PTL. PMID:12046368

Community education on preterm birth. Does it change practice?

PubMed

Sprague, Ann; Stewart, Paula; Niday, Patricia; Nimrod, Carl; Walker, Robin

2002-04-01

To evaluate how well physicians and other prenatal care providers educate women about early recognition of and appropriate response to the signs and symptoms of preterm labour (PTL). To assess use of antenatal steroids for babies born at less than 34 weeks' gestation. Before-after study using a population-based approach. Health care providers' offices, hospitals, and prenatal classes in Ottawa, Ont. Prenatal care providers, women in hospital after giving birth, prenatal class participants. Prenatal care providers received information and educational materials on PTL and preterm birth (PTB). They passed this information on to pregnant women at their 18- to 20-week prenatal visits. Teachers of prenatal classes gave the same information in early-series classes. Clinical practice guidelines were developed, and hospital staff received education on appropriate response to PTL. Use of educational materials and steroid treatment. Statistically significant increases were seen in the numbers of care providers who had educational material about PTL and PTB, who reported giving the educational material to all women, and who reported discussing signs and symptoms of PTL and PTB with all women; women who reported that their care providers talked with them about PTL and PTB, and women delivering preterm (< 34 weeks) babies who received steroids. Providing knowledge and standardized educational materials to health care providers can help improve preventive practice for PTL and educate women about PTL.

2016 Workplace and Gender Relations Survey of Active Duty Members: Statistical Methodology Report

DTIC Science & Technology

2017-03-01

2016 Workplace and Gender Relations Survey of Active Duty Members Statistical Methodology Report Additional copies of this report may be...MEMBERS: STATISTICAL METHODOLOGY REPORT Office of People Analytics (OPA) Defense Research, Surveys, and Statistics Center 4800 Mark Center Drive...20 1 2016 WORKPLACE AND GENDER RELATIONS SURVEY OF ACTIVE DUTY MEMBERS: STATISTICAL METHODOLOGY REPORT

Factors associated with adoption of beneficial newborn care practices in rural Eastern Uganda: a cross-sectional study.

PubMed

Owor, Michael O; Matovu, Joseph K B; Murokora, Daniel; Wanyenze, Rhoda K; Waiswa, Peter

2016-04-21

Beneficial newborn care practices can improve newborn survival. However, little is known about the factors that affect adoption of these practices. Cross-sectional study conducted among 1,616 mothers who had delivered in the past year in two health sub-districts (Luuka and Buyende) in Eastern Uganda. Data collection took place between November and December 2011. Data were collected on socio-demographic and economic characteristics, antenatal care visits, skilled delivery attendance, parity, distance to health facility and early newborn care knowledge and practices. Descriptive statistics were computed to determine the proportion of mothers who adopted beneficial newborn care practices (optimal thermal care; good feeding practices; weighing and immunizing the baby immediately after birth; and good cord care) during the neonatal period. We conducted multivariable logistic regression to assess the covariates of adoption of all beneficial newborn care practices. Analysis was done using STATA statistical software, version 12.1. Of the 1,616 mothers enrolled, 622 (38.5%) were aged 25-34; 1,472 (91.1%) were married; 1,096 (67.8%) had primary education; while 1,357 (84%) were laborers or peasants. Utilization of all beneficial newborn care practices was 11.7%; lower in Luuka (9.4%, n = 797) than in Buyende health sub-district (13.9%, n = 819; p = 0.005). Good cord care (83.6% in Luuka; 95% in Buyende) and immunization of newborn (80.7% in Luuka; 82.5% in Buyende) were the most prevalent newborn care practices reported by mothers. At the multivariable analysis, number of ANC visits (3-4 vs. 1-2: Adjusted (Adj.) Odds Ratio (OR) = 1.69, 95% CI = 1.13, 2.52), skilled delivery (Adj. OR = 2.66, 95% CI = 1.92, 3.69), socio-economic status (middle vs. low: Adj. OR = 1.57, 95% CI = 1.09, 2.26) were positively associated with adoption of all beneficial newborn care practices among mothers. Adoption of all beneficial newborn care practices was low, although associated with higher ANC visits; middle-level socio-economic status and skilled delivery attendance. These findings suggest a need for interventions to improve quality ANC and skilled delivery attendance as well as targeting of women with low and high socio-economic status with newborn care health educational messages, improved work conditions for breastfeeding, and supportive policies at national level for uptake of newborn care practices.

Psychosocial correlates of immediate versus delayed reconstruction of the breast.

PubMed

Wellisch, D K; Schain, W S; Noone, R B; Little, J W

1985-11-01

Two groups of consecutive patients from two different plastic surgical practice populations were evaluated to determine psychosocial differences between those who underwent immediate (n = 25) versus delayed (n = 38) breast reconstruction. Psychological assessment consisted of a standardized symptom inventory (BSI) and a specially designed self-report questionnaire investigating reactions unique to mastectomy and reconstruction. Both groups were extremely equivalent with regard to sociodemographic data, with the typical subject being a well-educated and employed Caucasian wife. Verbal reports of physical complaints revealed no significant differences between the two groups except for difficulty with arm movement, which was statistically higher for the immediate group (p = 0.006.). This difference most likely was due to the axillary dissection being performed simultaneously at the time of reconstruction. The relationship between timing of reconstruction and self-reported distress over the mastectomy experience revealed that only 25 percent of the women who underwent immediate repair reported "high distress" in recalling their mastectomy surgery compared with 60 percent of the delayed reconstruction group (p = 0.02). In reference to the two scales measuring psychological symptoms, a general trend was present, with the delayed group scoring higher (although not statistically significantly) on 9 of our 12 scales. Ninety-six percent of the immediate group and 89 percent of the delayed group reported satisfaction with results.(ABSTRACT TRUNCATED AT 250 WORDS)

Recent development of risk-prediction models for incident hypertension: An updated systematic review

PubMed Central

Xiao, Lei; Liu, Ya; Wang, Zuoguang; Li, Chuang; Jin, Yongxin; Zhao, Qiong

2017-01-01

Background Hypertension is a leading global health threat and a major cardiovascular disease. Since clinical interventions are effective in delaying the disease progression from prehypertension to hypertension, diagnostic prediction models to identify patient populations at high risk for hypertension are imperative. Methods Both PubMed and Embase databases were searched for eligible reports of either prediction models or risk scores of hypertension. The study data were collected, including risk factors, statistic methods, characteristics of study design and participants, performance measurement, etc. Results From the searched literature, 26 studies reporting 48 prediction models were selected. Among them, 20 reports studied the established models using traditional risk factors, such as body mass index (BMI), age, smoking, blood pressure (BP) level, parental history of hypertension, and biochemical factors, whereas 6 reports used genetic risk score (GRS) as the prediction factor. AUC ranged from 0.64 to 0.97, and C-statistic ranged from 60% to 90%. Conclusions The traditional models are still the predominant risk prediction models for hypertension, but recently, more models have begun to incorporate genetic factors as part of their model predictors. However, these genetic predictors need to be well selected. The current reported models have acceptable to good discrimination and calibration ability, but whether the models can be applied in clinical practice still needs more validation and adjustment. PMID:29084293

Statistical approaches in published ophthalmic clinical science papers: a comparison to statistical practice two decades ago.

PubMed

Zhang, Harrison G; Ying, Gui-Shuang

2018-02-09

The aim of this study is to evaluate the current practice of statistical analysis of eye data in clinical science papers published in British Journal of Ophthalmology ( BJO ) and to determine whether the practice of statistical analysis has improved in the past two decades. All clinical science papers (n=125) published in BJO in January-June 2017 were reviewed for their statistical analysis approaches for analysing primary ocular measure. We compared our findings to the results from a previous paper that reviewed BJO papers in 1995. Of 112 papers eligible for analysis, half of the studies analysed the data at an individual level because of the nature of observation, 16 (14%) studies analysed data from one eye only, 36 (32%) studies analysed data from both eyes at ocular level, one study (1%) analysed the overall summary of ocular finding per individual and three (3%) studies used the paired comparison. Among studies with data available from both eyes, 50 (89%) of 56 papers in 2017 did not analyse data from both eyes or ignored the intereye correlation, as compared with in 60 (90%) of 67 papers in 1995 (P=0.96). Among studies that analysed data from both eyes at an ocular level, 33 (92%) of 36 studies completely ignored the intereye correlation in 2017, as compared with in 16 (89%) of 18 studies in 1995 (P=0.40). A majority of studies did not analyse the data properly when data from both eyes were available. The practice of statistical analysis did not improve in the past two decades. Collaborative efforts should be made in the vision research community to improve the practice of statistical analysis for ocular data. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Procedural and short-term safety of bronchial thermoplasty in clinical practice: evidence from a national registry and Hospital Episode Statistics.

PubMed

Burn, Julie; Sims, Andrew J; Keltie, Kim; Patrick, Hannah; Welham, Sally A; Heaney, Liam G; Niven, Robert M

2017-10-01

Bronchial thermoplasty (BT) is a novel treatment for severe asthma. Its mode of action and ideal target patient group remain poorly defined, though clinical trials provided some evidence on efficacy and safety. This study presents procedural and short-term safety evidence from routine UK clinical practice. Patient characteristics and safety outcomes (procedural complications, 30-day readmission and accident and emergency (A&E) attendance, length of stay) were assessed using two independent data sources, the British Thoracic Society UK Difficult Asthma Registry (DAR) and Hospital Episodes Statistics (HES) database. A matched cohort (with records in both) was used to estimate safety outcome event rates and compare them with clinical trials. Between June 2011 and January 2015, 215 procedure records (83 patients; 68 treated in England) were available from DAR and 203 (85 patients) from HES. 152 procedures matched (59 patients; 6 centres), and of these, 11.2% reported a procedural complication, 11.8% resulted in emergency respiratory readmission, 0.7% in respiratory A&E attendance within 30 days (20.4% had at least one event) and 46.1% involved a post-procedure stay. Compared with published clinical trials which found lower hospitalisation rates, BT patients in routine clinical practice were, on average, older, had worse baseline lung function and asthma quality of life. A higher proportion of patients experienced adverse events compared with clinical trials. The greater severity of disease amongst patients treated in clinical practice may explain the observed rate of post-procedural stay and readmission. Study of long-term safety and efficacy requires continuing data collection.

Health-risk behaviour in Croatia.

PubMed

Bécue-Bertaut, Mónica; Kern, Josipa; Hernández-Maldonado, Maria-Luisa; Juresa, Vesna; Vuletic, Silvije

2008-02-01

To identify the health-risk behaviour of various homogeneous clusters of individuals. The study was conducted in 13 of the 20 Croatian counties and in Zagreb, the Croatian capital. In the first stage, general practices were selected in each county. The second-stage sample was created by drawing a random subsample of 10% of the patients registered at each selected general practice. The sample was divided into seven homogenous clusters using statistical methodology, combining multiple factor analysis with a hybrid clustering method. Seven homogeneous clusters were identified, three composed of males and four composed of females, based on statistically significant differences between selected characteristics (P<0.001). Although, in general, self-assessed health declined with age, significant variations were observed within specific age intervals. Higher levels of self-assessed health were associated with higher levels of education and/or socio-economic status. Many individuals, especially females, who self-reported poor health were heavy consumers of sleeping pills. Males and females reported different health-risk behaviours related to lifestyle, diet and use of the healthcare system. Heavy alcohol and tobacco use, unhealthy diet, risky physical activity and non-use of the healthcare system influenced self-assessed health in males. Females were slightly less satisfied with their health than males of the same age and educational level. Even highly educated females who took preventive healthcare tests and ate a healthy diet reported a less satisfactory self-assessed level of health than expected. Sociodemographic characteristics, life style, self-assessed health and use of the healthcare system were used in the identification of seven homogeneous population clusters. A comprehensive analysis of these clusters suggests health-related prevention and intervention efforts geared towards specific populations.

Knowledge and attitude of health-care professionals in hospitals towards pharmacovigilance in Saudi Arabia.

PubMed

Alshammari, Thamir M; Alamri, Khaled K; Ghawa, Yazeed A; Alohali, Noura F; Abualkol, Shaza A; Aljadhey, Hisham S

2015-12-01

Drug safety has major implications for patients' lives. However, this concept is still considered new to some healthcare professionals. This study aims to investigate the knowledge and awareness of Saudi healthcare professionals to pharmacovigilance (PV). Setting Governmental and private hospitals at three main cities in Saudi Arabia (Riyadh, Jeddah, and Dammam). A cross-sectional survey among healthcare professionals (pharmacists, physicians, and nurses) within 12 Saudi hospitals was conducted between November and December 2012. The questionnaire consisted of 18 questions assessing the knowledge, awareness, and attitude of healthcare professionals (HCPs) towards science and the concept of PV. Descriptive statistics were used to analyze the data. The data were analyzed using Statistical Analysis Software (SAS 9.3). Main outcome measure Knowledge, attitude and practice of HCPs toward pharmacovigilance. Three-hundred and thirty-two healthcare professionals completed the survey (response rate 72 %), 110 (34 %) physicians, 106 (33 %) pharmacists, and 104 (32 %) nurses. More than half of the participants (55 %) did not know the correct definition of PV. Two-thirds of the respondents, 207 (65.5 %), had knowledge of the aim of post-marketing surveillance, yet only 113 (36.9 %) were aware that the National Pharmacovigilance and Drug Safety Center is the official body for monitoring adverse drug reaction in Saudi Arabia. In addition, 34.7 % agreed that lack of time could be a major barrier for reporting. The majority of the respondents (78.4 %) believed that reporting was a professional obligation and hospitals should have a drug safety department. There was a limited knowledge of pharmacovigilance that could have affected reporting incidence. Educational intervention and a practical training program need to be applied by the drug regulatory body as well as health authorities to enhance the pharmacovigilance and drug safety culture in Saudi Arabia.

Reiki for Cancer Patients Undergoing Chemotherapy in a Brazilian Hospital: A Pilot Study.

PubMed

Siegel, Pamela; da Motta, Pedro Mourão Roxo; da Silva, Luis G; Stephan, Celso; Lima, Carmen Silvia Passos; de Barros, Nelson Filice

2016-01-01

The purpose of this pilot study was to explore whether individualized Reiki given to cancer patients at a Brazilian hospital improved symptoms and well-being. Data from 36 patients who received 5 Reiki sessions were collected using the MYMOP and were compared before and after their treatment and also with 14 patients who did not receive Reiki and who acted as a comparison group. Twenty-one patients reported feeling better, 12 felt worse, and 3 reported no change. Of the comparison group, 6 patients reported feeling better and 8 felt worse. The Reiki practice delivered as part of the integrative care in oncology did produce clinically significant effects, although not statistically significant results, for more than half of the patients undergoing cancer treatment.

Macroscopic anomalies before the September 2010 M = 7.1 earthquake in Christchurch, New Zealand

NASA Astrophysics Data System (ADS)

Whitehead, N. E.; Ulusoy, Ü.

2013-01-01

Previous published work after the Kobe and İzmit earthquakes (1995 and 1999, respectively) demonstrated some reported meteorological and animal behaviour precursors were valid. Predictions were freshly tested for the Christchurch earthquake (M = 7.1, 4 September 2010). An internet survey with nearly 400 valid replies showed relative numbers of reports in precursor categories the day before the quake, were statistically significantly different from those in the preceding three days (excess meteorological events and animal behaviour). The day before the quake, there was also altered relative precursor class occurrence within 56 km compared with further away. Both these confirmed the earlier published work. Owners were woken up by unique pet behaviour 12 times as often in the hour before the quake compared with other hours immediately before (statistically highly significant). Lost and Found pet reports were double normal the week before, and 4.5 times normal both the day before the quake, and 9 days before. (Results were again statistically significant). Unique animal behaviour before the quake was often repeated before the numerous aftershocks. These pet owners claimed an approximate 80% prediction reliability. However, a preliminary telephone survey suggested that animals showing any precursor response are a minority. Some precursors seem real, but usefulness seemed mostly restricted to 7 cases where owners were in, or near, a place of safety through disruptive pet behaviour, and one in which owners were diverted by a pet from being struck by falling fixtures. For a later 22 February 2011 M = 6.3 quake no reports of escape through warning by pets were recorded, which raises serious questions whether such prediction is practically useful, because lives claimed saved are extremely low compared with fatalities. It is shown the lost-pet statistics dates, correspond to ionospheric anomalies recorded using the GPS satellite system and geomagnetic disturbance data, and claimed as precursory. The latter more objective measurements may be the way of the future, but improved statistical treatment should include observations over longer periods of time without earthquakes.

Outcomes of an early feeding practices intervention to prevent childhood obesity.

PubMed

Daniels, Lynne Allison; Mallan, Kimberley Margaret; Nicholson, Jan Maree; Battistutta, Diana; Magarey, Anthea

2013-07-01

The goal of this study was to evaluate outcomes of a universal intervention to promote protective feeding practices that commenced in infancy and aimed to prevent childhood obesity. The NOURISH randomized controlled trial enrolled 698 first-time mothers (mean ± SD age: 30.1 ± 5.3 years) with healthy term infants (51% female) aged 4.3 ± 1.0 months at baseline. Mothers were randomly allocated to self-directed access to usual care or to attend two 6-session interactive group education modules that provided anticipatory guidance on early feeding practices. Outcomes were assessed 6 months after completion of the second information module, 20 months from baseline and when the children were 2 years old. Maternal feeding practices were self-reported by using validated questionnaires and study-developed items. Study-measured child height and weight were used to calculate BMI z scores. Retention at follow-up was 78%. Mothers in the intervention group reported using responsive feeding more frequently on 6 of 9 subscales and 8 of 8 items (all, P ≤ .03) and overall less controlling feeding practices (P < .001). They also more frequently used feeding practices (3 of 4 items; all, P < .01) likely to enhance food acceptance. No statistically significant differences were noted in anthropometric outcomes (BMI z score: P = .10) nor in prevalence of overweight/obesity (control 17.9% vs intervention 13.8%; P = .23). Evaluation of NOURISH data at child age 2 years found that anticipatory guidance on complementary feeding, tailored to developmental stage, increased use by first-time mothers of "protective" feeding practices that potentially support the development of healthy eating and growth patterns in young children.

Licorice Production and Manufacturing: All-Sorts of Practical Applications for Statistics

ERIC Educational Resources Information Center

Watson, Jane; Skalicky, Jane; Fitzallen, Noleine; Wright, Suzie

2009-01-01

Among the practical applications of statistics is the collection of data from manufacturing processes. Often collected in the form of a time series, data collected from a series of measurements show the variation in those measurements, such as mass of a product manufactured. Limits are set for quality control and if these are exceeded then a…

Sets, Probability and Statistics: The Mathematics of Life Insurance.

ERIC Educational Resources Information Center

Clifford, Paul C.; And Others

The practical use of such concepts as sets, probability and statistics are considered by many to be vital and necessary to our everyday life. This student manual is intended to familiarize students with these concepts and to provide practice using real life examples. It also attempts to illustrate how the insurance industry uses such mathematic…

Exploring Teachers' Practices in Teaching Mathematics and Statistics in Kwazulu-Natal Schools

ERIC Educational Resources Information Center

Umugiraneza, Odette; Bansilal, Sarah; North, Delia

2017-01-01

Teaching approaches and assessment practices are key factors that contribute to the improvement of learner outcomes. The study on which this article is based, explored the methods used by KwaZulu-Natal (KZN) teachers in teaching and assessing mathematics and statistics. An instrument containing closed and open-ended questions was distributed to…

Validity of Medical Student Questionnaire Data in Prediction of Rural Practice Choice and Its Association With Service Orientation.

PubMed

Shannon, C Ken; Jackson, Jodie

2015-01-01

The validity of medical student projection of, and predictors for, rural practice and the association of a measure of service orientation, projected practice accessibility to the indigent, were investigated. West Virginia (WV) medical student online pre- and postrural rotation questionnaire data were collected during the time period 2001-2009. Of the 1,517 respondent students, submissions by 1,271 met the time interval criterion for inclusion in analyses. Subsequent WV licensing data were available for 461 in 2013. These 2 databases were used to assess for validity of projection of rural practice, for predictors of rural practice, and for student projected accessibility of the future practice to indigent patients. There were statistically significant associations between both pre- and postrotation projections of rural practice and subsequent rural practice. The most significant independent predictors of rural practice were student rural background, reported primary care intent, prediction of rural practice and projection of greater accessibility of the future practice to indigent patients. For scoring of practice access, there were trends for higher scoring by rural students and rural practitioners, with greater pre-post increases for those with urban hometowns. This study demonstrates the utility of medical student questionnaires for projections of numbers of future rural physicians. It suggests that students with a rural background, rural practice intent, or greater service orientation are more likely to enter rural practice. It also suggests that students, particularly those with urban hometowns, are influenced by rural rotation experiences in forecasting greater practice accessibility and in entering rural practice. © 2015 National Rural Health Association.

Trauma and fear in Australian midwives.

PubMed

Toohill, J; Fenwick, J; Sidebotham, M; Gamble, J; Creedy, D K

2018-05-11

Relatively little is known about the extent of trauma and birth-related fear in midwives and how this might affect practice. (1) Determine prevalence of birth related trauma and fear in midwives and associations with midwives' confidence to advise women during pregnancy of their birth options and to provide care in labour. (2) Describe midwives' experiences of birth related trauma and/or fear. A mixed methods design. A convenience sample of midwives (n=249) completed an anonymous online survey. Descriptive and inferential statistics were used to analyse the quantitative data. Latent content analysis was used to extrapolate meaning from the 170 midwives who wrote about their experiences of personal and/or professional trauma. The majority of midwives (93.6%) reported professional (n=199, 85.4%) and/or personal (n=97, 41.6%) traumatic birth experiences. Eight percent (n=20) reported being highly fearful of birth. Trauma was not associated with practice concerns but fear was. Midwives categorised as having 'high fear' reported more practice concerns (Med 23.5, n=20) than midwives with 'low fear' (Med 8, n=212) (U=1396, z=-3.79, p<0.001, r=0.24). Reasons for personal trauma included experiencing assault, intervention and stillbirth. Professional trauma related to both witnessing and experiencing disrespectful care and subsequently feeling complicit in the provision of poor care. Feeling unsupported in the workplace and fearing litigation intensified trauma. High fear was associated with lower confidence to support childbearing women. Fear and trauma in midwives warrants further investigation to better understand the impact on professional practice. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

The Black Dentist Workforce in the United States

PubMed Central

Mertz, Elizabeth; Calvo, Jean; Wides, Cynthia; Gates, Paul

2017-01-01

Objectives The purpose of this paper is to describe the Black dentist workforce, the practice patterns of providers, and their contributions to oral health care for minority and underserved patients. Methods A national sample survey of underrepresented minority dentists was conducted in 2012 and received a 32.6% response rate for self-reported Black dentists. Data were weighted for selection and response bias to be nationally representative. Descriptive and multivariable statistics were computed to provide a workforce profile of Black dentists. National comparisons are provided from published data. Results Among all Black dentists (weighted n=6,254), 76.6% self-identify as African-American, 13.2% as African, and 10.3% as Afro-Caribbean. The largest share of Black dentists are male, married, heterosexual, born in the U.S. and raised in a medium to large city. One third of Black dentists were the first in their family to graduate from college. Black dentists report higher average educational debt than all dental students, graduates from International Dentist Programs having the greatest debt. Traditional practices (i.e., private practices) dominate, with 67.1% of Black dentists starting out in this setting and 73.5% currently in the setting. Black dentists care for a disproportionate share of Black patients, with an average patient mix that is 44.9% Black. Two in five Black dentists reported their patient pool is made up of more than 50% Black patients. Conclusions The underrepresentation for Black dentists is extraordinary, and the Black dentists that are in practice are shouldering a disproportionate share of dental care for minority and underserved communities. PMID:27966789

Worth the "Likes"? The Use of Facebook among Plastic Surgeons and Its Perceived Impact.

PubMed

Chang, Jessica B; Woo, Shoshana L; Cederna, Paul S

2015-05-01

Facebook is the leading online media platform used by plastic surgeons. This study examined Facebook use among plastic surgeons and its perceived impact. A survey on Facebook use was distributed to two groups of plastic surgeons: 500 with professional Facebook pages and 500 without Facebook pages. Responses were stripped of identifying information and analyzed for statistical significance (p < 0.05). One hundred twenty-three total surveys were completed (12.3 percent response rate). No respondents with Facebook reported a negative impact on their practice, whereas 57 percent reported a very positive or positive impact. There was no correlation with perceived impact and number of "likes." Perceived advantages of Facebook included facilitation of patient feedback/communication (77 percent) and increased practice exposure (67 percent). Many surgeons (15 to 36 percent) did not follow the direct impact of Facebook on their practices. Some reported that Facebook was responsible for only one to 50 professional Web site hits and less than 5 percent of their new patient referrals in the past year. Estimated conversion-to-surgery rates were highly variable for Facebook users and nonusers. Most Facebook nonusers (67 percent) expected a "neutral" impact, expressing more concerns about unsolicited advertising (51 percent) and wasting time (47 percent). Plastic surgeons tend to perceive Facebook's impact on their practices as positive, but most do not track its direct effects on professional Web site hits, new referrals, or conversion-to-surgery rates. Plastic surgeons using Facebook are encouraged to monitor these parameters to determine whether its continued use is actually worthwhile.

Participation in the Child and Adult Care Food Program Is Associated with Healthier Nutrition Environments at Family Child Care Homes in Mississippi.

PubMed

Erinosho, Temitope; Vaughn, Amber; Hales, Derek; Mazzucca, Stephanie; Gizlice, Ziya; Ward, Dianne

2018-05-01

Describe foods and beverages offered, nutrition practices, and nutrition policies of family child care homes in Mississippi and differences by participation in the Child and Adult Care Food Program (CACFP). Cross-sectional study conducted between fall, 2015 and spring, 2016. Mississippi. Random, stratified sample of 134 family child care homes that enroll 3- to 5-year-olds. Providers completed a modified version of the Environment and Policy Assessment and Observation-self-report tool. Foods and beverages offered at lunch, provider practices regarding nutrition, and presence or absence of written nutrition policies. Descriptive statistics, likelihood ratio chi-square, and t tests. Most homes (>75%) provided components from the fruit, vegetable, grain/bread, meat/meat alternative, and milk food groups at lunch. At some homes, the food and beverage selections offered were high in fat, sugar, and refined grains. Providers at CACFP-participating homes (P < .05) reported healthier beverage selections, more healthful nutrition practices, and more written nutrition policies compared with providers at non-CACFP homes. Interventions and regulatory standards are needed, particularly in non-CACFP homes, to ensure that food and beverage offerings, provider practices, and policies regarding nutrition support the development of healthful dietary behaviors in early childhood. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Everyday Ethics: Ethical Issues and Stress in Nursing Practice

PubMed Central

Ulrich, Connie M.; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-01-01

Aim This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Background Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. Methods A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analyzed using descriptive statistics, cross-tabulations and Pearson correlations. Results A total of 422 questionnaires were used in the analysis. The five most frequently-occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Conclusion Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. PMID:20735502

Everyday ethics: ethical issues and stress in nursing practice.

PubMed

Ulrich, Connie M; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-11-01

This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analysed using descriptive statistics, cross-tabulations and Pearson correlations. A total of 422 questionnaires were used in the analysis. The five most frequently occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. © 2010 Blackwell Publishing Ltd.

Return to play after cervical spine injury.

PubMed

Morganti, C; Sweeney, C A; Albanese, S A; Burak, C; Hosea, T; Connolly, P J

2001-05-15

A questionnaire survey was mailed to members of the Cervical Spine Research Society, the Herodiuus Sports Medicine Society, and to members of the authors' Department of Orthopaedics. The purpose of our study was to evaluate what influence, if any, factors such as published guidelines, type of sport of the patient, number of years in practice, subspecialty interest, and sports participation of the respondent held in the "return to play" decision-making process after a cervical spine injury. The consequences of cervical spine injury are potentially catastrophic, and return to play decisions in athletes with a history of neck injury can be agonizing. Although recent publications have addressed some of the concerns regarding cervical spine injuries in the athletic population, many questions remain unanswered. Factors such as published guidelines, type of sport of the patient, number of years in practice, subspecialty interest, and sports participation of the respondent have all been suggested as having a possible role in return to play decisions. Representative radiographs and case histories of 10 athletes who had sustained neck injury were mailed to 346 physicians. For each case physicians selected every type of play (of six categories) that they felt comfortable recommending. Type of play was divided into six categories: Type 1, collision sports; Type 2, contact sports; Type 3, noncontact, high velocity sports; Type 4, noncontact, repetitive load sports (e.g., running); Type 5, noncontact, low impact sports; Type 6, no sports. In addition, demographic data regarding board certification, subspecialty interest, number of years in practice, use of guidelines in return to play decisions, and personal participation in sports were queried from all respondents. Statistical analysis was completed with Statview (Berkeley, CA). Basic descriptive statistics, chi2, and ANOVA were used where appropriate. Three hundred forty-six questionnaires were mailed and 113 were returned (response rate 32.7%). One hundred ten (97%) of the respondents who completed the questionnaire were board certified. Seventy-five were subspecialists in spine, 22 were subspecialists in sportsmedicine, and 13 reported interests in both sports medicine and spine. Use of Published Guidelines. Although 49% of respondents reported using guidelines in decision-making, the use of guidelines was statistically significant in only one case (P = 0.04). Hierarchy of Risk. In general, those physicians who participated in the study followed the hierarchy of risk that we established in this study (Type 1 [collision sports; highest level of risk] through Type 6 [no sports; lowest level of risk]). Twelve (10.6%) respondents, however, deviated from it in one or more cases. Years in Practice. In three cases there was a statistically significant association between the number of years a physician was in practice and the type of play selected (P < 0.05). In each case a lower level of play tended to be recommended by more senior physicians. Subspecialty Interest. In three cases those respondents with a spine subspecialty interest recommended returned to a higher level of play (P < 0.05). There is no consensus on the postinjury management of many cervical spine-injured patients. Further research, education, and discussion on this topic are needed.

49 CFR 1248.6 - Public inspection-railroad reports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... STATISTICS § 1248.6 Public inspection—railroad reports. The individual commodity statistics reports of class... public inspection, and such required commodity statistics reports, to be filed for the years beginning..., may be excluded from a railroad's regular freight commodity statistics report and filed in a...

How often should we expect to be wrong? Statistical power, P values, and the expected prevalence of false discoveries.

PubMed

Marino, Michael J

2018-05-01

There is a clear perception in the literature that there is a crisis in reproducibility in the biomedical sciences. Many underlying factors contributing to the prevalence of irreproducible results have been highlighted with a focus on poor design and execution of experiments along with the misuse of statistics. While these factors certainly contribute to irreproducibility, relatively little attention outside of the specialized statistical literature has focused on the expected prevalence of false discoveries under idealized circumstances. In other words, when everything is done correctly, how often should we expect to be wrong? Using a simple simulation of an idealized experiment, it is possible to show the central role of sample size and the related quantity of statistical power in determining the false discovery rate, and in accurate estimation of effect size. According to our calculations, based on current practice many subfields of biomedical science may expect their discoveries to be false at least 25% of the time, and the only viable course to correct this is to require the reporting of statistical power and a minimum of 80% power (1 - β = 0.80) for all studies. Copyright © 2017 Elsevier Inc. All rights reserved.

Kappa statistic to measure agreement beyond chance in free-response assessments.

PubMed

Carpentier, Marc; Combescure, Christophe; Merlini, Laura; Perneger, Thomas V

2017-04-19

The usual kappa statistic requires that all observations be enumerated. However, in free-response assessments, only positive (or abnormal) findings are notified, but negative (or normal) findings are not. This situation occurs frequently in imaging or other diagnostic studies. We propose here a kappa statistic that is suitable for free-response assessments. We derived the equivalent of Cohen's kappa statistic for two raters under the assumption that the number of possible findings for any given patient is very large, as well as a formula for sampling variance that is applicable to independent observations (for clustered observations, a bootstrap procedure is proposed). The proposed statistic was applied to a real-life dataset, and compared with the common practice of collapsing observations within a finite number of regions of interest. The free-response kappa is computed from the total numbers of discordant (b and c) and concordant positive (d) observations made in all patients, as 2d/(b + c + 2d). In 84 full-body magnetic resonance imaging procedures in children that were evaluated by 2 independent raters, the free-response kappa statistic was 0.820. Aggregation of results within regions of interest resulted in overestimation of agreement beyond chance. The free-response kappa provides an estimate of agreement beyond chance in situations where only positive findings are reported by raters.

Empirical Correction to the Likelihood Ratio Statistic for Structural Equation Modeling with Many Variables.

PubMed

Yuan, Ke-Hai; Tian, Yubin; Yanagihara, Hirokazu

2015-06-01

Survey data typically contain many variables. Structural equation modeling (SEM) is commonly used in analyzing such data. The most widely used statistic for evaluating the adequacy of a SEM model is T ML, a slight modification to the likelihood ratio statistic. Under normality assumption, T ML approximately follows a chi-square distribution when the number of observations (N) is large and the number of items or variables (p) is small. However, in practice, p can be rather large while N is always limited due to not having enough participants. Even with a relatively large N, empirical results show that T ML rejects the correct model too often when p is not too small. Various corrections to T ML have been proposed, but they are mostly heuristic. Following the principle of the Bartlett correction, this paper proposes an empirical approach to correct T ML so that the mean of the resulting statistic approximately equals the degrees of freedom of the nominal chi-square distribution. Results show that empirically corrected statistics follow the nominal chi-square distribution much more closely than previously proposed corrections to T ML, and they control type I errors reasonably well whenever N ≥ max(50,2p). The formulations of the empirically corrected statistics are further used to predict type I errors of T ML as reported in the literature, and they perform well.

A practical and systematic review of Weibull statistics for reporting strengths of dental materials

PubMed Central

Quinn, George D.; Quinn, Janet B.

2011-01-01

Objectives To review the history, theory and current applications of Weibull analyses sufficient to make informed decisions regarding practical use of the analysis in dental material strength testing. Data References are made to examples in the engineering and dental literature, but this paper also includes illustrative analyses of Weibull plots, fractographic interpretations, and Weibull distribution parameters obtained for a dense alumina, two feldspathic porcelains, and a zirconia. Sources Informational sources include Weibull's original articles, later articles specific to applications and theoretical foundations of Weibull analysis, texts on statistics and fracture mechanics and the international standards literature. Study Selection The chosen Weibull analyses are used to illustrate technique, the importance of flaw size distributions, physical meaning of Weibull parameters and concepts of “equivalent volumes” to compare measured strengths obtained from different test configurations. Conclusions Weibull analysis has a strong theoretical basis and can be of particular value in dental applications, primarily because of test specimen size limitations and the use of different test configurations. Also endemic to dental materials, however, is increased difficulty in satisfying application requirements, such as confirming fracture origin type and diligence in obtaining quality strength data. PMID:19945745

Commentary on Sommer et al. 'A randomized experiment of the effects of including alternative medicine in the mandatory benefit package of health insurance.

PubMed

Heusser, P

2000-03-01

The study by Sommer et al. recently reported in Complementary Therapies in Medicine has been heavily criticised in Switzerland since its original publication. Its major problems are an inadequate reflection of real practice, an inadequate study design relative to the central research objective, questionable value of the applied instrument and procedure for health assessment, methodological and statistical problems, and failure to consider literature relevant to the topic. For these reasons, this experimental study does not allow an answer to its central questions as to costs and effectiveness of complementary medicine made available within Switzerland's mandatory basic health insurance provisions. We propose more practice-related, non-experimental prospective study designs to realistically answer these questions.

Six Sigma and Introductory Statistics Education

ERIC Educational Resources Information Center

Maleyeff, John; Kaminsky, Frank C.

2002-01-01

A conflict exists between the way statistics is practiced in contemporary business environments and the way statistics is taught in schools of management. While businesses are embracing programs, such as six sigma and TQM, that bring statistical methods to the forefront of management decision making, students do not graduate with the skills to…

Statistics without Tears: Complex Statistics with Simple Arithmetic

ERIC Educational Resources Information Center

Smith, Brian

2011-01-01

One of the often overlooked aspects of modern statistics is the analysis of time series data. Modern introductory statistics courses tend to rush to probabilistic applications involving risk and confidence. Rarely does the first level course linger on such useful and fascinating topics as time series decomposition, with its practical applications…

Hormone replacement therapy is associated with gastro-oesophageal reflux disease: a retrospective cohort study

PubMed Central

2012-01-01

Background Oestrogen and progestogen have the potential to influence gastro-intestinal motility; both are key components of hormone replacement therapy (HRT). Results of observational studies in women taking HRT rely on self-reporting of gastro-oesophageal symptoms and the aetiology of gastro-oesophageal reflux disease (GORD) remains unclear. This study investigated the association between HRT and GORD in menopausal women using validated general practice records. Methods 51,182 menopausal women were identified using the UK General Practice Research Database between 1995–2004. Of these, 8,831 were matched with and without hormone use. Odds ratios (ORs) were calculated for GORD and proton-pump inhibitor (PPI) use in hormone and non-hormone users, adjusting for age, co-morbidities, and co-pharmacy. Results In unadjusted analysis, all forms of hormone use (oestrogen-only, tibolone, combined HRT and progestogen) were statistically significantly associated with GORD. In adjusted models, this association remained statistically significant for oestrogen-only treatment (OR 1.49; 1.18–1.89). Unadjusted analysis showed a statistically significant association between PPI use and oestrogen-only and combined HRT treatment. When adjusted for covariates, oestrogen-only treatment was significant (OR 1.34; 95% CI 1.03–1.74). Findings from the adjusted model demonstrated the greater use of PPI by progestogen users (OR 1.50; 1.01–2.22). Conclusions This first large cohort study of the association between GORD and HRT found a statistically significant association between oestrogen-only hormone and GORD and PPI use. This should be further investigated using prospective follow-up to validate the strength of association and describe its clinical significance. PMID:22642788

The impact of leadership hubs on the uptake of evidence-informed nursing practices and workplace policies for HIV care: a quasi-experimental study in Jamaica, Kenya, Uganda and South Africa.

PubMed

Edwards, Nancy; Kaseje, Dan; Kahwa, Eulalia; Klopper, Hester C; Mill, Judy; Webber, June; Roelofs, Susan; Harrowing, Jean

2016-08-03

The enormous impact of HIV on communities and health services in Sub-Saharan Africa and the Caribbean has especially affected nurses, who comprise the largest proportion of the health workforce in low- and middle-income countries (LMICs). Strengthening action-based leadership for and by nurses is a means to improve the uptake of evidence-informed practices for HIV care. A prospective quasi-experimental study in Jamaica, Kenya, Uganda and South Africa examined the impact of establishing multi-stakeholder leadership hubs on evidence-informed HIV care practices. Hub members were engaged through a participatory action research (PAR) approach. Three intervention districts were purposefully selected in each country, and three control districts were chosen in Jamaica, Kenya and Uganda. WHO level 3, 4 and 5 health care institutions and their employed nurses were randomly sampled. Self-administered, validated instruments measured clinical practices (reports of self and peers), quality assurance, work place policies and stigma at baseline and follow-up. Standardised average scores ranging from 0 to 1 were computed for clinical practices, quality assurance and work place policies. Stigma scores were summarised as 0 (no reports) versus 1 (one or more reports). Pre-post differences in outcomes between intervention and control groups were compared using the Mantel Haenszel chi-square for dichotomised stigma scores, and independent t tests for other measures. For South Africa, which had no control group, pre-post differences were compared using a Pearson chi-square and independent t test. Multivariate analysis was completed for Jamaica and Kenya. Hub members in all countries self-assessed changes in their capacity at follow-up; these were examined using a paired t test. Response rates among health care institutions were 90.2 and 80.4 % at baseline and follow-up, respectively. Results were mixed. There were small but statistically significant pre-post, intervention versus control district improvements in workplace policies and quality assurance in Jamaica, but these were primarily due to a decline in scores in the control group. There were modest improvements in clinical practices, workplace policies and quality assurance in South Africa (pre-post) (clinical practices of self-pre 0.67 (95 % CI, 0.62, 0.72) versus post 0.78 (95 % CI, 0.73-0.82), p = 0.002; workplace policies-pre 0.82 (95 % CI, 0.70, 0.85) versus post 0.87 (95 % CI, 0.84, 0.90), p = 0.001; quality assurance-pre 0.72 (95 % CI, 0.67, 0.77) versus post 0.84 (95 % CI, 0.80, 0.88)). There were statistically significant improvements in scores for nurses stigmatising patients (Jamaica reports of not stigmatising-pre-post intervention 33.9 versus 62.4 %, pre-post control 54.7 versus 64.4 %, p = 0.002-and Kenya pre-post intervention 35 versus 51.6 %, pre-post control 34.2 versus 47.8 %, p = 0.006) and for nurses being stigmatised (Kenya reports of no stigmatisation-pre-post intervention 23 versus 37.3 %, pre-post control 15.4 versus 27 %, p = 0.004). Multivariate results for Kenya and Jamaica were non-significant. Twelve hubs were established; 11 were active at follow-up. Hub members (n = 34) reported significant improvements in their capacity to address care gaps. Leadership hubs, comprising nurses and other stakeholders committed to change and provided with capacity building can collectively identify issues and act on strategies that may improve practice and policy. Overall, hubs did not provide the necessary force to improve the uptake of evidence-informed HIV care in their districts. If hubs are to succeed, they must be integrated within district health authorities and become part of formal, legal organisations that can regularise and sustain them.

Evidence-based practice knowledge, attitudes, and practice of online graduate nursing students.

PubMed

Rojjanasrirat, Wilaiporn; Rice, Jan

2017-06-01

This study aimed to evaluate changes in evidence-based practice (EBP) knowledge, attitudes, and practice of nursing students before and after completing an online, graduate level, introductory research/EBP course. A prospective one-group pretest-posttest design. A private university in the Midwestern, USA. Sixty-three online nurse practitioner students in Master's program. A convenient sample of online graduate nursing students who enrolled in the research/EBP course was invited to participate in the study. Study outcomes were measured using the Evidence-Based Practice Questionnaire (EBPQ) before and after completing the course. Descriptive statistics and paired-Samples t-test was used to assess the mean differences between pre-and post-test scores. Overall, students' post-test EBP scores were significantly improved over pre-test scores, t(63)=-9.034, p<0.001). Statistically significant differences were found for practice of EBP mean scores t(63)=-12.78, p=0.001). No significant differences were found between pre and post-tests on knowledge and attitudes toward EBP scores. Most frequently cited barriers to EBP were lack of understanding of statistics, interpretation of findings, lack of time, and lack of library resources. Copyright © 2017 Elsevier Ltd. All rights reserved.

Narrative Review of Statistical Reporting Checklists, Mandatory Statistical Editing, and Rectifying Common Problems in the Reporting of Scientific Articles.

PubMed

Dexter, Franklin; Shafer, Steven L

2017-03-01

Considerable attention has been drawn to poor reproducibility in the biomedical literature. One explanation is inadequate reporting of statistical methods by authors and inadequate assessment of statistical reporting and methods during peer review. In this narrative review, we examine scientific studies of several well-publicized efforts to improve statistical reporting. We also review several retrospective assessments of the impact of these efforts. These studies show that instructions to authors and statistical checklists are not sufficient; no findings suggested that either improves the quality of statistical methods and reporting. Second, even basic statistics, such as power analyses, are frequently missing or incorrectly performed. Third, statistical review is needed for all papers that involve data analysis. A consistent finding in the studies was that nonstatistical reviewers (eg, "scientific reviewers") and journal editors generally poorly assess statistical quality. We finish by discussing our experience with statistical review at Anesthesia & Analgesia from 2006 to 2016.

Techniques in teaching statistics : linking research production and research use.

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

Martinez-Moyano, I .; Smith, A.; Univ. of Massachusetts at Boston)

In the spirit of closing the 'research-practice gap,' the authors extend evidence-based principles to statistics instruction in social science graduate education. The authors employ a Delphi method to survey experienced statistics instructors to identify teaching techniques to overcome the challenges inherent in teaching statistics to students enrolled in practitioner-oriented master's degree programs. Among the teaching techniques identi?ed as essential are using real-life examples, requiring data collection exercises, and emphasizing interpretation rather than results. Building on existing research, preliminary interviews, and the ?ndings from the study, the authors develop a model describing antecedents to the strength of the link between researchmore » and practice.« less

Methodological issues in current practice may lead to bias in the development of biomarker combinations for predicting acute kidney injury.

PubMed

Meisner, Allison; Kerr, Kathleen F; Thiessen-Philbrook, Heather; Coca, Steven G; Parikh, Chirag R

2016-02-01

Individual biomarkers of renal injury are only modestly predictive of acute kidney injury (AKI). Using multiple biomarkers has the potential to improve predictive capacity. In this systematic review, statistical methods of articles developing biomarker combinations to predict AKI were assessed. We identified and described three potential sources of bias (resubstitution bias, model selection bias, and bias due to center differences) that may compromise the development of biomarker combinations. Fifteen studies reported developing kidney injury biomarker combinations for the prediction of AKI after cardiac surgery (8 articles), in the intensive care unit (4 articles), or other settings (3 articles). All studies were susceptible to at least one source of bias and did not account for or acknowledge the bias. Inadequate reporting often hindered our assessment of the articles. We then evaluated, when possible (7 articles), the performance of published biomarker combinations in the TRIBE-AKI cardiac surgery cohort. Predictive performance was markedly attenuated in six out of seven cases. Thus, deficiencies in analysis and reporting are avoidable, and care should be taken to provide accurate estimates of risk prediction model performance. Hence, rigorous design, analysis, and reporting of biomarker combination studies are essential to realizing the promise of biomarkers in clinical practice.

Medical home capabilities of primary care practices that serve sociodemographically vulnerable neighborhoods.

PubMed

Friedberg, Mark W; Coltin, Kathryn L; Safran, Dana Gelb; Dresser, Marguerite; Schneider, Eric C

2010-06-14

Under current medical home proposals, primary care practices using specific structural capabilities will receive enhanced payments. Some practices disproportionately serve sociodemographically vulnerable neighborhoods. If these practices lack medical home capabilities, their ineligibility for enhanced payments could worsen disparities in care. Via survey, 308 Massachusetts primary care practices reported their use of 13 structural capabilities commonly included in medical home proposals. Using geocoded US Census data, we constructed racial/ethnic minority and economic disadvantage indices to describe the neighborhood served by each practice. We compared the structural capabilities of "disproportionate-share" practices (those in the most sociodemographically vulnerable quintile on each index) and others. Racial/ethnic disproportionate-share practices were more likely than others to have staff assisting patient self-management (69% vs 55%; P = .003), on-site language interpreters (54% vs 26%; P < .001), multilingual clinicians (80% vs 51%; P < .001), and multifunctional electronic health records (48% vs 29%; P = .01). Similarly, economic disproportionate-share practices were more likely than others to have physician awareness of patient experience ratings (73% vs 65%; P = .03), on-site language interpreters (56% vs 25%; P < .001), multilingual clinicians (78% vs 51%; P < .001), and multifunctional electronic health records (40% vs 31%; P = .03). Disproportionate-share practices were larger than others. After adjustment for practice size, only language capabilities continued to have statistically significant relationships with disproportionate-share status. Contrary to expectations, primary care practices serving sociodemographically vulnerable neighborhoods were more likely than other practices to have structural capabilities commonly included in medical home proposals. Payments tied to these capabilities may aid practices serving vulnerable populations.

Future time perspective and positive health practices in young adults: an extension.

PubMed

Mahon, N E; Yarcheski, T J; Yarcheski, A

1997-06-01

A sample of 69 young adults attending a public university responded to the Future Time Perspective Inventory, two subscales of the Time Experience Scales (Fast and Slow Tempo), and the Personal Lifestyle Questionnaire in classroom settings. A statistically significant correlation (.52) was found between scores for future time perspective and the ratings for the practice of positive health behaviors in young adults. This correlation was larger than those previously found for middle and late adolescents. Scores on subscales of individual health practices and future time perspective indicated statistically significant correlations for five (.25 to .56) of the six subscales. Scores on neither Fast nor Slow Tempo were related to ratings of positive health practices or ratings on subscales measuring positive health practices.

State of Business Statistics Education in MENA Region: A Comparative Study with Best Practices

ERIC Educational Resources Information Center

Hijazi, Rafiq; Zoubeidi, Taoufik

2017-01-01

Purpose: The purpose of this study is to investigate the state of undergraduate business statistics education in the Middle East and North Africa (MENA) and assess its alignment with the best practices in equipping business graduates with the knowledge and skills demanded by the labor market. Design/methodology/approach: A survey of 108…

Work-related acute physical injuries, chronic overuse complaints, and the psychosocial work environment in Danish primary care chiropractic practice - a cross-sectional study.

PubMed

Hansen, Mille Charlotte; Aagaard, Tine; Christensen, Henrik Wulff; Hartvigsen, Jan

2018-01-01

Little is known about the physical and psychosocial work environment of chiropractors and their work-related health complaints, and this has never been described for Danish chiropractors. The aim of this study was, therefore, to describe work-related acute physical injuries, overuse complaints, and psychosocial stress in Danish chiropractic work settings. We developed a questionnaire specifically for this study and distributed it electronically in August 2016 using SurveyXact to all 575 members of the Danish Chiropractors' Association working in primary care clinics. Chiropractors were asked about their work-related acute physical injuries and overuse complaints as well as any psychosocial stress they experienced at work during the previous year. We described our sample and variables using means, medians, ranges, and confidence intervals where appropriate. Statistically significant differences between genders, types of complaints and injuries, and between clinic owners and associates were examined using Chi-square and Fischer's exact tests, where appropriate, or by examining confidence intervals for non-overlap. 355 (65.2%) chiropractors answered the survey. Of these, 216 (61%, 95% CI 56-66) had experienced a work-related acute physical injury and/or overuse complaint during the previous year. Work-related overuse complaints were most commonly reported in the low back, wrist, thumb, and shoulder, and were more common among women (63%, 95% CI 56-70) than men (51%, 95% CI 43-59). Chiropractors with more than five years in practice (59%, 95% CI 52-64) reported significantly fewer work-related acute injuries and overuse complaints during the previous year compared with chiropractors with less than five years in practice (83%, 95% CI 73-91). In general, these practicing Danish chiropractors reported having a good psychosocial work environment, and 90% of chiropractors "always" or "often" felt that they were motivated and committed to their work. This sample of Danish practicing chiropractors commonly reported work-related acute physical injuries or overuse complaints. Overuse complaints were most commonly reported in the low back, wrist, thumb, and shoulder and were more common among women than men. Newly educated chiropractors reported more overuse complaints than experienced chiropractors. Collectively, this sample of Danish chiropractors reported that they had a good psychosocial work environment.

One size doesn't fit all: time to revisit patient-reported outcome measures (PROMs) in paediatric ophthalmology?

PubMed Central

Tadić, V; Rahi, J S

2017-01-01

The purpose of this article is to summarise methodological challenges and opportunities in the development and application of patient reported outcome measures (PROMs) for the rare and complex population of children with visually impairing disorders. Following a literature review on development and application of PROMs in children in general, including those with disabilities and or/chronic condition, we identified and discuss here 5 key issues that are specific to children with visual impairment: (1) the conflation between theoretically distinct vision-related constructs and outcomes, (2) the importance of developmentally appropriate approaches to design and application of PROMs, (3) feasibility of standard questionnaire formats and administration for children with different levels of visual impairment, (4) feasibility and nature of self-reporting by visually impaired children, and (5) epidemiological, statistical and ethical considerations. There is an established need for vision-specific age-appropriate PROMs for use in paediatric ophthalmology, but there are significant practical and methodological challenges in developing and applying appropriate measures. Further understanding of the characteristics and needs of visually impaired children as questionnaire respondents is necessary for development of quality PROMs and their meaningful application in clinical practice and research. PMID:28085146

TU-B-304-01: The Aftermath of TG-142

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

Klein, E.

2015-06-15

Although published in 2009, the AAPM TG-142 report on accelerator quality assurance still proves a challenge for full clinical implementation. The choice of methodologies to satisfy TG-142 requirements is critical to a successful application. Understanding the philosophy of TG-142 can help in creating an institution-specific QA practice that is both efficient and effective. The concept of maintaining commissioned beam profiles is still found confusing. The physicist must also consider technologies not covered by TG-142 (i.e. arc therapy techniques). On the horizon is TG-198 report on implementing TG-142. Although the community still lacks a final TG-100 report, performing a failure-mode -and-effectsmore » analysis and statistical process control analysis to determine the institution-specific clinical impact of each TG-142 test may be useful for identifying trends for pro-active surveillance. Learning Objectives: To better understand the confusing and controversial aspects of TG-142. To understand what is still missing from TG-142 and how to account for these tests in clinical practice To describe which QA tests in TG-142 yield the largest potential clinical result if not discovered.« less

TU-B-304-02: Quantitative FMEA of TG-142

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

O’Daniel, J.

2015-06-15

Although published in 2009, the AAPM TG-142 report on accelerator quality assurance still proves a challenge for full clinical implementation. The choice of methodologies to satisfy TG-142 requirements is critical to a successful application. Understanding the philosophy of TG-142 can help in creating an institution-specific QA practice that is both efficient and effective. The concept of maintaining commissioned beam profiles is still found confusing. The physicist must also consider technologies not covered by TG-142 (i.e. arc therapy techniques). On the horizon is TG-198 report on implementing TG-142. Although the community still lacks a final TG-100 report, performing a failure-mode -and-effectsmore » analysis and statistical process control analysis to determine the institution-specific clinical impact of each TG-142 test may be useful for identifying trends for pro-active surveillance. Learning Objectives: To better understand the confusing and controversial aspects of TG-142. To understand what is still missing from TG-142 and how to account for these tests in clinical practice To describe which QA tests in TG-142 yield the largest potential clinical result if not discovered.« less

TU-B-304-00: The Aftermath of TG-142

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

NONE

2015-06-15

Although published in 2009, the AAPM TG-142 report on accelerator quality assurance still proves a challenge for full clinical implementation. The choice of methodologies to satisfy TG-142 requirements is critical to a successful application. Understanding the philosophy of TG-142 can help in creating an institution-specific QA practice that is both efficient and effective. The concept of maintaining commissioned beam profiles is still found confusing. The physicist must also consider technologies not covered by TG-142 (i.e. arc therapy techniques). On the horizon is TG-198 report on implementing TG-142. Although the community still lacks a final TG-100 report, performing a failure-mode -and-effectsmore » analysis and statistical process control analysis to determine the institution-specific clinical impact of each TG-142 test may be useful for identifying trends for pro-active surveillance. Learning Objectives: To better understand the confusing and controversial aspects of TG-142. To understand what is still missing from TG-142 and how to account for these tests in clinical practice To describe which QA tests in TG-142 yield the largest potential clinical result if not discovered.« less

Applied extreme-value statistics

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

Kinnison, R.R.

1983-05-01

The statistical theory of extreme values is a well established part of theoretical statistics. Unfortunately, it is seldom part of applied statistics and is infrequently a part of statistical curricula except in advanced studies programs. This has resulted in the impression that it is difficult to understand and not of practical value. In recent environmental and pollution literature, several short articles have appeared with the purpose of documenting all that is necessary for the practical application of extreme value theory to field problems (for example, Roberts, 1979). These articles are so concise that only a statistician can recognise all themore » subtleties and assumptions necessary for the correct use of the material presented. The intent of this text is to expand upon several recent articles, and to provide the necessary statistical background so that the non-statistician scientist can recognize and extreme value problem when it occurs in his work, be confident in handling simple extreme value problems himself, and know when the problem is statistically beyond his capabilities and requires consultation.« less

Statistical panorama of female physics graduate students for 2000-2010 in Peru

NASA Astrophysics Data System (ADS)

Cerón Loayza, María Luisa; Bravo Cabrejos, Jorge Aurelio

2013-03-01

We report the results of a statistical study on the number of women entering the undergraduate and master's programs of physics at Universidad Nacional Mayor de San Marcos in Peru. From 2006 through 2010, 13 female students entered the master's degree program but no females graduated with the degree. Considering that Peru is a developing country, a career in physics is not considered an attractive professional choice even for male students because it is thought that there are no work centers to practice this profession. We recommend that the causes preventing female physics students from completing their studies and research work be analyzed, and that strategies be planned to help women complete their academic work. We are considering getting help from the Peruvian Physics Society (SOPERFI) in order to draw more attention for our plan.

The development and validation of the Instructional Practices Log in Science: a measure of K-5 science instruction

NASA Astrophysics Data System (ADS)

Adams, Elizabeth L.; Carrier, Sarah J.; Minogue, James; Porter, Stephen R.; McEachin, Andrew; Walkowiak, Temple A.; Zulli, Rebecca A.

2017-02-01

The Instructional Practices Log in Science (IPL-S) is a daily teacher log developed for K-5 teachers to self-report their science instruction. The items on the IPL-S are grouped into scales measuring five dimensions of science instruction: Low-level Sense-making, High-level Sense-making, Communication, Integrated Practices, and Basic Practices. As part of the current validation study, 206 elementary teachers completed 4137 daily log entries. The purpose of this paper is to provide evidence of validity for the IPL-S's scales, including (a) support for the theoretical framework; (b) cognitive interviews with logging teachers; (c) item descriptive statistics; (d) comparisons of 28 pairs of teacher and rater logs; and (e) an examination of the internal structure of the IPL-S. We present evidence to describe the extent to which the items and the scales are completed accurately by teachers and differentiate various types of science instructional strategies employed by teachers. Finally, we point to several practical implications of our work and potential uses for the IPL-S. Overall, results provide neutral to positive support for the validity of the groupings of items or scales.

The DNP project: Quandaries for nursing scholars.

PubMed

Dols, Jean Dowling; Hernández, Christina; Miles, Heather

In the evolving Doctor of Nursing Practice (DNP) movement, there continues to be a lack of agreement about the final scholarly project. This study identifies and describes the faculty practices and challenges related to the DNP project across the United States. In a descriptive research study, 90 DNP program directors responded to an online survey describing the environment of the DNP program with emphasis on the final scholarly project. According to the respondents, 87% of faculty are somewhat or very dissatisfied with the DNP project. Elements that may contribute to the dissatisfaction are the reported lack of faculty knowledge of evidence-based practice and quality improvement, lack of consensus on the DNP project, lack of faculty resources for DNP projects, challenges with clinical sites for the DNP project, and students' scholarly writing skills. It is imperative to have academic/practice faculty oriented to DNP concepts; achieve consensus on the project title, type, depth, and outcomes; and have an ongoing dialog regarding DNP project design, execution, and challenges. Project implementation models need to be appropriate for the escalating DNP enrollment. Program support related to institutional review board relationships, student writing and statistical skills, and program-practice site partnerships are needed. Copyright © 2016 Elsevier Inc. All rights reserved.

Hold My Calls: An Activity for Introducing the Statistical Process

ERIC Educational Resources Information Center

Abel, Todd; Poling, Lisa

2015-01-01

Working with practicing teachers, this article demonstrates, through the facilitation of a statistical activity, how to introduce and investigate the unique qualities of the statistical process including: formulate a question, collect data, analyze data, and interpret data.

Multipayer patient-centered medical home implementation guided by the chronic care model.

PubMed

Gabbay, Robert A; Bailit, Michael H; Mauger, David T; Wagner, Edward H; Siminerio, Linda

2011-06-01

A unique statewide multipayer ini Pennsylvania was undertaken to implement the Patient-Centered Medical Home (PCMH) guided by the Chronic Care Model (CCM) with diabetes as an initial target disease. This project represents the first broad-scale CCM implementation with payment reform across a diverse range of practice organizations and one of the largest PCMH multipayer initiatives. Practices implemented the CCM and PCMH through regional Breakthrough Series learning collaboratives, supported by Improving Performance in Practice (IPIP) practice coaches, with required monthly quality reporting enhanced by multipayer infrastructure payments. Some 105 practices, representing 382 primary care providers, were engaged in the four regional collaboratives. The practices from the Southeast region of Pennsylvania focused on diabetes patients (n = 10,016). During the first intervention year (May 2008-May 2009), all practices achieved at least Level 1 National Committee for Quality Assurance (NCQA) Physician Practice Connections Patient-Centered Medical Home (PPC-PCMH) recognition. There was significant improvement in the percentage of patients who had evidence-based complications screening and who were on therapies to reduce morbidity and mortality (statins, angiotensin-converting enzyme inhibitors). In addition, there were small but statistically significant improvements in key clinical parameters for blood pressure and cholesterol levels, with the greatest absolute improvement in the highest-risk patients. Transforming primary care delivery through implementation of the PCMH and CCM supported by multipayer infrastructure payments holds significant promise to improve diabetes care.

Perceived barriers to preventive dental care among Libyan dentists.

PubMed

Arheiam, Arheiam; Masoud, Ibtisam; Bernabé, Eduardo

2014-01-01

Aim To explore the barriers to providing preventive dental care to patients, as perceived by Libyan dentists working in Benghazi. Settings and design A cross-sectional, questionnaire-based survey was conducted among dentists working in Benghazi, Libya. Materials and methods All dentists registered with the Dental Association of Benghazi and with 2 or more years of practice were invited to participate. The questionnaire collected information on participants' demographic and professional characteristics as well as the patient-, practice- and dentist-related barriers to providing preventive dental care. Statistical analysis Scores for each type of barrier were compared by demographic and professional characteristics in bivariate and multivariate analyses. Results One hundred and seventy five dentists returned the questionnaires (response rate: 79%) and 166 had complete information on all the variables selected for analysis (75%). The majority were females (70%), aged between 23 and 34 years (85%), was working in the public health sector (43%), and had up to 5 years of service (46%). Patient-related barriers were scored the highest, followed by practice- and dentist-related barriers. Dentists with mixed practice reported lower scores on patient- and practice-related barriers than those in public or private practice. Conclusion Respondents were generally aware of the barriers to preventive dentistry and perceived the barriers as being more related to their patients than to their practices or themselves. However, these perceptions varied by practice sector.

The influence of curricular and extracurricular learning activities on students' choice of chiropractic technique

PubMed Central

Sikorski, David M.; KizhakkeVeettil, Anupama; Tobias, Gene S.

2016-01-01

Objective: Surveys for the National Board of Chiropractic Examiners indicate that diversified chiropractic technique is the most commonly used chiropractic manipulation method. The study objective was to investigate the influences of our diversified core technique curriculum, a technique survey course, and extracurricular technique activities on students' future practice technique preferences. Methods: We conducted an anonymous, voluntary survey of 1st, 2nd, and 3rd year chiropractic students at our institution. Surveys were pretested for face validity, and data were analyzed using descriptive and inferential statistics. Results: We had 164 students (78% response rate) participate in the survey. Diversified was the most preferred technique for future practice by students, and more than half who completed the chiropractic technique survey course reported changing their future practice technique choice as a result. The students surveyed agreed that the chiropractic technique curriculum and their experiences with chiropractic practitioners were the two greatest bases for their current practice technique preference, and that their participation in extracurricular technique clubs and seminars was less influential. Conclusions: Students appear to have the same practice technique preferences as practicing chiropractors. The chiropractic technique curriculum and the students' experience with chiropractic practitioners seem to have the greatest influence on their choice of chiropractic technique for future practice. Extracurricular activities, including technique clubs and seminars, although well attended, showed a lesser influence on students' practice technique preferences. PMID:26655282

The influence of curricular and extracurricular learning activities on students' choice of chiropractic technique.

PubMed

Sikorski, David M; KizhakkeVeettil, Anupama; Tobias, Gene S

2016-03-01

Surveys for the National Board of Chiropractic Examiners indicate that diversified chiropractic technique is the most commonly used chiropractic manipulation method. The study objective was to investigate the influences of our diversified core technique curriculum, a technique survey course, and extracurricular technique activities on students' future practice technique preferences. We conducted an anonymous, voluntary survey of 1st, 2nd, and 3rd year chiropractic students at our institution. Surveys were pretested for face validity, and data were analyzed using descriptive and inferential statistics. We had 164 students (78% response rate) participate in the survey. Diversified was the most preferred technique for future practice by students, and more than half who completed the chiropractic technique survey course reported changing their future practice technique choice as a result. The students surveyed agreed that the chiropractic technique curriculum and their experiences with chiropractic practitioners were the two greatest bases for their current practice technique preference, and that their participation in extracurricular technique clubs and seminars was less influential. Students appear to have the same practice technique preferences as practicing chiropractors. The chiropractic technique curriculum and the students' experience with chiropractic practitioners seem to have the greatest influence on their choice of chiropractic technique for future practice. Extracurricular activities, including technique clubs and seminars, although well attended, showed a lesser influence on students' practice technique preferences.

Main outcomes of an RCT to pilot test reporting and feedback to foster research integrity climates in the VA.

PubMed

Martinson, Brian C; Mohr, David C; Charns, Martin P; Nelson, David; Hagel-Campbell, Emily; Bangerter, Ann; Bloomfield, Hanna E; Owen, Richard; Thrush, Carol R

2017-01-01

Assessing the integrity of research climates and sharing such information with research leaders may support research best practices. We report here results of a pilot trial testing the effectiveness of a reporting and feedback intervention using the Survey of Organizational Research Climate (SOuRCe). We randomized 41 Veterans Health Administration (VA) facilities to a phone-based intervention designed to help research leaders understand their survey results (enhanced arm) or to an intervention in which results were simply distributed to research leaders (basic arm). Primary outcomes were (1) whether leaders took action, (2) whether actions taken were consistent with the feedback received, and (3) whether responses differed by receptivity to quality improvement input. Research leaders from 25 of 42 (59%) VA facilities consented to participate in the study intervention and follow-up, of which 14 were at facilities randomized to the enhanced arm. We completed follow-up interviews with 21 of the 25 leaders (88%), 12 from enhanced arm facilities. While not statistically significant, the proportion of leaders reporting taking some action in response to the feedback was twice as high in the enhanced arm than in the basic arm (67% vs. 33%, p = .20). While also not statistically significant, a higher proportion of actions taken among facilities in the enhanced arm were responsive to the survey results than in the basic arm (42% vs. 22%, p = .64). Enhanced feedback of survey results appears to be a promising intervention that may increase the likelihood of responsive action to improve organizational climates. Due to the small sample size of this pilot study, even large percentage-point differences between study arms are not statistically distinguishable. This hypothesis should be tested in a larger trial.

Critiquing qualitative research.

PubMed

Beck, Cheryl Tatano

2009-10-01

The ability to critique research is a valuable skill that is fundamental to a perioperative nurse's ability to base his or her clinical practice on evidence derived from research. Criteria differ for critiquing a quantitative versus a qualitative study (ie, statistics are evaluated in a quantitative study, but not in a qualitative study). This article provides on guidelines for assessing qualitative research. Excerpts from a published qualitative research report are summarized and then critiqued. Questions are provided that help evaluate different sections of a research study (eg, sample, data collection methods, data analysis).

Comparison of four-hour and twenty-four-hour refrigerated storage of nonpotable water for fecal coliform analysis.

PubMed Central

Standridge, J H; Lesar, D J

1977-01-01

The problem of extending the storage time of water samples for fecal coliform analysis was addressed. Included in this report is a literature review of the storage problem. Twenty-eight samples were analyzed in replicate to determine the effect of 24-h storage of water samples at 4 degrees C. A new statistical approach to data analysis, coupled with the concept of practical acceptability, is presented. According to our results, many samples can successfully be stored at 4 degrees C for 24 h. PMID:335972