Sample records for study design primary

  1. [Impact of anchorage implant design factors on its primary stability].

    PubMed

    Zhang, J N; Lu, H P; Zhong, C

    2017-08-09

    During the past decade, the anchorage implants have been widely used in the orthodontic treatment. Many scholars have studied the influence of different factors on anchorage implant's primary stability, including anchorage implant's material properties, structural design, surgical procedure, bone condition, loading force's magnitude and direction. This article is to review the influence of anchorage implant's shape, dimension, neck design and thread design on its primary stability.

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

    PubMed

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

    2013-06-25

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

  3. Impact of implant design on primary stability of orthodontic mini-implants.

    PubMed

    Wilmes, Benedict; Ottenstreuer, Stephanie; Su, Yu-Yu; Drescher, Dieter

    2008-01-01

    Skeletal anchorage with mini-implants has greatly broadened the treatment possibilities in orthodontics over the last few years. To reduce implant failure rates, it is advisable to obtain adequate primary stability. The aim of this study was to quantitatively analyze the impact of implant design and dimension on primary stability. Forty-two porcine iliac bone segments were prepared and embedded in resin. To evaluate the primary stability, we documented insertion torques of the following mini-implants: Aarhus Screw, AbsoAnchor, LOMAS, Micro-Anchorage-System, ORLUS and Spider Screw. In each bone, five Dual Top Screws were inserted for reference purposes to achieve comparability among the specimens. We observed wide variation in insertion torques and hence primary stability, depending on mini-implant design and dimension; the great impact that mini-implant diameter has on insertion torques was particularly conspicuous. Conical mini-implants achieved higher primary stabilities than cylindrical designs. The diameter and design of the mini-implant thread have a distinctive impact on primary stability. Depending on the region of insertion and local bone quality, the choice of the mini-implant design and size is crucial to establish sufficient primary stability.

  4. An analysis of characteristics of post-authorisation studies registered on the ENCePP EU PAS Register

    PubMed Central

    Carroll, Robert; Ramagopalan, Sreeram V.; Cid-Ruzafa, Javier; Lambrelli, Dimitra; McDonald, Laura

    2017-01-01

    Background: The objective of this study was to investigate the study design characteristics of Post-Authorisation Studies (PAS) requested by the European Medicines Agency which were recorded on the European Union (EU) PAS Register held by the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP). Methods: We undertook a cross-sectional descriptive analysis of all studies registered on the EU PAS Register as of 18 th October 2016. Results: We identified a total of 314 studies on the EU PAS Register, including 81 (26%) finalised, 160 (51%) ongoing and 73 (23%) planned. Of those studies identified, 205 (65%) included risk assessment in their scope, 133 (42%) included drug utilisation and 94 (30%) included effectiveness evaluation. Just over half of the studies (175; 56%) used primary data capture, 135 (43%) used secondary data and 4 (1%) used a hybrid design combining both approaches. Risk assessment and effectiveness studies were more likely to use primary data capture (60% and 85% respectively as compared to 39% and 14% respectively for secondary). The converse was true for drug utilisation studies where 59% were secondary vs. 39% for primary. For type 2 diabetes mellitus, database studies were more commonly used (80% vs 3% chart review, 3% hybrid and 13% primary data capture study designs) whereas for studies in oncology, primary data capture were more likely to be used (85% vs 4% chart review, and 11% database study designs). Conclusions: Results of this analysis show that PAS design varies according to study objectives and therapeutic area. PMID:29188016

  5. Designing Tasks to Promote and Assess Mathematical Transfer in Primary School Children

    ERIC Educational Resources Information Center

    Clark, Julie; Page, Shaileigh; Thornton, Steve

    2013-01-01

    This study aims to design learning situations and tasks that promote and assess the capacity of primary school children to transfer mathematical knowledge to new contexts. We discuss previous studies investigating mathematical transfer, and particularly the strengths and limitations of tasks used to assess transfer in these studies. We describe…

  6. Proposed primary endpoints for use in clinical trials that compare treatment options for bloodstream infection in adults: a consensus definition.

    PubMed

    Harris, P N A; McNamara, J F; Lye, D C; Davis, J S; Bernard, L; Cheng, A C; Doi, Y; Fowler, V G; Kaye, K S; Leibovici, L; Lipman, J; Llewelyn, M J; Munoz-Price, S; Paul, M; Peleg, A Y; Rodríguez-Baño, J; Rogers, B A; Seifert, H; Thamlikitkul, V; Thwaites, G; Tong, S Y C; Turnidge, J; Utili, R; Webb, S A R; Paterson, D L

    2017-08-01

    To define standardized endpoints to aid the design of trials that compare antibiotic therapies for bloodstream infections (BSI). Prospective studies, randomized trials or registered protocols comparing antibiotic therapies for BSI, published from 2005 to 2016, were reviewed. Consensus endpoints for BSI studies were defined using a modified Delphi process. Different primary and secondary endpoints were defined for pilot (small-scale studies designed to evaluate protocol design, feasibility and implementation) and definitive trials (larger-scale studies designed to test hypotheses and influence clinical practice), as well as for Staphylococcus aureus and Gram-negative BSI. For pilot studies of S. aureus BSI, a primary outcome of success at day 7 was defined by: survival, resolution of fever, stable/improved Sequential Organ Failure Assessment (SOFA) score and clearance of blood cultures, with no microbiologically confirmed failure up to 90 days. For definitive S. aureus BSI studies, a primary outcome of success at 90 days was defined by survival and no microbiologically confirmed failure. For pilot studies of Gram-negative BSI, a primary outcome of success at day 7 was defined by: survival, resolution of fever and symptoms related to BSI source, stable or improved SOFA score and negative blood cultures. For definitive Gram-negative BSI studies, a primary outcome of survival at 90 days supported by a secondary outcome of success at day 7 (as previously defined) was agreed. These endpoints provide a framework to aid future trial design. Further work will be required to validate these endpoints with respect to patient-centred clinical outcomes. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. All rights reserved.

  7. Three-meter telescope study

    NASA Technical Reports Server (NTRS)

    Wissinger, A.; Scott, R. M.; Peters, W.; Augustyn, W., Jr.; Arnold, R.; Offner, A.; Damast, M.; Boyce, B.; Kinnaird, R.; Mangus, J. D.

    1971-01-01

    A means is presented whereby the effect of various changes in the most important parameters of a three meter aperature space astronomy telescope can be evaluated to determine design trends and to optimize the optical design configuration. Methods are defined for evaluating the theoretical optical performance of axisymmetric, centrally obscured telescopes based upon the intended astronomy research usage. A series of design parameter variations is presented to determine the optimum telescope configuration. The design optimum requires very fast primary mirrors, so the study also examines the current state of the art in fabricating large, fast primary mirrors. The conclusion is that a 3-meter primary mirror having a focal ratio as low as f/2 is feasible using currently established techniques.

  8. LUTE primary mirror materials and design study report

    NASA Astrophysics Data System (ADS)

    Ruthven, Greg

    1993-02-01

    The major objective of the Lunar Ultraviolet Telescope Experiment (LUTE) Primary Mirror Materials and Design Study is to investigate the feasibility of the LUTE telescope primary mirror. A systematic approach to accomplish this key goal was taken by first understanding the optical, thermal, and structural requirements and then deriving the critical primary mirror-level requirements for ground testing, launch, and lunar operations. After summarizing the results in those requirements which drove the selection of material and the design for the primary mirror are discussed. Most important of these are the optical design which was assumed to be the MSFC baseline (i.e. 3 mirror optical system), telescope wavefront error (WFE) allocations, the telescope weight budget, and the LUTE operational temperature ranges. Mechanical load levels, reflectance and microroughness issues, and options for the LUTE metering structure were discussed and an outline for the LUTE telescope sub-system design specification was initiated. The primary mirror analysis and results are presented. The six material substrate candidates are discussed and four distinct mirror geometries which are considered are shown. With these materials and configurations together with varying the location of the mirror support points, a total of 42 possible primary mirror designs resulted. The polishability of each substrate candidate was investigated and a usage history of 0.5 meter and larger precision cryogenic mirrors (the operational low end LUTE temperature of 60 K is the reason we feel a survey of cryogenic mirrors is appropriate) that were flown or tested are presented.

  9. LUTE primary mirror materials and design study report

    NASA Technical Reports Server (NTRS)

    Ruthven, Greg

    1993-01-01

    The major objective of the Lunar Ultraviolet Telescope Experiment (LUTE) Primary Mirror Materials and Design Study is to investigate the feasibility of the LUTE telescope primary mirror. A systematic approach to accomplish this key goal was taken by first understanding the optical, thermal, and structural requirements and then deriving the critical primary mirror-level requirements for ground testing, launch, and lunar operations. After summarizing the results in those requirements which drove the selection of material and the design for the primary mirror are discussed. Most important of these are the optical design which was assumed to be the MSFC baseline (i.e. 3 mirror optical system), telescope wavefront error (WFE) allocations, the telescope weight budget, and the LUTE operational temperature ranges. Mechanical load levels, reflectance and microroughness issues, and options for the LUTE metering structure were discussed and an outline for the LUTE telescope sub-system design specification was initiated. The primary mirror analysis and results are presented. The six material substrate candidates are discussed and four distinct mirror geometries which are considered are shown. With these materials and configurations together with varying the location of the mirror support points, a total of 42 possible primary mirror designs resulted. The polishability of each substrate candidate was investigated and a usage history of 0.5 meter and larger precision cryogenic mirrors (the operational low end LUTE temperature of 60 K is the reason we feel a survey of cryogenic mirrors is appropriate) that were flown or tested are presented.

  10. Investigating Primary Source Literacy

    ERIC Educational Resources Information Center

    Archer, Joanne; Hanlon, Ann M.; Levine, Jennie A.

    2009-01-01

    Primary source research requires students to acquire specialized research skills. This paper presents results from a user study testing the effectiveness of a Web guide designed to convey the concepts behind "primary source literacy". The study also evaluated students' strengths and weaknesses when conducting primary source research. (Contains 3…

  11. Using Design-Based Research to Improve the Lesson Study Approach to Professional Development in Camden (London)

    ERIC Educational Resources Information Center

    Brown, Chris; Taylor, Carol; Ponambalum, Lorna

    2016-01-01

    The Haverstock Primary to Secondary Transition Project was designed to improve the experience of transition to secondary school for vulnerable pupils in Camden (London). The project used lesson study to help primary and secondary practitioners work collaboratively, to develop effective cross-phase pedagogical approaches to teaching…

  12. Exploring AI Language Assistants with Primary EFL Students

    ERIC Educational Resources Information Center

    Underwood, Joshua

    2017-01-01

    The main objective of this study was to identify ways to incorporate voice-driven Artificial Intelligence (AI) effectively in classroom language learning. This nine month teacher-led design research study employed technology probes (Amazon's Alexa, Apple's Siri, Google voice search) and co-design methods with a class of primary age English as a…

  13. Didactital design of mathematics teaching in primary school

    NASA Astrophysics Data System (ADS)

    Nur’aeni, E.; Muharram, M. R. W.

    2018-05-01

    The fact that the low ability of geometrical understanding of primary school students is what triggers this study to be conducted. Thus, this research aimed to find out how to create a didactical design of students' mathematical understanding, particularly on one of geometry materials that is unit of length. A qualitative approach promoting Didactical Design Research (DDR) was administered in this study. Participants of the study were primary school students in Tasikmalaya, an city in West Java Province, Indonesia. The results show that there was a learning design based on learning obstacles found in the mathematics teaching and learning processes. The learning obstacles comprised students' difficulties in memorizing, relating, and operating the standards of unit of lengths. It has been proven that the most influential factor in the success of mathematics teaching and learning processes is the use of creative media.

  14. Influence of stem design on the primary stability of megaprostheses of the proximal femur.

    PubMed

    Kinkel, Stefan; Graage, Jan Dennis; Kretzer, Jan Philippe; Jakubowitz, Eike; Nadorf, Jan

    2013-10-01

    Extended bone defects of the proximal femur can be reconstructed by megaprostheses for which aseptic loosening constitutes one of the major failure modes. The basic requirement for long-term success of endoprostheses is primary stability. We therefore assessed whether sufficient primary stability can be achieved by four different megaprostheses in a standardised bone defect of the proximal femur and whether their different design leads to different fixation patterns. Four different designs of proximal femoral replacements were implanted into 16 Sawbones® after preparing segmental bone defects (AAOS type II). Primary rotational stability was analysed by application of a cyclic torque of ±7 Nm and measuring the relative micromotions between bone and implant at different levels. The main fixation zones and differences of fixation patterns of the stem designs were determined by an analysis of variance. All four implants exhibited micromotions below 150 μm, indicating adequate primary stability. Lowest micromotions for all designs were located near the femoral isthmus. The extent of primary stability and the global implant fixation pattern differed considerably and could be related to the different design concepts. All megaprostheses studied provided sufficient primary stability if the fixation conditions of the femoral isthmus were intact. The design characteristics of the different stems largely determined the extent of primary stability and fixation pattern. Understanding these different fixation types could help the surgeon to choose the most suitable implant if the fixation conditions in the isthmus are compromised.

  15. A Study of the Knowledge of Phonics, Phonemic Awareness, and Developmental Spelling Ability in Primary Non-Readers.

    ERIC Educational Resources Information Center

    Hill, Susan

    Since one way to study a non-reading primary child's phonics knowledge is to examine his/her invented spelling, a researcher's quandary led to a quasi-experimental design study, employed to answer three questions: (1) Do primary non-readers possess phonics knowledge? (2) Do primary non-readers possess phonemic awareness? and (3) Do primary…

  16. Self-Management for Primary School Students Demonstrating Problem Behavior in Regular Classrooms: Evidence Review of Single-Case Design Research

    ERIC Educational Resources Information Center

    Busacca, Margherita L.; Anderson, Angelika; Moore, Dennis W.

    2015-01-01

    This review evaluates self-management literature targeting problem behaviors of primary school students in general education settings. Thirty-one single-case design studies met inclusion criteria, of which 16 demonstrated adequate methodological rigor, according to What Works Clearinghouse (WWC) design standards. Visual analysis and WWC…

  17. Design Study of an 8 Meter Monolithic Mirror UV/Optical Space Telescope

    NASA Technical Reports Server (NTRS)

    Stahl, H. Philip

    2008-01-01

    This paper will review a recent NASA MSFC preliminary study that demonstrated the feasibility of launching a 6 to 8 meter class monolithic primary mirror telescope to Sun-Earth L2 using an Ares V. The study started with the unique capabilities of the Ares V vehicle and examined the feasibility of launching a large aperture low cost low risk telescope based on a conventional ground based glass primary mirror. Specific technical areas studied included optical design; structural design/analysis including primary mirror support structure, sun shade and secondary mirror support structure; thermal analysis; launch vehicle performance and trajectory; spacecraft including structure, propulsion, GN & C, avionics, power systems and reaction wheels; operations & servicing, mass budget and system cost. The study telescope was an on-axis three-mirror anastigmatic design with a fine steering mirror. The observatory has a 100 arc-minute (8.4 X 12 arc-minutes) of diffraction limited field of view at a wavelength les than 500 nm. The study assumed that the primary mirror would be fabricated from an existing Schott Zerodur residual VLT blank edged to 6.2 meters, 175 mm thick at the edge with a mass of 11,000 kg. The entire mass budget for the observatory including primary mirror, structure, light baffle tube, instruments, space craft, avionics, etc. is less than 40,000 kg - a 33% mass margin on the Ares V's 60,000 kg Sun-Earth L2 capability. An 8 meter class observatory would have a total mass of less than 60,000 kg of which the primary mirror is the largest contributor.

  18. Evaluation of Turkish Grammar Instruction Based on Primary School Teachers' Opinions

    ERIC Educational Resources Information Center

    Anilan, Hüseyin

    2014-01-01

    This study aims to evaluate the effectiveness of the holistic approach to Turkish grammar instruction in the first stage of primary education from the opinions and experiences of Turkish primary school teachers. This study is a qualitative research designed as a phenomenological study. The study participants were selected using maximum variation…

  19. Developing Pedagogical Practices in Myanmar Primary Schools: Possibilities and Constraints

    ERIC Educational Resources Information Center

    Hardman, Frank; Stoff, Christian; Aung, Wan; Elliott, Louise

    2016-01-01

    This paper presents the findings of a baseline study of pedagogic practices used by Myanmar primary teachers in the teaching of mathematics and Myanmar language at Grades 3 and 5. The main purpose of the baseline study was to inform the design of teacher education programmes and allow for subsequent evaluations of interventions designed to improve…

  20. An Evaluation of Learning Objects in Singapore Primary Education: A Case Study Approach

    ERIC Educational Resources Information Center

    Grace, Tay Pei Lyn; Suan, Ng Peck; Wanzhen, Liaw

    2008-01-01

    Purpose: The purpose of this paper is to evaluate the usability and interface design of e-learning portal developed for primary schools in Singapore. Design/methodology/approach: Using Singapore-based learning EDvantage (LEAD) portal as a case study, this paper reviews and analyses the usability and usefulness of embedded learning objects (LOs)…

  1. Staff Perspectives on the Use of a Computer-Based Concept for Lifestyle Intervention Implemented in Primary Health Care

    ERIC Educational Resources Information Center

    Carlfjord, Siw; Johansson, Kjell; Bendtsen, Preben; Nilsen, Per; Andersson, Agneta

    2010-01-01

    Objective: The aim of this study was to evaluate staff experiences of the use of a computer-based concept for lifestyle testing and tailored advice implemented in routine primary health care (PHC). Design: The design of the study was a cross-sectional, retrospective survey. Setting: The study population consisted of staff at nine PHC units in the…

  2. A Study on Basic Process Skills of Turkish Primary School Students

    ERIC Educational Resources Information Center

    Aydogdu, Bulent

    2017-01-01

    Purpose: The purpose of this study was to find out primary school students' basic process skills (BPSs) in terms of select variables. In addition, this study aims to investigate the relationship between BPSs and academic achievement. Research Methods: The study had a survey design and was conducted with 1272 primary school students. The study data…

  3. Design trade study for a 4-meter off-axis primary mirror substrate and mount for the Habitable-zone Exoplanet Direct Imaging Mission

    NASA Astrophysics Data System (ADS)

    Arnold, William R.; Stahl, H. Philip

    2017-09-01

    An extensive trade study was conducted to evaluate primary mirror substrate design architectures for the HabEx mission baseline 4-meter off-axis telescope. The study's purpose is not to produce a final design, but rather to established a design methodology for matching the mirror's properties (mass and stiffness) with the mission's optical performance specifications (static dynamic wavefront error, WFE). The study systematically compares the effect of proven design elements (closed-back vs open-back vs partial-back; meniscus vs flat back vs shaped back; etc.), which can be implemented with proven space mirror materials (ULE and Zerodur), on static and dynamic WFE. Additionally, the study compares static and dynamic WFE of each substrate point design integrated onto three and six point mounts.

  4. Design development of graphite primary structures enables SSTO success

    NASA Astrophysics Data System (ADS)

    Biagiotti, V. A.; Yahiro, J. S.; Suh, Daniel E.; Hodges, Eric R.; Prior, Donald J.

    1997-01-01

    This paper describes the development of a graphite composite wing and a graphite composite intertank primary structure for application toward Single-Stage to Orbit space vehicles such as those under development in NASA's X-33/Reusable Launch Vehicle (RLV) Program. The trade study and designs are based on a Rockwell vertical take-off and horizontal landing (VTHL) wing-body RLV vehicle. Northrop Grumman's approach using a building block development technique is described. Composite Graphite/Bismaleimide (Gr/BMI) material characterization test results are presented. Unique intertank and wing composite subcomponent test article designs are described and test results to date are presented. Wing and intertank Full Scale Section Test Article (FSTA) objectives and designs are outlined. Trade studies, supporting building block testing, and FSTA demonstrations combine to develop graphite primary structure composite technology that enables developing X-33/RLV design programs to meet critical SSTO structural weight and operations performance criteria.

  5. Design study of primary ion provider for relativistic heavy ion collider electron beam ion source.

    PubMed

    Kondo, K; Kanesue, T; Tamura, J; Okamura, M

    2010-02-01

    Brookhaven National Laboratory has developed the new preinjector system, electron beam ion source (EBIS) for relativistic heavy ion collider (RHIC) and National Aeronautics and Space Administration Space Radiation Laboratory. Design of primary ion provider is an essential problem since it is required to supply beams with different ion species to multiple users simultaneously. The laser ion source with a defocused laser can provide a low charge state and low emittance ion beam, and is a candidate for the primary ion source for RHIC-EBIS. We show a suitable design with appropriate drift length and solenoid, which helps to keep sufficient total charge number with longer pulse length. The whole design of primary ion source, as well as optics arrangement, solid targets configuration and heating about target, is presented.

  6. An Effective Introduction to Technology and Design in Norwegian Primary Education

    ERIC Educational Resources Information Center

    Kirkeby, Pal J.

    2010-01-01

    How can young pupils get "An effective introduction" to technology and design at the primary level in the Norwegian context? This question is highlighted with examples based on case studies at five classes in two schools doing their first technology and design project at grades 1 or 2 (age 6-8 years). The project was about air rockets.…

  7. Computer Assisted Educational Material Preparation for Fourth Grade Primary School Students' English Language Class in Teaching Numbers

    ERIC Educational Resources Information Center

    Yüzen, Abdulkadir; Karamete, Aysen

    2016-01-01

    In this study, using ADDIE instructional design model, it is aimed to prepare English language educational material for 4th grade primary students to teach them numbers. At the same time, ARCS model of motivation's attention, relevance and satisfaction phases are also taken into consideration. This study also comprises of Design Based Research…

  8. World War II Unit. Using Primary Sources in the Classroom.

    ERIC Educational Resources Information Center

    Alabama Dept. of Archives and History, Montgomery.

    This teaching unit, "World War II Unit," is the ninth in a series of 10 units about Alabama state history, part of a project designed to help teachers integrate the use of primary source materials into their classrooms. Although the units are designed to augment the study of Alabama, they are useful in the study of U.S. history, world…

  9. Designing a mixed methods study in primary care.

    PubMed

    Creswell, John W; Fetters, Michael D; Ivankova, Nataliya V

    2004-01-01

    Mixed methods or multimethod research holds potential for rigorous, methodologically sound investigations in primary care. The objective of this study was to use criteria from the literature to evaluate 5 mixed methods studies in primary care and to advance 3 models useful for designing such investigations. We first identified criteria from the social and behavioral sciences to analyze mixed methods studies in primary care research. We then used the criteria to evaluate 5 mixed methods investigations published in primary care research journals. Of the 5 studies analyzed, 3 included a rationale for mixing based on the need to develop a quantitative instrument from qualitative data or to converge information to best understand the research topic. Quantitative data collection involved structured interviews, observational checklists, and chart audits that were analyzed using descriptive and inferential statistical procedures. Qualitative data consisted of semistructured interviews and field observations that were analyzed using coding to develop themes and categories. The studies showed diverse forms of priority: equal priority, qualitative priority, and quantitative priority. Data collection involved quantitative and qualitative data gathered both concurrently and sequentially. The integration of the quantitative and qualitative data in these studies occurred between data analysis from one phase and data collection from a subsequent phase, while analyzing the data, and when reporting the results. We recommend instrument-building, triangulation, and data transformation models for mixed methods designs as useful frameworks to add rigor to investigations in primary care. We also discuss the limitations of our study and the need for future research.

  10. AASHTO mechanistic-empirical pavement design guide parametric study.

    DOT National Transportation Integrated Search

    2012-03-01

    This study focuses on assessing the robustness of the AASHTO Mechanistic-Empirical Pavement Design Guide (MEPDG v 1.1) for rigid pavement : design projects in Wisconsin. The primary tasks conducted in this study included performing sensitivity analys...

  11. Free Primary Education Policy: Coping Strategies in Public Primary Schools in Kakamega South District, Kakamega County, Kenya

    ERIC Educational Resources Information Center

    Mulinya, Lidoro Charles; Orodho, John Aluko

    2015-01-01

    This study examined the challenges of implementing free primary education and copping strategies in public primary schools in Kakamega South District, Kakamega County, Kenya. The study was premised on the demand and supply theory. A descriptive survey research design was adopted. The sample comprised 23 headteachers, 92 teachers and one Ministry…

  12. The influence of uncemented femoral stem length and design on its primary stability: a finite element analysis.

    PubMed

    Reimeringer, M; Nuño, N; Desmarais-Trépanier, C; Lavigne, M; Vendittoli, P A

    2013-01-01

    One of the crucial factors for short- and long-term clinical success of total hip arthroplasty cementless implants is primary stability. Indeed, motion at the bone-implant interface above 40 μm leads to partial bone ingrowth, while motion exceeding 150 μm completely inhibits bone ingrowth. The aim of this study was to investigate the effect of two cementless femoral stem designs with different lengths on the primary stability. A finite element model of a composite Sawbones(®) fourth generation, implanted with five lengths of the straight prosthesis design and four lengths of the curved prosthesis design, was loaded with hip joint and abductor forces representing two physiological activities: fast walking and stair climbing. We found that reducing the straight stem length from 146 to 54 mm increased the average micromotion from 17 to 52 μm during fast walking, while the peak value increased from 42 to 104 μm. With the curved stem, reducing length from 105 to 54 mm increased the average micromotion from 10 to 29 μm, while the peak value increased from 37 to 101 μm. Similar findings are obtained for stair climbing for both stems. Although the present study showed that femoral stem length as well as stem design directly influences its primary stability, for the two femoral stems tested, length could be reduced substantially without compromising the primary stability. With the aim of minimising surgical invasiveness, newer femoral stem design and currently well performing stems might be used with a reduced length without compromising primary stability and hence, long-term survivorship.

  13. Design Trade Study for a 4-Meter Off-Axis Primary Mirror Substrate and Mount for the Habitable-Zone Exoplanet Direct Imaging Mission

    NASA Technical Reports Server (NTRS)

    Arnold, William R.; Stahl, H. Philip

    2017-01-01

    An extensive trade study was conducted to evaluate primary mirror substrate design architectures for the HabEx mission baseline 4-meter off-axis telescope. The study’s purpose is not to produce a final design, but rather to established a design methodology for matching the mirror’s properties (mass and stiffness) with the mission’s optical performance specifications (static dynamic wavefront error, WFE). The study systematically compares the effect of proven design elements (closed-back vs. open-back vs. partial-back; meniscus vs. flat back vs. shaped back; etc.), which can be implemented with proven space mirror materials (ULE and Zerodur), on static and dynamic WFE. Additionally, the study compares static and dynamic WFE of each substrate point design integrated onto three and six point mounts.

  14. Changes in Patterns of Teacher Interaction in Primary Classrooms: 1976-96.

    ERIC Educational Resources Information Center

    Galton, Maurice; Hargreaves, Linda; Comber, Chris; Wall, Debbie; Pell, Tony

    1999-01-01

    Addresses the effectiveness of teaching methods in English primary school classrooms. Evaluates the interventions designed to change primary educators' teaching methods by replicating the Observational Research and Classroom Learning Evaluation (ORACLE) study that was originally conducted in 1976. Compares the results from the original study to…

  15. Turkish Primary School Teachers' Perceptions of School Culture Regarding ICT Integration

    ERIC Educational Resources Information Center

    Tezci, Erdogan

    2011-01-01

    The current study aimed at identifying Turkish primary school teachers' perceptions of school culture regarding ICT integration in education. In addition, the current study was designed to investigate factors that might influence their perceptions. The participants were 1540 primary school teachers. The findings revealed that the teachers'…

  16. Job Satisfaction of Catholic Primary School Staff: A Study of Biographical Differences

    ERIC Educational Resources Information Center

    De Nobile, John J.; McCormick, John

    2008-01-01

    Purpose: This study's purpose is to examine the relationships between the biographical characteristics gender, age, years of experience and employment position, and job satisfaction of staff members in Catholic primary schools. Design/methodology/approach: Survey data were collected from 356 staff members from Catholic primary schools. Research…

  17. Dermatologic Practice: Implications for a Primary Care Residency Curriculum.

    ERIC Educational Resources Information Center

    Branch, William T., Jr.; And Others

    1983-01-01

    The problems encountered, diagnostic procedures performed, and treatments prescribed in dermatology were studied in a primary care practice and in a dermatology clinic. It is proposed that the findings of this study be the basis for designing a curriculum in dermatology for residents in primary care medicine. (Author/MLW)

  18. Perceived Sources of Occupational Stress among Primary School Teachers in Delta State of Nigeria

    ERIC Educational Resources Information Center

    Akpochafo, G. O.

    2012-01-01

    This study investigated the most prevalent sources of occupational stress and also the demographic variables of gender, age and length of service among primary school teachers in Delta State. Two research questions and three hypotheses guided the study. The study used a descriptive survey design. The population was the primary school teachers in…

  19. The Effect of Using Computer Edutainment on Developing 2nd Primary Graders' Writing Skills

    ERIC Educational Resources Information Center

    Mohammed Abdel Raheem, Azza Ashraf

    2011-01-01

    The present study attempted to examine the effect of using computer edutainment on developing 2nd graders' writing skills. The study comprised thirty-second year primary stage enrolled in Bani Hamad primary governmental school, Minia governorate. The study adopted the quasi-experimental design. Thirty participants were randomly assigned to one…

  20. Using the Van Hiele theory to analyze primary school teachers' written work on geometrical proof problems

    NASA Astrophysics Data System (ADS)

    Jupri, A.

    2018-05-01

    The lack of ability of primary school teachers in deductive thinking, such as doing geometrical proof, is an indispensable issue to be dealt with. In this paper, we report on results of a three-step of the field document study. The study was part of a pilot study for improving deductive thinking ability of primary school teachers. First, we designed geometrical proof problems adapted from literature. Second, we administered an individual written test involving nine master students of primary education program, in which they are having experiences as primary school mathematics teachers. Finally, we analyzed the written work from the view of the Van Hiele theory. The results revealed that even if about the half of the teachers show ability in doing formal proof, still the rest provides inappropriate proving. For further investigation, we wonder whether primary school teachers would show better deductive thinking if the teaching of geometry is designed in a systematic and appropriate manner according to the Van Hiele theory.

  1. Methodology of phase II clinical trials in metastatic elderly breast cancer: a literature review.

    PubMed

    Cabarrou, B; Mourey, L; Dalenc, F; Balardy, L; Kanoun, D; Roché, H; Boher, J M; Rougé-Bugat, M E; Filleron, Thomas

    2017-08-01

    As the incidence of invasive breast cancer will increase with age, the number of elderly patients with a diagnosis metastatic breast cancer will also rise. But the use of cytotoxic drugs in elderly metastatic breast cancer patients is not systematic and is dreaded by medical oncologists. The need for prospective oncologic data from this population seems increasingly obvious. The main objective of this review is to investigate design and characteristics of phase II trials that assess activity and feasibility of chemotherapies in elderly advanced/metastatic breast cancer patients. An electronic search in PUBMED allowed us to retrieve articles published in English language on phase II trials in elderly metastatic breast cancer between January 2002 and May 2016. Sixteen publications were finally included in this review. The primary endpoint was a simple, a composite, and a co-primary endpoints in 11, three, and two studies, respectively. Efficacy was the primary objective in 15 studies: simple (n = 10), composite (n = 3), co-primary endpoints (n = 2). Composite or co-primary endpoints combined efficacy and toxicity. Thirteen studies used multistage designs. Only five studies evaluated the feasibility, i.e., to jointly assess efficacy and tolerance to treatment (toxicity, quality of life, etc) as primary endpoint. Development of elderly specific phase III clinical trials might be challenging, it therefore seems essential to conduct phase II clinical trials evaluating jointly efficacy and toxicity in a well-defined geriatric population. Use of multistage designs that take into account heterogeneity would allow to identify a subpopulation at interim analysis and to reduce the number of patients exposed to an inefficient or a toxic treatment regimen. It is crucial to evaluate new therapies (targeted therapies, immunotherapies) using adequate methodologies (Study design, endpoint).

  2. Parental Involvement as a Correlate of Academic Achievement of Primary School Pupils in Edo State, Nigeria

    ERIC Educational Resources Information Center

    Fajoju, Samuel A.; Aluede, Oyaziwo; Ojugo, Augustine I.

    2016-01-01

    This study investigated the relationship between parental involvement in children's education and the academic achievement of primary six pupils in Edo State, Nigeria. The ex-post facto research design was employed in this study. The sample consisted of 1,895 primary six pupils (1,024 males and 863 females drawn from 37,908 primary six pupils in…

  3. SIRTF primary mirror design, analysis, and testing

    NASA Technical Reports Server (NTRS)

    Sarver, George L., III; Maa, Scott; Chang, LI

    1990-01-01

    The primary mirror assembly (PMA) requirements and concepts for the Space Infrared Telescope Facility (SIRTF) program are discussed. The PMA studies at NASA/ARC resulted in the design of two engineering test articles, the development of a mirror mount cryogenic static load testing system, and the procurement and partial testing of a full scale spherical mirror mounting system. Preliminary analysis and testing of the single arch mirror with conical mount design and the structured mirror with the spherical mount design indicate that the designs will meet all figure and environmental requirements of the SIRTF program.

  4. Traumatic Dental Injuries in the primary dentition: a 15-year bibliometric analysis of Dental Traumatology.

    PubMed

    Kramer, Paulo Floriani; Onetto, Juan; Flores, Marie Therese; Borges, Tássia Silvana; Feldens, Carlos Alberto

    2016-10-01

    To explore the profile of articles on traumatic dental injuries (TDI) in the primary dentition published in Dental Traumatology in the last 15 years using bibliometric analysis. Three researchers read all titles and abstracts of articles published in Dental Traumatology between 2000 and 2014 (excluding editorials and letters) and selected all articles on TDI in the primary dentition. The articles were categorized according to year of publication, country in which the study was conducted, study design, and topics addressed. Divergences were resolved by consensus between the researchers. Among a total of 1257 articles published, 98 were initially excluded. Among the remaining 1159 articles, 152 (13.1%) focused on TDI in the primary dentition. The articles were conducted in 29 countries, with Brazil (38.8%) and Turkey (11.8%) accounting for the largest numbers. Cross-sectional studies (36.2%) and case report/case series (33.6%) were the most frequent study designs. Only two systematic reviews were published. The most commonly addressed topics were frequency/etiology/associated factors (36.8%), treatment (30.9%), and prognosis (19.7%). Among the articles addressing treatment, two-thirds were case reports or case series. The effects of TDI in primary teeth on their permanent successors were addressed in 20.4% of the articles (31/152). The number of articles on TDI in the primary dentition has increased, but remains low. The evaluation of study designs and topics addressed identified gaps that could contribute to the development of new studies on TDI in the primary dentition, especially cohort studies that evaluate risk factors, prognosis, and treatment. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Critical Thinking Dispositions of Pre-Service Turkish Language Teachers and Primary Teachers

    ERIC Educational Resources Information Center

    Maltepe, Sadet

    2016-01-01

    The present study aimed to determine critical thinking dispositions of pre-service Turkish language and primary teachers in terms of several variables by employing descriptive survey design. The study group consisted of 215 senior students attending Turkish Language Teaching and Primary Education Departments of Necatibey Faculty of Education at…

  6. Investigation of Primary Mathematics Student Teachers' Concept Images: Cylinder and Cone

    ERIC Educational Resources Information Center

    Ertekin, Erhan; Yazici, Ersen; Delice, Ali

    2014-01-01

    The aim of the present study is to determine the influence of concept definitions of cylinder and cone on primary mathematics student teachers' construction of relevant concept images. The study had a relational survey design and the participants were 238 primary mathematics student teachers. Statistical analyses implied the following: mathematics…

  7. Humor Climate of the Primary Schools

    ERIC Educational Resources Information Center

    Sahin, Ahmet

    2018-01-01

    The aim of this study is to determine the opinions primary school administrators and teachers on humor climates in primary schools. The study was modeled as a convergent parallel design, one of the mixed methods. The data gathered from 253 administrator questionnaires, and 651 teacher questionnaires was evaluated for the quantitative part of the…

  8. Primary Teacher Trainees Preparedness to Teach Science: A Gender Perspective

    ERIC Educational Resources Information Center

    Mutisya, Sammy M.

    2015-01-01

    The purpose of this study was to determine Primary Teacher Education (PTE) Trainees' perceptions regarding their preparedness to teach science in primary schools. A descriptive survey research design was used and stratified proportionate random sampling techniques used to select 177 males and 172 females. The study found out that more male trainee…

  9. Designing A Mixed Methods Study In Primary Care

    PubMed Central

    Creswell, John W.; Fetters, Michael D.; Ivankova, Nataliya V.

    2004-01-01

    BACKGROUND Mixed methods or multimethod research holds potential for rigorous, methodologically sound investigations in primary care. The objective of this study was to use criteria from the literature to evaluate 5 mixed methods studies in primary care and to advance 3 models useful for designing such investigations. METHODS We first identified criteria from the social and behavioral sciences to analyze mixed methods studies in primary care research. We then used the criteria to evaluate 5 mixed methods investigations published in primary care research journals. RESULTS Of the 5 studies analyzed, 3 included a rationale for mixing based on the need to develop a quantitative instrument from qualitative data or to converge information to best understand the research topic. Quantitative data collection involved structured interviews, observational checklists, and chart audits that were analyzed using descriptive and inferential statistical procedures. Qualitative data consisted of semistructured interviews and field observations that were analyzed using coding to develop themes and categories. The studies showed diverse forms of priority: equal priority, qualitative priority, and quantitative priority. Data collection involved quantitative and qualitative data gathered both concurrently and sequentially. The integration of the quantitative and qualitative data in these studies occurred between data analysis from one phase and data collection from a subsequent phase, while analyzing the data, and when reporting the results. DISCUSSION We recommend instrument-building, triangulation, and data transformation models for mixed methods designs as useful frameworks to add rigor to investigations in primary care. We also discuss the limitations of our study and the need for future research. PMID:15053277

  10. A modified varying-stage adaptive phase II/III clinical trial design.

    PubMed

    Dong, Gaohong; Vandemeulebroecke, Marc

    2016-07-01

    Conventionally, adaptive phase II/III clinical trials are carried out with a strict two-stage design. Recently, a varying-stage adaptive phase II/III clinical trial design has been developed. In this design, following the first stage, an intermediate stage can be adaptively added to obtain more data, so that a more informative decision can be made. Therefore, the number of further investigational stages is determined based upon data accumulated to the interim analysis. This design considers two plausible study endpoints, with one of them initially designated as the primary endpoint. Based on interim results, another endpoint can be switched as the primary endpoint. However, in many therapeutic areas, the primary study endpoint is well established. Therefore, we modify this design to consider one study endpoint only so that it may be more readily applicable in real clinical trial designs. Our simulations show that, the same as the original design, this modified design controls the Type I error rate, and the design parameters such as the threshold probability for the two-stage setting and the alpha allocation ratio in the two-stage setting versus the three-stage setting have a great impact on the design characteristics. However, this modified design requires a larger sample size for the initial stage, and the probability of futility becomes much higher when the threshold probability for the two-stage setting gets smaller. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  11. An Examination of the Role of Nursery Education on Primary School Pupils in Nigeria

    ERIC Educational Resources Information Center

    Oniwon, H. O. Evelyn

    2015-01-01

    This study examines the role of Nursery education among primary school pupils. The sole objective of the study was to find out the differences in academic achievement between primary school pupils who received nursery education and those who did not. Descriptive survey research design was adopted to achieve the study objective. Consequently, 20…

  12. Effect of Training in Math Metacognitive Strategy on Fractional Achievement of Nigerian Schoolchildren

    ERIC Educational Resources Information Center

    Onu, V. C.; Eskay, M.; Igbo, J. N.; Obiyo, N.; Agbo, O.

    2012-01-01

    This study examined the effect of training in math metacognition on fractional mathematics among primary school pupils, with a quasi-experimental design, specifically a post-test only control group design. Two intact classes were randomly selected and assigned to treatment and control conditions. Sixty primary six pupils constituted the sample…

  13. Design and Development of a Geography Module for First-Year Primary Student Teachers

    ERIC Educational Resources Information Center

    Blankman, Marian; van der Schee, Joop; Boogaard, Marianne; Volman, Monique

    2016-01-01

    This paper describes the result of a design study in which a geography course was developed and tested aiming to develop the Pedagogical Content Knowledge (PCK) of first-year primary student teachers. This resulted in a course called "Consciously Teaching Geography" with characteristics as (1) starting from students' preconceptions and…

  14. Design development of graphite primary structures enables SSTO success

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

    Biagiotti, V.A.; Yahiro, J.S.; Suh, D.E.

    1997-01-01

    This paper describes the development of a graphite composite wing and a graphite composite intertank primary structure for application toward Single-Stage to Orbit space vehicles such as those under development in NASA{close_quote}s X-33/Reusable Launch Vehicle (RLV) Program. The trade study and designs are based on a Rockwell vertical take-off and horizontal landing (VTHL) wing-body RLV vehicle. Northrop Grumman{close_quote}s approach using a building block development technique is described. Composite Graphite/Bismaleimide (Gr/BMI) material characterization test results are presented. Unique intertank and wing composite subcomponent test article designs are described and test results to date are presented. Wing and intertank Full Scale Sectionmore » Test Article (FSTA) objectives and designs are outlined. Trade studies, supporting building block testing, and FSTA demonstrations combine to develop graphite primary structure composite technology that enables developing X-33/RLV design programs to meet critical SSTO structural weight and operations performance criteria. {copyright} {ital 1997 American Institute of Physics.}« less

  15. An adaptive two-stage sequential design for sampling rare and clustered populations

    USGS Publications Warehouse

    Brown, J.A.; Salehi, M.M.; Moradi, M.; Bell, G.; Smith, D.R.

    2008-01-01

    How to design an efficient large-area survey continues to be an interesting question for ecologists. In sampling large areas, as is common in environmental studies, adaptive sampling can be efficient because it ensures survey effort is targeted to subareas of high interest. In two-stage sampling, higher density primary sample units are usually of more interest than lower density primary units when populations are rare and clustered. Two-stage sequential sampling has been suggested as a method for allocating second stage sample effort among primary units. Here, we suggest a modification: adaptive two-stage sequential sampling. In this method, the adaptive part of the allocation process means the design is more flexible in how much extra effort can be directed to higher-abundance primary units. We discuss how best to design an adaptive two-stage sequential sample. ?? 2008 The Society of Population Ecology and Springer.

  16. Small Gas Turbine Combustor Primary Zone Study

    NASA Technical Reports Server (NTRS)

    Sullivan, R. E.; Young, E. R.; Miles, G. A.; Williams, J. R.

    1983-01-01

    A development process is described which consists of design, fabrication, and preliminary test evaluations of three approaches to internal aerodynamic primary zone flow patterns: (1) conventional double vortex swirl stabilization; (2) reverse flow swirl stabilization; and (3) large single vortex flow system. Each concept incorporates special design features aimed at extending the performance capability of the small engine combustor. Since inherent geometry of these combustors result in small combustion zone height and high surface area to volume ratio, design features focus on internal aerodynamics, fuel placement, and advanced cooling. The combustors are evaluated on a full scale annular combustor rig. A correlation of the primary zone performance with the overall performance is accomplished using three intrusion type gas sampling probes located at the exit of the primary zone section. Empirical and numerical methods are used for designing and predicting the performance of the three combustor concepts and their subsequent modifications. The calibration of analytical procedures with actual test results permits an updating of the analytical design techniques applicable to small reverse flow annular combustors.

  17. The extent, quality and impact of patient and public involvement in primary care research: a mixed methods study.

    PubMed

    Blackburn, Steven; McLachlan, Sarah; Jowett, Sue; Kinghorn, Philip; Gill, Paramjit; Higginbottom, Adele; Rhodes, Carol; Stevenson, Fiona; Jinks, Clare

    2018-01-01

    In the UK, more patients go to primary care than other parts of the health service. Therefore it is important for research into primary care to include the insights and views of people who receive these services. To explore the extent, quality and impact of patient and public involvement (PPI) in primary care research, we examined documents of 200 projects and surveyed 191 researchers.We found that about half of studies included PPI to develop research ideas and during the study itself. Common activities included designing study materials, advising on methods, and managing the research. Some studies did not undertake the PPI activities initially planned and funded for. PPI varied by study design, health condition and study population. We found pockets of good practice: having a PPI budget, supporting PPI contributors, and PPI informing recruitment issues. However, good practice was lacking in other areas. Few projects offered PPI contributors training, used PPI to develop information for participants about study progress and included PPI to advise on publishing findings.Researchers reported beneficial impacts of PPI. Most impact was reported when the approach to PPI included more indicators of good practice. The main cost of PPI for researchers was their time. Many reported difficulties providing information about PPI.In partnership with PPI contributors, we have used these findings to develop:a new Cost and Consequences Framework for PPI highlighting financial and non-financial costs, benefits and harms of PPIFifteen co-produced recommendations to improve the practice and delivery of PPI. Background: To improve the lives of patients in primary care requires the involvement of service users in primary care research. We aimed to explore the extent, quality and impact of patient and public involvement (PPI) in primary care research. Methods: We extracted information about PPI from grant applications, reports and an electronic survey of researchers of studies funded by the NIHR School for Primary Care Research (SPCR). We applied recognised quality indicators to assess the quality of PPI and assessed its impact on research. Results: We examined 200 grant applications and reports of 181 projects. PPI was evident in the development of 47 (24%) grant applications. 113 (57%) grant applications included plans for PPI during the study, mostly in study design, oversight, and dissemination. PPI during projects was reported for 83 (46%) projects, including designing study materials and managing the research. We identified inconsistencies between planned and reported PPI. PPI varied by study design, health condition and study population.Of 46 (24%) of 191 questionnaires completed, 15 reported PPI activity. Several projects showed best practice according to guidelines, in terms of having a PPI budget, supporting PPI contributors, and PPI informing recruitment issues. However few projects offered PPI contributors training, used PPI to develop information for participants about study progress, and had PPI in advising on dissemination.Beneficial impacts of PPI in designing studies and writing participant information was frequently reported. Less impact was reported on developing funding applications, managing or carrying out the research. The main cost of PPI for researchers was their time. Many researchers found it difficult to provide information about PPI activities.Our findings informed:a new Cost and Consequences Framework for PPI in primary care research highlighting financial and non-financial costs, plus the benefits and harms of PPIFifteen co-produced recommendations to improve PPI in research and within the SPCR. Conclusions: The extent, quality and impact of PPI in primary care research is inconsistent across research design and topics. Pockets of good practice were identified making a positive impact on research. The new Cost and Consequences Framework may help others assess the impact of PPI.

  18. A Practice Study on the Informatization of Primary School Chinese Curriculum from the Perspective of Edutainment

    ERIC Educational Resources Information Center

    Hongke, Li

    2014-01-01

    This article is based on some of the results of the cooperative project "A Practice Study on Information-based Teaching" started and accomplished by Hubei University and other secondary and primary schools. This paper elaborates on the connotation of edutainment and explores ideas and design strategies of primary school Chinese…

  19. The Reading Profile of Turkish Primary School Students

    ERIC Educational Resources Information Center

    Dag, Nilgün

    2017-01-01

    This study aims to reveal the reading profile of primary school students. The research design is based on a survey model with the research population being comprised of primary school students in the 2014-2015 academic year in the city center of Nevsehir, Turkey. The sample of the study consists of 120 fourth-grade students. The research data was…

  20. Self Efficacy and Some Demographic Variables as Predictors of Occupational Stress among Primary School Teachers in Delta State of Nigeria

    ERIC Educational Resources Information Center

    Akpochafo, G. O.

    2014-01-01

    This study investigated self efficacy and some demographic variables as predictors of occupational stress among primary school teachers in Delta State. Three hypotheses were formulated to guide the study. The study adopted a descriptive survey design that utilized an expost-facto research type. A sample of one hundred and twenty primary school…

  1. Extending the Career of the English Primary School Headteacher: A Second Headship

    ERIC Educational Resources Information Center

    Fidler, Brian; Jones, Jeff; Makori, Andrew

    2009-01-01

    Purpose: The purpose of this article is to report findings from a national study of primary headteachers in their second headship in England. This investigated their reasons for moving schools, their choice of second school and a comparison of their experiences as heads of the two schools. Design/methodology/approach: The research design involved…

  2. Settlement Unit. Using Primary Sources in the Classroom.

    ERIC Educational Resources Information Center

    Alabama Dept. of Archives and History, Montgomery.

    This teaching unit, "Settlement Unit,"which focuses on the settlement of Alabama's land, is the second in a series of 10 units about Alabama state history, part of a project designed to help teachers integrate the use of primary source materials into their classrooms. Although the units are designed to augment the study of Alabama, they…

  3. Block 2 Solid Rocket Motor (SRM) conceptual design study. Volume 1: Appendices

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The design studies task implements the primary objective of developing a Block II Solid Rocket Motor (SRM) design offering improved flight safety and reliability. The SRM literature was reviewed. The Preliminary Development and Validation Plan is presented.

  4. Integrating data from an online diabetes prevention program into an electronic health record and clinical workflow, a design phase usability study.

    PubMed

    Mishuris, Rebecca Grochow; Yoder, Jordan; Wilson, Dan; Mann, Devin

    2016-07-11

    Health information is increasingly being digitally stored and exchanged. The public is regularly collecting and storing health-related data on their own electronic devices and in the cloud. Diabetes prevention is an increasingly important preventive health measure, and diet and exercise are key components of this. Patients are turning to online programs to help them lose weight. Despite primary care physicians being important in patients' weight loss success, there is no exchange of information between the primary care provider (PCP) and these online weight loss programs. There is an emerging opportunity to integrate this data directly into the electronic health record (EHR), but little is known about what information to share or how to share it most effectively. This study aims to characterize the preferences of providers concerning the integration of externally generated lifestyle modification data into a primary care EHR workflow. We performed a qualitative study using two rounds of semi-structured interviews with primary care providers. We used an iterative design process involving primary care providers, health information technology software developers and health services researchers to develop the interface. Using grounded-theory thematic analysis 4 themes emerged from the interviews: 1) barriers to establishing healthy lifestyles, 2) features of a lifestyle modification program, 3) reporting of outcomes to the primary care provider, and 4) integration with primary care. These themes guided the rapid-cycle agile design process of an interface of data from an online diabetes prevention program into the primary care EHR workflow. The integration of external health-related data into the EHR must be embedded into the provider workflow in order to be useful to the provider and beneficial for the patient. Accomplishing this requires evaluation of that clinical workflow during software design. The development of this novel interface used rapid cycle iterative design, early involvement by providers, and usability testing methodology. This provides a framework for how to integrate external data into provider workflow in efficient and effective ways. There is now the potential to realize the importance of having this data available in the clinical setting for patient engagement and health outcomes.

  5. Design, Recruitment and Start Up of a Primary Care Weight Loss Trial Targeting African American and Hispanic Adults

    PubMed Central

    Kumanyika, Shiriki; Fassbender, Jennifer; Phipps, Etienne; Tan-Torres, Susan; Localio, Russell; Morales, Knashawn H.; Sarwer, David B.; Harralson, Tina; Allison, Kelly; Wesby, Lisa; Kessler, Ronni; Tsai, Adam Gilden; Wadden, Thomas A.

    2011-01-01

    Primary care offices are critical access points for obesity treatment, but evidence for approaches that can be implemented within these settings is limited. The Think Health! (¡Vive Saludable!) Study was designed to assess the feasibility and effectiveness of a behavioral weight loss program, adapted from the Diabetes Prevention Program, for implementation in routine primary care. Recruitment of clinical sites targeted primary care practices serving African American and Hispanic adults. The randomized design compares (a) a moderate-intensity treatment consisting of primary care provider counseling plus additional counseling by an auxiliary staff member (i.e., lifestyle coach), with (b) a low-intensity, control treatment involving primary care provider counseling only. Treatment and follow up duration are 1 to 2 years. The primary outcome is weight change from baseline at 1 and 2 years post-randomization. Between November 2006 and January 2008, 14 primary care providers (13 physicians; 1 physician assistant) were recruited at five clinical sites. Patients were recruited between October 2007 and November 2008. A total of 412 patients were pre-screened, of whom 284 (68.9%) had baseline assessments and 261 were randomized, with the following characteristics: 65% African American; 16% Hispanic American; 84% female; mean (SD) age of 47.2 (11.7) years; mean (SD) BMI of 37.2(6.4) kg/m2; 43.7% with high blood pressure; and 18.4% with diabetes. This study will provide insights into the potential utility of moderate-intensity lifestyle counseling delivered by motivated primary care clinicians and their staff. The study will have particular relevance to African Americans and women. PMID:21062645

  6. Effect of implant macro-design on primary stability: A prospective clinical study

    PubMed Central

    Lozano-Carrascal, Naroa; Salomó-Coll, Oscar; Gilabert-Cerdà, Marta; Farré-Pagés, Nuria; Hernández-Alfaro, Federico

    2016-01-01

    Background Implant restorations have become a high predictable treatment option. Several caracteristics such as surgical technique and implant design can influence the treatment outcomes. The aim of the present study was to evaluate the influence of implant macro-design on primary stability measured with resonance frequency analysis (RFA) and insertion torque (IT). Material and Methods A total of 47 implants divided in two groups: Test group (TI): 22 Tapered MIS® Seven implants; Control group (CI): 25 cylindrical Astra® Osseospeed implants. All implants were inserted following the manufacturers’ standard protocols. Implant primary stability was measured at the moment of implant placement by registering insertion torque values (ITv) and ISQ values by means of Osstell™ Mentor (ISQv) (Integration Diagnostic Ltd., Goteborg, Sweden). Results In the mandible, mean ISQv for tapered implants (TI) was 71.67±5.16 and for cylindrical implants (CI) 57.15±4.83 (p=0.01). Mean insertion torque was 46.67±6.85 Ncm for TI and 35.77±6.72 Ncm for CI (p=0.01). In the maxilla, mean ISQ was 67.2±4.42 for tapered implants and 49.17±15.30 for cylindrical implants (p=0.01). Mean insertion torque for TI was 41.5±6.26 Ncm and for CI 39.17±6.34 Ncm (p>0.05). For tapered implants, no correlation could be found between implant diameter and primary stability. But for cylindrical implants there was a statistically significant correlation between implant diameter and primary stability: ITv (p=0.03); ISQv (p=0.04). Conclusions Within the limits of the present study, tapered shaped implants achieve higher primary stability measured through ISQ and insertion torque values. Moreover, for cylindrical implants positive correlation has been established between implant diameter and primary stability. Key words:Primary stability, tapered, cylindrical, conical, implant macro-design. PMID:26827067

  7. Epistemic Habits: Primary School Teachers' Development of Pedagogical Content Knowledge (PCK) in a Design-Based Research Project

    ERIC Educational Resources Information Center

    Hultén, Magnus; Björkholm, Eva

    2016-01-01

    Generalist primary school teachers often have little or no training in school subjects such as science and technology. Not surprisingly, several studies show that they often experience difficulties when teaching these subjects, in fact some primary teachers even avoid teaching them. The over all aim of this study is to contribute to new…

  8. Status of Health Appraisal Services for Primary School Children in Edo State, Nigeria

    ERIC Educational Resources Information Center

    Ojugo, Augustine I.

    2005-01-01

    The purpose of this study was to determine the status of the health appraisal services provided for primary school children in Edo State, Nigeria. Using the cross-sectional survey design a total of 1506 primary school children were selected from across the state as the study participants. The analysis of data collected through a 14-item…

  9. Influence of Leadership Styles on Teachers' Job Satisfaction: A Case of Selected Primary Schools in Songea and Morogoro Districts, Tanzania

    ERIC Educational Resources Information Center

    Machumu, Haruni J.; Kaitila, Mafwimbo M.

    2014-01-01

    This study reports on the kind of school leadership style that best suits for promoting teachers' job satisfaction in primary schools in Tanzania. The study employed cross sectional research design with samples of 200 teachers from 20 selected primary schools in Songea and Morogoro districts. Interviews, documentary analysis and questionnaires…

  10. Instructional Constraints Faced by Learners with Muscular Dystrophy: A Case of Joytown Special Primary School, Thika, Kenya

    ERIC Educational Resources Information Center

    Wang'ang'a, Annrose Wanjiku; Wamocho, Franciscah Irangi; Kioy, Paul

    2015-01-01

    The purpose of this study was to investigate the instructional constraints facing learners with muscular dystrophy in Joy Town special primary school, Thika, Kenya. Descriptive design was used for this study. The target population were all the 20 learners suffering from muscular dystrophy from S.A Joy Town Special Primary School. The total target…

  11. Brief cognitive behavioral therapy in primary care: a hybrid type 2 patient-randomized effectiveness-implementation design.

    PubMed

    Cully, Jeffrey A; Armento, Maria E A; Mott, Juliette; Nadorff, Michael R; Naik, Aanand D; Stanley, Melinda A; Sorocco, Kristen H; Kunik, Mark E; Petersen, Nancy J; Kauth, Michael R

    2012-07-11

    Despite the availability of evidence-based psychotherapies for depression and anxiety, they are underused in non-mental health specialty settings such as primary care. Hybrid effectiveness-implementation designs have the potential to evaluate clinical and implementation outcomes of evidence-based psychotherapies to improve their translation into routine clinical care practices. This protocol article discusses the study methodology and implementation strategies employed in an ongoing, hybrid, type 2 randomized controlled trial with two primary aims: (1) to determine whether a brief, manualized cognitive behavioral therapy administered by Veterans Affairs Primary Care Mental Health Integration program clinicians is effective in treating depression and anxiety in a sample of medically ill (chronic cardiopulmonary diseases) primary care patients and (2) to examine the acceptability, feasibility, and preliminary outcomes of a focused implementation strategy on improving adoption and fidelity of brief cognitive behavioral therapy at two Primary Care-Mental Health Integration clinics. The study uses a hybrid type 2 effectiveness/implementation design to simultaneously test clinical effectiveness and to collect pilot data on a multifaceted implementation strategy that includes an online training program, audit and feedback of session content, and internal and external facilitation. Additionally, the study engages the participation of an advisory council consisting of stakeholders from Primary Care-Mental Health Integration, as well as regional and national mental health leaders within the Veterans Administration. It targets recruitment of 320 participants randomized to brief cognitive behavioral therapy (n = 200) or usual care (n = 120). Both effectiveness and implementation outcomes are being assessed using mixed methods, including quantitative evaluation (e.g., intent-to-treat analyses across multiple time points) and qualitative methods (e.g., focus interviews and surveys from patients and providers). Patient-effectiveness outcomes include measures of depression, anxiety, and physical health functioning using blinded independent evaluators. Implementation outcomes include patient engagement and adherence and clinician brief cognitive behavioral therapy adoption and fidelity. Hybrid designs are needed to advance clinical effectiveness and implementation knowledge to improve healthcare practices. The current article describes the rationale and challenges associated with the use of a hybrid design for the study of brief cognitive behavioral therapy in primary care. Although trade-offs exist between scientific control and external validity, hybrid designs are part of an emerging approach that has the potential to rapidly advance both science and practice. NCT01149772 at http://www.clinicaltrials.gov/ct2/show/NCT01149772.

  12. Examining organizational change in primary care practices: experiences from using ethnographic methods.

    PubMed

    Russell, Grant; Advocat, Jenny; Geneau, Robert; Farrell, Barbara; Thille, Patricia; Ward, Natalie; Evans, Samantha

    2012-08-01

    Qualitative methods are an important part of the primary care researcher's toolkit providing a nuanced view of the complexity in primary care reform and delivery. Ethnographic research is a comprehensive approach to qualitative data collection, including observation, in-depth interviews and document analysis. Few studies have been published outlining methodological issues related to ethnography in this setting. This paper examines some of the challenges of conducting an ethnographic study in primary care setting in Canada, where there recently have been major reforms to traditional methods of organizing primary care services. This paper is based on an ethnographic study set in primary care practices in Ontario, Canada, designed to investigate changes to organizational and clinical routines in practices undergoing transition to new, interdisciplinary Family Health Teams (FHTs). The study was set in six new FHTs in Ontario. This paper is a reflexive examination of some of the challenges encountered while conducting an ethnographic study in a primary care setting. Our experiences in this study highlight some potential benefits of and difficulties in conducting an ethnographic study in family practice. Our study design gave us an opportunity to highlight the changes in routines within an organization in transition. A study with a clinical perspective requires training, support, a mixture of backgrounds and perspectives and ongoing communication. Despite some of the difficulties, the richness of this method has allowed the exploration of a number of additional research questions that emerged during data analysis.

  13. 24 CFR 3282.361 - Design Approval Primary Inspection Agency (DAPIA).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 5 2011-04-01 2011-04-01 false Design Approval Primary Inspection... REGULATIONS Primary Inspection Agencies § 3282.361 Design Approval Primary Inspection Agency (DAPIA). (a... manufactured home designs submitted to it by the manufacturer and for assuring that they conform to the...

  14. Design of MSR primary circuit with minimum pressure losses

    NASA Astrophysics Data System (ADS)

    Noga, Tomáš; Žitek, Pavel; Valenta, Václav

    This article describes a design of a MSR primary circuit with minimum pressure losses. It includes a brief description of this type of a reactor and its integral layout, properties, purpose, etc. The objective of this paper is to define problems of pressure losses calculation and to design a proper device for a primary circuit of MSR reactor, including its basic dimensions. Thanks to this, it can become an initial project for a construction of a real piece of work. This is the main contribution of the carried out study. Of course, this article is not a detailed solution, but it points out facts and problems, which future designers may have to face. The further step of our work will be a reconstruction of the current experiment for a two-stage flowing.

  15. The Effects of Multimedia Learning on Thai Primary Pupils' Achievement in Size and Depth of Vocabulary Knowledge

    ERIC Educational Resources Information Center

    Jingjit, Mathukorn

    2015-01-01

    This study aims to obtain more insight regarding the effect of multimedia learning on third grade of Thai primary pupils' achievement in Size and Depth Vocabulary of English. A quasi-experiment is applied using "one group pretest-posttest design" combined with "time series design," as well as data triangulation. The sample…

  16. Place of Instructional Supervision in Enhancing Public Primary School Teachers' Effectiveness

    ERIC Educational Resources Information Center

    Nwambam, Aja Sunday; Eze, Prisca Ijeoma

    2017-01-01

    The study examined the place of instructional supervision in enhancing teachers' effectiveness in public primary schools in Ebonyi State. Four research questions were formulated to guide the study. Descriptive survey research design was adopted for the study. The population of the study consists of all the 462,186 teachers including the…

  17. Design Study of 8 Meter Monolithic Mirror UV/Optical Space Telescope

    NASA Technical Reports Server (NTRS)

    Stahl, H. Philip

    2008-01-01

    The planned Ares V launch vehicle with its 10 meter fairing shroud and 55,000 kg capacity to the Sun Earth L2 point enables entirely new classes of space telescopes. NASA MSFC has conducted a preliminary study that demonstrates the feasibility of launching a 6 to 8 meter class monolithic primary mirror telescope to Sun-Earth L2 using an Ares V. Specific technical areas studied included optical design; structural design/analysis including primary mirror support structure, sun shade and secondary mirror support structure; thermal analysis; launch vehicle performance and trajectory; spacecraft including structure, propulsion, GN&C, avionics, power systems and reaction wheels; operations and servicing; mass and power budgets; and system cost.

  18. Problem Solving Strategies among Primary School Teachers

    ERIC Educational Resources Information Center

    Yew, Wun Thiam; Lian, Lim Hooi; Meng, Chew Cheng

    2017-01-01

    The purpose of this article was to examine problem solving strategies among primary school teachers. The researchers employed survey research design to examine their problem solving strategies. The participants of this study consisted of 120 primary school teachers from a public university in Peninsula Malaysia who enrolled in a 4-year Graduating…

  19. Design Study: Integer Subtraction Operation Teaching Learning Using Multimedia in Primary School

    ERIC Educational Resources Information Center

    Aris, Rendi Muhammad; Putri, Ratu Ilma Indra

    2017-01-01

    This study aims to develop a learning trajectory to help students understand concept of subtraction of integers using multimedia in the fourth grade. This study is thematic integrative learning in Curriculum 2013 PMRI based. The method used is design research consists of three stages; preparing for the experiment, design experiment, retrospective…

  20. Effects of Storylines Embedded within the Context-Based Approach on Pre-Service Primary School Teachers' Conceptions of Matter and Its States

    ERIC Educational Resources Information Center

    Demircioglu, Hülya; Ayas, Alipasa; Demircioglu, Gökhan; Özmen, Haluk

    2015-01-01

    In this study, the effect of the context-based approach on pre-service primary school teachers' understanding of matter and its states and their attitude towards chemistry was investigated. Using a simple experimental design, the study was conducted with 35 pre-service primary school teachers who were exposed to context-based material with…

  1. Conceptual design of a lunar oxygen pilot plant Lunar Base Systems Study (LBSS) task 4.2

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The primary objective was to develop conceptual designs of two pilot plants to produce oxygen from lunar materials. A lunar pilot plant will be used to generate engineering data necessary to support an optimum design of a larger scale production plant. Lunar oxygen would be of primary value as spacecraft propellant oxidizer. In addition, lunar oxygen would be useful for servicing nonregenerative fuel cell power systems, providing requirements for life support, and to make up oxygen losses from leakage and airlock cycling. Thirteen different lunar oxygen production methods are described. Hydrogen reduction of ilmenite and extraction of solar-wind hydrogen from bulk lunar soil were selected for conceptual design studies. Trades and sensitivity analyses were performed with these models.

  2. Designing Excellence and Quality Model for Training Centers of Primary Health Care: A Delphi Method Study.

    PubMed

    Tabrizi, Jafar-Sadegh; Farahbakhsh, Mostafa; Shahgoli, Javad; Rahbar, Mohammad Reza; Naghavi-Behzad, Mohammad; Ahadi, Hamid-Reza; Azami-Aghdash, Saber

    2015-10-01

    Excellence and quality models are comprehensive methods for improving the quality of healthcare. The aim of this study was to design excellence and quality model for training centers of primary health care using Delphi method. In this study, Delphi method was used. First, comprehensive information were collected using literature review. In extracted references, 39 models were identified from 34 countries and related sub-criteria and standards were extracted from 34 models (from primary 39 models). Then primary pattern including 8 criteria, 55 sub-criteria, and 236 standards was developed as a Delphi questionnaire and evaluated in four stages by 9 specialists of health care system in Tabriz and 50 specialists from all around the country. Designed primary model (8 criteria, 55 sub-criteria, and 236 standards) were concluded with 8 criteria, 45 sub-criteria, and 192 standards after 4 stages of evaluations by specialists. Major criteria of the model are leadership, strategic and operational planning, resource management, information analysis, human resources management, process management, costumer results, and functional results, where the top score was assigned as 1000 by specialists. Functional results had the maximum score of 195 whereas planning had the minimum score of 60. Furthermore the most and the least sub-criteria was for leadership with 10 sub-criteria and strategic planning with 3 sub-criteria, respectively. The model that introduced in this research has been designed following 34 reference models of the world. This model could provide a proper frame for managers of health system in improving quality.

  3. Issues of Instructional Supervisory Practices in Primary Schools of Ebonyi State

    ERIC Educational Resources Information Center

    Onele, Adali A.; Aja-Okorie, Uzoma

    2016-01-01

    The study examines the issue of instructional supervision in primary schools of Onueke educational zone of Ebonyi state. The purpose of the study was to find out the problems militating against effective instructional supervision in the zone. Four research questions guided the study and descriptive survey research design was employed. The…

  4. Effectiveness of Problem-Solving Therapy for Older, Primary Care Patients with Depression: Results from the IMPACT Project

    ERIC Educational Resources Information Center

    Arean, Patricia; Hegel, Mark; Vannoy, Steven; Fan, Ming-Yu; Unuzter, Jurgen

    2008-01-01

    Purpose: We compared a primary-care-based psychotherapy, that is, problem-solving therapy for primary care (PST-PC), to community-based psychotherapy in treating late-life major depression and dysthymia. Design and Methods: The data here are from the IMPACT study, which compared collaborative care within a primary care clinic to care as usual in…

  5. African Primary Care Research: qualitative interviewing in primary care.

    PubMed

    Reid, Steve; Mash, Bob

    2014-06-05

    This article is part of a series on African Primary Care Research and focuses on the topic of qualitative interviewing in primary care. In particular it looks at issues of study design, sample size, sampling and interviewing in relation to individual and focus group interviews.There is a particular focus on helping postgraduate students at a Masters level to write their research proposals.

  6. Classroom Observation Data and Instruction in Primary Mathematics Education: Improving Design and Rigour

    ERIC Educational Resources Information Center

    Thompson, Carla J.; Davis, Sandra B.

    2014-01-01

    The use of formal observation in primary mathematics classrooms is supported in the literature as a viable method of determining effective teaching strategies and appropriate tasks for inclusion in the early years of mathematics learning. The twofold aim of this study was to (a) investigate predictive relationships between primary mathematics…

  7. Primary data collection in health technology assessment.

    PubMed

    McIsaac, Michelle L; Goeree, Ron; Brophy, James M

    2007-01-01

    This study discusses the value of primary data collection as part of health technology assessment (HTA). Primary data collection can help reduce uncertainty in HTA and better inform evidence-based decision making. However, methodological issues such as choosing appropriate study design and practical concerns such as the value of collecting additional information need to be addressed. The authors emphasize the conditions required for successful primary data collection in HTA: experienced researchers, sufficient funding, and coordination among stakeholders, government, and researchers. The authors conclude that, under specific conditions, primary data collection is a worthwhile endeavor in the HTA process.

  8. Experience of Primary Care among Homeless Individuals with Mental Health Conditions

    PubMed Central

    Chrystal, Joya G.; Glover, Dawn L.; Young, Alexander S.; Whelan, Fiona; Austin, Erika L.; Johnson, Nancy K.; Pollio, David E.; Holt, Cheryl L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa A.; Daigle, Shanette G.; Steward, Jocelyn L.; Kertesz, Stefan G

    2015-01-01

    The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons’ needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers. PMID:25659142

  9. Experience of primary care among homeless individuals with mental health conditions.

    PubMed

    Chrystal, Joya G; Glover, Dawn L; Young, Alexander S; Whelan, Fiona; Austin, Erika L; Johnson, Nancy K; Pollio, David E; Holt, Cheryl L; Stringfellow, Erin; Gordon, Adam J; Kim, Theresa A; Daigle, Shanette G; Steward, Jocelyn L; Kertesz, Stefan G

    2015-01-01

    The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons' needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers.

  10. Annual Review of Asian American Psychology, 2014

    PubMed Central

    Kim, Su Yeong; Shen, Yishan; Hou, Yang; Tilton, Kelsey E.; Juang, Linda; Wang, Yijie

    2015-01-01

    This 2014 review of Asian American psychology is the sixth review in the series. It includes 316 articles that met the inclusion criteria established by the past five annual reviews. Featured articles were derived from three sources: 137 were generated via the search term “Asian American” in PyscINFO, 111 were generated via a search for specific Asian American ethnic groups, and 32 were generated via author searches of articles that met the inclusion criteria. The top primary topic was health and health-related behaviors, the most frequently employed study design was cross-sectional, and the most studied Asian American ethnic group was Chinese. This year’s review includes information on the target population of the primary topic, the age range and developmental period of participants, and whether the study design was cross-sectional or longitudinal. It also identifies top authors and journals contributing to the 2014 annual review. These new features reveal that the most common target population of the primary topic was youths; studies most commonly included emerging adults ages 18–25; cross-sectional study design was employed more often than longitudinal design; the top contributor to the 2014 review was Stephen Chen, who authored the highest number of papers included; and the Asian American Journal of Psychology generated the highest number of publications for this review. PMID:26925199

  11. Continuous Classroom Assessment at Primary Level

    ERIC Educational Resources Information Center

    Ali, Imtiaz; Shah, Syed Manzoor Hussein; Gujjar, Aijaz Ahmed

    2014-01-01

    This study was designed to analyze the continuous classroom assessment at primary level in Pakistan. Findings of the study revealed that the students' achievement of single class teacher in the subject of English, General science, Urdu and mathematics were almost on average and rubric observation during continuous classroom assessment ranked…

  12. Challenges in designing, conducting, and reporting oral health behavioral intervention studies in primary school age children: methodological issues

    PubMed Central

    Cooper, Anna Mary; Coffey, Margaret; Dugdill, Lindsey

    2014-01-01

    Often within oral health, clinical outcome measures dominate trial design rather than behavioral outcome measures, and often there is a reliance on proxy self-reporting of children’s behavior with no corroboration through triangulation of measures. The complexity of the interventions involved in oral health intervention is often overlooked in trial design, and more flexible pragmatic designs that take account of the research context may be more appropriate. Some of the limitations in oral health behavioral intervention studies (trials) in primary school age children were reported in a recently published Cochrane review. This paper aims to critically discuss the findings of a recent Cochrane review in terms of the methodological implications that arise for future design, development, measurement, and reporting of oral health trials in primary school age children. Key components of the UK Medical Research Council’s framework for the design and evaluation of complex interventions are discussed in relation to using taxonomies of behavior change. This paper is not designed to be a definitive guide but aims to bring learning from other areas of public health and health promotion into dental public health. Ultimately, the aim is to aid the design of more successful interventions that produce long-term behavioral changes in children in relation to toothbrushing and nighttime sugar snacking. PMID:27774028

  13. Neptune aerocapture mission and spacecraft design overview

    NASA Technical Reports Server (NTRS)

    Bailey, Robert W.; Hall, Jeff L.; Spliker, Tom R.; O'Kongo, Nora

    2004-01-01

    A detailed Neptune aerocapture systems analysis and spacecraft design study was performed as part of NASA's In-Space Propulsion Program. The primary objectives were to assess the feasibility of a spacecraft point design for a Neptune/Triton science mission. That uses aerocapture as the Neptune orbit insertion mechanism. This paper provides an overview of the science, mission and spacecraft design resulting from that study.

  14. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-29

    ... Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage Areas AGENCY: Health... facilities designated as primary medical care, mental health, and dental health professional shortage areas... primary care, dental, or mental health services in these HPSAs. NHSC health [[Page 38839

  15. Effect of implant macro-design on primary stability: A prospective clinical study.

    PubMed

    Lozano-Carrascal, Naroa; Salomó-Coll, Oscar; Gilabert-Cerdà, Marta; Farré-Pagés, Nuria; Gargallo-Albiol, Jordi; Hernández-Alfaro, Federico

    2016-03-01

    Implant restorations have become a high predictable treatment option. Several caracteristics such as surgical technique and implant design can influence the treatment outcomes. The aim of the present study was to evaluate the influence of implant macro-design on primary stability measured with resonance frequency analysis (RFA) and insertion torque (IT). Material and Mehods: A total of 47 implants divided in two groups: Test group (TI): 22 Tapered MIS® Seven implants; Control group (CI): 25 cylindrical Astra® Osseospeed implants. All implants were inserted following the manufacturers' standard protocols. Implant primary stability was measured at the moment of implant placement by registering insertion torque values (ITv) and ISQ values by means of Osstell™ Mentor (ISQv) (Integration Diagnostic Ltd., Goteborg, Sweden). In the mandible, mean ISQv for tapered implants (TI) was 71.67±5.16 and for cylindrical implants (CI) 57.15±4.83 (p=0.01). Mean insertion torque was 46.67±6.85 Ncm for TI and 35.77±6.72 Ncm for CI (p=0.01). In the maxilla, mean ISQ was 67.2±4.42 for tapered implants and 49.17±15.30 for cylindrical implants (p=0.01). Mean insertion torque for TI was 41.5±6.26 Ncm and for CI 39.17±6.34 Ncm (p>0.05). For tapered implants, no correlation could be found between implant diameter and primary stability. But for cylindrical implants there was a statistically significant correlation between implant diameter and primary stability: ITv (p=0.03); ISQv (p=0.04). Within the limits of the present study, tapered shaped implants achieve higher primary stability measured through ISQ and insertion torque values. Moreover, for cylindrical implants positive correlation has been established between implant diameter and primary stability.

  16. The role and benefits of accessing primary care patient records during unscheduled care: a systematic review.

    PubMed

    Bowden, Tom; Coiera, Enrico

    2017-09-22

    The purpose of this study was to assess the impact of accessing primary care records on unscheduled care. Unscheduled care is typically delivered in hospital Emergency Departments. Studies published to December 2014 reporting on primary care record access during unscheduled care were retrieved. Twenty-two articles met inclusion criteria from a pool of 192. Many shared electronic health records (SEHRs) were large in scale, servicing many millions of patients. Reported utilization rates by clinicians was variable, with rates >20% amongst health management organizations but much lower in nation-scale systems. No study reported on clinical outcomes or patient safety, and no economic studies of SEHR access during unscheduled care were available. Design factors that may affect utilization included consent and access models, SEHR content, and system usability and reliability. Despite their size and expense, SEHRs designed to support unscheduled care have been poorly evaluated, and it is not possible to draw conclusions about any likely benefits associated with their use. Heterogeneity across the systems and the populations they serve make generalization about system design or performance difficult. None of the reviewed studies used a theoretical model to guide evaluation. Value of Information models may be a useful theoretical approach to design evaluation metrics, facilitating comparison across systems in future studies. Well-designed SEHRs should in principle be capable of improving the efficiency, quality and safety of unscheduled care, but at present the evidence for such benefits is weak, largely because it has not been sought.

  17. Eligibility for clinical trials in primary Sjögren’s syndrome: lessons from the UK Primary Sjögren’s Syndrome Registry

    PubMed Central

    Oni, Clare; Mitchell, Sheryl; James, Katherine; Ng, Wan-Fai; Griffiths, Bridget; Hindmarsh, Victoria; Price, Elizabeth; Pease, Colin T.; Emery, Paul; Lanyon, Peter; Jones, Adrian; Bombardieri, Michele; Sutcliffe, Nurhan; Pitzalis, Costantino; Hunter, John; Gupta, Monica; McLaren, John; Cooper, Annie; Regan, Marian; Giles, Ian; Isenberg, David; Saravanan, Vadivelu; Coady, David; Dasgupta, Bhaskar; McHugh, Neil; Young-Min, Steven; Moots, Robert; Gendi, Nagui; Akil, Mohammed; Barone, Francesca; Fisher, Ben; Rauz, Saaeha; Richards, Andrea; Bowman, Simon J.

    2016-01-01

    Abstract Objective: To identify numbers of participants in the UK Primary Sjögren’s Syndrome Registry (UKPSSR) who would fulfil eligibility criteria for previous/current or potential clinical trials in primary SS (pSS) in order to optimize recruitment. Methods: We did a retrospective analysis of UKPSSR cohort data of 688 participants who had pSS with evaluable data. Results: In relation to previous/current trials, 75.2% fulfilled eligibility for the Belimumab in Subjects with Primary Sjögren’s Syndrome study (Belimumab), 41.4% fulfilled eligibility for the Trial of Remicade in primary Sjögren’s syndrome study (Infliximab), 35.4% for the Efficacy of Tocilizumab in Primary Sjögren’s Syndrome study (Tocilizumab), 46.3% for the Tolerance and Efficacy of Rituximab in Sjögren’s Disease study (Rituximab), 26.9% for the Trial of anti-B-cell therapy in pSS study (Rituximab) and 26.6% for the Efficacy and Safety of Abatacept in Patients With Primary Sjögren’s Syndrome study (Abatacept). If recent measures of outcome, such as the EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI) score ⩾5 (measure of patient symptoms) and the EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI) score ⩾5 (measure of systemic disease activity) are incorporated into a study design, with requirements for an unstimulated salivary flow >0 and anti-Ro positivity, then the pool of eligible participants is reduced to 14.3%. Conclusion: The UKPSSR identified a number of options for trial design, including selection on ESSDAI ⩾5, ESSPRI ⩾5 and serological and other parameters. PMID:26510429

  18. Eligibility for clinical trials in primary Sjögren's syndrome: lessons from the UK Primary Sjögren's Syndrome Registry.

    PubMed

    Oni, Clare; Mitchell, Sheryl; James, Katherine; Ng, Wan-Fai; Griffiths, Bridget; Hindmarsh, Victoria; Price, Elizabeth; Pease, Colin T; Emery, Paul; Lanyon, Peter; Jones, Adrian; Bombardieri, Michele; Sutcliffe, Nurhan; Pitzalis, Costantino; Hunter, John; Gupta, Monica; McLaren, John; Cooper, Annie; Regan, Marian; Giles, Ian; Isenberg, David; Saravanan, Vadivelu; Coady, David; Dasgupta, Bhaskar; McHugh, Neil; Young-Min, Steven; Moots, Robert; Gendi, Nagui; Akil, Mohammed; Barone, Francesca; Fisher, Ben; Rauz, Saaeha; Richards, Andrea; Bowman, Simon J

    2016-03-01

    To identify numbers of participants in the UK Primary Sjögren's Syndrome Registry (UKPSSR) who would fulfil eligibility criteria for previous/current or potential clinical trials in primary SS (pSS) in order to optimize recruitment. We did a retrospective analysis of UKPSSR cohort data of 688 participants who had pSS with evaluable data. In relation to previous/current trials, 75.2% fulfilled eligibility for the Belimumab in Subjects with Primary Sjögren's Syndrome study (Belimumab), 41.4% fulfilled eligibility for the Trial of Remicade in primary Sjögren's syndrome study (Infliximab), 35.4% for the Efficacy of Tocilizumab in Primary Sjögren's Syndrome study (Tocilizumab), 31.6% for the Tolerance and Efficacy of Rituximab in Sjögren's Disease study (Rituximab), 26.9% for the Trial of anti-B-cell therapy in pSS study (Rituximab) and 26.6% for the Efficacy and Safety of Abatacept in Patients With Primary Sjögren's Syndrome study (Abatacept). If recent measures of outcome, such as the EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) score ⩾5 (measure of patient symptoms) and the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) score ⩾5 (measure of systemic disease activity) are incorporated into a study design, with requirements for an unstimulated salivary flow >0 and anti-Ro positivity, then the pool of eligible participants is reduced to 14.3%. The UKPSSR identified a number of options for trial design, including selection on ESSDAI ⩾5, ESSPRI ⩾5 and serological and other parameters. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Constructivist Approach Enhances the Learning: A Search of Reality

    ERIC Educational Resources Information Center

    Dev, Meenu

    2016-01-01

    The primary aim of the study was to study the effect of constructivist approach of teaching on the learning of English Language on Primary School Students. The study consisted of 60 students of class VI from Janta Brahmi Sr. Secondary School, Nathupur, Sonipat. A single quasi experimental pre-test and post-test design was applied in the present…

  20. The Analysis of Reading Skills and Visual Perception Levels of First Grade Turkish Students

    ERIC Educational Resources Information Center

    Memis, Aysel; Sivri, Diler Ayvaz

    2016-01-01

    In this study, primary school first grade students' reading skills and visual perception levels were investigated. Sample of the study, which was designed with relational scanning model, consisted of 168 first grade students studying at three public primary schools in Kozlu, Zonguldak, in 2013-2014 education year. Students' reading level, reading…

  1. Phenomenological Analysis of Teachers' Organizational Deviance Experiences in a Rural Primary School in Turkey

    ERIC Educational Resources Information Center

    Anasiz, Burcu Türkkas; Püsküllüoglu, Elif Iliman

    2018-01-01

    The purpose of this study was to analyze organizational deviance experiences of teachers. The study was in phenomenological design among qualitative research methods. In the research convenience sampling technique was used. The research was conducted in a rural primary school in Mugla province in Turkey. Nine teachers participated in the study,…

  2. A Comparative Study of Teachers' Pedagogical Competencies in Supporting Children with Learning Difficulties in Primary Schools in Ghana and Brunei Darussalam

    ERIC Educational Resources Information Center

    Abosi, Okechukwu; Alhassan, Abdul Razak Kuyini

    2017-01-01

    Teachers' pedagogical competencies level is increasingly affecting the implementation of inclusive education policy in many countries. The aimed at comparing primary school teachers' competence levels in supporting children with learning difficulties in Brunei Darussalam and Ghana. Descriptive survey design was used and 188 primary school teachers…

  3. Quasi-Experimental Evaluation of a National Primary School HIV Intervention in Kenya

    ERIC Educational Resources Information Center

    Maticka-Tyndale, Eleanor; Wildish, Janet; Gichuru, Mary

    2007-01-01

    This study examined the impact of a primary-school HIV education initiative on the knowledge, self-efficacy and sexual and condom use activities of upper primary-school pupils in Kenya. A quasi-experimental mixed qualitative-quantitative pre- and 18-month post-design using 40 intervention and 40 matched control schools demonstrated significant…

  4. Primary School Playgrounds as Spaces of Inclusion/Exclusion in New South Wales, Australia

    ERIC Educational Resources Information Center

    Ndhlovu, Sithembile; Varea, Valeria

    2018-01-01

    The purpose of this study was to determine how the design and organisation of primary school playground spaces may result in the inclusion or exclusion of some groups of children. Two primary school playgrounds in rural New South Wales, Australia, were selected for this investigation. Data were collected through observations and unstructured…

  5. The Collaborative Learning Behaviours of Middle Primary School Students in a Classroom Music Creation Activity

    ERIC Educational Resources Information Center

    Baker, William J.; Harvey, Georgina

    2014-01-01

    Located in a northern Tasmanian government primary school, this study presents the findings of an investigation into the learning behaviours of middle primary (Grade 3/4) students in a collaborative music soundscape task. Recent literature regarding music education and social development are presented and the design of the research described.…

  6. Designing Tasks to Examine Mathematical Knowledge for Teaching Statistics for Primary Teachers

    NASA Astrophysics Data System (ADS)

    Siswono, T. Y. E.; Kohar, A. W.; Hartono, S.

    2018-01-01

    Mathematical knowledge for teaching (MKT) is viewed as fuel resources for conducting an orchestra in a teaching and learning process. By understanding MKT, especially for primary teachers, it can predict the success of a goal of an instruction and analyze the weaknesses and improvements of it. To explore what teachers think about subject matters, pedagogical terms, and appropriate curriculum, it needs a task which can be identified the teachers’ MKT including the subject matter knowledge (SMK) and pedagogical content knowledge (PCK). This study aims to design an appropriate task for exploring primary teachers’ MKT for statistics in primary school. We designed six tasks to examine 40 primary teachers’ MKT, of which each respectively represents the categories of SMK (common content knowledge (CCK) and specialised content knowledge (SCK)) and PCK (knowledge of content and students (KCS), knowledge of content and teaching (KCT), and knowledge of content and curriculum (KCC)). While MKT has much attention of numbers of scholars, we consider knowledge of content and culture (KCCl) to be hypothesized in the domains of MKT. Thus, we added one more task examining how the primary teachers used their knowledge of content (KC) regarding to MKT in statistics. Some examples of the teachers’ responses on the tasks are discussed and some refinements of MKT task in statistics for primary teachers are suggested.

  7. Design values of resilient modulus of stabilized and non-stabilized base.

    DOT National Transportation Integrated Search

    2010-10-01

    The primary objective of this research study is to determine design value ranges for typical base materials, as allowed by LADOTD specifications, through laboratory tests with respect to resilient modulus and other parameters used by pavement design ...

  8. The design-build contracting methodology for transportation projects : a review of practice and evaluation for Connecticut applications.

    DOT National Transportation Integrated Search

    2010-06-10

    Two primary contracting methods are used by most state transportation agencies to : design and build infrastructure: design-bid-build and design-build. The objective : of this study is to conduct a literature review to identify how ConnDOTs use of...

  9. 78 FR 28896 - Design Limits and Loading Combinations for Metal Primary Reactor Containment System Components

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... NUCLEAR REGULATORY COMMISSION [NRC-2013-0095] Design Limits and Loading Combinations for Metal... Regulatory Guide (RG) 1.57, ``Design Limits and Loading Combinations for Metal Primary Reactor Containment... the NRC staff considers acceptable for design limits and loading combinations for metal primary...

  10. Spectacle design preferences among Chinese primary and secondary students and their parents: a qualitative and quantitative study.

    PubMed

    Zhou, Zhongqiang; Kecman, Maja; Chen, Tingting; Liu, Tianyu; Jin, Ling; Chen, Shangji; Chen, Qianyun; He, Mingguang; Silver, Josh; Moore, Bruce; Congdon, Nathan

    2014-01-01

    To identify the specific characteristics making glasses designs, particularly those compatible with adjustable glasses, more or less appealing to Chinese children and their parents. Primary and secondary school children from urban and rural China with < = -1.00 diopters of bilateral myopia and their parents ranked four conventional-style frames identified by local optical shops as popular versus four child-specific frames compatible with adjustable spectacles. Scores based on the proportion of maximum possible ranking were computed for each style. Selected children and their parents also participated in Focus Groups (FGs) discussing spectacle design preference. Recordings were transcribed and coded by two independents reviewers using NVivo software. Among 136 urban primary school children (age range 9-11 years), 290 rural secondary school children (11-17 years) and 16 parents, all adjustable-style frames (scores on 0-100 scale 25.7-62.4) were ranked behind all conventional frames (63.0-87.5). For eight FGs including 12 primary children, 26 secondary children and 16 parents, average kappa values for NVivo coding were 0.81 (students) and 0.70 (parents). All groups agreed that the key changes to make adjustable designs more attractive were altering the round lenses to rectangular or oval shapes and adding curved earpieces for more stable wear. The thick frames of the adjustable designs were considered stylish, and children indicated they would wear them if the lens shape were modified. Current adjustable lens designs are unattractive to Chinese children and their parents, though this study identified specific modifications which would make them more appealing.

  11. Relationship between Political Discrimination and Dissent Behaviour Displayed by Teachers

    ERIC Educational Resources Information Center

    Kara, Sultan Bilge Keskinkiliç

    2015-01-01

    The aim of this study is to find out whether there is a significant relationship between perceived political discrimination and dissent behaviour displayed by primary school teachers. This study was designed with correlational research method and survey technique was used to collect data. Primary school teachers working in Tuzla, Istanbul…

  12. Total Quality Management Practices in Turkish Primary Schools

    ERIC Educational Resources Information Center

    Toremen, Fatih; Karakus, Mehmet; Yasan, Tezcan

    2009-01-01

    Purpose: The purpose of this paper is to determine the extent of total quality management (TQM) practices in primary schools based on teachers' perceptions, and how their perceptions are related to different variables. Design/methodology/approach: In this study, a survey based descriptive scanning model was used. This study was carried out in…

  13. Primary Student Teachers' Perspectives of the Teaching of Fractions

    ERIC Educational Resources Information Center

    Savas Basturk

    2016-01-01

    The aim of this study was to investigate primary student teachers' perspectives of the teaching of fractions, i.e. their PCK of fractions. The research design used for the study was a descriptive survey method. As data collection instrument, we conducted a questionnaire composing of 14 open and closed-ended questions. The questionnaire was…

  14. Constraints on primary and secondary particulate carbon sources using chemical tracer and 14C methods during CalNex-Bakersfield

    EPA Science Inventory

    The present study investigates primary and secondary sources of organic carbon for Bakersfield, CA, USA as part of the 2010 CalNex study. The method used here involves integrated sampling that is designed to allow for detailed and specific chemical analysis of particulate matter ...

  15. Laboratory study of concrete properties to support implementation of the new AASHTO mechanistic-empirical pavement design guide.

    DOT National Transportation Integrated Search

    2012-09-01

    Properties of concrete embodying materials typically used in Wisconsin paving projects were evaluated in support of future : implementation of the AASHTO Mechanistic-Empirical Pavement Design Guide (MEPDG). The primary concrete : properties studied w...

  16. Laboratory study of concrete properties to support implementation of the new AASHTO mechanistic empirical pavement design guide.

    DOT National Transportation Integrated Search

    2012-09-01

    Properties of concrete embodying materials typically used in Wisconsin paving projects were evaluated in support of future : implementation of the AASHTO Mechanistic-Empirical Pavement Design Guide (MEPDG). The primary concrete : properties studied w...

  17. Phase 2 design study of the electronic assembly for the HRUV spectrometer/polarimeter intended for the solar maximum mission. Implementation phase program plan, revision A

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The primary function of the implementation phase is to convert the ERA design of the design study phase into deliverable flight hardware. The development aspects of the experiment logic unit, the dual power converter, the junction box and the cables are considered.

  18. Preliminary design study of hydrogen and ammonia resistojets for prime and auxiliary thrusters

    NASA Technical Reports Server (NTRS)

    Page, Russell J.; Stoner, Willis A.; Barker, Larry

    1988-01-01

    Designs of high performance resistojets for primary and auxiliary propulsion are described.Thruster power for the primary propulsion application was in the 2 to 3 kW range while auxiliary propulsion power per thruster was 0.15 to 0.25 kW. Propellants considered were hydrogen and ammonia. The report described design techniques used to forecast the temperature and energy flux distributions using mathematical modeling by personal microcomputer. BASIC language is used throughout to give the designer rapid interaction and control. Both designs integrate compact first stage coils with concentric tubular heaters. The hybrid heater design allows better thruster power matching with the spacecraft power bus. Projected specific impulse levels were 760 to 830 s for hydrogen and 380 to 410 s for ammonia.

  19. Effective Home-School Partnership: Some Strategies to Help Strengthen Parental Involvement

    ERIC Educational Resources Information Center

    Okeke, Chinedu I.

    2014-01-01

    The primary aim of the study from which this paper derives was to investigate the level of parental involvement in the schooling of their children. The study employed a descriptive case study research design. All data were based on unstructured interviews with the 30 parents whose children attended one of the primary schools located in the London…

  20. Secondary outcome analysis for data from an outcome-dependent sampling design.

    PubMed

    Pan, Yinghao; Cai, Jianwen; Longnecker, Matthew P; Zhou, Haibo

    2018-04-22

    Outcome-dependent sampling (ODS) scheme is a cost-effective way to conduct a study. For a study with continuous primary outcome, an ODS scheme can be implemented where the expensive exposure is only measured on a simple random sample and supplemental samples selected from 2 tails of the primary outcome variable. With the tremendous cost invested in collecting the primary exposure information, investigators often would like to use the available data to study the relationship between a secondary outcome and the obtained exposure variable. This is referred as secondary analysis. Secondary analysis in ODS designs can be tricky, as the ODS sample is not a random sample from the general population. In this article, we use the inverse probability weighted and augmented inverse probability weighted estimating equations to analyze the secondary outcome for data obtained from the ODS design. We do not make any parametric assumptions on the primary and secondary outcome and only specify the form of the regression mean models, thus allow an arbitrary error distribution. Our approach is robust to second- and higher-order moment misspecification. It also leads to more precise estimates of the parameters by effectively using all the available participants. Through simulation studies, we show that the proposed estimator is consistent and asymptotically normal. Data from the Collaborative Perinatal Project are analyzed to illustrate our method. Copyright © 2018 John Wiley & Sons, Ltd.

  1. Design Study for the Asteroid Redirect Vehicle (ARV) Composite Primary Bulkhead

    NASA Technical Reports Server (NTRS)

    Cressman, Thomas O.; Paddock, David A.

    2017-01-01

    A design study was undertaken of a carbon fiber primary bulkhead for a large solar electric propulsion (SEP) spacecraft. The bulkhead design, supporting up to 16 t of xenon propellant, progressed from one consisting of many simple parts with many complex joints, to one consisting of a few complex parts with a few simple joints. The unique capabilities of composites led to a topology that transitioned loads from bending to in-plane tension and shear, with low part count. This significantly improved bulkhead manufacturability, cost, and mass. The stiffness-driven structure utilized high-modulus M55J fiber unidirectional prepregs. A full-scale engineering demonstration unit (EDU) of the concept was used to demonstrate manufacturability of the concept. Actual labor data was obtained, which could be extrapolated to a full bulkhead. The effort demonstrated the practicality of using high-modulus fiber (HMF) composites for unique shape topologies that minimize mass and cost. The lessons are applicable to primary and secondary aerospace structures that are stiffness driven.

  2. The Challenges of Primary Sources, Collaboration, and the K-16 Elizabeth Murray Project

    ERIC Educational Resources Information Center

    Cleary, Patricia; Neumann, David

    2009-01-01

    In recent years, the use of primary sources in the history and social studies classroom has been increasingly promoted as a necessary and welcome practice, one designed to improve the quality of history education and to encourage student interest and engagement. Although some K-12 educators have been wary of adopting the use of primary sources,…

  3. An Investigation of the Relationship between Digital Citizenship Levels of Pre-Service Primary School Teachers and Their Democratic Values

    ERIC Educational Resources Information Center

    Aladag, Soner; Çiftci, Serdar

    2017-01-01

    This study seeks to investigate the relationship between digital citizenship levels of pre-service primary school teachers and their democratic values. The research was designed in descriptive survey model. The research was conducted with the participation of 346 pre-service primary school teachers (juniors and seniors) from Adnan Menderes…

  4. GeoGebra Workshop for the Initial Teacher Training in Primary Education

    ERIC Educational Resources Information Center

    Lopez, Natalia Ruiz

    2011-01-01

    The GeoGebra Workshop for the degree "Teacher in Primary Education" has been designed to work the main geometric competencies that primary pre-service teachers need to develop. In this paper, some case studies are included in which we analyse the development of geometric skills and the use of GeoGebra dynamic tools in three types of activities:…

  5. Extent of Head Teachers' Utilization of Innovative Sources of Funding Primary Schools in Enugu State of Nigeria

    ERIC Educational Resources Information Center

    Amogechukwu, Eze Thecla; Unoma, Chidobi Roseline

    2017-01-01

    The purpose of this study was to examine the extent Head teachers utilize innovative sources of funding primary schools in Enugu State of Nigeria. Descriptive survey design was employed to examine the extent head teachers utilize innovative sources of funding primary schools in Enugu State. Data were collected through a 14-item questionnaire…

  6. An overview of current Navy programs to develop thrust augmenting ejectors

    NASA Technical Reports Server (NTRS)

    Green, K. A.

    1979-01-01

    The primary objective of Navy sponsored research in thrust augmentation is the development of an improved augmenter for V/STOL application. In support of this goal, a data base is being established to provide an accurate prediction capability for use in ejector design. A general technology development of ejectors and associated effects presently is split into the more specific areas of lift and control, since thrust augmenting ejectors may be suitable for both. Research areas examined include advanced diffuser and end wall design; advanced primary nozzles; analytic studies; augmenting reaction controls; and nozzle design.

  7. Enhancing Shared Decision Making Through Carefully Designed Interventions That Target Patient And Provider Behavior.

    PubMed

    Tai-Seale, Ming; Elwyn, Glyn; Wilson, Caroline J; Stults, Cheryl; Dillon, Ellis C; Li, Martina; Chuang, Judith; Meehan, Amy; Frosch, Dominick L

    2016-04-01

    Patient-provider communication and shared decision making are essential for primary care delivery and are vital contributors to patient experience and health outcomes. To alleviate communication shortfalls, we designed a novel, multidimensional intervention aimed at nudging both patients and primary care providers to communicate more openly. The intervention was tested against an existing intervention, which focused mainly on changing patients' behaviors, in four primary care clinics involving 26 primary care providers and 300 patients. Study results suggest that compared to usual care, both the novel and existing interventions were associated with better patient reports of how well primary care providers engaged them in shared decision making. Future research should build on the work in this pilot to rigorously examine the comparative effectiveness and scalability of these interventions to improve shared decision making at the point of care. Project HOPE—The People-to-People Health Foundation, Inc.

  8. Examining the practice of generalist expertise: a qualitative study identifying constraints and solutions

    PubMed Central

    Reeve, Joanne; Dowrick, Christopher F; Freeman, George K; Gunn, Jane; Mair, Frances; May, Carl; Mercer, Stewart; Palmer, Victoria; Howe, Amanda; Irving, Greg; Shiner, Alice; Watson, Jessica

    2013-01-01

    Objectives Provision of person-centred generalist care is a core component of quality primary care systems. The World Health Organisation believes that a lack of generalist primary care is contributing to inefficiency, ineffectiveness and inequity in healthcare. In UK primary care, General Practitioners (GPs) are the largest group of practising generalists. Yet GPs fulfil multiple roles and the pressures of delivering these roles along with wider contextual changes create real challenges to generalist practice. Our study aimed to explore GP perceptions of enablers and constraints for expert generalist care, in order to identify what is needed to ensure health systems are designed to support the generalist role. Design Qualitative study in General Practice. Setting UK primary care. Main outcome measures A qualitative study – interviews, surveys and focus groups with GPs and GP trainees. Data collection and analysis was informed by Normalisation Process Theory. Design and setting Qualitative study in General Practice. We conducted interviews, surveys and focus groups with GPs and GP trainees based mainly, but not exclusively, in the UK. Data collection and analysis were informed by Normalization Process Theory. Participants UK based GPs (interview and surveys); European GP trainees (focus groups). Results Our findings highlight key gaps in current training and service design which may limit development and implementation of expert generalist practice (EGP). These include the lack of a consistent and universal understanding of the distinct expertise of EGP, competing priorities inhibiting the delivery of EGP, lack of the consistent development of skills in interpretive practice and a lack of resources for monitoring EGP. Conclusions We describe four areas for change: Translating EGP, Priority setting for EGP, Trusting EGP and Identifying the impact of EGP. We outline proposals for work needed in each area to help enhance the expert generalist role. PMID:24475347

  9. Implementing Self-Assessment in Singapore Primary Schools: Effects on Students' Perceptions of Self-Assessment

    ERIC Educational Resources Information Center

    Wong, Hwei Ming

    2017-01-01

    Student academic self-assessment engages the students in deliberate reflection about what they are learning and how they are learning it. This intervention study investigated the effects of self-assessment training on students' perceptions towards self-assessment in two Singaporean primary schools. The study, which used a pretest-posttest design,…

  10. Children's Physical Activity Levels during Primary School Break Times: A Quantitative and Qualitative Research Design

    ERIC Educational Resources Information Center

    Powell, Emma; Woodfield, Lorayne A.; Nevill, Alan A. M.

    2016-01-01

    The overall aim of this study was to assess the diversity of primary school children's physical activity (PA) during outdoor recess. The study was grounded in a mixed method approach, assisting in the identification of multifaceted predictors of children's PA, including insights to social behaviours during break time. Data were obtained from…

  11. Primary-Grade Students' Knowledge and Thinking about Shelter as a Cultural Universal.

    ERIC Educational Resources Information Center

    Brophy, Jere; Alleman, Janet

    The traditional K-3 social studies curriculum has focused on food, clothing, shelter, communication, transportation, and other cultural universals. A study was designed to provide information with respect to the topic of shelter, and in the process, to assess claims that primary grade students do not need instruction in the topic because they…

  12. A Longitudinal Study Exploring Liverpool Primary Schoolchildren's Perspectives on Smoking

    ERIC Educational Resources Information Center

    Porcellato, Lorna; Dugdill, Lindsey; Springett, Jane

    2005-01-01

    A cohort study was designed to explore over 200 primary schoolchildren's (ages 4-7) perspectives on smoking in the context of their own lives and subsequently, to assess any changes in these perspectives over time. Results showed that, in general, the children had a negative disposition about the habit, which did not dissipate over the 3-year…

  13. Prevalence for Private Tuition among Parents, Teachers and Pupils in Public Primary Schools in Machakos County

    ERIC Educational Resources Information Center

    Kirigwi, Lucy Wambui; Maithya, Redempta

    2016-01-01

    Private tuition refers to tutoring offered outside mainstream teaching. The study sought to establish the difference in prevalence for private tuition among parents, teachers and pupils in public primary schools in Machakos County. The study employed descriptive survey design. The target populations were all teachers, parents and pupils of public…

  14. Approaches of Inquiry Learning With Multimedia Resources in Primary Classrooms

    ERIC Educational Resources Information Center

    So, Wing-Mui Winnie; Kong, Siu-Cheung

    2007-01-01

    This study aims to examine the design of approaches for inquiry learning with multimedia resources in primary classrooms. The study describes the development of a multimedia learning unit that helps learners understand the natural phenomenon of the movement of the Earth. An analysis of the use of the multimedia learning unit by a teacher in two…

  15. Primary Assessment Activity and Learner Perceptions of Attitude Change in Four MOOCs

    ERIC Educational Resources Information Center

    Watson, Sunnie Lee; Watson, William R.; Kim, Woori

    2017-01-01

    This study seeks to examine perceptions of attitudinal change in relation to the primary assessment activity within four Massive Open Online Courses (MOOCs) that were designed for attitudinal learning. The purpose of this study was twofold. First, we sought to understand if by focusing on assessing cognitive learning (quizzes) as opposed to…

  16. Primary uterine inertia in four labrador bitches.

    PubMed

    Davidson, Autumn P

    2011-01-01

    Uterine inertia is a common cause of dystocia in the bitch and is designated as primary (i.e., uterine contractions fail to ever be initiated) or secondary (i.e., uterine contractions cease after a period of time but before labor is completed). The etiology of primary uterine inertia is not well understood. The accurate diagnosis of primary uterine inertia requires the use of tocodynamometry (uterine monitoring). Primary uterine inertia has been postulated to result from a failure of luteolysis resulting in persistently elevated progesterone concentrations. In this study, primary uterine inertia was diagnosed in a series of four bitches in which luteolysis was documented suggesting some other etiopathogenesis for primary uterine inertia.

  17. Design, rationale, and baseline characteristics of a cluster randomized controlled trial of pay for performance for hypertension treatment: study protocol

    PubMed Central

    2011-01-01

    Background Despite compelling evidence of the benefits of treatment and well-accepted guidelines for treatment, hypertension is controlled in less than one-half of United States citizens. Methods/design This randomized controlled trial tests whether explicit financial incentives promote the translation of guideline-recommended care for hypertension into clinical practice and improve blood pressure (BP) control in the primary care setting. Using constrained randomization, we assigned 12 Veterans Affairs hospital outpatient clinics to four study arms: physician-level incentive; group-level incentive; combination of physician and group incentives; and no incentives (control). All participants at the hospital (cluster) were assigned to the same study arm. We enrolled 83 full-time primary care physicians and 42 non-physician personnel. The intervention consisted of an educational session about guideline-recommended care for hypertension, five audit and feedback reports, and five disbursements of incentive payments. Incentive payments rewarded participants for chart-documented use of guideline-recommended antihypertensive medications, BP control, and appropriate responses to uncontrolled BP during a prior four-month performance period over the 20-month intervention. To identify potential unintended consequences of the incentives, the study team interviewed study participants, as well as non-participant primary care personnel and leadership at study sites. Chart reviews included data collection on quality measures not related to hypertension. To evaluate the persistence of the effect of the incentives, the study design includes a washout period. Discussion We briefly describe the rationale for the interventions being studied, as well as the major design choices. Rigorous research designs such as the one described here are necessary to determine whether performance-based payment arrangements such as financial incentives result in meaningful quality improvements. Trial Registration http://www.clinicaltrials.gov NCT00302718 PMID:21967830

  18. Traditional Tales and Imaginary Contexts in Primary Design and Technology: A Case Study

    ERIC Educational Resources Information Center

    McLain, Matt; McLain, Mel; Tsai, Jess; Martin, Mike; Bell, Dawne; Wooff, David

    2017-01-01

    Working with contexts is a key component to design and technology activity and education. The most recent iteration of the national curriculum programme of study for design and technology, in England, sets out that children between the ages of 5 and 7 "should work in a range of relevant contexts" (DfE, 2013, p.193); suggested contexts…

  19. Design-Driven Education in Primary and Secondary School Contexts. A Qualitative Study on Teachers' Conceptions on Designing

    ERIC Educational Resources Information Center

    Heikkilä, Anni-Sofia; Vuopala, Essi; Leinonen, Teemu

    2017-01-01

    Design in educational contexts is a relatively new topic. The basic idea of design and design-driven education is that students and teachers participate together in the planning, implementation and evaluation of learning projects. However, how design-driven education should be carried out in practice is yet to be established. Therefore, the aim of…

  20. Research Ethics

    ERIC Educational Resources Information Center

    Dooly, Melinda; Moore, Emilee; Vallejo, Claudia

    2017-01-01

    Qualitative research, especially studies in educational contexts, often brings up questions of ethics because the study design involves human subjects, some of whom are under age (e.g. data collected in primary education classrooms). It is not always easy for young researchers to anticipate where ethical issues might emerge while designing their…

  1. Effects of Sand Harvesting on Environment and Educational Outcomes in Public Primary Schools in Kathiani Sub-County, Machakos County, Kenya

    ERIC Educational Resources Information Center

    Nthambi, Mutiso Veronicah; Orodho, John Aluko

    2015-01-01

    The purpose of this study was to examine the effects of sand harvesting on environment and educational outcomes in public primary schools in Kathiani Sub-County, Machakos County, Kenya. This study was premised on treadmill theory of production proposed by Schnaiberg (1980). The study adopted a survey design. Combinations of purposive and…

  2. Performance Assessment of High and Low Income Families through "Online RAW Achievement Battery Test" of Primary Grade Students

    ERIC Educational Resources Information Center

    Ahmed, Tamim; Hanif, Maria

    2016-01-01

    This study is intended to investigate student's achievement capability among two families i.e. Low and High income families and designed for primary level learners. A Reading, Arithmetic and Writing (RAW) Achievement test that was developed as a part of another research study (Tamim Ahmed Khan, 2015) was adopted for this study. Both English medium…

  3. Spectacle Design Preferences among Chinese Primary and Secondary Students and Their Parents: A Qualitative and Quantitative Study

    PubMed Central

    Zhou, Zhongqiang; Kecman, Maja; Chen, Tingting; Liu, Tianyu; Jin, Ling; Chen, Shangji; Chen, Qianyun; He, Mingguang; Silver, Josh; Moore, Bruce; Congdon, Nathan

    2014-01-01

    Purpose To identify the specific characteristics making glasses designs, particularly those compatible with adjustable glasses, more or less appealing to Chinese children and their parents. Patients and Methods Primary and secondary school children from urban and rural China with < = −1.00 diopters of bilateral myopia and their parents ranked four conventional-style frames identified by local optical shops as popular versus four child-specific frames compatible with adjustable spectacles. Scores based on the proportion of maximum possible ranking were computed for each style. Selected children and their parents also participated in Focus Groups (FGs) discussing spectacle design preference. Recordings were transcribed and coded by two independents reviewers using NVivo software. Results Among 136 urban primary school children (age range 9–11 years), 290 rural secondary school children (11–17 years) and 16 parents, all adjustable-style frames (scores on 0–100 scale 25.7–62.4) were ranked behind all conventional frames (63.0–87.5). For eight FGs including 12 primary children, 26 secondary children and 16 parents, average kappa values for NVivo coding were 0.81 (students) and 0.70 (parents). All groups agreed that the key changes to make adjustable designs more attractive were altering the round lenses to rectangular or oval shapes and adding curved earpieces for more stable wear. The thick frames of the adjustable designs were considered stylish, and children indicated they would wear them if the lens shape were modified. Conclusions Current adjustable lens designs are unattractive to Chinese children and their parents, though this study identified specific modifications which would make them more appealing. PMID:24594799

  4. Study Links Learning Design to Changes in Knowledge, Beliefs, and Behaviors. Lessons from Research

    ERIC Educational Resources Information Center

    Killion, Joellen

    2015-01-01

    In this study of 16 teachers in two primary schools in the Netherlands, researchers built on findings from previous studies to demonstrate that a thoughtfully designed professional development program can be "effective and sustainable, if certain conditions are met" (p. 772) in changing teachers' knowledge, beliefs, perceived problems,…

  5. Learning on the Fly: Exploring the Informal Learning Process of Aviation Instructors

    ERIC Educational Resources Information Center

    Wofford, Michael Grant; Ellinger, Andrea D.; Watkins, Karen E.

    2013-01-01

    Purpose: This study aims to examine the process of informal learning of aviation instructors. Design/methodology/approach: A qualitative instrumental case study design was used for this study. In-depth, multiple semi-structured interviews and document review were the primary approaches to data collection and the data were analyzed using constant…

  6. Self-cutting blades and their influence on primary stability of tapered dental implants in a simulated low-density bone model: a laboratory study.

    PubMed

    Kim, Duck-Rae; Lim, Young-Jun; Kim, Myung-Joo; Kwon, Ho-Beom; Kim, Sung-Hun

    2011-11-01

    This study tested the hypothesis that there would be differences in primary stability due to the presence of self cutting blades. We investigated the effect of a self-cutting blade implant design on the primary stability of tapered dental implants in a simulated low-density bone model. Implant fixtures with 2 different designs, one with self-cutting blades and the other without self-cutting blades, were fabricated in the same implant system. Insertion torque, resonance frequency analysis, reverse torque, and pull-out and push-in tests were evaluated in grade no. 10 solid rigid polyurethane foam. All 5 assessments of the group without self-cutting blades were significantly higher than those of the self-cutting group (P < .001). The implants without self-cutting blades create a lateral compression with increased contact surface area and consequently improve the primary stability in a simulated low-density bone model. Copyright © 2011 Mosby, Inc. All rights reserved.

  7. Developing Mathematical Thinking in the Primary Classroom: Liberating Students and Teachers as Learners of Mathematics

    ERIC Educational Resources Information Center

    Hudson, Brian; Henderson, Sheila; Hudson, Alison

    2015-01-01

    This paper reports on a research study conducted with a group of practising primary school teachers (n = 24) in North East Scotland during 2011-2012. The teachers were all participants in a newly developed Masters course that had been designed with the aim of promoting the development of mathematical thinking in the primary classroom as part of…

  8. Turkish Primary School Students' Strategies in Solving a Non-Routine Mathematical Problem and Some Implications for the Curriculum Design and Implementation

    ERIC Educational Resources Information Center

    Erdogan, Abdulkadir

    2015-01-01

    Turkish primary mathematics curriculum emphasizes the role of problem solving for teaching mathematics and pays particular attention to problem solving strategies. Patterns as a subject and the use of patterns as a non-routine problem solving strategy are also emphasized in the curriculum. The primary purpose of this study was to determine how…

  9. Study Quality in SLA: An Assessment of Designs, Analyses, and Reporting Practices in Quantitative L2 Research

    ERIC Educational Resources Information Center

    Plonsky, Luke

    2013-01-01

    This study assesses research and reporting practices in quantitative second language (L2) research. A sample of 606 primary studies, published from 1990 to 2010 in "Language Learning and Studies in Second Language Acquisition," was collected and coded for designs, statistical analyses, reporting practices, and outcomes (i.e., effect…

  10. Geometric modeling for computer aided design

    NASA Technical Reports Server (NTRS)

    Schwing, James L.

    1993-01-01

    Over the past several years, it has been the primary goal of this grant to design and implement software to be used in the conceptual design of aerospace vehicles. The work carried out under this grant was performed jointly with members of the Vehicle Analysis Branch (VAB) of NASA LaRC, Computer Sciences Corp., and Vigyan Corp. This has resulted in the development of several packages and design studies. Primary among these are the interactive geometric modeling tool, the Solid Modeling Aerospace Research Tool (smart), and the integration and execution tools provided by the Environment for Application Software Integration and Execution (EASIE). In addition, it is the purpose of the personnel of this grant to provide consultation in the areas of structural design, algorithm development, and software development and implementation, particularly in the areas of computer aided design, geometric surface representation, and parallel algorithms.

  11. Design and methodology of the COACH-2 (Comparative study on guideline adherence and patient compliance in heart failure patients) study: HF clinics versus primary care in stable patients on optimal therapy.

    PubMed

    Luttik, M L A; Brons, M; Jaarsma, T; Hillege, H L; Hoes, A; de Jong, R; Linssen, G; Lok, D J; Berger, M; van Veldhuisen, D J

    2012-08-01

    Since the number of heart failure (HF) patients is still growing and long-term treatment of HF patients is necessary, it is important to initiate effective ways for structural involvement of primary care services in HF management programs. However, evidence on whether and when patients can be referred back to be managed in primary care is lacking. To determine whether long-term patient management in primary care, after initial optimisation of pharmacological and non-pharmacological treatment in a specialised HF clinic, is equally effective as long-term management in a specialised HF clinic in terms of guideline adherence and patient compliance. The study is designed as a randomised, controlled, non-inferiority trial. Two-hundred patients will be randomly assigned to be managed and followed in primary care or in a HFclinic. Patients are eligible to participate if they are (1) clinically stable, (2) optimally up-titrated on medication (according to ESC guidelines) and, (3) have received optimal education and counselling on pre-specified issues regarding HF and its treatment. Furthermore, close cooperation between secondary and primary care in terms of back referral to or consultation of the HF clinic will be provided.The primary outcome will be prescriber adherence and patient compliance with medication after 12 months. Secondary outcomes measures will be readmission rate, mortality, quality of life and patient compliance with other lifestyle changes. The results of the study will add to the understanding of the role of primary care and HF clinics in the long-term follow-up of HF patients.

  12. Missing an opportunity: the embedded nature of weight management in primary care

    PubMed Central

    Osunlana, A. M.; Ogunleye, A. A.; Sharma, A. M.; Campbell‐Scherer, D.

    2015-01-01

    Summary The 5As Team study was designed to create, implement and evaluate a flexible intervention to improve the quality and quantity of weight management visits in primary care. The objective of this portion of the study was to explore how primary care providers incorporate weight management in their practice. 5AsT is a randomized controlled trial (RCT) on the implementation of a 6‐month 5 As Team (5AsT) intervention designed to operationalize the 5As of obesity management in primary care. Data for the qualitative portion of the study presented here included semi‐structured interviews with 29 multidisciplinary team providers and field notes of intervention sessions. Thematic analysis was undertaken. A key pattern that emerged from the data was that healthcare providers usually do not address obesity as a primary focus for a visit. Rather, obesity is embedded in a wide range of primary care encounters for other conditions. Implications were it can take extra time to discuss weight, it can be inappropriate to bring up weight as a topic, and treating risk factors and root causes of obesity have indirect benefits to patient weight management. Our findings have implications for obesity treatment approaches and tools that assume a discreet weight management visit. The embedded nature of obesity management in primary care can be harnessed to leverage multiple opportunities for asking and assessing root causes of obesity, and working longitudinally towards individual health goals. PMID:26303812

  13. New dedicated bifurcated silicone stent placement for stenosis around the primary right carina.

    PubMed

    Oki, Masahide; Saka, Hideo

    2013-08-01

    Silicone stenting has been widely used to palliate respiratory symptoms in patients suffering from airway stenosis. Although many types and shapes of stents have been developed, there is no ideal stent for stenosis around the carina between the bronchus to the right upper lobe and the bronchus intermedius (primary right carina). The purpose of this study was to evaluate the feasibility, efficacy, and safety of a new silicone stent designed for treating airway stenosis around the primary right carina. We recruited 16 patients with suspected stenosis around the primary right carina. Ten of the patients met the inclusion criteria for inserting the study stent. All stenting procedures were performed with a rigid and flexible bronchoscope under general anesthesia. The study stent could be mounted successfully on the primary right carina in all 10 patients. Five patients underwent stenting using only the new stent, and the other five underwent stenting with it on the primary right carina and a silicone Y stent on the main carina. The dyspnea index improved in eight of the 10 patients, including one who was mechanically ventilated. Early complications developed in three patients (temporary pneumonia in two and retention of secretions in one), and late complications occurred in two patients (granuloma formation in one and hemoptysis in one). Stent placement with the new silicone stent designed to fit on the primary right carina is feasible, effective, and acceptably safe. UMIN-Clinical Trials Registry; No.: UMIN000001776; URL: www.umin.ac.jp/ctr.

  14. Coordinating resources for prospective medication risk management of older home care clients in primary care: procedure development and RCT study design for demonstrating its effectiveness.

    PubMed

    Toivo, Terhi; Dimitrow, Maarit; Puustinen, Juha; Savela, Eeva; Pelkonen, Katariina; Kiuru, Valtteri; Suominen, Tuula; Kinnunen, Sirkka; Uunimäki, Mira; Kivelä, Sirkka-Liisa; Leikola, Saija; Airaksinen, Marja

    2018-03-16

    The magnitude of safety risks related to medications of the older adults has been evidenced by numerous studies, but less is known of how to manage and prevent these risks in different health care settings. The aim of this study was to coordinate resources for prospective medication risk management of home care clients ≥ 65 years in primary care and to develop a study design for demonstrating effectiveness of the procedure. Health care units involved in the study are from primary care in Lohja, Southern Finland: home care (191 consented clients), the public healthcare center, and a private community pharmacy. System based risk management theory and action research method was applied to construct the collaborative procedure utilizing each profession's existing resources in medication risk management of older home care clients. An inventory of clinical measures in usual clinical practice and systematic review of rigorous study designs was utilized in effectiveness study design. The new coordinated medication management model (CoMM) has the following 5 stages: 1) practical nurses are trained to identify clinically significant drug-related problems (DRPs) during home visits and report those to the clinical pharmacist. Clinical pharmacist prepares the cases for 2) an interprofessional triage meeting (50-70 cases/meeting of 2 h) where decisions are made on further action, e.g., more detailed medication reviews, 3) community pharmacists conduct necessary medication reviews and each patients' physician makes final decisions on medication changes needed. The final stages concern 4) implementation and 5) follow-up of medication changes. Randomized controlled trial (RCT) was developed to demonstrate the effectiveness of the procedure. The developed procedure is feasible for screening and reviewing medications of a high number of older home care clients to identify clients with severe DRPs and provide interventions to solve them utilizing existing primary care resources. The study is registered in the Clinical Trials.gov ( NCT02545257 ). Registration date September 9 2015.

  15. [Design of a supervision model for administration of the Child Development Evaluation Test at primary care facilities in Mexico].

    PubMed

    Villasís-Keever, Miguel Ángel; Rizzoli-Córdoba, Antonio; Delgado-Ginebra, Ismael; Mares-Serratos, Blanca Berenice; Martell-Valdez, Liliana; Sánchez-Velázquez, Olivia; Reyes-Morales, Hortensia; O'Shea-Cuevas, Gabriel; Aceves-Villagrán, Daniel; Carrasco-Mendoza, Joaquín; Antillón-Ocampo, Fátima Adriana; Villagrán-Muñoz, Víctor Manuel; Halley-Castillo, Elizabeth; Baqueiro-Hernández, César Iván; Pizarro-Castellanos, Mariel; Martain-Pérez, Itzamara Jacqueline; Palma-Tavera, Josuha Alexander; Vargas-López, Guillermo; Muñoz-Hernández, Onofre

    The Child Development Evaluation (CDE) test designed and validated in Mexico has been used as a screening tool for developmental problems in primary care facilities across Mexico. Heterogeneous results were found among those states where these were applied, despite using the same standardized training model for application. The objective was to evaluate a supervision model for quality of application of the CDE test at primary care facilities. A study was carried out in primary care facilities from three Mexican states to evaluate concordance of the results between supervisor and primary care personnel who administered the test using two different methods: direct observation (shadow study) or reapplication of the CDE test (consistency study). There were 380 shadow studies applied to 51 psychologists. General concordance of the shadow study was 86.1% according to the supervisor: green 94.5%, yellow 73.2% and red 80.0%. There were 302 re-test evaluations with a concordance of 88.1% (n=266): green 96.8%, yellow 71.7% and red 81.8%. There were no differences between CDE test subgroups by age. Both shadow and re-test study were adequate for the evaluation of the quality of the administration of the CDE Test and may be useful as a model of supervision in primary care facilities. The decision of which test to use relies on the availability of supervisors. Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  16. The Cognitive Neuroscience of Sign Language: Engaging Undergraduate Students' Critical Thinking Skills Using the Primary Literature.

    PubMed

    Stevens, Courtney

    2015-01-01

    This article presents a modular activity on the neurobiology of sign language that engages undergraduate students in reading and analyzing the primary functional magnetic resonance imaging (fMRI) literature. Drawing on a seed empirical article and subsequently published critique and rebuttal, students are introduced to a scientific debate concerning the functional significance of right-hemisphere recruitment observed in some fMRI studies of sign language processing. The activity requires minimal background knowledge and is not designed to provide students with a specific conclusion regarding the debate. Instead, the activity and set of articles allow students to consider key issues in experimental design and analysis of the primary literature, including critical thinking regarding the cognitive subtractions used in blocked-design fMRI studies, as well as possible confounds in comparing results across different experimental tasks. By presenting articles representing different perspectives, each cogently argued by leading scientists, the readings and activity also model the type of debate and dialogue critical to science, but often invisible to undergraduate science students. Student self-report data indicate that undergraduates find the readings interesting and that the activity enhances their ability to read and interpret primary fMRI articles, including evaluating research design and considering alternate explanations of study results. As a stand-alone activity completed primarily in one 60-minute class block, the activity can be easily incorporated into existing courses, providing students with an introduction both to the analysis of empirical fMRI articles and to the role of debate and critique in the field of neuroscience.

  17. The Cognitive Neuroscience of Sign Language: Engaging Undergraduate Students’ Critical Thinking Skills Using the Primary Literature

    PubMed Central

    Stevens, Courtney

    2015-01-01

    This article presents a modular activity on the neurobiology of sign language that engages undergraduate students in reading and analyzing the primary functional magnetic resonance imaging (fMRI) literature. Drawing on a seed empirical article and subsequently published critique and rebuttal, students are introduced to a scientific debate concerning the functional significance of right-hemisphere recruitment observed in some fMRI studies of sign language processing. The activity requires minimal background knowledge and is not designed to provide students with a specific conclusion regarding the debate. Instead, the activity and set of articles allow students to consider key issues in experimental design and analysis of the primary literature, including critical thinking regarding the cognitive subtractions used in blocked-design fMRI studies, as well as possible confounds in comparing results across different experimental tasks. By presenting articles representing different perspectives, each cogently argued by leading scientists, the readings and activity also model the type of debate and dialogue critical to science, but often invisible to undergraduate science students. Student self-report data indicate that undergraduates find the readings interesting and that the activity enhances their ability to read and interpret primary fMRI articles, including evaluating research design and considering alternate explanations of study results. As a stand-alone activity completed primarily in one 60-minute class block, the activity can be easily incorporated into existing courses, providing students with an introduction both to the analysis of empirical fMRI articles and to the role of debate and critique in the field of neuroscience. PMID:26557797

  18. A Learner-Centred Game-Design Approach: Impacts on Teachers' Creativity

    ERIC Educational Resources Information Center

    Frossard, Frederique; Barajas, Mario; Trifonova, Anna

    2012-01-01

    This study presents an innovative pedagogical approach where teachers become game designers and engage in creative teaching practices. Within co-design training workshops, 21 Spanish primary and secondary school teachers have developed their own Game-Based Learning (GBL) scenarios, especially tailored to their teaching contexts and students…

  19. 78 FR 75442 - Designation of the Primary Freight Network

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-11

    ...] Designation of the Primary Freight Network AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice... period for the Designation of the highway Primary Freight Network (PFN) notice, which was published on... the complete National Freight Network (NFN), and to solicit comments on aspects of the NFN. The five...

  20. Shared Cognition Facilitated by Teacher Use of Interactive Whiteboard Technologies

    ERIC Educational Resources Information Center

    Redman, Christine; Vincent, John Terence

    2015-01-01

    Purpose: The purpose of this study is to examine questioning opportunities afforded by interactive whiteboards (IWBs) by highlighting pedagogical decisions enacted by teachers to ensure that they work with the wider affordances of the device. Design/Methodology/Approach: Three primary/elementary teachers participated in a study designed to…

  1. Rationale, design and methods of the HEALTHY study physical education intervention component

    USDA-ARS?s Scientific Manuscript database

    The HEALTHY primary prevention trial was designed to reduce risk factors for type 2 diabetes in middle school students. Middle schools at seven centers across the United States participated in the 3-year study. Half of them were randomized to receive a multi-component intervention. The intervention ...

  2. Depression Treatment Preferences in Older Primary Care Patients

    ERIC Educational Resources Information Center

    Gum, Amber M.; Arean, Patricia A.; Hunkeler, Enid; Tang, Lingqi; Katon, Wayne; Hitchcock, Polly; Steffens, David C.; Dickens, Jeanne; Unutzer, Jurgen

    2006-01-01

    Purpose: For depressed older primary care patients, this study aimed to examine (a) characteristics associated with depression treatment preferences; (b) predictors of receiving preferred treatment; and (c) whether receiving preferred treatment predicted satisfaction and depression outcomes. Design and Methods: Data are from 1,602 depressed older…

  3. Prospective Primary Teachers' Beliefs about Mathematics

    ERIC Educational Resources Information Center

    Maasepp, Brooke; Bobis, Janette

    2015-01-01

    Concerns about the negative mathematical beliefs of prospective primary teachers have arisen from evidence that such beliefs detrimentally impact future teaching practices. The aim of this study was to explore factors contributing to the effectiveness of a mathematics content-focused intervention designed to nurture positive mathematical beliefs.…

  4. Assessment for Learning in Norway and Portugal: The Case of Primary School Mathematics Teaching

    ERIC Educational Resources Information Center

    Nortvedt, Guri A.; Santos, Leonor; Pinto, Jorge

    2016-01-01

    In this study, we aim to understand the forces driving assessment for learning (AfL) in primary school teaching. By applying a case study design, including the two cases of Norway and Portugal and using mathematics teaching as an example, available policy documents and research reports are analysed to identify the differences and similarities that…

  5. Multilevel Assessment of the Predictive Validity of Teacher Made Tests in the Zimbabwean Primary Education Sector

    ERIC Educational Resources Information Center

    Machingambi, Zadzisai

    2017-01-01

    The principal focus of this study was to undertake a multilevel assessment of the predictive validity of teacher made tests in the Zimbabwean primary education sector. A correlational research design was adopted for the study, mainly to allow for statistical treatment of data and subsequent classical hypotheses testing using the spearman's rho.…

  6. The Impact of ISO Quality Management Systems on Primary and Secondary Schools in Spain

    ERIC Educational Resources Information Center

    Arribas Díaz, Jorge Antonio; Martínez-Mediano, Catalina

    2018-01-01

    Purpose: The purpose of this study is to evaluate the application of quality management systems (QMS) based on international standards of quality in education (ISO 9001:2008) and ascertain the influence of this quality model on primary and secondary schools in Spain. Design/methodology/approach: The study was conducted in 26 publicly funded,…

  7. "You Just Have to Take a Bit of a Risk Sometimes": Breaking the "Cycle of Tradition" in Primary Mathematics

    ERIC Educational Resources Information Center

    Frid, Sandra; Sparrow, Len

    2009-01-01

    The purpose of this study was to explore the mathematics teaching practices of graduates of a pre-service primary/early childhood education program designed to develop teachers' capacities to implement non-traditional mathematics curricula. As a complementary component of a large survey study of graduate teachers, graduates were interviewed to…

  8. Status of Biodiversity and Its Conservation in the Kobadak River Basin of Maheshpur Upazila, Jhenaidah, Bangladesh

    ERIC Educational Resources Information Center

    Uddin, Jashim Md.

    2015-01-01

    This research project represents the Status of Biodiversity and Its Conservation of Kobadak River basin of Maheshpur Upazila. The study was designed to develop a set of information about the present condition of biodiversity of the study area. Both primary and secondary data have been used to fulfill the survey successfully. Primary data have been…

  9. Primary Teachers' Understanding of Four Chemical Phenomena: Effect of an In-Service Training Course

    ERIC Educational Resources Information Center

    Papageorgiou, George; Stamovlasis, Dimitrios; Johnson, Philip

    2013-01-01

    One hundred and thirty Greek primary school teachers participated in a study, where the effectiveness of a specially designed intervention on chemical changes was tested. The study took place in the wider context of an in-service training course where the key feature was an innovative approach based on the concept of a substance and its…

  10. The Use of Interactive Computer Animations Based on POE as a Presentation Tool in Primary Science Teaching

    ERIC Educational Resources Information Center

    Akpinar, Ercan

    2014-01-01

    This study investigates the effects of using interactive computer animations based on predict-observe-explain (POE) as a presentation tool on primary school students' understanding of the static electricity concepts. A quasi-experimental pre-test/post-test control group design was utilized in this study. The experiment group consisted of 30…

  11. Revision of Primary I-III Science Curriculum in Somalia. African Studies in Curriculum Development & Evaluation No. 83.

    ERIC Educational Resources Information Center

    Abdi, Ahmed Ali

    This study was designed to evaluate: (1) the content of the primary I-III science curriculum in Somalia; (2) the instructional materials that back up the content and methodologies; and (3) the professional competence of the teachers in charge of teaching this subject. Data were collected by means of a questionnaire, observations, and unstructured…

  12. Critical Home-Based Challenges Inhibiting Effective Participation of Pupils in Rural Public Primary Schools in Narok North Sub-County, Narok County, Kenya

    ERIC Educational Resources Information Center

    Mwanik, Kantim; Orodho, John Aluko

    2016-01-01

    The thrust of this study was to examine the critical challenges inhibiting effective participation in education by pupils from rural public primary schools in Central Division, Narok North Sub-County, in Narok County, Kenya. The study adopted a descriptive cross-sectional research design. Combinations of stratified and purposive sampling…

  13. Relations between Value-Based Leadership and Distributed Leadership: A Casual Research on School Principles' Behaviors

    ERIC Educational Resources Information Center

    Baloglu, Nuri

    2012-01-01

    In this study, the relations between value-based leadership and distributed leadership behaviors of school principals were defined on the basis of the views of the primary school teachers. A casual research was designed for this. 225 primary school teachers were took part in study group determined the maximum variation sampling method. Data were…

  14. Primary Teachers' Particle Ideas and Explanations of Physical Phenomena: Effect of an In-Service Training Course

    ERIC Educational Resources Information Center

    Papageorgiou, George; Stamovlasis, Dimitrios; Johnson, Phil Michael

    2010-01-01

    This paper presents a study concerning Greek primary school teachers' (n = 162) ideas about the particulate nature of matter and their explanations of physical phenomena. The study took place during an in-service training course where the effectiveness of a specially designed intervention was tested. A key feature was an approach based on the…

  15. Conflict Management and Resolution Strategies between Teachers and School Leaders in Primary Schools of Wolaita Zone, Ethiopia

    ERIC Educational Resources Information Center

    Shanka, Engdawork Birhanu; Thuo, Mary

    2017-01-01

    The purpose of this study was to investigate various strategies used to manage and resolve conflict between teachers and school leaders in government primary schools of Wolaita zone. The study employed a descriptive survey design where both quantitative and qualitative approaches were used to correct and analyze data, concurrently. From six…

  16. The "Curriculum Challenge": Moving towards the "Storyline" Approach in a Case Study Urban Primary School

    ERIC Educational Resources Information Center

    Nuttall, Amanda

    2016-01-01

    This article draws on an inquiry into the design and implementation of the curriculum in a case study urban primary school in the north of England. In response to the introduction of the revised National Curriculum in September 2014, teachers and the school head engaged in a critical discourse around their perceptions of students' attainment and…

  17. Assessing the Impact of Free Primary Education Using Retrospective and Prospective Data: Lessons from the Nairobi Case Study

    ERIC Educational Resources Information Center

    Ngware, Moses Waithanji; Oketch, Moses; Ezeh, Alex Chika; Mutisya, Maurice; Ejakait, Charles Epari

    2012-01-01

    This paper describes the design and methodology used to assess the impact of free primary education (FPE) policy in Nairobi, Kenya. The key outcome of the study was to assess the impact of FPE on schooling outcomes among the urban poor. The study assesses the impact of FPE by examining how two non-comparable groups responded to the introduction of…

  18. Primary mirror and mount technology for the Stratospheric Observatory for Infrared Astronomy (SOFIA) telescope

    NASA Technical Reports Server (NTRS)

    Melugin, Ramsey K.; Chang, L. S.; Mansfield, J. A.; Howard, Steven D.

    1989-01-01

    Candidate technologies for a lightweight primary mirror for the SOFIA telescope are evaluated for both mirror blank fabrication and polishing. Two leading candidates for the type mirror blank are considered: the frit-bonded, structured form, and the thin meniscus form. The feasible mirror is required to be very lightweight with an areal density of approximately 100 kg/sq m, have an f/ratio near 1.0, and have surface quality that permits imaging in the visible as well as the infrared. Also considered are the results of a study conducted to assess the feasibility of designing a suitable mounting system for the primary mirror. The requirements for the mount design are given both in terms of the environmental conditions and the expected optical performance. PATRAN and NASTRAN programs are used to model mirror and mounting. The sandwich-type mirror made of ultra low expansion silica with square cells in the core, is modeled using equivalent solid elements for the core. The design study produces primary mirror surface deflections in 1g as a function of mirror elevation angles. The surface is analyzed using an optical analysis program, FRINGE, to give a prediction of the mirror optical performance. Results from this analysis are included.

  19. School Based Factors Affecting Learning of Kenyan Sign Language in Primary Schools for Hearing Impaired in Embu and Isiolo Counties, Kenya

    ERIC Educational Resources Information Center

    Rwaimba, Samuel Muthomi

    2016-01-01

    This was a descriptive survey study design which sought to establish the school based factors that affect the learning of Kenyan Sign Language in primary schools for learners with hearing impairment in Embu and Isiolo counties in Kenya. The target population was all teachers teaching in primary schools for learners with hearing impairment in the…

  20. Junior Primary Greek School Pupils' Perceptions of the City's Public Open Spaces and Especially of the Urban Square: A Case Study

    ERIC Educational Resources Information Center

    Papageorgiou, Nikoletta; Galani, Apostolia; Mavrikaki, Evangelia

    2016-01-01

    This work--part of a wider project aimed at engaging first year primary school pupils in public open-space design--explores the perceptions of junior primary school children as to the urban square. Data collection tools comprised semi-structured interviews, sketches and storytelling via puppet-animation. Our findings have shown that--according to…

  1. Organizational interventions improving access to community-based primary health care for vulnerable populations: a scoping review.

    PubMed

    Khanassov, Vladimir; Pluye, Pierre; Descoteaux, Sarah; Haggerty, Jeannie L; Russell, Grant; Gunn, Jane; Levesque, Jean-Frederic

    2016-10-10

    Access to community-based primary health care (hereafter, 'primary care') is a priority in many countries. Health care systems have emphasized policies that help the community 'get the right service in the right place at the right time'. However, little is known about organizational interventions in primary care that are aimed to improve access for populations in situations of vulnerability (e.g., socioeconomically disadvantaged) and how successful they are. The purpose of this scoping review was to map the existing evidence on organizational interventions that improve access to primary care services for vulnerable populations. Scoping review followed an iterative process. Eligibility criteria: organizational interventions in Organisation for Economic Cooperation and Development (OECD) countries; aiming to improve access to primary care for vulnerable populations; all study designs; published from 2000 in English or French; reporting at least one outcome (avoidable hospitalization, emergency department admission, or unmet health care needs). Main bibliographic databases (Medline, Embase, CINAHL) and team members' personal files. One researcher selected relevant abstracts and full text papers. Theory-driven synthesis: The researcher classified included studies using (i) the 'Patient Centered Access to Healthcare' conceptual framework (dimensions and outcomes of access to primary care), and (ii) the classification of interventions of the Cochrane Effective Practice and Organization of Care. Using pattern analysis, interventions were mapped in accordance with the presence/absence of 'dimension-outcome' patterns. Out of 8,694 records (title/abstract), 39 studies with varying designs were included. The analysis revealed the following pattern. Results of 10 studies on interventions classified as 'Formal integration of services' suggested that these interventions were associated with three dimensions of access (approachability, availability and affordability) and reduction of hospitalizations (four/four studies), emergency department admissions (six/six studies), and unmet healthcare needs (five/six studies). These 10 studies included seven non-randomized studies, one randomized controlled trial, one quantitative descriptive study, and one mixed methods study. Our results suggest the limited breadth of research in this area, and that it will be feasible to conduct a full systematic review of studies on the effectiveness of the formal integration of services to improve access to primary care services for vulnerable populations.

  2. 77 FR 46295 - Extension of Deadline for Promulgating Designations for the 2010 Primary Sulfur Dioxide National...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-03

    ... Deadline for Promulgating Designations for the 2010 Primary Sulfur Dioxide National Ambient Air Quality... extend by up to 1 year the deadline for promulgating initial area designations for the primary sulfur... necessary to modify any of the state recommendations. The EPA was originally intending to complete the...

  3. Implementing the Health Promoting School in Denmark: A Case Study

    ERIC Educational Resources Information Center

    Nordin, Lone Lindegaard

    2016-01-01

    Purpose: The purpose of this paper is to provide insight into teachers' practice in implementing school-based health promotion. Design/methodology/approach: This qualitative research was designed as a multiple case study. The study involved five schools, 233 pupils in the age 12-16 and 23 teachers. The primary data generation method were focus…

  4. Strategies facilitating practice change in pediatric cancer: a systematic review.

    PubMed

    Robinson, Paula D; Dupuis, Lee L; Tomlinson, George; Phillips, Bob; Greenberg, Mark; Sung, Lillian

    2016-09-01

    By conducting a systematic review, we describe strategies to actively disseminate knowledge or facilitate practice change among healthcare providers caring for children with cancer and we evaluate the effectiveness of these strategies. We searched Ovid Medline, EMBASE and PsychINFO. Fully published primary studies were included if they evaluated one or more professional intervention strategies to actively disseminate knowledge or facilitate practice change in pediatric cancer or hematopoietic stem cell transplantation. Data extracted included study characteristics and strategies evaluated. In studies with a quantitative analysis of patient outcomes, the relationship between study-level characteristics and statistically significant primary analyses was evaluated. Of 20 644 titles and abstracts screened, 146 studies were retrieved in full and 60 were included. In 20 studies, quantitative evaluation of patient outcomes was examined and a primary outcome was stated. Eighteen studies were 'before and after' design; there were no randomized studies. All studies were at risk for bias. Interrupted time series was never the primary analytic approach. No specific strategy type was successful at improving patient outcomes. Literature describing strategies to facilitate practice change in pediatric cancer is emerging. However, major methodological limitations exist. Studies with robust designs are required to identify effective strategies to effect practice change. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Does a Socio-Ecological School Model Promote Resilience in Primary Schools?

    ERIC Educational Resources Information Center

    Lee, Patricia C.; Stewart, Donald E.

    2013-01-01

    Background: This research investigates the extent to which the holistic, multistrategy "health-promoting school" (HPS) model using a resilience intervention can lead to improved resilience among students. Methods: A quasi-experimental design using a study cohort selected from 20 primary schools in Queensland, Australia was employed. Ten…

  6. Online Resource-Based Learning Environment: Case Studies in Primary Classrooms

    ERIC Educational Resources Information Center

    So, Winnie Wing Mui; Ching, Fiona Ngai Ying

    2012-01-01

    This paper discusses the creation of learning environments with online resources by three primary school teachers for pupil's learning of science-related topics with reference to the resource-based e-learning environments (RBeLEs) framework. Teachers' choice of contexts, resources, tools, and scaffolds in designing the learning environments are…

  7. Gender Differences in the Primary Representational System according to Neurolinguistic Programming.

    ERIC Educational Resources Information Center

    Cassiere, M. F.; And Others

    Neurolinguistic Programming (NLP) is a currently popular therapeutic modality in which individuals organize information through three basic sensory systems, one of which is the Primary Representational System (PRS). This study was designed to investigate gender differences in PRS according to the predicate preference method. It was expected that…

  8. Multiple Solutions Approach (MSA): Conceptions and Practices of Primary School Teachers in Ghana

    ERIC Educational Resources Information Center

    Nabie, Michael Johnson; Raheem, Kolawole; Agbemaka, John Bijou; Sabtiwu, Rufai

    2016-01-01

    The study explored the curriculum guidelines and primary school teachers' conceptions and practices of the Multiple Solutions Approach (MSA) in teaching mathematics using basic qualitative research design. Informal conversation interviews (ICIs), observations, video and document analyses were used to collect data. Participants included a purposive…

  9. Digital Divide in Post-Primary Schools

    ERIC Educational Resources Information Center

    Marcus-Quinn, Ann; McGarr, Oliver

    2013-01-01

    This research study developed curricular specific open educational resources (OERs) for the teaching of poetry at Junior Certificate level in Irish post-primary schools. It aimed to capture the collaborative design and development process used in the development of the digital resources and describe and evaluate the implementation of the resources…

  10. Disparities in Reportable Quality Metrics by Insurance Status in the Primary Spine Neoplasm Population

    PubMed Central

    Mehdi, Syed K.; Tanenbaum, Joseph E.; Alentado, Vincent J.; Miller, Jacob A.; Lubelski, Daniel; Benzel, Edward C.; Mroz, Thomas E.

    2017-01-01

    STUDY DESIGN Retrospective cohort study. BACKGROUND CONTEXT CMS defines “adverse quality events” as the incidence of certain complications such as post-surgical hematoma and/or iatrogenic pneumothorax during an inpatient stay. Patient safety indicators (PSI) are a means to measure the incidence of these adverse events. When these occur, reimbursement to the hospital decreases. The incidence of adverse quality events among patients hospitalized for primary spinal neoplasms is unknown. Similarly, it is unclear what the impact of insurance status is on adverse care quality among this patient population. PURPOSE We aimed to determine the incidence of patient safety indicators (PSI) among patients admitted with primary spinal neoplasms, and to determine the association between insurance status and the incidence of PSI in this population. STUDY DESIGN Retrospective cohort design PATIENT SAMPLE All patients, 18 years and older, in the Nationwide Inpatient Sample (NIS) that were hospitalized for primary spine neoplasms from 1998–2011. OUTCOME MEASURES Incidence of PSI from 1998–2011. METHODS The Nationwide Inpatient Sample (NIS) was queried for all hospitalizations with a diagnosis of primary spinal neoplasm during the inpatient episode from 1998–2011. Incidence of PSI was determined using publicly available lists of ICD-9-CM diagnosis codes. Logistic regression models were used to determine the effect of primary payer status on PSI incidence. All comparisons were made between privately insured patients and Medicaid/self-pay patients. RESULTS We identified 6,095 hospitalizations in which a primary spinal neoplasm was recorded during the inpatient episode. We excluded patients younger than 18 years as well as those with “other” or “missing” primary insurance status, leaving 5,880 patients for analysis. After adjusting for patient demographics and hospital characteristics, Medicaid/self-pay patients had significantly greater odds of experiencing one or more PSI (OR 1.81 95% CI 1.11– 2.95) relative to privately insured patients. CONCLUSIONS Among patients hospitalized for primary spinal neoplasms, primary payer status predicts the incidence of PSI, an indicator of adverse healthcare quality used to determine hospital reimbursement by CMS. As reimbursement continues to be intertwined with reportable quality metrics, identifying vulnerable populations is critical to improving patient care. PMID:27664341

  11. 24 CFR 3282.362 - Production Inspection Primary Inspection Agencies (IPIAs).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... in production which fails to conform to the design or where the design is not specific, to the... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Production Inspection Primary... REGULATIONS Primary Inspection Agencies § 3282.362 Production Inspection Primary Inspection Agencies (IPIAs...

  12. Bridging a divide: architecture for a joint hospital-primary care data warehouse.

    PubMed

    An, Jeff; Keshavjee, Karim; Mirza, Kashif; Vassanji, Karim; Greiver, Michelle

    2015-01-01

    Healthcare costs are driven by a surprisingly small number of patients. Predicting who is likely to require care in the near future could help reduce costs by pre-empting use of expensive health care resources such as emergency departments and hospitals. We describe the design of an architecture for a joint hospital-primary care data warehouse (JDW) that can monitor the effectiveness of in-hospital interventions in reducing readmissions and predict which patients are most likely to be admitted to hospital in the near future. The design identifies the key governance elements, the architectural principles, the business case, the privacy architecture, future work flows, the IT infrastructure, the data analytics and the high level implementation plan for realization of the JDW. This architecture fills a gap in bridging data from two separate hospital and primary care organizations, not a single managed care entity with multiple locations. The JDW architecture design was well received by the stakeholders engaged and by senior leadership at the hospital and the primary care organization. Future plans include creating a demonstration system and conducting a pilot study.

  13. Designing and Validating a Measure of Teacher Knowledge of Universal Design for Assessment (UDA)

    ERIC Educational Resources Information Center

    Jamgochian, Elisa Megan

    2010-01-01

    The primary purpose of this study was to design and validate a measure of teacher knowledge of Universal Design for Assessment (TK-UDA). Guided by a validity framework, a number of inferences, assumptions, and evidences supported this investigation. By addressing a series of research questions, evidence was garnered for the use of the measure to…

  14. Planned Missing Data Designs for Spline Growth Models in Salivary Cortisol Research

    ERIC Educational Resources Information Center

    Hogue, Candace M.; Pornprasertmanit, Sunthud; Fry, Mary D.; Rhemtulla, Mijke; Little, Todd D.

    2013-01-01

    Salivary cortisol is often used as an index of physiological and psychological stress in exercise science and psychoneuroendocrine research. A primary concern when designing research studies examining cortisol stems from the high cost of analysis. Planned missing data designs involve intentionally omitting a random subset of observations from data…

  15. Designing an intervention to prevent suicide: PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial)

    PubMed Central

    Bruce, Martha L.; Pearson, Jane L.

    1999-01-01

    Suicide is a major public health problem with greatest risk in the very old. This paper describes an approach to reducing the risk of suicide by intervening on depression in elderly primary care patients. Depression is an appropriate target for an intervention as it is highly prevalent in primary care, is a strong risk factor for suicide, and is more often than not inadequately treated. PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial) is a National institute of Mental Health (NIMH)-funded collaborative study that is testing this approach to suicide risk prevention in 18 primary care practices in the United States. PROSPECT'S intervention of “guideline management” introduces a health specialist into the primary care setting to help physicians provide “on-time, on-target” treatment and long-term management of late-life depression following structured clinical guidelines. The effectiveness of the intervention in reducing suicidal risk and depression is evaluated by following a representative sample of older patients identified using a 2-stage design. PMID:22033641

  16. Evolving design criteria for very large aperture space-based telescopes and their influence on the need for intergrated tools in the optimization process

    NASA Astrophysics Data System (ADS)

    Arnold, William R.

    2015-09-01

    NASA's Advanced Mirror Technology Development (AMTD) program has been developing the means to design and build the future generations of space based telescopes. With the nearing completion of the James Webb Space Telescope (JWST), the astrophysics community is already starting to define the requirements for follow on observatories. The restrictions of available launch vehicles and the possibilities of planned future vehicles have fueled the competition between monolithic primaries (with better optical quality) and segmented primaries (with larger apertures, but with diffraction, costs and figure control issues). Regardless of the current shroud sizes and lift capacities, these competing architectures share the need for rapid design tools. As part of the AMTD program a number of tools have been developed and tested to speed up the design process. Starting with the Arnold Mirror Modeler (which creates Finite Element Models (FEM) for structural analysis) and now also feeds these models into thermal stability analyses. They share common file formats and interchangeable results. During the development of the program, numerous trade studies were created for 4 meter and 8 meter monolithic primaries, complete with support systems. Evaluation of these results has led to a better understanding of how the specification drives the results. This paper will show some of the early trade studies for typical specification requirements such as lowest mirror bending frequency and suspension system lowest frequency. The results use representative allowable stress values for each mirror substrate material and construction method and generic material properties. These studies lead to some interesting relationships between feasible designs and the realities of actually trying to build these mirrors. Much of the traditional specifications were developed for much smaller systems, where the mass and volume of the primary where a small portion of the overall satellite. JWST shows us that as the aperture grows, the primary takes up the majority of the mass and volume and the established rules need to be adjusted. For example, a small change in lowest frequency requirement can change the cost by millions of dollars.

  17. Evolving Design Criteria for Very Large Aperture Space-Based Telescopes and Their Influence on the Need for Integrated Tools in the Optimization Process

    NASA Technical Reports Server (NTRS)

    Arnold, William R., Sr.

    2015-01-01

    NASA's Advanced Mirror Technology Development (AMTD) program has been developing the means to design and build the future generations of space based telescopes. With the nearing completion of the James Webb Space Telescope (JWST), the astrophysics community is already starting to define the requirements for follow on observatories. The restrictions of available launch vehicles and the possibilities of planned future vehicles have fueled the competition between monolithic primaries (with better optical quality) and segmented primaries (with larger apertures, but with diffraction, costs and figure control issues). Regardless of the current shroud sizes and lift capacities, these competing architectures share the need for rapid design tools. As part of the AMTD program a number of tools have been developed and tested to speed up the design process. Starting with the Arnold Mirror Modeler (which creates Finite Element Models (FEM) for structural analysis) and now also feeds these models into thermal stability analyses. They share common file formats and interchangeable results. During the development of the program, numerous trade studies were created for 4 meter and 8 meter monolithic primaries, complete with support systems. Evaluation of these results has led to a better understanding of how the specification drives the results. This paper will show some of the early trade studies for typical specification requirements such as lowest mirror bending frequency and suspension system lowest frequency. The results use representative allowable stress values for each mirror substrate material and construction method and generic material properties. These studies lead to some interesting relationships between feasible designs and the realities of actually trying to build these mirrors. Much of the traditional specifications were developed for much smaller systems, where the mass and volume of the primary where a small portion of the overall satellite. JWST shows us that as the aperture grows, the primary takes up the majority of the mass and volume and the established rules need to be adjusted. For example, a small change in lowest frequency requirement can change the cost by millions of dollars.

  18. Researching Primary Teachers' Professional Agency: Employing Interactive Ethnography to Overcome Reluctance to Teach Science

    NASA Astrophysics Data System (ADS)

    Martin, Jenny

    2017-09-01

    This paper provides a report of a case study on the professional agency of an experienced early years teacher, Sarah, who successfully embedded a chemical science program of teaching-learning for her students aged between 6 and 8. Interactive ethnography informs the research design, and discursive psychology provides the tools for the analysis of Sarah's speech acts for her positioning as a responsible agent. Reframing the problem of primary teacher reluctance to teach science in terms of primary teachers' professional agency using discursive psychology, this ontological study provides new insight into issues related to the provision of science education in primary schools and asks: How do primary teachers position themselves and others in relation to science curriculum and education? The research calls for research methodologies and reform efforts in primary science that are better grounded in the local moral orders of primary schools.

  19. Designing Intervention Studies: Selected Populations, Range Restrictions, and Statistical Power

    ERIC Educational Resources Information Center

    Miciak, Jeremy; Taylor, W. Pat; Stuebing, Karla K.; Fletcher, Jack M.; Vaughn, Sharon

    2016-01-01

    An appropriate estimate of statistical power is critical for the design of intervention studies. Although the inclusion of a pretest covariate in the test of the primary outcome can increase statistical power, samples selected on the basis of pretest performance may demonstrate range restriction on the selection measure and other correlated…

  20. Challenges in Distributed Leadership: Evidence from the Perspective of Headteachers

    ERIC Educational Resources Information Center

    Tahir, Lokman Mohd; Lee, Sui Liang; Musah, Mohammed Borhandden; Jaffri, Hadijah; Said, Mohd Nihra Haruzuan Mohamad; Yasin, Mohd Hanafi Mohd

    2016-01-01

    Purpose: The purpose of this paper is to investigate the issues and challenges faced by headteachers in practicing the suggested distributed leadership (DL) approach in three primary schools to their middle layer leaders. Design/methodology/approach: The study employed a case study design and data were collected through semi-structured interviews.…

  1. Design and Implementation of an Interdisciplinary Leadership Studies Minor at an Historically Black, Liberal Arts College

    ERIC Educational Resources Information Center

    White, Belinda Johnson

    2006-01-01

    This article summarizes the design, implementation, and current status of an undergraduate interdisciplinary leadership studies minor at Morehouse College. The college's primary mission is to "develop men with disciplined minds who will lead lives of leadership, service, and self-realization," as well as provide students with an…

  2. Cyclone-Resistant Rural Primary School Construction - A Design Guide. Educational Building Report 7.

    ERIC Educational Resources Information Center

    Sinnamon, Ian T.; Loo, G. A. van't

    One of a series of documents on design of disaster-resistant buildings, this publication treats construction of rural primary schools to resist destruction by wind and water from cyclones. Also appropriate for other buildings, material is aimed at rural primary schools because they are less likely to be professionally designed or supervised; the…

  3. INTEGRATED DISINFECTION BY-PRODUCTS (DBP) MIXTURES RESEARCH: GENE EXPRESSION ALTERATIONS IN PRIMARY RAT HEPATOCYTE CULTURES EXPOSED TO DBP MIXTURES FORMED BY CHLORINATION AND OZONATION/POSTCHLORINATION

    EPA Science Inventory

    What is the study?
    This study was designed to provide data on the in vitro toxicity of water concentrates containing complex mixtures of DBPs. Rat hepatocytes in primary culture were exposed for 24 hr to full strength, 1:10 or 1:20 dilutions of chlorination or ozonation/chl...

  4. A Field Study of a Rural Ungraded Primary School with a Statistical Analysis of Reading Achievement and Personality Adjustment.

    ERIC Educational Resources Information Center

    McCoy, Edwardine Cordell

    The purpose of this field study was to develop a rural ungraded primary school with an accompanying design and appropriate materials for use by educators interested in this innovation. Pretests and posttests measured the effects of ungradedness on the reading achievement and personality development of the 177 students. Implemented by a $50,000…

  5. Music and Drama in Primary Schools in the Madeira Island--Narratives of Ownership and Leadership

    ERIC Educational Resources Information Center

    Mota, Graça; Araújo, Maria Jose

    2013-01-01

    A three-year-case study funded by the Foundation for Science and Technology (FCT) from the Portuguese Ministry of Science, Technology and Higher Education was designed to study a 30-year project of music and drama in primary schools in Madeira. This article reports on the narratives of the three main figures in the project as they elaborate on its…

  6. Factors Influencing Teachers' Competence in Developing Resilience in Vulnerable Children in Primary Schools in Uasin Gishu County, Kenya

    ERIC Educational Resources Information Center

    Silyvier, Tsindoli; Nyandusi, Charles

    2015-01-01

    The purpose of the study was to assess the effect of teacher characteristics on their competence in developing resilience in vulnerable primary school children. A descriptive survey research design was used. This study was based on resiliency theory as proposed by Krovetz (1998). Simple random sampling was used to select a sample size of 108…

  7. The Effects of Learning Strategies Instruction on Metacognitive Knowledge, Using Metacognitive Skills and Academic Achievement (Primary Education Sixth Grade Turkish Course Sample)

    ERIC Educational Resources Information Center

    Caliskan, Muhittin; Sunbul, Ali Murat

    2011-01-01

    This study investigated the effects of learning strategies instruction on metacognitive knowledge, metacognitive skills, and achievement. An experimental pre-test/post-test control group design was used in the research. The study was conducted in the 2008-2009 school year on 6th grade students at Orgeneral Tural and Dikmeli Primary Schools located…

  8. The Use of Organising Purposes in Science Instruction as a Scaffolding Mechanism to Support Progressions: A Study of Talk in Two Primary Science Classrooms

    ERIC Educational Resources Information Center

    Johansson, Annie-Maj; Wickman, Per-Olof

    2018-01-01

    Purpose: This study examines how different purposes can support teachers in their work with progressions as a part of a teaching sequences in science in primary school. Design/Method: The study was carried out in two classes working with inquiry and the events that took place in the classroom were filmed. In the study, we have chosen to use the…

  9. Incorporating Primary and Secondary Prevention Approaches To Address Childhood Obesity Prevention and Treatment in a Low-Income, Ethnically Diverse Population: Study Design and Demographic Data from the Texas Childhood Obesity Research Demonstration (TX CORD) Study

    PubMed Central

    Butte, Nancy F.; Barlow, Sarah; Vandewater, Elizabeth A.; Sharma, Shreela V.; Huang, Terry; Finkelstein, Eric; Pont, Stephen; Sacher, Paul; Byrd-Williams, Courtney; Oluyomi, Abiodun O.; Durand, Casey; Li, Linlin; Kelder, Steven H.

    2015-01-01

    Abstract Background: There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2–12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. Methods: Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. Results: Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3–83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. Conclusions: Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity. PMID:25555188

  10. Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study.

    PubMed

    Hoelscher, Deanna M; Butte, Nancy F; Barlow, Sarah; Vandewater, Elizabeth A; Sharma, Shreela V; Huang, Terry; Finkelstein, Eric; Pont, Stephen; Sacher, Paul; Byrd-Williams, Courtney; Oluyomi, Abiodun O; Durand, Casey; Li, Linlin; Kelder, Steven H

    2015-02-01

    There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2-12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3-83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity.

  11. Children's Health and Indoor Air Quality in Primary Schools and Homes in Portugal-Study Design.

    PubMed

    Madureira, Joana; Paciência, Inês; Ramos, Elisabete; Barros, Henrique; Pereira, Cristiana; Teixeira, João Paulo; Fernandes, Eduardo de Oliveira

    2015-01-01

    The main aim of the research project "On the Contribution of Schools to Children's Overall Indoor Air Exposure" is to study associations between adverse health effects, namely, allergy, asthma, and respiratory symptoms, and indoor air pollutants to which children are exposed to in primary schools and homes. Specifically, this investigation reports on the design of the study and methods used for data collection within the research project and discusses factors that need to be considered when designing such a study. Further, preliminary findings concerning descriptors of selected characteristics in schools and homes, the study population, and clinical examination are presented. The research project was designed in two phases. In the first phase, 20 public primary schools were selected and a detailed inspection and indoor air quality (IAQ) measurements including volatile organic compounds (VOC), aldehydes, particulate matter (PM2.5, PM10), carbon dioxide (CO2), carbon monoxide (CO), bacteria, fungi, temperature, and relative humidity were conducted. A questionnaire survey of 1600 children of ages 8-9 years was undertaken and a lung function test, exhaled nitric oxide (eNO), and tear film stability testing were performed. The questionnaire focused on children's health and on the environment in their school and homes. One thousand and ninety-nine questionnaires were returned. In the second phase, a subsample of 68 children was enrolled for further studies, including a walk-through inspection and checklist and an extensive set of IAQ measurements in their homes. The acquired data are relevant to assess children's environmental exposures and health status.

  12. Investigating Primary School Mathematics Teachers’ Deductive Reasoning Ability through Varignon’s Theorem

    NASA Astrophysics Data System (ADS)

    Jupri, A.

    2017-09-01

    The responsibility to promote the growth of deductive reasoning ability of school students through learning mathematics is in the hand of mathematics teachers and particularly primary school mathematics teachers. However, how we can make sure whether teachers are able to do so. To investigate this issue, we conducted a three-step of an exploratory survey study. First, we designed tasks from the Varignon’s theorem. Second, we administered an individual written test involving twenty master students of primary education program, in which they are prospective of and primary school mathematics teachers. Finally, we address the results in the light of Van Hiele theory. The results showed that participated students lack of deductive reasoning ability in the context of geometry. For further research, we wonder whether the designed tasks are also applicable to assess student deductive reasoning ability if the students have acquired appropriate teaching.

  13. How best to structure interdisciplinary primary care teams: the study protocol for a systematic review with narrative framework synthesis.

    PubMed

    Wranik, W Dominika; Hayden, Jill A; Price, Sheri; Parker, Robin M N; Haydt, Susan M; Edwards, Jeanette M; Suter, Esther; Katz, Alan; Gambold, Liesl L; Levy, Adrian R

    2016-10-04

    Western publicly funded health care systems increasingly rely on interdisciplinary teams to support primary care delivery and management of chronic conditions. This knowledge synthesis focuses on what is known in the academic and grey literature about optimal structural characteristics of teams. Its goal is to assess which factors contribute to the effective functioning of interdisciplinary primary care teams and improved health system outcomes, with specific focus on (i) team structure contribution to team process, (ii) team process contribution to primary care goals, and (iii) team structure contribution to primary care goals. The systematic search of academic literature focuses on four chronic conditions and co-morbidities. Within this scope, qualitative and quantitative studies that assess the effects of team characteristics (funding, governance, organization) on care process and patient outcomes will be searched. Electronic databases (Ovid MEDLINE, Embase, CINAHL, PAIS, Web of Science) will be searched systematically. Online web-based searches will be supported by the Grey Matters Tool. Studies will be included, if they report on interdisciplinary primary care in publicly funded Western health systems, and address the relationships between team structure, process, and/or patient outcomes. Studies will be selected in a three-stage screening process (title/abstract/full text) by two independent reviewers in each stage. Study quality will be assessed using the Mixed Methods Assessment Tool. An a priori framework will be applied to data extraction, and a narrative framework approach is used for the synthesis. Using an integrated knowledge translation approach, an electronic decision support tool will be developed for decision makers. It will be searchable along two axes of inquiry: (i) what primary care goals are supported by specific team characteristics and (ii) how should teams be structured to support specific primary care goals? The results of this evidence review will contribute directly to the design of interdisciplinary primary care teams. The optimized design will support the goals of primary care, contributing to the improved health of populations. PROSPERO CRD42016041884.

  14. Mental health and primary dysmenorrhea: a systematic review.

    PubMed

    Bajalan, Zahra; Moafi, Farnoosh; MoradiBaglooei, Mohammad; Alimoradi, Zainab

    2018-05-10

    Several factors including demographic, reproductive, lifestyle, psychological and social factors can affect incidence and severity of primary dysmenorrhea. This study aimed to systematically review the psychological risk factors associated with primary dysmenorrhea. Embase, ISI web of knowledge, ProQuest, Science Direct, Scopus and PubMed central were searched using keywords related to risk factors and primary dysmenorrhea. Observational studies, published in English after 2000, focusing solely on psychological factors affecting primary dysmenorrhea were included. The search process retrieved 11,928 potential related articles. Thirty three articles met inclusion criteria and were assessed for final synthesis. The STROBE checklist was used to quality assessment of studies. Results of study showed that few studies had investigated relationship between dysmenorrhea and most psychological disorders. Most studies have investigated the relationship between dysmenorrhea and depression, anxiety, stress, alcohol abuse and somatic disorders. So, further studies are needed to investigate relation between most psychological disorders with primary dysmenorrhea. Significant relationship between some mental health components such as depression, anxiety and stress with primary dysmenorrhea shows the importance of psychological assessment before the choice of therapeutic methods. Also, the feasibility of designing and evaluating the effectiveness of the use of psychotherapy interventions for the treatment of primary dysmenorrhea as alternative therapies can be considered.

  15. Integrating preventive care and nursing standardized terminologies in nursing education: a case study.

    PubMed

    Burkhart, Lisa; Sommer, Sheryl

    2007-01-01

    This study investigated the development of a community-focused curriculum integrating primary, secondary, and tertiary prevention and nursing standardized terminologies as an organizing infrastructure. This is a case study of the curriculum redesign of the Marcella Niehoff School of Nursing, Loyola University Chicago. Faculty developed a conceptual framework integrating core concepts into curriculum design, course content, and clinical applications. A coherent curriculum was designed using a community-focused approach; primary, secondary, and tertiary prevention strategies; and standardized terminologies as the organizing infrastructure to teach and apply nursing practice. The curriculum provides a meaningful correlation between the classroom and clinical experience. Students journey with their patients throughout the health care experience, applying nursing concepts using standardized terminologies. Clinical experiences provide students with the opportunity to transfer knowledge to the health experiences of patients in their care. Patient encounters, whether at the primary, secondary, or tertiary level of prevention, are used to assist students in developing critical thinking skills through the use of standardized nursing terminologies.

  16. ATLAST-8 Mission Concept Study for 8-Meter Monolithic UV/Optical Space Telescope

    NASA Technical Reports Server (NTRS)

    Stahl, H. Philip; Postman, Marc; Arnold, William R., Sr.; Hopkins, Randall C.; Hornsby, Linda; Mosier, Gary E.; Pasquale, Bert A.

    2010-01-01

    ATLAST-8m is an 8-meter monolithic UV/optical/NIR space observatory which could be placed in orbit at Sun-Earth L2 by a heavily lift launch vehicle. Two development study cycles have resulted in a detailed concept including a dual foci optical design; several primary mirror launch support and secondary mirror support structural designs; spacecraft propulsion, power and pointing control design; and thermal design. ATLAST-8m is designed to yield never before achieved performance to obtain fundamental astronomical breakthroughs

  17. Auricular Acupressure Combined with an Internet-Based Intervention or Alone for Primary Dysmenorrhea: A Control Study

    PubMed Central

    Yeh, Mei-Ling; Hung, Yu-Ling; Lin, Jaung-Geng

    2013-01-01

    Background. Primary dysmenorrhea is prevalent in adolescents and young women. Menstrual pain and distress causes poor school performance and physiological damage. Auricular acupressure can be used to treat these symptoms, and Internet-based systems are a flexible way of communicating and delivering the relevant information. Objective. This study investigates the effects of auricular acupressure (AA) alone and combined with an interactive Internet-based (II) intervention for the management of menstrual pain and self-care of adolescents with primary dysmenorrhea. Design. This study adopts a pretest/posttest control research design with a convenience sample of 107 participants. Results. The outcomes were measured using the short-form McGill pain questionnaire (SF-MPQ), visual analogue scale (VAS), menstrual distress questionnaire (MDQ), and adolescent dysmenorrheic self-care scale (ADSCS). Significant differences were found in ADSCS scores between the groups, and in SF-MPQ, VAS, MDQ, and ADSCS scores for each group. Conclusion. Auricular acupressure alone and a combination of auricular acupressure and interactive Internet both reduced menstrual pain and distress for primary dysmenorrhea. Auricular acupressure combined with interactive Internet instruction is better than auricular acupuncture alone in improving self-care behaviors. PMID:23653661

  18. Implementing collaborative primary care for depression and posttraumatic stress disorder: design and sample for a randomized trial in the U.S. military health system.

    PubMed

    Engel, Charles C; Bray, Robert M; Jaycox, Lisa H; Freed, Michael C; Zatzick, Doug; Lane, Marian E; Brambilla, Donald; Rae Olmsted, Kristine; Vandermaas-Peeler, Russ; Litz, Brett; Tanielian, Terri; Belsher, Bradley E; Evatt, Daniel P; Novak, Laura A; Unützer, Jürgen; Katon, Wayne J

    2014-11-01

    War-related trauma, posttraumatic stress disorder (PTSD), depression and suicide are common in US military members. Often, those affected do not seek treatment due to stigma and barriers to care. When care is sought, it often fails to meet quality standards. A randomized trial is assessing whether collaborative primary care improves quality and outcomes of PTSD and depression care in the US military health system. The aim of this study is to describe the design and sample for a randomized effectiveness trial of collaborative care for PTSD and depression in military members attending primary care. The STEPS-UP Trial (STepped Enhancement of PTSD Services Using Primary Care) is a 6 installation (18 clinic) randomized effectiveness trial in the US military health system. Study rationale, design, enrollment and sample characteristics are summarized. Military members attending primary care with suspected PTSD, depression or both were referred to care management and recruited for the trial (2592), and 1041 gave permission to contact for research participation. Of those, 666 (64%) met eligibility criteria, completed baseline assessments, and were randomized to 12 months of usual collaborative primary care versus STEPS-UP collaborative care. Implementation was locally managed for usual collaborative care and centrally managed for STEPS-UP. Research reassessments occurred at 3-, 6-, and 12-months. Baseline characteristics were similar across the two intervention groups. STEPS-UP will be the first large scale randomized effectiveness trial completed in the US military health system, assessing how an implementation model affects collaborative care impact on mental health outcomes. It promises lessons for health system change. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Assessment of the primary stability of root analog zirconia implants designed using cone beam computed tomography software by means of the Periotest® device: An ex vivo study. A preliminary report.

    PubMed

    Matys, Jacek; Świder, Katarzyna; Flieger, Rafał; Dominiak, Marzena

    2017-08-01

    The implant primary stability is a fundamental prerequisite for a success of osseointegration process which determines the prosthetic reconstruction time. The aim of the present study was to assess the quality and precision of modern conical bone computer tomography (CBCT) software in preparing root analog zirconia implants (RAZIs) by measuring its primary stability by means of the Periotest device. Thirteen pig jaws with proper erupted first premolar (P1) teeth were used in the study. The CBCT examination was conducted in the area of the P1 tooth in each mandible. The 3-dimensional (3D) view of each tooth was designed from CBCT scan. The created 3D images were used to prepare root analog zirconia implants milled from a medical-grade zirconia block by means of laboratory milling. The RAZIs and titanium implants were placed into an alveolar socket after the tooth had been removed. The primary stability of the teeth before their extraction (G1), RAZIs (G2) and titanium implants (G3) were checked by Periotest devices. The mean results in PTV were: 15.9, 3.35, 12.7 for G1, G2 and G3 group, respectively. RAZIs during immediate loading achieved a significantly higher primary stability (lower Periotest value) as compared to the teeth and implants. The modern CBCT device allows us to design a precise image of an extracted tooth for the purpose of manufacturing a root analog implant. The additional feature of the surgical protocol using RAZI is the possibility of avoiding the augmentation procedure, which reduces the whole cost of the treatment.

  20. Analyzing Historical Primary Source Open Educational Resources: A Blended Pedagogical Approach

    ERIC Educational Resources Information Center

    Oliver, Kevin M.; Purichia, Heather R.

    2018-01-01

    This qualitative case study addresses the need for pedagogical approaches to working with open educational resources (OER). Drawing on a mix of historical thinking heuristics and case analysis approaches, a blended pedagogical strategy and primary source database were designed to build student understanding of historical records with transfer of…

  1. Technology Mediated Information Sharing (Monitor Sharing) in Primary Care Encounters

    ERIC Educational Resources Information Center

    Asan, Onur

    2013-01-01

    The aim of this dissertation study was to identify and describe the use of electronic health records (EHRs) for information sharing between patients and clinicians in primary-care encounters and to understand work system factors influencing information sharing. Ultimately, this will promote better design of EHR technologies and effective training…

  2. Performance Appraisal of Physical Education Teachers

    ERIC Educational Resources Information Center

    Bahadir, Ziya

    2013-01-01

    In this study, the aim was to determine views of school principals on how performance appraisal of physical education teachers who worked at primary schools should be done. The research was designed in a screening model. The research group composed of 152 school principals and deputy principals who worked at state primary schools located in…

  3. Physical Education in Primary Schools: Classroom Teachers' Perceptions of Benefits and Outcomes

    ERIC Educational Resources Information Center

    Morgan, Philip J.; Hansen, Vibeke

    2008-01-01

    Objective: The aim of the current study was to examine the perceptions of classroom teachers regarding the benefits and outcomes of their PE programs. Design: Cross-sectional. Setting: Thirty eight randomly selected primary schools in New South Wales (NSW), Australia. Method: A mixed-mode methodology was utilized, incorporating semi-structured…

  4. Primary School Students' Views about Science, Technology and Engineering

    ERIC Educational Resources Information Center

    Pekmez, Esin

    2018-01-01

    Some of the main goals of science education are to increase students' knowledge about the technology and engineering design process, and to train students as scientifically and technologically literate individuals. The main purpose of this study is to find out primary students' views about science, technology and engineering. For this aim and in…

  5. Motivation among Public Primary School Teachers in Mauritius

    ERIC Educational Resources Information Center

    Seebaluck, Ashley Keshwar; Seegum, Trisha Devi

    2013-01-01

    Purpose: The purpose of this study was to critically analyse the factors that affect the motivation of public primary school teachers and also to investigate if there is any relationship between teacher motivation and job satisfaction in Mauritius. Design/methodology/approach: Simple random sampling method was used to collect data from 250 primary…

  6. Primary Teachers Conducting Inquiry Projects: Effects on Attitudes towards Teaching Science and Conducting Inquiry

    ERIC Educational Resources Information Center

    van Aalderen-Smeets, Sandra I.; Walma van der Molen, Juliette H.; van Hest, Erna G. W. C. M.; Poortman, Cindy

    2017-01-01

    This study used an experimental, pretest-posttest control group design to investigate whether participation in a large-scale inquiry project would improve primary teachers' attitudes towards teaching science and towards conducting inquiry. The inquiry project positively affected several elements of teachers' attitudes. Teachers felt less anxious…

  7. Primary Care Physicians' Dementia Care Practices: Evidence of Geographic Variation

    ERIC Educational Resources Information Center

    Fortinsky, Richard H.; Zlateva, Ianita; Delaney, Colleen; Kleppinger, Alison

    2010-01-01

    Purpose: This article explores primary care physicians' (PCPs) self-reported approaches and barriers to management of patients with dementia, with a focus on comparisons in dementia care practices between PCPs in 2 states. Design and Methods: In this cross-sectional study, questionnaires were mailed to 600 randomly selected licensed PCPs in…

  8. Instructional Leadership Structure in Singapore: A Co-Existence of Hierarchy and Heterarchy

    ERIC Educational Resources Information Center

    Nguyen, Dong Thanh; Ng, David; Yap, Pui San

    2017-01-01

    Purpose: The purpose of this paper is to explore the instructional leadership practices and structure in Singapore primary schools. Design/methodology/approach: The study employs a qualitative approach. Data were collected from interviews of 30 Singapore primary school principals and 25 working-day observations of five principals. A grounded…

  9. Virtual Learning Intervention to Reduce Bullying Victimization in Primary School: A Controlled Trial

    ERIC Educational Resources Information Center

    Sapouna, Maria; Wolke, Dieter; Vannini, Natalie; Watson, Scott; Woods, Sarah; Schneider, Wolfgang; Enz, Sibylle; Hall, Lynne; Paiva, Ana; Andre, Elizabeth; Dautenhahn, Kerstin; Aylett, Ruth

    2010-01-01

    Background: Anti-bullying interventions to date have shown limited success in reducing victimization and have rarely been evaluated using a controlled trial design. This study examined the effects of the FearNot! anti-bullying virtual learning intervention on escaping victimization, and reducing overall victimization rates among primary school…

  10. Parental Views of Food-Safety Education in a Japanese Primary School

    ERIC Educational Resources Information Center

    Horikawa, Haruka; Akamatsu, Rie; Horiguchi, Itsuko; Marui, Eiji

    2013-01-01

    Objective: This study examined Japanese mothers' satisfaction with food-safety education in primary schools, compared the characteristics of mothers who were not satisfied, and identified topics that should be included in food-safety education, according to mothers. Design: An online survey was conducted in March 2011 in Japan. The questionnaire…

  11. Physicians' Perspectives on Caring for Cognitively Impaired Elders.(author Abstract)

    ERIC Educational Resources Information Center

    Adams, Wendy L.; McIlvain, Helen E.; Geske, Jenenne A.; Porter, Judy L.

    2005-01-01

    Purpose: This study aims to develop ah in-depth understanding of the issues important to primary care physicians in providing care to cognitively impaired elders. Design and Methods: In-depth interviews were conducted with 20 primary care physicians. Text coded as "cognitive impairment" was retrieved and analyzed by use of grounded theory analysis…

  12. Evaluating the Implementation of an Emotional Wellbeing Programme for Primary School Children Using Participatory Approaches

    ERIC Educational Resources Information Center

    Clarke, Aleisha M.; Sixsmith, Jane; Barry, Margaret M.

    2015-01-01

    Objective: This paper reports on the use of child participatory approaches to evaluate the implementation and impact of the "Zippy's Friends" emotional wellbeing programme on children in disadvantaged primary schools in Ireland. Design: As part of the overall evaluation study, which comprised a clustered randomised controlled trial,…

  13. Digital London: Creating a Searchable Web of Interlinked Sources on Eighteenth Century London

    ERIC Educational Resources Information Center

    Shoemaker, Robert

    2005-01-01

    Purpose: To outline the conceptual and technical difficulties encountered, as well as the opportunities created, when developing an interlinked collection of web-based digitised primary sources on eighteenth century London. Design/methodology/approach: As a pilot study for a larger project, a variety of primary sources, including the "Old…

  14. The Contribution of Segmental and Suprasegmental Phonology to Reading Comprehension

    ERIC Educational Resources Information Center

    Veenendaal, Nathalie J.; Groen, Margriet A.; Verhoeven, Ludo

    2016-01-01

    The aim of the present study was to examine the relation between decoding and segmental and suprasegmental phonology, and their contribution to reading comprehension, in the upper primary grades. Following a longitudinal design, the performance of 99 Dutch primary school students on phonological awareness (segmental phonology) and text-reading…

  15. 78 FR 47191 - Air Quality Designations for the 2010 Sulfur Dioxide (SO2) Primary National Ambient Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-05

    ... Air Quality Designations for the 2010 Sulfur Dioxide (SO[bdi2]) Primary National Ambient Air Quality... air quality designations for certain areas in the United States for the 2010 primary Sulfur Dioxide... of this document? III. What is sulfur dioxide? IV. What is the 2010 SO 2 NAAQS and what are the...

  16. Urine sampling techniques in symptomatic primary-care patients: a diagnostic accuracy review.

    PubMed

    Holm, Anne; Aabenhus, Rune

    2016-06-08

    Choice of urine sampling technique in urinary tract infection may impact diagnostic accuracy and thus lead to possible over- or undertreatment. Currently no evidencebased consensus exists regarding correct sampling technique of urine from women with symptoms of urinary tract infection in primary care. The aim of this study was to determine the accuracy of urine culture from different sampling-techniques in symptomatic non-pregnant women in primary care. A systematic review was conducted by searching Medline and Embase for clinical studies conducted in primary care using a randomized or paired design to compare the result of urine culture obtained with two or more collection techniques in adult, female, non-pregnant patients with symptoms of urinary tract infection. We evaluated quality of the studies and compared accuracy based on dichotomized outcomes. We included seven studies investigating urine sampling technique in 1062 symptomatic patients in primary care. Mid-stream-clean-catch had a positive predictive value of 0.79 to 0.95 and a negative predictive value close to 1 compared to sterile techniques. Two randomized controlled trials found no difference in infection rate between mid-stream-clean-catch, mid-stream-urine and random samples. At present, no evidence suggests that sampling technique affects the accuracy of the microbiological diagnosis in non-pregnant women with symptoms of urinary tract infection in primary care. However, the evidence presented is in-direct and the difference between mid-stream-clean-catch, mid-stream-urine and random samples remains to be investigated in a paired design to verify the present findings.

  17. Learning Science through Creating a `Slowmation': A case study of preservice primary teachers

    NASA Astrophysics Data System (ADS)

    Hoban, Garry; Nielsen, Wendy

    2013-01-01

    Many preservice primary teachers have inadequate science knowledge, which often limits their confidence in implementing the subject. This paper proposes a new way for preservice teachers to learn science by designing and making a narrated stop-motion animation as an instructional resource to explain a science concept. In this paper, a simplified way for preservice teachers to design and make an animation called 'slowmation' (abbreviated from 'slow animation') is exemplified. A case study of three preservice primary teachers creating one from start to finish over 2 h was conducted to address the following research question: How do the preservice primary teachers create a slowmation and how does this process influence their science learning? The method of inquiry used a case study design involving pre- and post-individual interviews in conjunction with a discourse analysis of video and audio data recorded as they created a slowmation. The data illustrate how the preservice teachers' science learning was related to their prior knowledge and how they iteratively revisited the content through the construction of five representations as a cumulative semiotic progression: (i) research notes; (ii) storyboard; (iii) models; (iv) digital photographs; culminating in (v) the narrated animation. This progression enabled the preservice teachers to revisit the content in each representation and make decisions about which modes to use and promoted social interaction. Creating a slowmation facilitated the preservice teachers' learning about the life cycle of a ladybird beetle and revised their alternative conceptions.

  18. Review and assessment of designated driver programs as an alcohol countermeasure approach

    DOT National Transportation Integrated Search

    1987-02-01

    Many drinking establishments have instituted designated driver programs (DDPs) which encourage one person in a group of patrons to remain sober and drive the others home. The primary objectives of this exploratory study were to: 1) identify DDPs thro...

  19. Design, rationale, and baseline characteristics of a cluster randomized controlled trial of pay for performance for hypertension treatment: study protocol.

    PubMed

    Petersen, Laura A; Urech, Tracy; Simpson, Kate; Pietz, Kenneth; Hysong, Sylvia J; Profit, Jochen; Conrad, Douglas; Dudley, R Adams; Lutschg, Meghan Z; Petzel, Robert; Woodard, Lechauncy D

    2011-10-03

    Despite compelling evidence of the benefits of treatment and well-accepted guidelines for treatment, hypertension is controlled in less than one-half of United States citizens. This randomized controlled trial tests whether explicit financial incentives promote the translation of guideline-recommended care for hypertension into clinical practice and improve blood pressure (BP) control in the primary care setting. Using constrained randomization, we assigned 12 Veterans Affairs hospital outpatient clinics to four study arms: physician-level incentive; group-level incentive; combination of physician and group incentives; and no incentives (control). All participants at the hospital (cluster) were assigned to the same study arm. We enrolled 83 full-time primary care physicians and 42 non-physician personnel. The intervention consisted of an educational session about guideline-recommended care for hypertension, five audit and feedback reports, and five disbursements of incentive payments. Incentive payments rewarded participants for chart-documented use of guideline-recommended antihypertensive medications, BP control, and appropriate responses to uncontrolled BP during a prior four-month performance period over the 20-month intervention. To identify potential unintended consequences of the incentives, the study team interviewed study participants, as well as non-participant primary care personnel and leadership at study sites. Chart reviews included data collection on quality measures not related to hypertension. To evaluate the persistence of the effect of the incentives, the study design includes a washout period. We briefly describe the rationale for the interventions being studied, as well as the major design choices. Rigorous research designs such as the one described here are necessary to determine whether performance-based payment arrangements such as financial incentives result in meaningful quality improvements. http://www.clinicaltrials.govNCT00302718.

  20. Design and manufacture of customized dental implants by using reverse engineering and selective laser melting technology.

    PubMed

    Chen, Jianyu; Zhang, Zhiguang; Chen, Xianshuai; Zhang, Chunyu; Zhang, Gong; Xu, Zhewu

    2014-11-01

    Recently a new therapeutic concept of patient-specific implant dentistry has been advanced based on computer-aided design/computer-aided manufacturing technology. However, a comprehensive study of the design and 3-dimensional (3D) printing of the customized implants, their mechanical properties, and their biomechanical behavior is lacking. The purpose of this study was to evaluate the mechanical and biomechanical performance of a novel custom-made dental implant fabricated by the selective laser melting technique with simulation and in vitro experimental studies. Two types of customized implants were designed by using reverse engineering: a root-analog implant and a root-analog threaded implant. The titanium implants were printed layer by layer with the selective laser melting technique. The relative density, surface roughness, tensile properties, bend strength, and dimensional accuracy of the specimens were evaluated. Nonlinear and linear finite element analysis and experimental studies were used to investigate the stress distribution, micromotion, and primary stability of the implants. Selective laser melting 3D printing technology was able to reproduce the customized implant designs and produce high density and strength and adequate dimensional accuracy. Better stress distribution and lower maximum micromotions were observed for the root-analog threaded implant model than for the root-analog implant model. In the experimental tests, the implant stability quotient and pull-out strength of the 2 types of implants indicated that better primary stability can be obtained with a root-analog threaded implant design. Selective laser melting proved to be an efficient means of printing fully dense customized implants with high strength and sufficient dimensional accuracy. Adding the threaded characteristic to the customized root-analog threaded implant design maintained the approximate geometry of the natural root and exhibited better stress distribution and primary stability. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  1. Preventing AVF thrombosis: the rationale and design of the Omega-3 fatty acids (Fish Oils) and Aspirin in Vascular access OUtcomes in REnal Disease (FAVOURED) study.

    PubMed

    Irish, Ashley; Dogra, Gursharan; Mori, Trevor; Beller, Elaine; Heritier, Stephane; Hawley, Carmel; Kerr, Peter; Robertson, Amanda; Rosman, Johan; Paul-Brent, Peta-Anne; Starfield, Melissa; Polkinghorne, Kevan; Cass, Alan

    2009-01-21

    Haemodialysis (HD) is critically dependent on the availability of adequate access to the systemic circulation, ideally via a native arteriovenous fistula (AVF). The Primary failure rate of an AVF ranges between 20-54%, due to thrombosis or failure of maturation. There remains limited evidence for the use of anti-platelet agents and uncertainty as to choice of agent(s) for the prevention of AVF thrombosis. We present the study protocol for a randomised, double-blind, placebo-controlled, clinical trial examining whether the use of the anti-platelet agents, aspirin and omega-3 fatty acids, either alone or in combination, will effectively reduce the risk of early thrombosis in de novo AVF. The study population is adult patients with stage IV or V chronic kidney disease (CKD) currently on HD or where HD is planned to start within 6 months in whom a planned upper or lower arm AVF is to be the primary HD access. Using a factorial-design trial, patients will be randomised to aspirin or matching placebo, and also to omega-3 fatty acids or matching placebo, resulting in four treatment groups (aspirin placebo/omega-3 fatty acid placebo, aspirin/omega-3 fatty acid placebo, aspirin placebo/omega-3 fatty acid, aspirin/omega-3 fatty acid). Randomisation will be achieved using a dynamic balancing method over the two stratification factors of study site and upper versus lower arm AVF. The medication will be commenced pre-operatively and continued for 3 months post surgery. The primary outcome is patency of the AVF at three months after randomisation. Secondary outcome measures will include functional patency at six and twelve months, primary patency time, secondary (assisted) patency time, and adverse events, particularly bleeding. This multicentre Australian and New Zealand study has been designed to determine whether the outcome of surgery to create de novo AVF can be improved by the use of aspirin and/or omega-3 fatty acids. Recently a placebo-controlled trial has shown that clopidogrel is effective in safely preventing primary AVF thrombosis, but ineffective at increasing functional patency. Our study presents significant differences in the anti-platelet agents used, the study design, and surgical and patient demographics that should contribute further evidence regarding the efficacy of anti-platelet agents. Australia & New Zealand Clinical Trials Register (ACTRN12607000569404).

  2. Equal-Curvature X-ray Telescope Designs for Constellation-X Mission

    NASA Technical Reports Server (NTRS)

    Saha, Timo T.; Content, David A.; Zhang, William W.

    2003-01-01

    We study grazing incidence Equal-Curvature telescope designs for the Constellation-X mission. These telescopes have nearly spherical axial surfaces. The telescopes are designed so that the axial curvature is the same on the primary and secondary. The optical performance of these telescopes is for all practical purposes identical to the equivalent Wolter telescopes.

  3. Effect of genetic testing for risk of type 2 diabetes mellitus on health behaviors and outcomes: study rationale, development and design.

    PubMed

    Cho, Alex H; Killeya-Jones, Ley A; O'Daniel, Julianne M; Kawamoto, Kensaku; Gallagher, Patrick; Haga, Susanne; Lucas, Joseph E; Trujillo, Gloria M; Joy, Scott V; Ginsburg, Geoffrey S

    2012-01-18

    Type 2 diabetes is a prevalent chronic condition globally that results in extensive morbidity, decreased quality of life, and increased health services utilization. Lifestyle changes can prevent the development of diabetes, but require patient engagement. Genetic risk testing might represent a new tool to increase patients' motivation for lifestyle changes. Here we describe the rationale, development, and design of a randomized controlled trial (RCT) assessing the clinical and personal utility of incorporating type 2 diabetes genetic risk testing into comprehensive diabetes risk assessments performed in a primary care setting. Patients are recruited in the laboratory waiting areas of two primary care clinics and enrolled into one of three study arms. Those interested in genetic risk testing are randomized to receive either a standard risk assessment (SRA) for type 2 diabetes incorporating conventional risk factors plus upfront disclosure of the results of genetic risk testing ("SRA+G" arm), or the SRA alone ("SRA" arm). Participants not interested in genetic risk testing will not receive the test, but will receive SRA (forming a third, "no-test" arm). Risk counseling is provided by clinic staff (not study staff external to the clinic). Fasting plasma glucose, insulin levels, body mass index (BMI), and waist circumference are measured at baseline and 12 months, as are patients' self-reported behavioral and emotional responses to diabetes risk information. Primary outcomes are changes in insulin resistance and BMI after 12 months; secondary outcomes include changes in diet patterns, physical activity, waist circumference, and perceived risk of developing diabetes. The utility, feasibility, and efficacy of providing patients with genetic risk information for common chronic diseases in primary care remain unknown. The study described here will help to establish whether providing type 2 diabetes genetic risk information in a primary care setting can help improve patients' clinical outcomes, risk perceptions, and/or their engagement in healthy behavior change. In addition, study design features such as the use of existing clinic personnel for risk counseling could inform the future development and implementation of care models for the use of individual genetic risk information in primary care. ClinicalTrials.gov: NCT00849563.

  4. Implementation and evaluation of the 5As framework of obesity management in primary care: design of the 5As Team (5AsT) randomized control trial

    PubMed Central

    2014-01-01

    Background Obesity is a pressing public health concern, which frequently presents in primary care. With the explosive obesity epidemic, there is an urgent need to maximize effective management in primary care. The 5As of Obesity Management™ (5As) are a collection of knowledge tools developed by the Canadian Obesity Network. Low rates of obesity management visits in primary care suggest provider behaviour may be an important variable. The goal of the present study is to increase frequency and quality of obesity management in primary care using the 5As Team (5AsT) intervention to change provider behaviour. Methods/design The 5AsT trial is a theoretically informed, pragmatic randomized controlled trial with mixed methods evaluation. Clinic-based multidisciplinary teams (RN/NP, mental health, dietitians) will be randomized to control or the 5AsT intervention group, to participate in biweekly learning collaborative sessions supported by internal and external practice facilitation. The learning collaborative content addresses provider-identified barriers to effective obesity management in primary care. Evidence-based shared decision making tools will be co-developed and iteratively tested by practitioners. Evaluation will be informed by the RE-AIM framework. The primary outcome measure, to which participants are blinded, is number of weight management visits/full-time equivalent (FTE) position. Patient-level outcomes will also be assessed, through a longitudinal cohort study of patients from randomized practices. Patient outcomes include clinical (e.g., body mass index [BMI], blood pressure), health-related quality of life (SF-12, EQ5D), and satisfaction with care. Qualitative data collected from providers and patients will be evaluated using thematic analysis to understand the context, implementation and effectiveness of the 5AsT program. Discussion The 5AsT trial will provide a wide range of insights into current practices, knowledge gaps and barriers that limit obesity management in primary practice. The use of existing resources, collaborative design, practice facilitation, and integrated feedback loops cultivate an applicable, adaptable and sustainable approach to increasing the quantity and quality of weight management visits in primary care. Trial registration NCT01967797. PMID:24947045

  5. Developing nurse and physician questionnaires to assess primary work areas in intensive care units.

    PubMed

    Rashid, Mahbub; Boyle, Diane K; Crosser, Michael

    2014-01-01

    The objective of the study was to develop instruments for describing and assessing some aspects of design of the primary work areas of nurses and physicians in intensive care units (ICUs). Separate questionnaires for ICU physicians and nurses were developed. Items related to individual- and unit-level design features of the primary work areas of nurses and physicians were organized using constructs found in the literature. Items related to staff satisfaction and staff use of time in relation to primary work area design were also included. All items and constructs were reviewed by experts for content validity and were modified as needed before use. The final questionnaires were administered to a convenience sample of 4 ICUs in 2 large urban hospitals. A total of 55 nurses and 29 physicians completed the survey. The Cronbach α was used to measure internal consistency, and factor analysis was used to provide construct-related validity. Convergent and discriminant validity were assessed through examining bivariate correlations between relevant scales/items. Analysis of variance was used to identify whether the between-group member responses were significant among the 4 units. The Cronbach α values for all except 3 preliminary scales indicated acceptable reliability. Factor analysis indicated that some preliminary scales could be partitioned into subscales for finer descriptions of the primary work areas. Correlational analysis provided strong evidence of convergent and discriminant validity of all the scales and subscales. The significance level of F-statistics showed that the units were significantly different from each other, providing evidence of more between-unit variance than within-unit variance. Therefore, the questionnaires developed in the study offer a promising departure point for rigorous description and evaluation of the primary work areas in relation to staff satisfaction and use of time in ICUs at a time when the importance of such studies is growing.

  6. The Effect of Learning Geometry Topics of 7th Grade in Primary Education with Dynamic Geometer's Sketchpad Geometry Software to Success and Retention

    ERIC Educational Resources Information Center

    Kesan, Cenk; Caliskan, Sevdane

    2013-01-01

    The aim of this study is to investigate the effect of learning geometry topics of 7th grade in primary education with dynamic geometer's sketchpad geometry software to student's success and retention. The experimental research design with The Posttest-Only Control Group was used in this study. In the experimental group, dynamic geometer's…

  7. The 747 primary flight control systems reliability and maintenance study

    NASA Technical Reports Server (NTRS)

    1979-01-01

    The major operational characteristics of the 747 Primary Flight Control Systems (PFCS) are described. Results of reliability analysis for separate control functions are presented. The analysis makes use of a NASA computer program which calculates reliability of redundant systems. Costs for maintaining the 747 PFCS in airline service are assessed. The reliabilities and cost will provide a baseline for use in trade studies of future flight control system design.

  8. TPF coronagraph instrument design

    NASA Technical Reports Server (NTRS)

    Shaklan, S B.; Balasubramanian, K.; Ceperly, D.; Green, J.; Hoppe, D.; Lay, O. P.; Lisman, P. D.; Mouroulis, P. Z.

    2005-01-01

    For the past 2 years, NASA has invested substantial resources to study the design and performance of the Terrestrial Planet Finder Coronagraph (TPF-C). The work, led by the Jet Propulsion Laboratory with collaboration from Goddard Space Flight Center and several university and commercial entities, encompasses observatory design, performance modeling, materials characterization, primary mirror studies, and a significant technology development effort including a high-contrast imaging testbed that has achieved 1e-9 contrast in a laboratory experiment.

  9. Solid-state X-band Combiner Study

    NASA Technical Reports Server (NTRS)

    Pitzalis, O., Jr.; Russell, K. J.

    1979-01-01

    The feasibility of developing solid-state amplifiers at 4 and 10 GHz for application in spacecraft altimeters was studied. Bipolar-transistor, field-effect-transistor, and Impatt-diode amplifier designs based on 1980 solid-state technology are investigated. Several output power levels of the pulsed, low-duty-factor amplifiers are considered at each frequency. Proposed transistor and diode amplifier designs are illustrated in block diagrams. Projections of size, weight, and primary power requirements are given for each design.

  10. Comparing Skills-Focused and Self-Regulation Focused Preschool Curricula: Impacts on Academic and Self-Regulatory Skills

    ERIC Educational Resources Information Center

    Lonigan, Christopher J.; Phillips, Beth M.

    2012-01-01

    The primary goal of this study was to evaluate the relative effectiveness of a skills-focused preschool curriculum versus a curriculum designed to foster children's self-regulation skills. Additionally, the study was designed to evaluate if adding a self-regulation component to a skills-based curriculum would enhance children's outcomes in…

  11. Evolving Design Criteria for Very Large Aperture Space Based Telescopes and Their Influence on the Need for Integrated Tools in the Optimization Process

    NASA Technical Reports Server (NTRS)

    Arnold, William R., Sr.

    2015-01-01

    NASA's Advanced Mirror Technology Development (AMTD) program has been developing the means to design and build the future generations of space based telescopes. With the nearing completion of the James Webb Space Telescope (JWST), the astrophysics community is already starting to define the requirements for follow-on observatories. The restrictions of available launch vehicles and the possibilities of planned future vehicles have fueled the competition between monolithic primaries (with better optical quality) and segmented primaries (with larger apertures, but with diffraction, costs and figure control issues). Regardless of the current shroud sizes and lift capacities, these competing architectures share the need for rapid design tools. As part of the AMTD program a number of tools have been developed and tested to speed up the design process. Starting with the Arnold Mirror Modeler (which creates Finite Element Models (FEM) for structural analysis) and now also feeds these models into thermal stability analyses. They share common file formats and interchangeable results. During the development of the program, numerous trade studies were created for 4-meter and 8-meter monolithic primaries, complete with support systems. Evaluation of these results has led to a better understanding of how the specification drives the results. This paper will show some of the early trade studies for typical specification requirements such as lowest mirror bending frequency and suspension system lowest frequency. The results use representative allowable stress values for each mirror substrate material and construction method and generic material properties. These studies lead to some interesting relationships between feasible designs and the realities of actually trying to build these mirrors. Much of the traditional specifications were developed for much smaller systems, where the mass and volume of the primary where a small portion of the overall satellite. JWST shows us that as the aperture grows, the primary takes up the majority of the mass and volume and the established rules need to be adjusted. For example, a small change in lowest frequency requirement can change the cost by millions of dollars. The paper uses numerous trade studies created during the software development phase of the Arnold Mirror Modeler to illustrate the influences of system specifications on the design space. The future telescopes will require better performance, stability and documented feasibility to meet the hurdles of today's budget and schedules realities. AMTD is developing the tools, but the basic system planning mentality also has to adopt to the requirements of these very large and complex physical structures.

  12. Treating primary insomnia - the efficacy of valerian and hops.

    PubMed

    Salter, Shanah; Brownie, Sonya

    2010-06-01

    To evaluate the efficacy of valerian and hops in the treatment of primary insomnia. The AMED and MEDLINE databases were searched for primary sources of literature published between 1950 and 2009, using keywords: herbal medicine, medicinal plants, herbal, Valeriana officinalis, valerian, Humulus lupulus, hops, sleep, insomnia. Studies were included if they evaluated the efficacy of valerian or hops in improving primary insomnia in adults: sixteen studies met the inclusion criteria. Twelve of these found that the use of valerian, on its own, or in combination with hops, is associated with improvements in some sleep parameters (eg. sleep latency and quality of sleep). However, these results need to be interpreted cautiously as there were significant differences in design between the studies. Further randomised, double blind, placebo controlled trials are needed before such herbal treatments can be confidently recommended for the treatment of primary insomnia.

  13. Healthy eating and active living for diabetes in primary care networks (HEALD-PCN): rationale, design, and evaluation of a pragmatic controlled trial for adults with type 2 diabetes

    PubMed Central

    2012-01-01

    Background While strong and consistent evidence supports the role of lifestyle modification in the prevention and management of type 2 diabetes (T2DM), the best strategies for program implementation to support lifestyle modification within primary care remain to be determined. The objective of the study is to evaluate the implementation of an evidence-based self- management program for patients with T2DM within a newly established primary care network (PCN) environment. Method Using a non-randomized design, participants (total N = 110 per group) will be consecutively allocated in bi-monthly blocks to either a 6-month self-management program lead by an Exercise Specialist or to usual care. Our primary outcome is self-reported physical activity and pedometer steps. Discussion The present study will assess whether a diabetes self-management program lead by an Exercise Specialist provided within a newly emerging model of primary care and linked to available community-based resources, can lead to positive changes in self-management behaviours for adults with T2DM. Ultimately, our work will serve as a platform upon which an emerging model of primary care can incorporate effective and efficient chronic disease management practices that are sustainable through partnerships with local community partners. Clinical Trials Registration ClinicalTrials.gov identifier: NCT00991380 PMID:22712881

  14. A gatekeeping procedure to test a primary and a secondary endpoint in a group sequential design with multiple interim looks.

    PubMed

    Tamhane, Ajit C; Gou, Jiangtao; Jennison, Christopher; Mehta, Cyrus R; Curto, Teresa

    2018-03-01

    Glimm et al. (2010) and Tamhane et al. (2010) studied the problem of testing a primary and a secondary endpoint, subject to a gatekeeping constraint, using a group sequential design (GSD) with K=2 looks. In this article, we greatly extend the previous results to multiple (K>2) looks. If the familywise error rate (FWER) is to be controlled at a preassigned α level then it is clear that the primary boundary must be of level α. We show under what conditions one α-level primary boundary is uniformly more powerful than another. Based on this result, we recommend the choice of the O'Brien and Fleming (1979) boundary over the Pocock (1977) boundary for the primary endpoint. For the secondary endpoint the choice of the boundary is more complicated since under certain conditions the secondary boundary can be refined to have a nominal level α'>α, while still controlling the FWER at level α, thus boosting the secondary power. We carry out secondary power comparisons via simulation between different choices of primary-secondary boundary combinations. The methodology is applied to the data from the RALES study (Pitt et al., 1999; Wittes et al., 2001). An R library package gsrsb to implement the proposed methodology is made available on CRAN. © 2017, The International Biometric Society.

  15. 40 CFR Appendix S to Part 50 - Interpretation of the Primary National Ambient Air Quality Standards for Oxides of Nitrogen...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... measured from midnight to midnight (local standard time) that are used in NAAQS computations. Design values..., calculated as specified in section 5 of this appendix. The design values for the primary NAAQS are: (1) The annual mean value for a monitoring site for one year (referred to as the “annual primary standard design...

  16. 40 CFR Appendix S to Part 50 - Interpretation of the Primary National Ambient Air Quality Standards for Oxides of Nitrogen...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... measured from midnight to midnight (local standard time) that are used in NAAQS computations. Design values..., calculated as specified in section 5 of this appendix. The design values for the primary NAAQS are: (1) The annual mean value for a monitoring site for one year (referred to as the “annual primary standard design...

  17. 40 CFR Appendix S to Part 50 - Interpretation of the Primary National Ambient Air Quality Standards for Oxides of Nitrogen...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... measured from midnight to midnight (local standard time) that are used in NAAQS computations. Design values..., calculated as specified in section 5 of this appendix. The design values for the primary NAAQS are: (1) The annual mean value for a monitoring site for one year (referred to as the “annual primary standard design...

  18. 40 CFR Appendix S to Part 50 - Interpretation of the Primary National Ambient Air Quality Standards for Oxides of Nitrogen...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... measured from midnight to midnight (local standard time) that are used in NAAQS computations. Design values..., calculated as specified in section 5 of this appendix. The design values for the primary NAAQS are: (1) The annual mean value for a monitoring site for one year (referred to as the “annual primary standard design...

  19. 40 CFR Appendix S to Part 50 - Interpretation of the Primary National Ambient Air Quality Standards for Oxides of Nitrogen...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... measured from midnight to midnight (local standard time) that are used in NAAQS computations. Design values..., calculated as specified in section 5 of this appendix. The design values for the primary NAAQS are: (1) The annual mean value for a monitoring site for one year (referred to as the “annual primary standard design...

  20. Anthropometric evaluation and recommendation for primary schools classroom furniture design in Perlis

    NASA Astrophysics Data System (ADS)

    Shan, Lim Shaiu; Jing, Ewe Hui; Effendi, M. S. M.; Rosli, Muhamad Farizuan

    2017-09-01

    This study was carried out with the objective to obtain the anthropometric data of primary school children from Year 1 to Year 6 and evaluate the children's anthropometry with the current dimensions of classroom furniture (i.e. chair and table). In addition, this study also proposed the design dimensions for the improvement in classroom furniture design with the consideration of children's anthropometric data. A total of 390 children selected from 13 primary schools in Perlis, Malaysia were participated in this study. There were 11 anthropometric measurements of children have been measured in this study, which include stature (St), popliteal height (PH), knee height (KH), thigh thickness (TT), buttock popliteal length (BPL), hip breadth (HB), sitting shoulder height (SSH), sitting elbow height (SEH), forearm-hand length (FHL), height of lumbar point (HLP) and buttock clearance (BC). Besides that, 7 dimensions relating to current classroom chair have been measured, such as seat height (SH), seat depth (SD), seat width (SW), upper edge of backrest (UEB), lower edge of backrest (LEB), S point (SP), overall chair height (OCH). Another 5 dimensions of the existing classroom table have been measured too, which involve table height (TH), table depth (TD), table width (TW), under table height (UH) and seat to table clearance (STC). All the measurements were performed by using metal measuring tape. The anthropometric data of the children were analyzed with the help of Microsoft Excel 2013. Several equations with associated with the anthropometric data and furniture dimensions have been applied in this research. The new design dimensions for classroom furniture that proposed in this paper which based on the collected anthropometric data can be referred as a guideline for classroom furniture design. The implementation of these data may help to create comfortability, safety, suitability and improve performance of children in the classroom.

  1. Back Complaints in the Elders (BACE); design of cohort studies in primary care: an international consortium

    PubMed Central

    2011-01-01

    Background Although back complaints are common among older people, limited information is available in the literature about the clinical course of back pain in older people and the identification of older persons at risk for the transition from acute back complaints to chronic back pain. The aim of this study is to assess the course of back complaints and identify prognostic factors for the transition from acute back complaints to chronic back complaints in older people who visit a primary health care physician. Methods/design The design is a prospective cohort study with one-year follow-up. There will be no interference with usual care. Patients older than 55 years who consult a primary health care physician with a new episode of back complaints will be included in this study. Data will be collected using a questionnaire, physical examination and X-ray at baseline, and follow-up questionnaires after 6 weeks and 3, 6, 9 and 12 months. The study 'Back Complaints in the Elders' (BACE) will take place in different countries: starting in the Netherlands, Brazil and Australia. The research groups collaborate in the BACE consortium. The design and basic objectives of the study will be the same across the studies. Discussion This consortium is a collaboration between different research groups, aiming to provide insight into the course of back complaints in older people and to identify prognostic factors for the transition from acute back complaints to chronic back complaints in older persons. The BACE consortium allows to investigate differences between older people with back complaints and the health care systems in the different countries and to increase the statistical power by enabling meta-analyses using the individual patient data. Additional research groups worldwide are invited to join the BACE consortium. PMID:21854620

  2. The current state of cancer family history collection tools in primary care: a systematic review.

    PubMed

    Qureshi, Nadeem; Carroll, June C; Wilson, Brenda; Santaguida, Pasqualina; Allanson, Judith; Brouwers, Melissa; Raina, Parminder

    2009-07-01

    Systematic collection of family history is a prerequisite for identifying genetic risk. This study reviewed tools applicable to the primary care assessment of family history of breast, colorectal, ovarian, and prostate cancer. MEDLINE, EMBASE, CINAHL, and Cochrane Central were searched for publications. All primary study designs were included. Characteristics of the studies, the family history collection tools, and the setting were evaluated. Of 40 eligible studies, 18 relevant family history tools were identified, with 11 developed for use in primary care. Most collected information on more than one cancer and on affected relatives used self-administered questionnaires and paper-based formats. Eleven tools had been evaluated relative to current practice, demonstrating 46-78% improvement in data recording over family history recording in patient charts and 75-100% agreement with structured genetic interviews. Few tools have been developed specifically for primary care settings. The few that have been evaluated performed well. The very limited evidence, which depends in part on extrapolation from studies in settings other than primary care, suggests that systematic tools may add significant family health information compared with current primary care practice. The effect of their use on health outcomes has not been evaluated.

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

    Not Available

    Potomac Electric Power Company (PEPCO) and Acres American Incorporated (AAI) have carried out a preliminary design study of water-compensated Compressed Air Energy Storage (CAES) and Underground Pumped Hydroelectric (UPH) plants for siting in geological conditions suitable for hard rock excavations. The work was carried out over a period of three years and was sponsored by the US Department of Energy (DOE), the Electric Power Research Institute (EPRI) and PEPCO. The study was divided into five primary tasks as follows: establishment of design criteria and analysis of impact on power system; selection of site and establishment of site characteristics; formulation ofmore » design approaches; assessment of environmental and safety aspects; and preparation of preliminary design of plant. The salient aspects considered and the conclusions reached during the consideration of the five primary tasks for both CAES and UPH are presented in this Executive Summary, which forms Volume 1 of the series of reports prepared during the study. The investigations and analyses carried out, together with the results and conclusions reached, are described in detail in Volumes 2 through 13 and ten appendices.« less

  4. Pre-Visit Prioritization for Complex Patients with Diabetes: Randomized Trial Design and Implementation within an Integrated Health Care System

    PubMed Central

    Grant, Richard W; Uratsu, Connie S; Hansen, Karen R; Altschuler, Andrea; Kim, Eileen; Fireman, Bruce; Adams, Alyce S; Schmittdiel, Julie A; Heisler, Michele

    2016-01-01

    Background/Aims Despite robust evidence to guide clinical care, most patients with diabetes do not meet all goals of risk factor control. Improved patient-provider communication during time-limited primary care visits may represent one strategy for improving diabetes care. Methods We designed a controlled, cluster-randomized, multi-site intervention (Pre-Visit Prioritization for Complex Patients with Diabetes) that enables patients with poorly controlled type 2 diabetes to identify their top priorities prior to a scheduled visit and sends these priorities to the primary care physician progress note in the electronic medical record. In this paper, we describe strategies to address challenges to implementing our health IT-based intervention study within a large health care system. Results This study is being conducted in 30 primary care practices within a large integrated care delivery system in Northern California. Over a 12-week period (3/1/2015 – 6/6/2015), 146 primary care physicians consented to enroll in the study (90.1%) and approved contact with 2496 of their patients (97.6%). Implementation challenges included: (1) Navigating research vs. quality improvement requirements; (2) Addressing informed consent considerations; and (3) Introducing a new clinical tool into a highly time-constrained workflow. Strategies for successfully initiating this study included engagement with institutional leaders, Institutional Review Board members, and clinical stakeholders at multiple stages both before and after notice of Federal funding; flexibility by the research team in study design; and strong support from institutional leadership for “self-learning health system” research. Conclusions By paying careful attention to identifying and collaborating with a wide range of key clinical stakeholders, we have shown that researchers embedded within a learning care system can successfully apply rigorous clinical trial methods to test new care innovations. PMID:26820612

  5. SLIMMER: a randomised controlled trial of diabetes prevention in Dutch primary health care: design and methods for process, effect, and economic evaluation

    PubMed Central

    2014-01-01

    Background Implementation of interventions in real-life settings requires a comprehensive evaluation approach. The aim of this article is to describe the evaluation design of the SLIMMER diabetes prevention intervention in a Dutch real-life setting. Methods/Design The SLIMMER study is a randomised, controlled intervention study including subjects aged 40 through 70 years with impaired fasting glucose or high risk of diabetes. The 10-month SLIMMER intervention involves a dietary and physical activity intervention, including case management and a maintenance programme. The control group receives usual health care and written information about a healthy lifestyle. A logic model of change is composed to link intervention activities with intervention outcomes in a logical order. Primary outcome is fasting insulin. Measurements are performed at baseline and after 12 and 18 months and cover quality of life, cardio-metabolic risk factors (e.g. glucose tolerance, serum lipids, body fatness, and blood pressure), eating and physical activity behaviour, and behavioural determinants. A process evaluation gives insight in how the intervention was delivered and received by participants and health care professionals. The economic evaluation consists of a cost-effectiveness analysis and a cost-utility analysis. Costs are assessed from both a societal and health care perspective. Discussion This study is expected to provide insight in the effectiveness, including its cost-effectiveness, and delivery of the SLIMMER diabetes prevention intervention conducted in Dutch primary health care. Results of this study provide valuable information for primary health care professionals, researchers, and policy makers. Trial registration The SLIMMER study is registered with ClinicalTrials.gov (NCT02094911) since March 19, 2014. PMID:24928217

  6. Pre-Visit Prioritization for complex patients with diabetes: Randomized trial design and implementation within an integrated health care system.

    PubMed

    Grant, Richard W; Uratsu, Connie S; Estacio, Karen R; Altschuler, Andrea; Kim, Eileen; Fireman, Bruce; Adams, Alyce S; Schmittdiel, Julie A; Heisler, Michele

    2016-03-01

    Despite robust evidence to guide clinical care, most patients with diabetes do not meet all goals of risk factor control. Improved patient-provider communication during time-limited primary care visits may represent one strategy for improving diabetes care. We designed a controlled, cluster-randomized, multi-site intervention (Pre-Visit Prioritization for Complex Patients with Diabetes) that enables patients with poorly controlled type 2 diabetes to identify their top priorities prior to a scheduled visit and sends these priorities to the primary care physician progress note in the electronic medical record. In this paper, we describe strategies to address challenges to implementing our health IT-based intervention study within a large health care system. This study is being conducted in 30 primary care practices within a large integrated care delivery system in Northern California. Over a 12-week period (3/1/2015-6/6/2015), 146 primary care physicians consented to enroll in the study (90.1%) and approved contact with 2496 of their patients (97.6%). Implementation challenges included: (1) navigating research vs. quality improvement requirements; (2) addressing informed consent considerations; and (3) introducing a new clinical tool into a highly time-constrained workflow. Strategies for successfully initiating this study included engagement with institutional leaders, Institutional Review Board members, and clinical stakeholders at multiple stages both before and after notice of Federal funding; flexibility by the research team in study design; and strong support from institutional leadership for "self-learning health system" research. By paying careful attention to identifying and collaborating with a wide range of key clinical stakeholders, we have shown that researchers embedded within a learning care system can successfully apply rigorous clinical trial methods to test new care innovations. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. The integration of occupational therapy into primary care: a multiple case study design

    PubMed Central

    2013-01-01

    Background For over two decades occupational therapists have been encouraged to enhance their roles within primary care and focus on health promotion and prevention activities. While there is a clear fit between occupational therapy and primary care, there have been few practice examples, despite a growing body of evidence to support the role. In 2010, the province of Ontario, Canada provided funding to include occupational therapists as members of Family Health Teams, an interprofessional model of primary care. The integration of occupational therapists into this model of primary care is one of the first large scale initiatives of its kind in North America. The objective of the study was to examine how occupational therapy services are being integrated into primary care teams and understand the structures supporting the integration. Methods A multiple case study design was used to provide an in-depth description of the integration of occupational therapy. Four Family Health Teams with occupational therapists as part of the team were identified. Data collection included in-depth interviews, document analyses, and questionnaires. Results Each Family Health Team had a unique organizational structure that contributed to the integration of occupational therapy. Communication, trust and understanding of occupational therapy were key elements in the integration of occupational therapy into Family Health Teams, and were supported by a number of strategies including co-location, electronic medical records and team meetings. An understanding of occupational therapy was critical for integration into the team and physicians were less likely to understand the occupational therapy role than other health providers. Conclusion With an increased emphasis on interprofessional primary care, new professions will be integrated into primary healthcare teams. The study found that explicit strategies and structures are required to facilitate the integration of a new professional group. An understanding of professional roles, trust and communication are foundations for interprofessional collaborative practice. PMID:23679667

  8. Designing a primary science curriculum in a globalizing world: How do social constructivism and Vietnamese culture meet?

    NASA Astrophysics Data System (ADS)

    Hằng, Ngô Vũ Thu; Meijer, Marijn Roland; Bulte, Astrid M. W.; Pilot, Albert

    2017-09-01

    The implementation of social constructivist approaches to learning science in primary education in Vietnamese culture as an example of Confucian heritage culture remains challenging and problematic. This theoretical paper focuses on the initial phase of a design-based research approach; that is, the description of the design of a formal, written curriculum for primary science education in which features of social constructivist approaches to learning are synthesized with essential aspects of Vietnamese culture. The written design comprises learning aims, a framework that is the synthesis of learning functions, learning settings and educational expectations for learning phases, and exemplary curriculum units. Learning aims are formulated to comprehensively develop scientific knowledge, skills, and attitudes toward science for primary students. Derived from these learning aims, the designed framework consists of four learning phases respectively labeled as Engagement, Experience, Exchange, and Follow-up. The designed framework refers to knowledge of the "nature of science" education and characteristics of Vietnamese culture as an example of Confucian heritage culture. The curriculum design aims to serve as an educational product that addresses previously analyzed problems of primary science education in the Vietnamese culture in a globalizing world.

  9. Connecting the Dots and Merging Meaning: Using Mixed Methods to Study Primary Care Delivery Transformation

    PubMed Central

    Scammon, Debra L; Tomoaia-Cotisel, Andrada; Day, Rachel L; Day, Julie; Kim, Jaewhan; Waitzman, Norman J; Farrell, Timothy W; Magill, Michael K

    2013-01-01

    Objective. To demonstrate the value of mixed methods in the study of practice transformation and illustrate procedures for connecting methods and for merging findings to enhance the meaning derived. Data Source/Study Setting. An integrated network of university-owned, primary care practices at the University of Utah (Community Clinics or CCs). CC has adopted Care by Design, its version of the Patient Centered Medical Home. Study Design. Convergent case study mixed methods design. Data Collection/Extraction Methods. Analysis of archival documents, internal operational reports, in-clinic observations, chart audits, surveys, semistructured interviews, focus groups, Centers for Medicare and Medicaid Services database, and the Utah All Payer Claims Database. Principal Findings. Each data source enriched our understanding of the change process and understanding of reasons that certain changes were more difficult than others both in general and for particular clinics. Mixed methods enabled generation and testing of hypotheses about change and led to a comprehensive understanding of practice change. Conclusions. Mixed methods are useful in studying practice transformation. Challenges exist but can be overcome with careful planning and persistence. PMID:24279836

  10. Architecture Studio Archive: A Case Study in the Comprehensive Digital Capture and Repository of Student Design Work as an Aid to Teaching, Research, and Accreditation

    ERIC Educational Resources Information Center

    Anderson, Ross; Arndell, Michael; Christensen, Sten

    2009-01-01

    The "Architecture Studio Archive" pilot sought to form a comprehensive digital archive of the diverse student work conducted in the first year of the Bachelor of Design in Architecture Degree at the University of Sydney. The design studio is the primary vehicle for teaching architectural design. It is a locus for creative activity, with…

  11. Orbit transfer vehicle engine study, phase A, extension 1: Volume 2: Study results

    NASA Technical Reports Server (NTRS)

    Mellish, J. A.

    1981-01-01

    Because of the advantage of the Advanced Expander Cycle Engine brought out in initial studies, further design optimization and comparative analyses were undertaken. The major results and conclusion derived are summarized. The primary areas covered are (1) thrust chamber geometry optimization, (2) expander cycle optimization, (3) alternate low thrust capability, (4) safety and reliability, (5) development risk comparison, and (6) cost comparisons. All of the results obtained were used to baseline the initial design concept for the OTV Advanced Expander Cycle Engine Point Design Study.

  12. The Practice of Continuous Assessment in Primary Schools: The Case of Chagni, Ethiopia

    ERIC Educational Resources Information Center

    Abejehu, Sintayehu Belay

    2016-01-01

    Continuous assessment is part and parcel of instructional process that has to be taken as a key tool in educational quality assurance endeavor. Thus, this article examined the actual practice of continuous assessment in primary schools of Chagni City Administration, Ethiopia. To address this purpose the study employed descriptive survey design.…

  13. Learning Science through Creating a "Slowmation": A Case Study of Preservice Primary Teachers

    ERIC Educational Resources Information Center

    Hoban, Garry; Nielsen, Wendy

    2013-01-01

    Many preservice primary teachers have inadequate science knowledge, which often limits their confidence in implementing the subject. This paper proposes a new way for preservice teachers to learn science by designing and making a narrated stop-motion animation as an instructional resource to explain a science concept. In this paper, a simplified…

  14. Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population

    USDA-ARS?s Scientific Manuscript database

    There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demo...

  15. Effects of Classroom-Based Energizers on Primary Grade Students' Physical Activity Levels

    ERIC Educational Resources Information Center

    Bailey, Catherine Goffreda; DiPerna, James Clyde

    2015-01-01

    The primary aim of this study was to determine the effects of classroom-based exercise breaks (Energizers; Mahar, Kenny, Shields, Scales, & Collins, 2006) on students' physical activity levels during the school day. A multiple baseline design across first grade (N = 3) and second grade (N = 3) classrooms was used to examine the effects of the…

  16. Quantitative Nuclease Protection Assays (qNPA) as Windows into Chemical-Induced Adaptive Response in Cultures of Primary Human Hepatocytes (Concentration and Time-Response)

    EPA Science Inventory

    Cultures of primary human hepatocytes have been shown to be dynamic in vitro model systems that retain liver-like functionality (e.g. metabolism, transport, induction). We have utilized these culture models to interrogate 309 ToxCast chemicals. The study design characterized both...

  17. The Real Life Application of Pulleys in a Competitive Environment

    ERIC Educational Resources Information Center

    Tekbiyik, Ahmet

    2015-01-01

    The aim of this research was to explore students' application of theoretical knowledge in real-life situations using pulley systems in a competition designed for primary school students. The study was conducted with 24 primary school students who had completed year seven, and who volunteered to participate in a summer science camp. In groups, the…

  18. Critical Perspectives on Free Primary Education in Kenya: Towards an Anti-Colonial Pedagogy

    ERIC Educational Resources Information Center

    Milu, Esther

    2013-01-01

    This paper is a reading of the "Free Primary Education" (FPE) policy in Kenya through the lenses of critical theory/pedagogy. The study critiques the National Alliance Rainbow Coalition (NARC) government for adoption of the Freirian banking model to design and implement the policy. The paper argues that such a model has ended up…

  19. Multimedia Scenario Based Learning Programme for Enhancing the English Language Efficiency among Primary School Students

    ERIC Educational Resources Information Center

    Tupe, Navnath

    2015-01-01

    This research was undertaken with a view to assess the deficiencies in English language among Primary School Children and to develop Multimedia Scenario Based Learning Programme (MSBLP) for mastery of English language which required special attention and effective treatment. The experimental study with pre-test, post-test control group design was…

  20. Evaluation of "Back to Basics" Mathematics Workbooks: A Randomised Control Trial of the Primary Mathematics Research Project

    ERIC Educational Resources Information Center

    Fleisch, Brahm; Taylor, Nick; Herholdt, Roelien; Sapire, Ingrid

    2011-01-01

    Can providing learner support materials, particularly custom-designed workbooks, improve primary mathematics achievement more cost effectively than providing conventional textbooks? To contribute to this debate, this paper reports on the findings of a study conducted in 2010 by a consortium of educational researchers at JET Education Services and…

  1. The Effects of Video Feedback Coaching for Teachers on Scientific Knowledge of Primary Students

    ERIC Educational Resources Information Center

    van Vondel, Sabine; Steenbeek, Henderien; van Dijk, Marijn; van Geert, Paul

    2018-01-01

    The present study was aimed at investigating the effects of a video feedback coaching intervention for upper-grade primary school teachers on students' cognitive gains in scientific knowledge. This teaching intervention was designed with the use of inquiry-based learning principles for teachers, such as the empirical cycle and the posing of…

  2. Academic Self-Concept and Achievement in Polish Primary Schools: Cross-Lagged Modelling and Gender-Specific Effects

    ERIC Educational Resources Information Center

    Grygiel, Pawel; Modzelewski, Michal; Pisarek, Jolanta

    2017-01-01

    This study reports relationships between general academic self-concept and achievement in grade 3 and grade 5. Gender-specific effects were investigated using a longitudinal, two-cycle, 3-year autoregressive cross-lagged panel design in a large, representative sample of Polish primary school pupils (N = 4,226). Analysis revealed (a) reciprocal…

  3. Cluster Supervision Practices in Primary School of Jimma Zone

    ERIC Educational Resources Information Center

    Afework, E. A.; Frew, A. T.; Abeya, G. G.

    2017-01-01

    The main objective of this study was to assess the supervisory practice of cluster resource centre (CRC) supervisors in Jimma Zone primary schools. To achieve this purpose, the descriptive survey design was employed. Data were collected from 238 randomly selected teachers, and 60 school principals with a response rate of 98.6%. Moreover, 12 CRC…

  4. A Longitudinal Analysis of Sex Differences in Math and Spatial Skills in Primary School Age Children

    ERIC Educational Resources Information Center

    Lachance, Jennifer A.; Mazzocco, Michele M. M.

    2006-01-01

    We report on a longitudinal study designed to assess possible sex differences in math achievement, math ability, and math-related tasks during the primary school age years. Participants included over 200 children from one public school district. Annual assessments included measures of math ability, math calculation achievement scores, rapid naming…

  5. Social Skills Scores: The Impact of Primary School Population Characteristics and Parental Involvement

    ERIC Educational Resources Information Center

    Dekker, Karien; Kamerling, Margje

    2017-01-01

    Purpose: The paper aims to examine to what extent and why parental involvement as well as characteristics of ethnic school population influence social skills scores (social position, behavioural skills) of students. Design/methodology/approach: The study used the COOL5-18 database (2010) that included 553 Dutch primary schools and nearly 38,000…

  6. A Case for Enhancing Environmental Education Programs in Schools: Reflecting on Primary School Students' Knowledge and Attitudes

    ERIC Educational Resources Information Center

    Treagust, David F.; Amarant, Arlene; Chandrasegaran, A. L.; Won, Mihye

    2016-01-01

    Environmental education in schools is of increasing importance as the world population increases with the subsequent demand on resources and the potential for increased pollution. In an effort to enhance the standing of environmental education in the school curriculum, this study was designed to determine primary students' knowledge about the…

  7. Development of Population-Based Resilience Measures in the Primary School Setting

    ERIC Educational Resources Information Center

    Sun, Jing; Stewart, Donald

    2007-01-01

    Purpose: The purpose of the population-based study in the paper is to report on progress in formulating instruments to measure children's resilience and associated protective factors in family, primary school and community contexts. Design/methodology/approach: In this paper a total of 2,794 students, 1,558 parents/caregivers, and 465 staff were…

  8. Children's Perceptions of Plants Following Their Visit to the Eden Project

    ERIC Educational Resources Information Center

    Bowker, Rob

    2004-01-01

    The study described is part of a larger research programme designed to investigate primary aged children's learning during a visit to the Eden Project. Children from eight primary schools were interviewed approximately four weeks after a one-day, teacher-led visit to the Eden Project (EP) in Cornwall. Their responses revealed that the children…

  9. Fluid design studies of integrated modular engine system

    NASA Technical Reports Server (NTRS)

    Frankenfield, Bruce; Carek, Jerry

    1993-01-01

    A study was performed to develop a fluid system design and show the feasibility of constructing an integrated modular engine (IME) configuration, using an expander cycle engine. The primary design goal of the IME configuration was to improve the propulsion system reliability. The IME fluid system was designed as a single fault tolerant system, while minimizing the required fluid components. This study addresses the design of the high pressure manifolds, turbopumps and thrust chambers for the IME configuration. A physical layout drawing was made, which located each of the fluid system components, manifolds and thrust chambers. Finally, a comparison was made between the fluid system designs of an IME system and a non-network (clustered) engine system.

  10. Trends in study design and the statistical methods employed in a leading general medicine journal.

    PubMed

    Gosho, M; Sato, Y; Nagashima, K; Takahashi, S

    2018-02-01

    Study design and statistical methods have become core components of medical research, and the methodology has become more multifaceted and complicated over time. The study of the comprehensive details and current trends of study design and statistical methods is required to support the future implementation of well-planned clinical studies providing information about evidence-based medicine. Our purpose was to illustrate study design and statistical methods employed in recent medical literature. This was an extension study of Sato et al. (N Engl J Med 2017; 376: 1086-1087), which reviewed 238 articles published in 2015 in the New England Journal of Medicine (NEJM) and briefly summarized the statistical methods employed in NEJM. Using the same database, we performed a new investigation of the detailed trends in study design and individual statistical methods that were not reported in the Sato study. Due to the CONSORT statement, prespecification and justification of sample size are obligatory in planning intervention studies. Although standard survival methods (eg Kaplan-Meier estimator and Cox regression model) were most frequently applied, the Gray test and Fine-Gray proportional hazard model for considering competing risks were sometimes used for a more valid statistical inference. With respect to handling missing data, model-based methods, which are valid for missing-at-random data, were more frequently used than single imputation methods. These methods are not recommended as a primary analysis, but they have been applied in many clinical trials. Group sequential design with interim analyses was one of the standard designs, and novel design, such as adaptive dose selection and sample size re-estimation, was sometimes employed in NEJM. Model-based approaches for handling missing data should replace single imputation methods for primary analysis in the light of the information found in some publications. Use of adaptive design with interim analyses is increasing after the presentation of the FDA guidance for adaptive design. © 2017 John Wiley & Sons Ltd.

  11. Tissue Engineering Platforms to Replicate the Tumor Microenvironment of Multiple Myeloma.

    PubMed

    Zhang, Wenting; Lee, Woo Y; Zilberberg, Jenny

    2017-01-01

    We described here the manufacturing and implementation of two prototype perfusion culture devices designed primarily for the cultivation of difficult-to-preserve primary patient-derived multiple myeloma cells (MMC). The first device consists of an osteoblast (OSB)-derived 3D tissue scaffold constructed in a perfused microfluidic environment. The second platform is a 96-well plate-modified perfusion culture device that can be utilized to reconstruct several tissue and tumor microenvironments utilizing both primary human and murine cells. This culture device was designed and fabricated specifically to: (1) enable the preservation of primary MMC for downstream use in biological studies and chemosensitivity analyses and, (2) provide a high-throughput format that is compatible with plate readers specifically seeing that this system is built on an industry standard 96-well tissue culture plate.

  12. University of Texas 7.6 meter telescope project

    NASA Astrophysics Data System (ADS)

    Barnes, T. G., III

    1982-10-01

    The University of Texas very large optical telescope design is fundamentally constrained by the requirements of completion by the late 1980s and costs within the range of private philanthropy. In light of these requirements, design studies indicate that the largest possible telescope must incorporate as its essential features a monolithic, 7.6-m diameter primary mirror constructed as either an ultrathin fused silica meniscus (of 10-15 cm thickness) or a borosilicate glass honeycomb (of classical thickness). This primary mirror would be of f/2 Ritchley-Chretien geometry. Light would be relayed from the primary to two f/13.5 Nasmyth foci. The mount would be of alt-azimuth type, housed in a building similar to that employed by the Multiple Mirror Telescope with an adjacent annex containing the mirror aluminizing chamber.

  13. Primary Surgery vs Radiotherapy for Early Stage Oral Cavity Cancer.

    PubMed

    Ellis, Mark A; Graboyes, Evan M; Wahlquist, Amy E; Neskey, David M; Kaczmar, John M; Schopper, Heather K; Sharma, Anand K; Morgan, Patrick F; Nguyen, Shaun A; Day, Terry A

    2018-04-01

    Objective The goal of this study is to determine the effect of primary surgery vs radiotherapy (RT) on overall survival (OS) in patients with early stage oral cavity squamous cell carcinoma (OCSCC). In addition, this study attempts to identify factors associated with receiving primary RT. Study Design Retrospective cohort study. Setting National Cancer Database (NCDB, 2004-2013). Subjects and Methods Reviewing the NCDB from 2004 to 2013, patients with early stage I to II OCSCC were identified. Kaplan-Meier estimates of survival, Cox regression analysis, and propensity score matching were used to examine differences in OS between primary surgery and primary RT. Multivariable logistic regression analysis was performed to identify factors associated with primary RT. Results Of the 20,779 patients included in the study, 95.4% (19,823 patients) underwent primary surgery and 4.6% (956 patients) underwent primary RT. After adjusting for covariates, primary RT was associated with an increased risk of mortality (adjusted hazard ratio [aHR], 1.97; 99% confidence interval [CI], 1.74-2.22). On multivariable analysis, factors associated with primary RT included age ≥70 years, black race, Medicaid or Medicare insurance, no insurance, oral cavity subsite other than tongue, clinical stage II disease, low-volume treatment facilities, and earlier treatment year. Conclusion Primary RT for early stage OCSCC is associated with increased mortality. Approximately 5% of patients receive primary RT; however, this percentage is decreasing. Patients at highest risk for receiving primary RT include those who are elderly, black, with public insurance, and treated at low-volume facilities.

  14. Large Advanced Space Systems (LASS) computer-aided design program additions

    NASA Technical Reports Server (NTRS)

    Farrell, C. E.

    1982-01-01

    The LSS preliminary and conceptual design requires extensive iteractive analysis because of the effects of structural, thermal, and control intercoupling. A computer aided design program that will permit integrating and interfacing of required large space system (LSS) analyses is discussed. The primary objective of this program is the implementation of modeling techniques and analysis algorithms that permit interactive design and tradeoff studies of LSS concepts. Eight software modules were added to the program. The existing rigid body controls module was modified to include solar pressure effects. The new model generator modules and appendage synthesizer module are integrated (interfaced) to permit interactive definition and generation of LSS concepts. The mass properties module permits interactive specification of discrete masses and their locations. The other modules permit interactive analysis of orbital transfer requirements, antenna primary beam n, and attitude control requirements.

  15. Rationale, design and methods of the HEALTHY study behavior intervention component

    USDA-ARS?s Scientific Manuscript database

    HEALTHY was a multi-center primary prevention trial designed to reduce risk factors for type 2 diabetes in adolescents. Seven centers each recruited six middle schools that were randomized to either intervention or control. The HEALTHY intervention integrated multiple components in nutrition, physic...

  16. Nonlinear and adaptive control

    NASA Technical Reports Server (NTRS)

    Athans, Michael

    1989-01-01

    The primary thrust of the research was to conduct fundamental research in the theories and methodologies for designing complex high-performance multivariable feedback control systems; and to conduct feasibiltiy studies in application areas of interest to NASA sponsors that point out advantages and shortcomings of available control system design methodologies.

  17. Development and Validation of the Primary Care Team Dynamics Survey

    PubMed Central

    Song, Hummy; Chien, Alyna T; Fisher, Josephine; Martin, Julia; Peters, Antoinette S; Hacker, Karen; Rosenthal, Meredith B; Singer, Sara J

    2015-01-01

    Objective To develop and validate a survey instrument designed to measure team dynamics in primary care. Data Sources/Study Setting We studied 1,080 physician and nonphysician health care professionals working at 18 primary care practices participating in a learning collaborative aimed at improving team-based care. Study Design We developed a conceptual model and administered a cross-sectional survey addressing team dynamics, and we assessed reliability and discriminant validity of survey factors and the overall survey's goodness-of-fit using structural equation modeling. Data Collection We administered the survey between September 2012 and March 2013. Principal Findings Overall response rate was 68 percent (732 respondents). Results support a seven-factor model of team dynamics, suggesting that conditions for team effectiveness, shared understanding, and three supportive processes are associated with acting and feeling like a team and, in turn, perceived team effectiveness. This model demonstrated adequate fit (goodness-of-fit index: 0.91), scale reliability (Cronbach's alphas: 0.71–0.91), and discriminant validity (average factor correlations: 0.49). Conclusions It is possible to measure primary care team dynamics reliably using a 29-item survey. This survey may be used in ambulatory settings to study teamwork and explore the effect of efforts to improve team-based care. Future studies should demonstrate the importance of team dynamics for markers of team effectiveness (e.g., work satisfaction, care quality, clinical outcomes). PMID:25423886

  18. Engaging Foreign Curriculum Experts in Curriculum Design: A Case Study of Primary School Curriculum Change in Lesotho

    ERIC Educational Resources Information Center

    Nhlapo, Molise David; Maharajh, Lokesh Ramnath

    2017-01-01

    Involvement of foreign consultants in the Lesotho curriculum design has been in operation since the beginning of formal education around 1833 in the country to-date. The expectation was that, with time, Lesotho would produce enough quality curriculum specialists who would be entrusted with the task of curriculum design. However, the trained…

  19. Providing Guidance in Virtual Lab Experimentation: The Case of an Experiment Design Tool

    ERIC Educational Resources Information Center

    Efstathiou, Charalampos; Hovardas, Tasos; Xenofontos, Nikoletta A.; Zacharia, Zacharias C.; deJong, Ton; Anjewierden, Anjo; van Riesen, Siswa A. N.

    2018-01-01

    The present study employed a quasi-experimental design to assess a computer-based tool, which was intended to scaffold the task of designing experiments when using a virtual lab for the process of experimentation. In particular, we assessed the impact of this tool on primary school students' cognitive processes and inquiry skills before and after…

  20. Design and Usability Testing of an mHealth Application for Midwives in Rural Ghana

    ERIC Educational Resources Information Center

    Velez, Olivia

    2011-01-01

    Midwives in Ghana provide the majority of rural primary and maternal healthcare services, but have limited access to data for decision making and knowledge work. Few mobile health (mHealth) applications have been designed for midwives. The study purpose was to design and test an mHealth application (mClinic) that can improve data access and reduce…

  1. A Youth-Led, Social Marketing Intervention Run by Adolescents to Encourage Healthy Lifestyles among Younger School Peers (EYTO-Kids Project): A Protocol for Pilot Cluster Randomized Controlled Trial (Spain)

    PubMed Central

    Aceves-Martins, Magaly; Papell-Garcia, Ignasi; Arola, Lluís; Giralt, Montse; Solà, Rosa

    2017-01-01

    Introduction: The EYTO-kids (European Youth Tackling Obesity in Adolescents and Children) study aims to increase fruit and/or vegetable consumption and physical activity, decrease sedentary lifestyles, and reduce the intake of sugary drinks and fast food using an innovative methodology based on social marketing and youth involvement. Methods: This study is a pilot school-based cluster randomized controlled 10-month intervention spanning two academic years (2015–2016 and 2016–2017), with eight primary schools and three high schools randomized into and designated the control group and eight primary schools and four high schools designated the intervention group in Reus, Spain. At least 301 younger school peers per group should be included. At the intervention high schools, the adolescent creators (ACs) receive an initial 16-h training session. In total, 26–32 high school ACs (12–14 years) from the four high schools will design and implement four health-promotion activities (1 h/each) for their younger (8–10 years), primary school peers. The control group will not receive any intervention. The outcomes (fruit, vegetable, fast food and sugary drink consumption; physical activity; and sedentary behaviors) of the control and intervention groups will be measured pre- and post-intervention. Conclusion: This study describes a protocol for pilot, peer-led, social marketing and youth-involved intervention, where adolescents design and implement activities for their younger peers to promote healthy lifestyles.

  2. The Effect of Process Oriented Writing Activities on the Achievement and Attitude of the Preservice Primary School Teachers: An Example of Mixed Method Study

    ERIC Educational Resources Information Center

    Özenç, Emine Gül

    2016-01-01

    The purpose of this study is to find out whether process oriented writing exercises/activities have any effect on the achievement and attitude of preservice teachers as well as to set forth the opinions of primary preservice teachers on process oriented writing approach. In the research one classroom was designated as experimental group (N = 35)…

  3. Fiberglass distribution poles: A case study

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

    Miller, M.F.; Hosford, G.S.; Boozer, J.F. III

    1995-01-01

    This paper addresses the design considerations and manufacturing techniques along with mechanical test results of fiberglass reinforced composite (FRC) primary distribution poles. With it`s light weight, and virtually no maintenance it offers a viable alternative for use in remote and inaccessible locations. This paper also discusses a case study where seventy five FRC primary distribution poles have been installed on a distribution system in a remote area accessible only by foot and helicopter.

  4. Anthropometric study of Mexican primary school children.

    PubMed

    Prado-León, L R; Avila-Chaurand, R; González-Muñoz, E L

    2001-08-01

    This paper presents the results of an anthropometric survey conducted on male and female Mexican primary school children age 6-11 years in the metropolitan area of the city of Guadalajara. A set of 50 body dimensions was taken based on international standards. The sample consisted of 4758 children (boys and girls). The anthropometric measurements were compared to those of American, Cuban and Mexican children. The results indicate that the body dimensions of Mexican children from this study are different from those of American, Cuban, and other Mexican children, probably due to ethnic differences and the time lapse between the different studies. It is considered that the 50 parameters are necessary for the design of school furniture, fittings and equipment in order to minimize musculoskeletal, visual, and circulatory problems resulting from using those badly designed elements.

  5. A primary-school-based study to reduce prevalence of childhood obesity in Catalunya (Spain) - EDAL-Educació en alimentació: study protocol for a randomised controlled trial

    PubMed Central

    2011-01-01

    Background The EdAL (Educació en Alimentació) study is a long-term, nutrition educational, primary-school-based program designed to prevent obesity by promoting a healthy lifestyle that includes dietary recommendations and physical activity. The aims are: 1) to evaluate the effects of a 3-year school-based life-style improvement program on the prevalence of obesity in an area of north-west Mediterranean 2) To design a health-promotion program to be implemented by health-promoter agents (university students) in primary schools. Methods/Design 1) The intervention study is a randomised, controlled, school-based program performed by university-student health-promoter agents. Initial pupil enrolment was in 2006 and continued for 3 years. We considered two clusters (designated as cluster A and cluster B) as the units for randomisation. The first cluster involved 24 schools from Reus and the second involved 14 schools from surrounding towns Cambrils, Salou and Vilaseca combined in order to obtain comparable groups. There are very good communications between schools in each town, and to avoid cross influence of the programs resulting from inter-school dialogue, the towns themselves were the unit for randomisation. Data collected included name, gender, date and place of birth at the start of the program and, subsequently, weight, height, body mass index (BMI) and waist circumference every year for 3 years. Questionnaires on eating and physical activity habits are filled-in by the parents at the start and end of the study and, providing that informed consent is given, the data are analysed on the intention-to-treat basis. The interventions are based on 8 nutritional and physical activity objectives. They are implemented by university students as part of the university curriculum in training health-promoter agents. These 8 objectives are developed in 4 educational activities/year for 3 years (a total of 12 activities; 1 h/activity) performed by the health-promoter agents in primary schools. Control pupils follow their usual activities. 2) Courses on education and promotion of health, within in the curriculum of medicine and health sciences for university students, are designed to train health-promoter agents to administer these activities in primary schools. Discussion This controlled school-based intervention will test the possibility of preventing childhood obesity. Trial registration number ISRCTN: ISRCTN29247645 PMID:21352597

  6. The Relationship between Teacher Training, Intervention Strategies, and Students' Academic Achievement in the Classroom with K-5 ADHD Students

    ERIC Educational Resources Information Center

    Cooper, Nancy A.

    2014-01-01

    The primary intent of this study was to explore the effect between teachers' training, intervention strategies, and the academic achievement of K-5 ADHD students. The study design employed a mixed research design. The quantitative method focused on collecting data from certified regular and special-education teachers. Additionally, effects were…

  7. Space Tug Point Design Study. Volume 3: Design Definition. Part 2: Insulation, Meteoroid Protection, Structures, Mass Properties, GSE, Reliability and Safety

    NASA Technical Reports Server (NTRS)

    1973-01-01

    A study was conducted to determine the configuration and performance of a space tug. Detailed descriptions of the insulation, meteoroid protection, primary structure, and ground support equipment are presented. Technical assessments leading to the concept selection are analyzed. The tug mass properties, reliability, and safety assessments are included.

  8. Errors Made by Elementary Fourth Grade Students When Modelling Word Problems and the Elimination of Those Errors through Scaffolding

    ERIC Educational Resources Information Center

    Ulu, Mustafa

    2017-01-01

    This study aims to identify errors made by primary school students when modelling word problems and to eliminate those errors through scaffolding. A 10-question problem-solving achievement test was used in the research. The qualitative and quantitative designs were utilized together. The study group of the quantitative design comprises 248…

  9. Themes and methods of research presented at European General Practice Research Network conferences.

    PubMed

    Kruschinski, Carsten; Lange, Maaike; Lionis, Christos; van Weel, Chris; Hummers-Pradier, Eva

    2010-08-01

    The World Organization of Family Doctors (Wonca) defined core characteristics of general practice and general practitioners' competencies. It is unclear to which extent research has addressed these issues so far. To determine themes and research methods of general practice research as reflected by presentations at the European General Practice Research Network (EGPRN) meetings. Descriptive and retrospective study. All abstracts presented at each of the 14 EGPRN conferences between June 2001 and October 2007 were analysed for content and study design/methodology. Categories for content were developed inductively; a predefined hierarchical scheme was used for study designs. A total of N=614 abstracts were classified. The main research topics were related to GP/health service issues (n=232), clinical (n=148) and patient-related themes (n=118). Original data (n=558) were mainly derived from cross-sectional designs (38.7%). Intervention studies (11.0%), longitudinal designs including case-control and cohort studies (13.3%) as well as instrumental research (2.2%) were less common. More than one-fourth of all original studies were qualitative studies (27.6%). Stratified analysis revealed that cross-sectional designs were less frequent in the second half of conferences. Analysis by country showed that, in contrast to different quantitative designs, the proportion of qualitative studies was comparable. To test effectiveness of diagnostic and therapeutic interventions under primary care conditions, a higher proportion of experimental studies would be preferable. This could increase the acceptance of general practitioners' specific approaches and provide clear guidance on approaches and procedures, especially in health care systems not predominantly based on primary care.

  10. Evaluating the primary and ready biodegradability of dianilinodithiophosphoric acid.

    PubMed

    Lin, Weixiong; Sun, Shuiyu; Xu, Pingting; Dai, Yongkang; Ren, Jie

    2016-04-01

    Dianilinodithiophosphoric acid (DDA) is widely used as sulfide mineral flotation collector in China. It is necessary to investigate the biodegradability of DDA to provide the fundamental knowledge to assess the environmental fate in the risk assessment of DDA and to design and operate the DDA flotation wastewater biological treatment plant. In the present study, the primary and ready aerobic biodegradations of DDA were studied and the primary biodegradation kinetic model of DDA was developed. The results show that DDA displays a good primary biodegradability and its biodegradation ratio reaches 99.8 % in 7 days. In contrast, DDA is not easily ready biodegradable; hence, it is a partially biodegradable organic compound. The primary aerobic biodegradation kinetics can be described using the first-order reaction kinetics equation: C = 19.72191e(-0.01513t).

  11. Observational Studies: Cohort and Case-Control Studies

    PubMed Central

    Song, Jae W.; Chung, Kevin C.

    2010-01-01

    Observational studies are an important category of study designs. To address some investigative questions in plastic surgery, randomized controlled trials are not always indicated or ethical to conduct. Instead, observational studies may be the next best method to address these types of questions. Well-designed observational studies have been shown to provide results similar to randomized controlled trials, challenging the belief that observational studies are second-rate. Cohort studies and case-control studies are two primary types of observational studies that aid in evaluating associations between diseases and exposures. In this review article, we describe these study designs, methodological issues, and provide examples from the plastic surgery literature. PMID:20697313

  12. The Effect of Iteration on the Design Performance of Primary School Children

    ERIC Educational Resources Information Center

    Looijenga, Annemarie; Klapwijk, Remke; de Vries, Marc J.

    2015-01-01

    Iteration during the design process is an essential element. Engineers optimize their design by iteration. Research on iteration in Primary Design Education is however scarce; possibly teachers believe they do not have enough time for iteration in daily classroom practices. Spontaneous playing behavior of children indicates that iteration fits in…

  13. Contemporary Primary Science Curricula in the United Kingdom

    ERIC Educational Resources Information Center

    Henry, John A.

    1976-01-01

    Following a review of the impact of Piaget's theories of cognitive development on science curriculum design, the evolution and development of the Science 5/13 Project, designed to extend the work of Nuffield Junior Science Project, is described. Evaluation studies assessing the aims and objectives of this project are detailed. (BT)

  14. Designing Digital Problem Based Learning Tasks that Motivate Students

    ERIC Educational Resources Information Center

    van Loon, Anne-Marieke; Ros, Anje; Martens, Rob

    2013-01-01

    This study examines whether teachers are able to apply the principles of autonomy support and structure support in designing digital problem based learning (PBL) tasks. We examine whether these tasks are more autonomy- and structure-supportive and whether primary and secondary school students experience greater autonomy, competence, and motivation…

  15. A Graphics Design Framework to Visualize Multi-Dimensional Economic Datasets

    ERIC Educational Resources Information Center

    Chandramouli, Magesh; Narayanan, Badri; Bertoline, Gary R.

    2013-01-01

    This study implements a prototype graphics visualization framework to visualize multidimensional data. This graphics design framework serves as a "visual analytical database" for visualization and simulation of economic models. One of the primary goals of any kind of visualization is to extract useful information from colossal volumes of…

  16. A primary-school-based study to reduce prevalence of childhood obesity in Catalunya (Spain)--EDAL-Educació en alimentació: study protocol for a randomised controlled trial.

    PubMed

    Giralt, Montse; Albaladejo, Rosa; Tarro, Lucia; Moriña, David; Arija, Victoria; Solà, Rosa

    2011-02-27

    The EdAL (Educació en Alimentació) study is a long-term, nutrition educational, primary-school-based program designed to prevent obesity by promoting a healthy lifestyle that includes dietary recommendations and physical activity.The aims are: 1) to evaluate the effects of a 3-year school-based life-style improvement program on the prevalence of obesity in an area of north-west Mediterranean 2) To design a health-promotion program to be implemented by health-promoter agents (university students) in primary schools. 1) The intervention study is a randomised, controlled, school-based program performed by university-student health-promoter agents. Initial pupil enrolment was in 2006 and continued for 3 years. We considered two clusters (designated as cluster A and cluster B) as the units for randomisation. The first cluster involved 24 schools from Reus and the second involved 14 schools from surrounding towns Cambrils, Salou and Vilaseca combined in order to obtain comparable groups. There are very good communications between schools in each town, and to avoid cross influence of the programs resulting from inter-school dialogue, the towns themselves were the unit for randomisation. Data collected included name, gender, date and place of birth at the start of the program and, subsequently, weight, height, body mass index (BMI) and waist circumference every year for 3 years. Questionnaires on eating and physical activity habits are filled-in by the parents at the start and end of the study and, providing that informed consent is given, the data are analysed on the intention-to-treat basis.The interventions are based on 8 nutritional and physical activity objectives. They are implemented by university students as part of the university curriculum in training health-promoter agents. These 8 objectives are developed in 4 educational activities/year for 3 years (a total of 12 activities; 1 h/activity) performed by the health-promoter agents in primary schools. Control pupils follow their usual activities.2) Courses on education and promotion of health, within in the curriculum of medicine and health sciences for university students, are designed to train health-promoter agents to administer these activities in primary schools. This controlled school-based intervention will test the possibility of preventing childhood obesity. ISRCTN: ISRCTN29247645.

  17. A randomised controlled trial on hypnotherapy for irritable bowel syndrome: design and methodological challenges (the IMAGINE study).

    PubMed

    Flik, Carla E; van Rood, Yanda R; Laan, Wijnand; Smout, André Jpm; Weusten, Bas Lam; Whorwell, Peter J; de Wit, Niek J

    2011-12-20

    Irritable Bowel Syndrome (IBS) is a common gastro-intestinal disorder in primary and secondary care, characterised by abdominal pain, discomfort, altered bowel habits and/or symptoms of bloating and distension. In general the efficacy of drug therapies is poor. Hypnotherapy as well as Cognitive Behaviour Therapy and short Psychodynamic Therapy appear to be useful options for patients with refractory IBS in secondary care and are cost-effective, but the evidence is still limited. The IMAGINE-study is therefore designed to assess the overall benefit of hypnotherapy in IBS as well as comparing the efficacy of individual versus group hypnotherapy in treating this condition. The design is a randomised placebo-controlled trial. The study group consists of 354 primary care and secondary care patients (aged 18-65) with IBS (Rome-III criteria). Patients will be randomly allocated to either 6 sessions of individual hypnotherapy, 6 sessions of group hypnotherapy or 6 sessions of educational supportive therapy in a group (placebo), with a follow up of 9 months post treatment for all patients. Ten hospitals and four primary care psychological practices in different parts of The Netherlands will collaborate in this study. The primary efficacy parameter is the responder rate for adequate relief of IBS symptoms. Secondary efficacy parameters are changes in the IBS symptom severity, quality of life, cognitions, psychological complaints, self-efficacy as well as direct and indirect costs of the condition. Hypnotherapy is expected to be more effective than the control therapy, and group hypnotherapy is expected not to be inferior to individual hypnotherapy. If hypnotherapy is effective and if there is no difference in efficacy between individual and group hypnotherapy, this group form of treatment could be offered to more IBS patients, at lower costs. ISRCTN: ISRCTN22888906.

  18. Factors contributing to the effectiveness of physical activity counselling in primary care: a realist systematic review.

    PubMed

    Gagliardi, Anna R; Abdallah, Flavia; Faulkner, Guy; Ciliska, Donna; Hicks, Audrey

    2015-04-01

    Physical activity (PA) counselling in primary care increases PA but is not consistently practiced. This study examined factors that optimise the delivery and impact of PA counselling. A realist systematic review based on the PRECEDE-PROCEED model and RAMESES principles was conducted to identify essential components of PA counselling. MEDLINE, EMBASE, Cochrane Library, PsycINFO, and Physical Education Index were searched from 2000 to 2013 for studies that evaluated family practice PA counselling. Of 1546 articles identified, 10 were eligible for review (3 systematic reviews, 5 randomised controlled trials, 2 observational studies). Counselling provided by clinicians or counsellors alone that explored motivation increased self-reported PA at least 12 months following intervention. Multiple sessions may sustain increased PA beyond 12 months. Given the paucity of eligible studies and limited detail reported about interventions, further research is needed to establish the optimal design and delivery of PA counselling. Research and planning should consider predisposing, reinforcing and enabling design features identified in these studies. Since research shows that PA counselling promotes PA but is not widely practiced, primary care providers will require training and tools to operationalize PA counselling. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Continuous Trailing-Edge Flaps for Primary Flight Control of a Helicopter Main Rotor

    NASA Technical Reports Server (NTRS)

    Thornburgh, Robert P.; Kreshock, Andrew R.; Wilbur, Matthew L.; Sekula, Martin K.; Shen, Jinwei

    2014-01-01

    The use of continuous trailing-edge flaps (CTEFs) for primary flight control of a helicopter main rotor is studied. A practical, optimized bimorph design with Macro-Fiber Composite actuators is developed for CTEF control, and a coupled structures and computational fluid dynamics methodology is used to study the fundamental behavior of an airfoil with CTEFs. These results are used within a comprehensive rotorcraft analysis model to study the control authority requirements of the CTEFs when utilized for primary flight control of a utility class helicopter. A study of the effect of blade root pitch index (RPI) on CTEF control authority is conducted, and the impact of structural and aerodynamic model complexity on the comprehensive analysis results is presented. The results show that primary flight control using CTEFs is promising; however, a more viable option may include the control of blade RPI, as well.

  20. Simulation of the thermal performance of a hybrid solar-assisted ground-source heat pump system in a school building

    NASA Astrophysics Data System (ADS)

    Androulakis, N. D.; Armen, K. G.; Bozis, D. A.; Papakostas, K. T.

    2018-04-01

    A hybrid solar-assisted ground-source heat pump (SAGSHP) system was designed, in the frame of an energy upgrade study, to serve as a heating system in a school building in Greece. The main scope of this study was to examine techniques to reduce the capacity of the heating equipment and to keep the primary energy consumption low. Simulations of the thermal performance of both the building and of five different heating system configurations were performed by using the TRNSYS software. The results are presented in this work and show that the hybrid SAGSHP system displays the lower primary energy consumption among the systems examined. A conventional ground-source heat pump system has the same primary energy consumption, while the heat pump's capacity is double and the ground heat exchanger 2.5 times longer. This work also highlights the contribution of simulation tools to the design of complex heating systems with renewable energy sources.

  1. Influencing Intended Teaching Practice: Exploring pre-service teachers' perceptions of science teaching resources

    NASA Astrophysics Data System (ADS)

    Cooper, Grant; Kenny, John; Fraser, Sharon

    2012-08-01

    Many researchers have identified and expressed concern over the state of science education internationally, but primary teachers face particular obstacles when teaching science due to their poor science background and low confidence with science. Research has suggested that exemplary resources, or units that work, may be an effective way to support primary teachers. This study explores the effect of one such resource on the intentions of pre-service primary teachers to teach science. The resource in question is Primary Connections, a series of learning resources produced by the Australian Academy of Science specifically designed for primary science. Evaluative studies of Primary Connections have indicated its efficacy with practising primary teachers but there is little evidence of its impact upon pre-service teachers. The purpose of this study was to investigate how effective these quality teaching resources were in influencing the intentions of primary pre-service teachers to teach science after they graduated. The theory of planned behaviour highlighted the linkage between the intentions of the pre-service teachers to teach science, and their awareness of and experiences with using Primary Connections during their education studies. This enabled key factors to be identified which influenced the intentions of the pre-service teachers to use Primary Connections to teach science after they graduate. The study also provided evidence of how quality science teaching resources can be effectively embedded in a teacher education programme as a means of encouraging and supporting pre-service teachers to teach science.

  2. A qualitative study of the relationship between clinician attributes, organization, and patient characteristics on implementation of a disease management program.

    PubMed

    Brazil, Kevin; Cloutier, Michelle M; Tennen, Howard; Bailit, Howard; Higgins, Pamela S

    2008-04-01

    The purpose of this study was to examine the challenges of integrating an asthma disease management (DM) program into a primary care setting from the perspective of primary care practitioners. A second goal was to examine whether barriers differed between urban-based and nonurban-based practices. Using a qualitative design, data were gathered using focus groups in primary care pediatric practices. A purposeful sample included an equal number of urban and nonurban practices. Participants represented all levels in the practice setting. Important themes that emerged from the data were coded and categorized. A total of 151 individuals, including physicians, advanced practice clinicians, registered nurses, other medical staff, and nonmedical staff participated in 16 focus groups that included 8 urban and 8 nonurban practices. Content analyses identified 4 primary factors influencing the implementation of a DM program in a primary care setting. They were related to providers, the organization, patients, and characteristics of the DM program. This study illustrates the complexity of the primary care environment and the challenge of changing practice in these settings. The results of this study identified areas in a primary care setting that influence the adoption of a DM program. These findings can assist in identifying effective strategies to change clinical behavior in primary care practices.

  3. A study protocol testing the implementation, efficacy, and cost effectiveness of the ezParent program in pediatric primary care

    PubMed Central

    Schoeny, Michael; Risser, Heather; Johnson, Tricia

    2016-01-01

    Introduction Up to 20% of children demonstrate behavior problems that interfere with relationship development and academic achievement. Parent participation in behavioral parent training programs has been shown to decrease child problem behaviors and promote positive parent-child relationships. However, attendance and parent involvement in face-to-face parent training remain low. Testing the implementation, efficacy, and cost of alternative delivery models is needed to (a) increase the reach and sustainability of parent training interventions and (b) address the barriers to parent participation and implementation of such programs, specifically in primary health care settings. The purpose of this paper is to describe the study protocol evaluating the implementation, efficacy, and cost-effectiveness of delivering the tablet-based ezParent program in pediatric primary care sites. Methods The implementation of the ezParent in four pediatric primary care sites will be evaluated using a descriptive design and cost-effectiveness analysis. The efficacy of the ezParent will be tested using a randomized controlled trial design with 312 parents of 2 to 5 year old children from pediatric primary care settings. Data on parenting and child behavior outcomes will be obtained from all participants at baseline, and 3, 6, and 12 months post baseline. Discussion Integrating and evaluating the implementation of the ezParent in pediatric primary care is an innovative opportunity to promote positive parenting with potential for universal access to the preschool population and for low cost by building on existing infrastructure in pediatric primary care. PMID:27592122

  4. Study Heterogeneity and Estimation of Prevalence of Primary Aldosteronism: A Systematic Review and Meta-Regression Analysis.

    PubMed

    Käyser, Sabine C; Dekkers, Tanja; Groenewoud, Hans J; van der Wilt, Gert Jan; Carel Bakx, J; van der Wel, Mark C; Hermus, Ad R; Lenders, Jacques W; Deinum, Jaap

    2016-07-01

    For health care planning and allocation of resources, realistic estimation of the prevalence of primary aldosteronism is necessary. Reported prevalences of primary aldosteronism are highly variable, possibly due to study heterogeneity. Our objective was to identify and explain heterogeneity in studies that aimed to establish the prevalence of primary aldosteronism in hypertensive patients. PubMed, EMBASE, Web of Science, Cochrane Library, and reference lists from January 1, 1990, to January 31, 2015, were used as data sources. Description of an adult hypertensive patient population with confirmed diagnosis of primary aldosteronism was included in this study. Dual extraction and quality assessment were the forms of data extraction. Thirty-nine studies provided data on 42 510 patients (nine studies, 5896 patients from primary care). Prevalence estimates varied from 3.2% to 12.7% in primary care and from 1% to 29.8% in referral centers. Heterogeneity was too high to establish point estimates (I(2) = 57.6% in primary care; 97.1% in referral centers). Meta-regression analysis showed higher prevalences in studies 1) published after 2000, 2) from Australia, 3) aimed at assessing prevalence of secondary hypertension, 4) that were retrospective, 5) that selected consecutive patients, and 6) not using a screening test. All studies had minor or major flaws. This study demonstrates that it is pointless to claim low or high prevalence of primary aldosteronism based on published reports. Because of the significant impact of a diagnosis of primary aldosteronism on health care resources and the necessary facilities, our findings urge for a prevalence study whose design takes into account the factors identified in the meta-regression analysis.

  5. Physicians' perception of alternative displays of clinical research evidence for clinical decision support - A study with case vignettes.

    PubMed

    Slager, Stacey L; Weir, Charlene R; Kim, Heejun; Mostafa, Javed; Del Fiol, Guilherme

    2017-07-01

    To design alternate information displays that present summaries of clinical trial results to clinicians to support decision-making; and to compare the displays according to efficacy and acceptability. A 6-between (information display presentation order) by 3-within (display type) factorial design. Two alternate displays were designed based on Information Foraging theory: a narrative summary that reduces the content to a few sentences; and a table format that structures the display according to the PICO (Population, Intervention, Comparison, Outcome) framework. The designs were compared with the summary display format available in PubMed. Physicians were asked to review five clinical studies retrieved for a case vignette; and were presented with the three display formats. Participants were asked to rate their experience with each of the information displays according to a Likert scale questionnaire. Twenty physicians completed the study. Overall, participants rated the table display more highly than either the text summary or PubMed's summary format (5.9vs. 5.4vs. 3.9 on a scale between 1 [strongly disagree] and 7 [strongly agree]). Usefulness ratings of seven pieces of information, i.e. patient population, patient age range, sample size, study arm, primary outcome, results of primary outcome, and conclusion, were high (average across all items=4.71 on a 1 to 5 scale, with 1=not at all useful and 5=very useful). Study arm, primary outcome, and conclusion scored the highest (4.9, 4.85, and 4.85 respectively). Participants suggested additional details such as rate of adverse effects. The table format reduced physicians' perceived cognitive effort when quickly reviewing clinical trial information and was more favorably received by physicians than the narrative summary or PubMed's summary format display. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Pupils' Environmental Awareness and Knowledge: A Springboard for Action in Primary Schools in Kenya's Rift Valley

    ERIC Educational Resources Information Center

    Mutisya, Sammy M.; Barker, Miles

    2011-01-01

    This study was carried out with 276 standard eight pupils in eleven primary schools in the rural town of Narok in Kenya's Rift Valley. It evaluated their awareness of key environmental issues in their local area and their knowledge about the causes, effects and solutions pertaining to these environmental issues. A descriptive research design was…

  7. An Evaluation of Two Approaches for Teaching Reading Comprehension Strategies in the Primary Years Using Science Information Texts

    ERIC Educational Resources Information Center

    Reutzel, D. Ray; Smith, John A.; Fawson, Parker C.

    2005-01-01

    There are few research studies on the effects of teaching comprehension strategies to young children in the primary grades. Using a Dominant-Less Dominant Mixed Model design employing both qualitative and quantitative data collection, we evaluated two approaches for teaching comprehension strategies to 7- and 8-year-old children in four…

  8. Digital Storytelling with Pre-Service Teachers. Raising Awareness for Refugees through ICTS in ESL Primary Classes

    ERIC Educational Resources Information Center

    Alcantud Diaz, Maria

    2016-01-01

    This article describes the design and implementation of a Digital Storytelling (DS) experience that was carried out in a foreign language setting with pre-service teachers. This case study sets out to assess the effect of DS aimed at becoming a social awareness and pedagogical tool for both, high education and consequently, primary students. The…

  9. Perception of Teaching Efficacy by Primary and Secondary School Teachers

    ERIC Educational Resources Information Center

    Bedir, Gülay

    2015-01-01

    This research aims to identify how teaching efficacy is perceived by teachers working at state schools. Having a survey model design, this study hosts a total of 678 primary and secondary school teachers--401 females and 277 males--working in the province of Tokat during the academic year of 2013 and 2014. Research data has been collected through…

  10. Space shuttle/food system study. Volume 2, Appendix F: Flight food and primary packaging

    NASA Technical Reports Server (NTRS)

    1974-01-01

    The analysis and selection of food items and primary packaging, the development of menus, the nutritional analysis of diet, and the analyses of alternate food mixes and contingency foods is reported in terms of the overall food system design for space shuttle flight. Stowage weights and cubic volumes associated with each alternate mix were also evaluated.

  11. An Investigation of Pre-Service Primary School Teachers' Attitudes towards Digital Technology and Digital Citizenship Levels in Terms of Some Variables

    ERIC Educational Resources Information Center

    Çiftci, Serdar; Aladag, Soner

    2018-01-01

    This study aims at investigating the relationship between pre-service primary school teachers' attitudes towards digital technology and digital citizenship scale levels. The research was designed in descriptive survey model. The data collection tools were "Attitude Scale for Digital Technology" (ASDT) developed by Cabi (2016) and…

  12. Analysis of Primary School Student's Science Learning Anxiety According to Some Variables

    ERIC Educational Resources Information Center

    Karakaya, Ferhat; Avgin, Sakine Serap; Kumperli, Ethem

    2016-01-01

    On this research, it is analyzed if the science learning anxiety level shows difference according to variables which are gender, grade level, science lesson grade, mother education, father education level. Scanning Design is used for this study. Research working group is consisted of 294 primary school from 6th, 7th and 8th graders on 2015-2016…

  13. Effectiveness of Game and Poem Enhanced Instructional Strategies and Verbal Ability on Students' Interest in Mathematics Learning

    ERIC Educational Resources Information Center

    Frederick-Jonah, Toinpere Mercy; Igbojinwaekwu, Patrick Chukwuemeka

    2015-01-01

    This study investigated the effects of game and poem-enhanced instructional strategies on students' interest in mathematics. The moderating effects of verbal ability were also examined on the dependent variable. A quasi-experimental design was adopted. Three hundred and forty four students in the sixth year of their primary education (primary 6…

  14. Students Learning to Program by Developing Games: Results of a Year-Long Project in Primary School Settings

    ERIC Educational Resources Information Center

    Fokides, Emmanuel

    2017-01-01

    Aim/Purpose: The purpose of this study was to examine whether the authoring of computer games in a mainstream primary school setting can support the learning of game design and programming concepts. Background: Despite the benefits for students when they learn how to program and the significant body of research regarding this matter, these…

  15. Teachers' Pedagogical Competence in Adapting Curricula for Children with Learning Difficulties (LD) in Primary Schools in Ghana

    ERIC Educational Resources Information Center

    Alhassan, Abdul-Razak Kuyini; Abosi, Chigorom Okechukwu

    2017-01-01

    Ghana education service (GES) has not achieved much in curriculum adaption to address the needs of children with disability. The aim of this study is to investigate teachers' pedagogical competence (TPC) in curriculum adaptation to include children with LD in primary schools. Mixed-Method Design Strategy involving 387 sampled teachers was used.…

  16. Bituminous concrete overlay studies.

    DOT National Transportation Integrated Search

    1971-01-01

    Deflection tests conducted on eight sections of primary highway, both before and after asphaltic concrete resurfacings, were analyzed as a study of the utility of such tests in the design of overlays. The application of tentative traffic and allowabl...

  17. Seismic design of passive tuned mass damper parameters using active control algorithm

    NASA Astrophysics Data System (ADS)

    Chang, Chia-Ming; Shia, Syuan; Lai, Yong-An

    2018-07-01

    Tuned mass dampers are a widely-accepted control method to effectively reduce the vibrations of tall buildings. A tuned mass damper employs a damped harmonic oscillator with specific dynamic characteristics, thus the response of structures can be regulated by the additive dynamics. The additive dynamics are, however, similar to the feedback control system in active control. Therefore, the objective of this study is to develop a new tuned mass damper design procedure based on the active control algorithm, i.e., the H2/LQG control. This design facilitates the similarity of feedback control in the active control algorithm to determine the spring and damper in a tuned mass damper. Given a mass ratio between the damper and structure, the stiffness and damping coefficient of the tuned mass damper are derived by minimizing the response objective function of the primary structure, where the structural properties are known. Varying a single weighting in this objective function yields the optimal TMD design when the minimum peak in the displacement transfer function of the structure with the TMD is met. This study examines various objective functions as well as derives the associated equations to compute the stiffness and damping coefficient. The relationship between the primary structure and optimal tuned mass damper is parametrically studied. Performance is evaluated by exploring the h2-and h∞-norms of displacements and accelerations of the primary structure. In time-domain analysis, the damping effectiveness of the tune mass damper controlled structures is investigated under impulse excitation. Structures with the optimal tuned mass dampers are also assessed under seismic excitation. As a result, the proposed design procedure produces an effective tuned mass damper to be employed in a structure against earthquakes.

  18. STARPROBE: A design study for an X-ray imaging instrument

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The primary objective of the X-ray imaging telescope on STARPROBE is the acquisition of very high spacial resolution observations during the spacecraft's perihelion passage. Design parameters, telescope prefilters, and structural and thermal analyses of the equipment are described and discussed. It is believed that the spatial resolution of the information recorded by the baseline design would be at least a factor of 10 better than can be reasonably expected from Earth orbit. Thermal models used in the study are also discussed.

  19. Fetal omphalocele ratios predict outcomes in prenatally diagnosed omphalocele.

    PubMed

    Montero, Freddy J; Simpson, Lynn L; Brady, Paula C; Miller, Russell S

    2011-09-01

    The objective of the study was to evaluate whether ratios considering omphalocele diameter relative to fetal biometric measurements perform better than giant omphalocele designation at predicting inability to achieve neonatal primary surgical closure. Cases of fetal omphalocele that underwent evaluation between May 2003 and July 2010 were identified. Inclusion was restricted to live births with plan for postnatal repair. Omphalocele diameter upon antenatal ultrasound was compared with abdominal circumference, femur length, and head circumference, yielding the respective omphalocele (O)/abdominal circumference (AC), O/femur length (FL), and O/head circumference (HC) ratios. The absolute measurements were used to classify giant lesions. Omphalocele ratios and giant omphalocele designations were evaluated as predictors of inability to achieve primary repair. Among 25 included cases, staged or delayed closure occurred in 52%. With an optimal cutoff of 0.21 or greater, O/HC best predicted the primary outcome (sensitivity, 84.6%; specificity, 58.3%; odds ratio, 7.7). The O/HC of 0.21 or greater outperformed giant designations. The O/HC of 0.21 or greater best predicted staged or delayed omphalocele closure. Giant omphalocele designation, regardless of definition, poorly predicted outcome. Copyright © 2011 Mosby, Inc. All rights reserved.

  20. Primary School 5th and 8th Graders' Understanding and Mental Models about the Shape of the World and Gravity

    ERIC Educational Resources Information Center

    Öztürk, Ayse; Doganay, Ahmet

    2013-01-01

    This study investigated primary school 5th and 8th graders' understanding and mental models related to the shape of the world and gravity, and how these models reflected the fact and what kind of a change there is from 5th to 8th graders. This research is based on a cross-sectional design. The study was conducted in a low socioeconomic level…

  1. Damage Tolerance Characterisitics of Composite Sandwich Structures

    DTIC Science & Technology

    2000-02-01

    requirements impose strict test program is devised and carried out, with hundreds of tests at constraints on the design of composite aircraft... design A particular effort was dedicated to the study of delamination methodologies, as well as static and fatigue strength and growth under...partition according to the theoretical tools, the industries are more or less forced, for the fundamental modes. design of primary composite structures

  2. Interactional Patterns Among Dental School Students and the Influence of Building Design. Final Progress Report on the Planning Study: Behavioral Factors in Dental School Design.

    ERIC Educational Resources Information Center

    Myrick, Richard; Marx, Barbara S.

    The relationship of architecture to human behavior is a topic of increasing concern both to designers and behavioral scientists. To further evaluate the extent of the relationship a series of preliminary investigations has been undertaken. The primary means of measurement was informal conversations of dental students as related to the…

  3. Next Generation Loading System for Detonators and Primers

    DTIC Science & Technology

    Designed , fabricated and installed next generation tooling to provide additional manufacturing capabilities for new detonators and other small...prototype munitions on automated, semi-automated and manual machines. Lead design effort, procured and installed a primary explosive Drying Oven for a pilot...facility. Designed , fabricated and installed a Primary Explosives Waste Treatment System in a pilot environmental processing facility. Designed

  4. 75 FR 52860 - Final Airworthiness Design Standards for Acceptance Under the Primary Category Rule; Orlando...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-30

    ...., wish to apply these airworthiness design standards to other airplane models, OHA, Inc. must submit a... affects only certain airworthiness design standards on Cessna model C172I, C172K, C172L, C172M airplanes... Design Standards for Acceptance Under the Primary Category Rule; Orlando Helicopter Airways (OHA), Inc...

  5. Towards Primary School Physics Teaching and Learning: Design Research Approach. Research Report 256

    ERIC Educational Resources Information Center

    Juuti, Kalle

    2005-01-01

    This thesis describes a project to design a primary school physics learning environment which takes into account teachers' needs, design procedures, properties of the learning environment, and pupil learning outcomes. The project's design team has wide experience in research and development work in relation to science education, the use of ICT in…

  6. PLAYgrounds: Effect of a PE playground program in primary schools on PA levels during recess in 6 to 12 year old children. Design of a prospective controlled trial

    PubMed Central

    2011-01-01

    Background The relative number of children meeting the minimal required dose of daily physical activity remains execrably low. It has been estimated that in 2015 one out of five children will be overweight. Therefore, low levels of physical activity during early childhood may compromise the current and future health and well-being of the population, and promoting physical activity in younger children is a major public health priority. This study is to gain insight into effects of a Physical Education based playground program on the PA levels during recess in primary school children aged 6-12. Methods/design The effectiveness of the intervention program will be evaluated using a prospective controlled trial design in which schools will be matched, with a follow-up of one school year. The research population will consist of 6-12 year old primary school children. The intervention program will be aimed at improving physical activity levels and will consist of a multi-component alteration of the schools' playground. In addition, playground usage will be increased through altered time management of recess times, as well as a modification of the Physical Education content. Discussion The effects of the intervention on physical activity levels during recess (primary outcome measure), overall daily physical activity and changes in physical fitness (secondary outcome measures) will be assessed. Results of this study could possibly lead to changes in the current playground system of primary schools and provide structured health promotion for future public health. Trial registration Netherlands Trial Register (NTR): NTR2386 PMID:21548998

  7. Collaborative Curriculum Design to Increase Science Teaching Self-Efficacy: A Case Study

    ERIC Educational Resources Information Center

    Velthuis, Chantal; Fisser, Petra; Pieters, Jules

    2015-01-01

    The purpose of this study was to establish whether participation in a teacher design team (TDT) is an effective way to increase the science teaching self-efficacy of primary school teachers who vary in their levels of experience and interest in science. A TDT is a group of at least 2 teachers from the same or related subjects working together to…

  8. Student Teachers of Technology and Design into Industry: A Northern Ireland Case Study

    ERIC Educational Resources Information Center

    Gibson, Ken

    2013-01-01

    This paper, based in Northern Ireland, is a case study of an innovative programme which places year 3 B.Ed. post-primary student teachers of Technology and Design into industry for a five-day period. The industrial placement programme is set in an international context of evolving pre-service field placements and in a local context defined by the…

  9. 47 CFR 11.18 - EAS Designations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Designations. (a) National Primary (NP) is a source of EAS Presidential messages. (b) Local Primary (LP) is a... as specified in its EAS Local Area Plan. If it is unable to carry out this function, other LP sources... broadcast stations in the Local Area. (c) State Primary (SP) is a source of EAS State messages. These...

  10. 47 CFR 11.18 - EAS Designations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Designations. (a) National Primary (NP) is a source of EAS Presidential messages. (b) Local Primary (LP) is a... as specified in its EAS Local Area Plan. If it is unable to carry out this function, other LP sources... broadcast stations in the Local Area. (c) State Primary (SP) is a source of EAS State messages. These...

  11. Water-quality parameters and benthic algal communities at selected streams in Minnesota, August 2000 - Study design, methods and data

    USGS Publications Warehouse

    Lee, K.E.

    2002-01-01

    This report describes the study design, sampling methods, and summarizes the physical, chemical, and benthic algal data for a component of the multiagency study that was designed to document diurnal water-quality measurements (specific conductance, pH, water temperature, and dissolved oxygen), benthic algal community composition and chlorophyll-a content, and primary productivity at 12 stream sites on 6 streams in Minnesota during August 2000. Specific conductance, pH, water temperature, dissolved oxygen concentrations and percent dissolved oxygen saturation measurements were made with submersible data recorders at 30 minute intervals for a period of 3-6 days during August 2000. Benthic algae collected from wood and rock substrate were identified and enumerated. Biovolume (volume of algal cells per unit area), density (number of cells per unit area), and chlorophyll-a content from benthic algae were determined. These data can be used as part of the multiagency study to develop an understanding of the relations among nutrient concentrations, algal abundance, algal community composition, and primary production and respiration processes in rivers of differing ecoregions in Minnesota.

  12. RApid Primary care Initiation of Drug treatment for Transient Ischaemic Attack (RAPID−TIA): study protocol for a pilot randomised controlled trial

    PubMed Central

    2013-01-01

    Background People who have a transient ischaemic attack (TIA) or minor stroke are at high risk of a recurrent stroke, particularly in the first week after the event. Early initiation of secondary prevention drugs is associated with an 80% reduction in risk of stroke recurrence. This raises the question as to whether these drugs should be given before being seen by a specialist – that is, in primary care or in the emergency department. The aims of the RAPID-TIA pilot trial are to determine the feasibility of a randomised controlled trial, to analyse cost effectiveness and to ask: Should general practitioners and emergency doctors (primary care physicians) initiate secondary preventative measures in addition to aspirin in people they see with suspected TIA or minor stroke at the time of referral to a specialist? Methods/Design This is a pilot randomised controlled trial with a sub-study of accuracy of primary care physician diagnosis of TIA. In the pilot trial, we aim to recruit 100 patients from 30 general practices (including out-of-hours general practice centres) and 1 emergency department whom the primary care physician diagnoses with TIA or minor stroke and randomly assign them to usual care (that is, initiation of aspirin and referral to a TIA clinic) or usual care plus additional early initiation of secondary prevention drugs (a blood-pressure lowering protocol, simvastatin 40 mg and dipyridamole 200 mg m/r bd). The primary outcome of the main study will be the number of strokes at 90 days. The diagnostic accuracy sub-study will include these 100 patients and an additional 70 patients in whom the primary care physician thinks the diagnosis of TIA is possible, rather than probable. For the pilot trial, we will report recruitment rate, follow-up rate, a preliminary estimate of the primary event rate and occurrence of any adverse events. For the diagnostic study, we will calculate sensitivity and specificity of primary care physician diagnosis using the final TIA clinic diagnosis as the reference standard. Discussion This pilot study will be used to estimate key parameters that are needed to design the main study and to estimate the accuracy of primary care diagnosis of TIA. The planned follow-on trial will have important implications for the initial management of people with suspected TIA. Trial registration ISRCTN62019087 PMID:23819476

  13. Orbit Transfer Rocket Engine Technology Program, Advanced Engine Study Task D.6

    DTIC Science & Technology

    1992-02-28

    l!J~iliiJl 1. Report No. 2. Government Accession No. 3 . Recipient’s Catalog No. NASA 187215 4. Title and Subtitle 5. Report Date ORBIT TRANSFER ROCKET...Engine Study, three primary subtasks were accomplished: 1) Design and Parametric Data, 2) Engine Requirement Variation Studies, and 3 ) Vehicle Study...Mixture Ratio Parametrics 18 3 . Thrust Parametrics Off-Design Mixture Ratio Scans 22 4. Expansion Area Ratio Parametrics 24 5. OTV 20 klbf Engine Off

  14. Statistical issues in the design, conduct and analysis of two large safety studies.

    PubMed

    Gaffney, Michael

    2016-10-01

    The emergence, post approval, of serious medical events, which may be associated with the use of a particular drug or class of drugs, is an important public health and regulatory issue. The best method to address this issue is through a large, rigorously designed safety study. Therefore, it is important to elucidate the statistical issues involved in these large safety studies. Two such studies are PRECISION and EAGLES. PRECISION is the primary focus of this article. PRECISION is a non-inferiority design with a clinically relevant non-inferiority margin. Statistical issues in the design, conduct and analysis of PRECISION are discussed. Quantitative and clinical aspects of the selection of the composite primary endpoint, the determination and role of the non-inferiority margin in a large safety study and the intent-to-treat and modified intent-to-treat analyses in a non-inferiority safety study are shown. Protocol changes that were necessary during the conduct of PRECISION are discussed from a statistical perspective. Issues regarding the complex analysis and interpretation of the results of PRECISION are outlined. EAGLES is presented as a large, rigorously designed safety study when a non-inferiority margin was not able to be determined by a strong clinical/scientific method. In general, when a non-inferiority margin is not able to be determined, the width of the 95% confidence interval is a way to size the study and to assess the cost-benefit of relative trial size. A non-inferiority margin, when able to be determined by a strong scientific method, should be included in a large safety study. Although these studies could not be called "pragmatic," they are examples of best real-world designs to address safety and regulatory concerns. © The Author(s) 2016.

  15. Using simulation to improve wildlife surveys: Wintering mallards in Mississippi, USA

    USGS Publications Warehouse

    Pearse, A.T.; Reinecke, K.J.; Dinsmore, S.J.; Kaminski, R.M.

    2009-01-01

    Wildlife conservation plans generally require reliable data about population abundance and density. Aerial surveys often can provide these data; however, associated costs necessitate designing and conducting surveys efficiently. We developed methods to simulate population distributions of mallards (Anas platyrhynchos) wintering in western Mississippi, USA, by combining bird observations from three previous strip-transect surveys and habitat data from three sets of satellite images representing conditions when surveys were conducted. For each simulated population distribution, we compared 12 primary survey designs and two secondary design options by using coefficients of variation (CV) of population indices as the primary criterion for assessing survey performance. In all, 3 of the 12 primary designs provided the best precision (CV???11.7%) and performed equally well (WR08082E1d.gif diff???0.6%). Features of the designs that provided the largest gains in precision were optimal allocation of sample effort among strata and configuring the study area into five rather than four strata, to more precisely estimate mallard indices in areas of consistently high density. Of the two secondary design options, we found including a second observer to double the size of strip transects increased precision or decreased costs, whereas ratio estimation using auxiliary habitat data from satellite images did not increase precision appreciably. We recommend future surveys of mallard populations in our study area use the strata we developed, optimally allocate samples among strata, employ PPS or EPS sampling, and include two observers when qualified staff are available. More generally, the methods we developed to simulate population distributions from prior survey data provide a cost-effective method to assess performance of alternative wildlife surveys critical to informing management decisions, and could be extended to account for effects of detectability on estimates of true abundance. ?? 2009 CSIRO.

  16. Evaluating a Dutch cardiology primary care plus intervention on the Triple Aim outcomes: study design of a practice-based quantitative and qualitative research.

    PubMed

    Quanjel, Tessa C C; Spreeuwenberg, Marieke D; Struijs, Jeroen N; Baan, Caroline A; Ruwaard, Dirk

    2017-09-06

    In an attempt to deal with the pressures on the health-care system and to guarantee sustainability, changes are needed. This study focuses on a cardiology primary care plus intervention. Primary care plus (PC+) is a new health-care delivery model focused on substitution of specialist care in the hospital setting with specialist care in the primary care setting. The intervention consists of a cardiology PC+ centre in which cardiologists, supported by other health-care professionals, provide consultations in a primary care setting. The PC+ centre aims to improve the health of the population and quality of care as experienced by patients, and reduce the number of referrals to hospital-based outpatient specialist care in order to reduce health-care costs. These aims reflect the Triple Aim principle. Hence, the objectives of the study are to evaluate the cardiology PC+ centre in terms of the Triple Aim outcomes and to evaluate the process of the introduction of PC+. The study is a practice-based, quantitative study with a longitudinal observational design, and an additional qualitative study to supplement, interpret and improve the quantitative study. The study population of the quantitative part will consist of adult patients (≥18 years) with non-acute and low-complexity cardiology-related health complaints, who will be referred to the cardiology PC+ centre (intervention group) or hospital-based outpatient cardiology care (control group). All eligible patients will be asked to complete questionnaires at three different time points consisting of questions about their demographics, health status and experience of care. Additionally, quantitative data will be collected about health-care utilization and related health-care costs at the PC+ centre and the hospital. The qualitative part, consisting of semi-structured interviews, focus groups, and observations, is designed to evaluate the process as well as to amplify, clarify and explain quantitative results. This study will evaluate a cardiology PC+ centre using quantitative and supplementary qualitative methods. The findings of both sub-studies will fill a gap in knowledge about the effects of PC+ and in particular whether PC+ is able to pursue the Triple Aim outcomes. NTR6629 (Data registered: 25-08-2017) (registered retrospectively).

  17. Life sciences payload definition and integration study, task C and D. Volume 1: Management summary

    NASA Technical Reports Server (NTRS)

    1973-01-01

    The findings of a study to define the required payloads for conducting life science experiments in space are presented. The primary objectives of the study are: (1) identify research functions to be performed aboard life sciences spacecraft laboratories and necessary equipment, (2) develop conceptual designs of potential payloads, (3) integrate selected laboratory designs with space shuttle configurations, and (4) establish cost analysis of preliminary program planning.

  18. Improving Science Process Skills for Primary School Students Through 5E Instructional Model-Based Learning

    NASA Astrophysics Data System (ADS)

    Choirunnisa, N. L.; Prabowo, P.; Suryanti, S.

    2018-01-01

    The main objective of this study is to describe the effectiveness of 5E instructional model-based learning to improve primary school students’ science process skills. The science process skills is important for students as it is the foundation for enhancing the mastery of concepts and thinking skills needed in the 21st century. The design of this study was experimental involving one group pre-test and post-test design. The result of this study shows that (1) the implementation of learning in both of classes, IVA and IVB, show that the percentage of learning implementation increased which indicates a better quality of learning and (2) the percentage of students’ science process skills test results on the aspects of observing, formulating hypotheses, determining variable, interpreting data and communicating increased as well.

  19. Prevalence of Primary Dysmenorrhea and Factors Associated with Its Intensity Among Undergraduate Students: A Cross-Sectional Study.

    PubMed

    Habibi, Nahal; Huang, Mary Soo Lee; Gan, Wan Ying; Zulida, Rejali; Safavi, Sayyed Morteza

    2015-12-01

    Primary dysmenorrhea is a womanhood problem around the world and negatively affects quality of life. This study was designed to investigate the prevalence of primary dysmenorrhea and to determine the factors associated with its intensity. A cross-sectional study was carried out among 311 undergraduate female students aged 18 to 27 years in Isfahan University of Medical Sciences, Iran. Socio-demographic characteristics and menstrual factors were obtained through interviews with the help of a pretested questionnaire. The prevalence of primary dysmenorrhea was 89.1%. Residing at home, younger age, lower number of years of formal education for the mother, positive family history of dysmenorrhea, higher severity of bleeding, and shorter menstrual period intervals were significantly associated with the higher intensity of primary dysmenorrhea. Primary dysmenorrhea is a common health concern among young women. Being aware of the factors that are associated with its intensity makes it possible for health professionals to organize better focused programs to reduce the adverse effects of dysmenorrhea. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  20. Direct coal liquefaction baseline design and system analysis. Quarterly report, January--March 1991

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

    Not Available

    1991-04-01

    The primary objective of the study is to develop a computer model for a base line direct coal liquefaction design based on two stage direct coupled catalytic reactors. This primary objective is to be accomplished by completing the following: a base line design based on previous DOE/PETC results from Wilsonville pilot plant and other engineering evaluations; a cost estimate and economic analysis; a computer model incorporating the above two steps over a wide range of capacities and selected process alternatives; a comprehensive training program for DOE/PETC Staff to understand and use the computer model; a thorough documentation of all underlyingmore » assumptions for baseline economics; and a user manual and training material which will facilitate updating of the model in the future.« less

  1. Direct coal liquefaction baseline design and system analysis

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

    Not Available

    1991-04-01

    The primary objective of the study is to develop a computer model for a base line direct coal liquefaction design based on two stage direct coupled catalytic reactors. This primary objective is to be accomplished by completing the following: a base line design based on previous DOE/PETC results from Wilsonville pilot plant and other engineering evaluations; a cost estimate and economic analysis; a computer model incorporating the above two steps over a wide range of capacities and selected process alternatives; a comprehensive training program for DOE/PETC Staff to understand and use the computer model; a thorough documentation of all underlyingmore » assumptions for baseline economics; and a user manual and training material which will facilitate updating of the model in the future.« less

  2. Long lifetime fast spectrum reactor for lunar surface power system

    NASA Astrophysics Data System (ADS)

    Kambe, Mitsuru

    1993-01-01

    In the framework of innovative reactor research activities, a conceptual design study of fast spectrum reactor and primary system for 800 kWe lunar surface power system to be combined with potassium Rankine cycle power conversion has been conducted to meet the power requirements of the lunar base activities in the next century. The reactor subsystem is characterized by RAPID (Refueling by All Pins Integrated Design) concept to enhance inherent safety and to enable quick and simplifed refueling in every 10 years. RAPID concept affords power plant design lifetime of up to 30 years. Integrity of the reactor structure and replacement of failed primary circuits are also discussed. Substantial reduction in per-kWh cost on considering launch, emplacement, and final disposition can be expected by a long system lifetime.

  3. Evaluation of primary care midwifery in the Netherlands: design and rationale of a dynamic cohort study (DELIVER)

    PubMed Central

    2012-01-01

    Background In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes the research design and methodology of the multicenter multidisciplinary prospective DELIVER study which is the first large-scale study evaluating the quality and provision of primary midwifery care. Methods/Design Between September 2009 and April 2011, data were collected from clients and their partners, midwives and other healthcare professionals across the Netherlands. Clients from twenty midwifery practices received up to three questionnaires to assess the expectations and experiences of clients (e.g. quality of care, prenatal screening, emotions, health, and lifestyle). These client data were linked to data from the Netherlands Perinatal Register and electronic client records kept by midwives. Midwives and practice assistants from the twenty participating practices recorded work-related activities in a diary for one week, to assess workload. Besides, the midwives were asked to complete a questionnaire, to gain insight into collaboration of midwives with other care providers, their tasks and attitude towards their job, and the quality of the care they provide. Another questionnaire was sent to all Dutch midwifery practices which reveals information regarding the organisation of midwifery practices, provision of preconception care, collaboration with other care providers, and provision of care to ethnic minorities. Data at client, midwife and practice level can be linked. Additionally, partners of pregnant women and other care providers were asked about their expectations and experiences regarding the care delivered by midwives and in six practices client consults were videotaped to objectively assess daily practice. Discussion In total, 7685 clients completed at least one questionnaire, 136 midwives and assistants completed a diary with work-related activities (response 100%), 99 midwives completed a questionnaire (92%), and 319 practices across the country completed a questionnaire (61%), 30 partners of clients participated in focus groups, 21 other care providers were interviewed and 305 consults at six midwifery practices were videotaped. The multicenter DELIVER study provides an extensive database with national representative data on the quality of primary care midwifery in the Netherlands. This study will support evidence-based practice in primary care midwifery in the Netherlands and contribute to a better understanding of the maternity care system. PMID:22433820

  4. HYFIRE II: fusion/high-temperature electrolysis conceptual-design study. Annual report

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

    Fillo, J.A.

    1983-08-01

    As in the previous HYFIRE design study, the current study focuses on coupling a Tokamak fusion reactor with a high-temperature blanket to a High-Temperature Electrolyzer (HTE) process to produce hydrogen and oxygen. Scaling of the STARFIRE reactor to allow a blanket power to 6000 MW(th) is also assumed. The primary difference between the two studies is the maximum inlet steam temperature to the electrolyzer. This temperature is decreased from approx. 1300/sup 0/ to approx. 1150/sup 0/C, which is closer to the maximum projected temperature of the Westinghouse fuel cell design. The process flow conditions change but the basic design philosophymore » and approaches to process design remain the same as before. Westinghouse assisted in the study in the areas of systems design integration, plasma engineering, balance-of-plant design, and electrolyzer technology.« less

  5. The Effects of a Systematically Designed Online Learning Environment on Preservice Teachers' Professional Knowledge

    ERIC Educational Resources Information Center

    Evens, Marie; Larmuseau, Charlotte; Dewaele, Katrien; Van Craesbeek, Leen; Elen, Jan; Depaepe, Fien

    2017-01-01

    This study examines the effects of an online learning environment on preservice teachers' pedagogical content knowledge (PCK), content knowledge (CK) (related to French in primary teacher education), and pedagogical knowledge (PK) in a quasi-experimental design. More specifically, the following research question is addressed: Is a systematically…

  6. Towards Systemic Support of Pupils with Emotional and Behavioural Disorders

    ERIC Educational Resources Information Center

    Mooij, Ton; Smeets, Ed

    2009-01-01

    Children with emotional and behavioural disorders (EBD) vary in many respects. In school, specific conditions have to be fulfilled in order to deal adequately with EBD. This study addresses the question how mainstream primary schools design different instructional situations to support pupils with EBD in practice, and how this design could be…

  7. Developing a "Conjecturing Atmosphere" in the Classroom through Task Design and Enactment

    ERIC Educational Resources Information Center

    Hunter, Jodie

    2014-01-01

    In recent years there has been an increased emphasis on algebraic reasoning in primary school classrooms. This includes introducing students to the mathematical practices of making conjectures, justifying and generalising. Drawing on findings from a classroom-based study, this paper explores one teacher's journey in shifting her task design and…

  8. Designing "Geometry 2.0" Learning Environments: A Preliminary Study with Primary School Students

    ERIC Educational Resources Information Center

    Prieto, Nuria Joglar; Sordo Juanena, José María; Star, Jon R.

    2014-01-01

    The information and communication technologies of Web 2.0 are arriving in our schools, allowing the design and implementation of new learning environments with great educational potential. This article proposes a pedagogical model based on a new geometry technology-integrated learning environment, called "Geometry 2.0," which was tested…

  9. A Situated Cultural Festival Learning System Based on Motion Sensing

    ERIC Educational Resources Information Center

    Chang, Yi-Hsing; Lin, Yu-Kai; Fang, Rong-Jyue; Lu, You-Te

    2017-01-01

    A situated Chinese cultural festival learning system based on motion sensing is developed in this study. The primary design principle is to create a highly interactive learning environment, allowing learners to interact with Kinect through natural gestures in the designed learning situation to achieve efficient learning. The system has the…

  10. Testing the effectiveness of a self-efficacy based exercise intervention for inactive people with type 2 diabetes mellitus: design of a controlled clinical trial

    PubMed Central

    2012-01-01

    Background Sufficient exercise is important for people with Type 2 Diabetes Mellitus (T2DM), as it can prevent future health problems. Despite, it is estimated that only 30-40% of people with T2DM are sufficiently active. One of the psychosocial constructs that is believed to influence physical activity behaviour, is exercise self-efficacy. The goal of this study is to evaluate a patient-tailored exercise intervention for people with T2DM that takes exercise self-efficacy into account. Methods/Design This study is conducted as a non-randomized controlled clinical trial. Patients are eligible when they are diagnosed with T2DM, exercise less than advised in the ADA guideline of 150 min/week of moderate-intensity aerobic physical activity, have an BMI >25 and are between 18 and 80 years old. Recruitment takes place at a Primary care organization of general practitioners and practice nurses in the south of the Netherlands. Participants are allocated to three groups: An advice intervention -for participants with a high exercise self-efficacy score- in which participants receive a patient-tailored exercise intervention, an intensive intervention -for participants with a low exercise self-efficacy score- in which participants receive a patient-tailored exercise intervention accomplished by a group based intervention, and a control group in which participants receive regular Dutch diabetes care. The primary outcome measure of this study is physical activity. Secondary outcome measures are health status, (symptoms of) depression, exercise self-efficacy, Body Mass Index (BMI), blood pressure and glycemic control. Discussion We aimed to design an intervention that can be implemented in Primary care, but also to design an easy accessible program. This study is innovative as it is -to our best knowledge- the first study that takes level of exercise self-efficacy of people with T2DM into account by means of giving extra support to those with the lowest exercise self-efficacy. If the program succeeds in increasing the amount of physical activity it can be implemented in regular primary care. Trial registration Dutch Trial Register NTR2734 PMID:22559322

  11. Redesigning printed educational materials for primary care physicians: design improvements increase usability.

    PubMed

    Grudniewicz, Agnes; Bhattacharyya, Onil; McKibbon, K Ann; Straus, Sharon E

    2015-11-04

    Printed educational materials (PEMs) are a frequently used tool to disseminate clinical information and attempt to change behavior within primary care. However, their effect on clinician behavior is limited. In this study, we explored how PEMs can be redesigned to better meet the needs of primary care physicians (PCPs) and whether usability and selection can be increased when design principles and user preferences are used. We redesigned a publicly available PEM using physician preferences, design principles, and graphic designer support. We invited PCPs to select their preferred document between the redesigned and original versions in a discrete choice experiment, followed by an assessment of usability with the System Usability Scale and a think aloud process. We conducted this study in both a controlled and opportunistic setting to determine whether usability testing results vary by study location. Think aloud data was thematically analyzed, and results were interpreted using the Technology Acceptance Model. One hundred and eighty four PCPs participated in the discrete choice experiment at the 2014 Family Medicine Forum, a large Canadian conference for family physicians. Of these, 87.7 % preferred the redesigned version. Follow-up interviews were held with a randomly selected group of seven participants. We repeated this in a controlled setting in Toronto, Canada, with a set of 14 participants. Using the System Usability Scale, we found that usability scores were significantly increased with the redesign (p < 0.001). We also found that when PCPs were given the choice between the two versions, they selected the redesigned version as their preferred PEM more often than the original (p < 0.001). Results did not appear to differ between the opportunistic and controlled setting. We used the results of the think aloud process to add to a list of end user preferences developed in a previous study. We found that redesigning a PEM with user preferences and design principles can improve its usability and result in the PEM being selected more often than the original. We feel this finding supports the involvement of the user, application of design principles, and the assistance of a graphic designer in the development of PEMs.

  12. Methodological considerations in the design and implementation of clinical trials.

    PubMed

    Cirrincione, Constance T; Lavoie Smith, Ellen M; Pang, Herbert

    2014-02-01

    To review study design issues related to clinical trials led by oncology nurses, with special attention to those conducted within the cooperative group setting; to emphasize the importance of the statistician's role in the process of clinical trials. Studies available at clinicaltrials.gov using experimental designs that have been published in peer-reviewed journals; cooperative group trials are highlighted. The clinical trial is a primary means to test intervention efficacy. A properly designed and powered study with clear and measurable objectives is as important as the intervention itself. Collaboration among the study team, including the statistician, is central in developing and conducting appropriately designed studies. For optimal results, collaboration is an ongoing process that should begin early on. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Current management and prognostic factors in physiotherapy practice for patients with shoulder pain: design of a prospective cohort study.

    PubMed

    Karel, Yasmaine H J M; Scholten-Peeters, Wendy G M; Thoomes-de Graaf, Marloes; Duijn, Edwin; Ottenheijm, Ramon P G; van den Borne, Maaike P J; Koes, Bart W; Verhagen, Arianne P; Dinant, Geert-Jan; Tetteroo, Eric; Beumer, Annechien; van Broekhoven, Joost B; Heijmans, Marcel

    2013-02-11

    Shoulder pain is disabling and has a considerable socio-economic impact. Over 50% of patients presenting in primary care still have symptoms after 6 months; moreover, prognostic factors such as pain intensity, age, disability level and duration of complaints are associated with poor outcome. Most shoulder complaints in this group are categorized as non-specific. Musculoskeletal ultrasound might be a useful imaging method to detect subgroups of patients with subacromial disorders.This article describes the design of a prospective cohort study evaluating the influence of known prognostic and possible prognostic factors, such as findings from musculoskeletal ultrasound outcome and working alliance, on the recovery of shoulder pain. Also, to assess the usual physiotherapy care for shoulder pain and examine the inter-rater reliability of musculoskeletal ultrasound between radiologists and physiotherapists for patients with shoulder pain. A prospective cohort study including an inter-rater reliability study. Patients presenting in primary care physiotherapy practice with shoulder pain are enrolled. At baseline validated questionnaires are used to measure patient characteristics, disease-specific characteristics and social factors. Physical examination is performed according to the expertise of the physiotherapists. Follow-up measurements will be performed 6, 12 and 26 weeks after inclusion. Primary outcome measure is perceived recovery, measured on a 7-point Likert scale. Logistic regression analysis will be used to evaluate the association between prognostic factors and recovery. The ShoCoDiP (Shoulder Complaints and using Diagnostic ultrasound in Physiotherapy practice) cohort study will provide information on current management of patients with shoulder pain in primary care, provide data to develop a prediction model for shoulder pain in primary care and to evaluate whether musculoskeletal ultrasound can improve prognosis.

  14. Rationale, design and methods of the Study of Work and Pain (SWAP): a cluster randomised controlled trial testing the addition of a vocational advice service to best current primary care for patients with musculoskeletal pain (ISRCTN 52269669)

    PubMed Central

    2014-01-01

    Background Musculoskeletal pain is a major contributor to short and long term work absence. Patients seek care from their general practitioner (GP) and yet GPs often feel ill-equipped to deal with work issues. Providing a vocational case management service in primary care, to support patients with musculoskeletal problems to remain at or return to work, is one potential solution but requires robust evaluation to test clinical and cost-effectiveness. Methods/Design This protocol describes a cluster randomised controlled trial, with linked qualitative interviews, to investigate the effect of introducing a vocational advice service into general practice, to provide a structured approach to managing work related issues in primary care patients with musculoskeletal pain who are absent from work or struggling to remain in work. General practices (n = 6) will be randomised to offer best current care or best current care plus a vocational advice service. Adults of working age who are absent from or struggling to remain in work due to a musculoskeletal pain problem will be invited to participate and 330 participants will be recruited. Data collection will be through patient completed questionnaires at baseline, 4 and 12 months. The primary outcome is self-reported work absence at 4 months. Incremental cost-utility analysis will be undertaken to calculate the cost per additional QALY gained and incremental net benefits. A linked interview study will explore the experiences of the vocational advice service from the perspectives of GPs, nurse practitioners (NPs), patients and vocational advisors. Discussion This paper presents the rationale, design, and methods of the Study of Work And Pain (SWAP) trial. The results of this trial will provide evidence to inform primary care practice and guide the development of services to provide support for musculoskeletal pain patients with work-related issues. Trial registration Current Controlled Trials ISRCTN52269669. PMID:25012813

  15. Design of the Coordinated Anxiety Learning and Management (CALM) Study: Innovations in Collaborative Care for Anxiety Disorders

    PubMed Central

    Sullivan, Greer; Craske, Michelle G; Sherbourne, Cathy; Edlund, Mark J; Rose, Raphael D; Golinelli, Daniela; Chavira, Denise A; Bystritsky, Alexander; Stein, Murray B; Roy-Byrne, Peter P

    2007-01-01

    Background: Despite a marked increase in persons seeking help for anxiety disorders, the care provided may not be evidence-based, especially when delivered by non-specialists. Since anxiety disorders are most often treated in primary care, quality improvement interventions are needed there. Research Design: A randomized controlled trial of a collaborative care effectiveness intervention for anxiety disorders. Subjects: Approximately 1040 adult primary care patients with one of four anxiety disorders (generalized anxiety disorder, panic disorder, posttraumatic stress disorder, or social anxiety disorder), recruited from four national sites. Intervention: Anxiety clinical specialists deliver education and behavioral activation to intervention patients and monitor their symptoms. Intervention patients choose cognitive behavioral therapy, anti-anxiety medications, or both, in a “stepped care” treatment that varies according to clinical need. Control patients receive usual care from their primary care clinician. CALM's innovations include the flexibility to treat any one of four anxiety disorders, co-occurring depression, and/or alcohol abuse; its use of on-site clinicians to conduct initial assessments, and its computer-assisted psychotherapy delivery. Evaluation: Anxiety symptoms, functioning, satisfaction with care, and health care utilization are assessed at 6-month intervals. Conclusion: CALM was designed for clinical effectiveness and easy dissemination in a variety of primary care settings. PMID:17888803

  16. Primary repair of colon injuries: clinical study of nonselective approach.

    PubMed

    Lazovic, Ranko G; Barisic, Goran I; Krivokapic, Zoran V

    2010-12-02

    This study was designed to determine the role of primary repair and to investigate the possibility of expanding indications for primary repair of colon injuries using nonselective approach. Two groups of patients were analyzed. Retrospective (RS) group included 30 patients managed by primary repair or two stage surgical procedure according to criteria published by Stone (S/F) and Flint (Fl). In this group 18 patients were managed by primary repair. Prospective (PR) group included 33 patients with primary repair as a first choice procedure. In this group, primary repair was performed in 30 cases. Groups were comparable regarding age, sex, and indexes of trauma severity. Time between injury and surgery was shorter in PR group, (1.3 vs. 3.1 hours). Stab wounds were more frequent in PR group (9:2), and iatrogenic lesions in RS group (6:2). Associated injuries were similar, as well as segmental distribution of colon injuries. S/F criteria and Flint grading were similar.In RS group 15 primary repairs were successful, while in two cases relaparotomy and colostomy was performed due to anastomotic leakage. One patient died. In PR group, 25 primary repairs were successful, with 2 immediate and 3 postoperative (7-10 days) deaths, with no evidence of anastomotic leakage. Results of this study justify more liberal use of primary repair in early management of colon injuries. Current Controlled Trials ISRCTN94682396.

  17. Describing the content of primary care: limitations of Canadian billing data.

    PubMed

    Katz, Alan; Halas, Gayle; Dillon, Michael; Sloshower, Jordan

    2012-02-15

    Primary health care systems are designed to provide comprehensive patient care. However, the ICD 9 coding system used for billing purposes in Canada neither characterizes nor captures the scope of clinical practice or complexity of physician-patient interactions. This study aims to describe the content of primary care clinical encounters and examine the limitations of using administrative data to capture the content of these visits. Although a number of U.S studies have described the content of primary care encounters, this is the first Canadian study to do so. Study-specific data collection forms were completed by 16 primary care physicians in community health and family practice clinics in Winnipeg, Manitoba, Canada. The data collection forms were completed immediately following the patient encounter and included patient and visit characteristics, such as primary reason for visit, topics discussed, actions taken, degree of complexity as well as diagnosis and ICD-9 codes. Data was collected for 760 patient encounters. The diagnostic codes often did not reflect the dominant topic of the visit or the topic requiring the most amount of time. Physicians often address multiple problems and provide numerous services thus increasing the complexity of care. This is one of the first Canadian studies to critically analyze the content of primary care clinical encounters. The data allowed a greater understanding of primary care clinical encounters and attests to the deficiencies of singular ICD-9 coding which fails to capture the comprehensiveness and complexity of the primary care encounter. As primary care reform initiatives in the U.S and Canada attempt to transform the way family physicians deliver care, it becomes increasingly important that other tools for structuring primary care data are considered in order to help physicians, researchers and policy makers understand the breadth and complexity of primary care.

  18. Alternation as a form of allocation for quality improvement studies in primary healthcare settings: the on-off study design.

    PubMed

    Mathe, Nonsikelelo; Johnson, Steven T; Wozniak, Lisa A; Majumdar, Sumit R; Johnson, Jeffrey A

    2015-08-25

    Randomized controlled trials are considered the "gold standard" for scientific rigor in the assessment of benefits and harms of interventions in healthcare. They may not always be feasible, however, when evaluating quality improvement interventions in real-world healthcare settings. Non-randomized controlled trials (NCTs) are designed to answer questions of effectiveness of interventions in routine clinical practice to inform a decision or process. The on-off NCT design is a relatively new design where participant allocation is by alternation. In alternation, eligible patients are allocated to the intervention "on" or control "off " groups in time series dependent sequential clusters. We used two quality improvement studies undertaken in a Canadian primary care setting to illustrate the features of the on-off design. We also explored the perceptions and experiences of healthcare providers tasked with implementing the on-off study design. The on-off design successfully allocated patients to intervention and control groups. Imbalances between baseline variables were attributed to chance, with no detectable biases. However, healthcare providers' perspectives and experiences with the design in practice reveal some conflict. Specifically, providers described the process of allocating patients to the off group as unethical and immoral, feeling it was in direct conflict with their professional principle of providing care for all. The degree of dissatisfaction seemed exacerbated by: 1) the patient population involved (e.g., patient population viewed as high-risk (e.g., depressed or suicidal)), 2) conducting assessments without taking action (e.g., administering the PHQ-9 and not acting on the results), and 3) the (non-blinded) allocation process. Alternation, as in the on-off design, is a credible form of allocation. The conflict reported by healthcare providers in implementing the design, while not unique to the on-off design, may be alleviated by greater emphasis on the purpose of the research and having research assistants allocate patients and collect data instead of the healthcare providers implementing the trial. In addition, consultation with front-line staff implementing the trials with an on-off design on appropriateness to the setting (e.g., alignment with professional values and the patient population served) may be beneficial. Health Eating and Active Living with Diabetes: ClinicalTrials.gov identifier: NCT00991380. Date registered: 7 October 2009. Controlled trial of a collaborative primary care team model for patients with diabetes and depression: Clintrials.gov Identifier: NCT01328639 Date registered: 30 March 2011.

  19. The Marine Resources Experiment Program (MAREX)

    NASA Technical Reports Server (NTRS)

    1982-01-01

    The Satellite Ocean Color Science Working Group was established to consider the scientific utility of repeated satellite measurements of ocean color, especially for measuring global ocean chlorophyll and for studying the fate of global primary productivity in the sea. Results of the group's deliberations are presented. The scientific requirements are given for ocean color data from a CZCS follow on sensor in order to address global primary productivity, fishery, and carbon storage problems. Some specific experiments, called the marine resource experiment and designed to determine critical nutrient fluxes, photosynthetic rates, and primary productivity and biomass, are outlined.

  20. Women’s experiences of referral to a domestic violence advocate in UK primary care settings: a service-user collaborative study

    PubMed Central

    Malpass, Alice; Sales, Kim; Johnson, Medina; Howell, Annie; Agnew-Davies, Roxane; Feder, Gene

    2014-01-01

    Background Women experiencing domestic violence and abuse (DVA) are more likely to be in touch with health services than any other agency, yet doctors and nurses rarely ask about abuse, often failing to identify signs of DVA in their patients. Aim To understand women’s experience of disclosure of DVA in primary care settings and subsequent referral to a DVA advocate in the context of a DVA training and support programme for primary care clinicians: Identification and Referral to Improve Safety (IRIS). Design and setting A service-user collaborative study using a qualitative study design. Recruitment was from across IRIS trial settings in Bristol and Hackney, London. Method Twelve women who had been referred to one of two specialist DVA advocates (based at specialist DVA agencies) were recruited by a GP taking part in IRIS. Women were interviewed by a survivor of DVA and interviews were recorded and transcribed verbatim. Analysis was thematic using constant comparison. Results GPs and nurses can play an important role in identifying women experiencing DVA and referring them to DVA specialist agencies. GPs may also have an important role to play in helping women maintain any changes they make as a result of referral to an advocate, by asking about DVA in subsequent consultations. Conclusion A short time interval between a primary care referral and initial contact with an advocate was valued by some women. For the initial contact with an advocate to happen as soon as possible after a primary care referral has been made, a close working relationship between primary care and the third sector needs to be cultivated. PMID:24567654

  1. Which Perceptions Do We Have Related to Our Rights as Child? Child Rights from the Perspective of Primary School Students

    ERIC Educational Resources Information Center

    Hareket, Erdem; Yel, Selma

    2017-01-01

    This study was carried out with the goal of investigation of perceptions and views which are related to children's rights of forth grade primary school students. The research was designed properly to qualitative research approach. This research was made with 156 4th grade students. In determining of the research group, criterion sampling technique…

  2. Determining the Appropriateness of Visual Based Activities in the Primary School Books for Low Vision Students

    ERIC Educational Resources Information Center

    Cakmak, Salih; Yilmaz, Hatice Cansu; Isitan, Hacer Damlanur

    2017-01-01

    The general aim of this research is to try to determine the appropriateness of the visuals in the primary school Turkish workbooks for the students with low visibility in terms of visual design elements. In the realization of the work, the document review method was used. In this study, purposive sampling method was used in the selection of…

  3. Influence of General Self-Efficacy on the Effects of a School-Based Universal Primary Prevention Program of Depressive Symptoms in Adolescents: A Randomized and Controlled Follow-up Study

    ERIC Educational Resources Information Center

    Possel, Patrick; Baldus, Christiane; Horn, Andrea B.; Groen, Gunter; Hautzinger, Martin

    2005-01-01

    Background: Depressive disorders in adolescents are a widespread and increasing problem. Prevention seems a promising and feasible approach. Methods: We designed a cognitive-behavioral school-based universal primary prevention program and followed 347 eighth-grade students participating in a randomized controlled trial for three months. Results:…

  4. Developing a Peace Education Curriculum for Vietnamese Primary Schools: A Case Study of Participatory Action Research in Cross-Cultural Design

    ERIC Educational Resources Information Center

    Conley Tyler, Melissa H.; Bretherton, Diane; Halafoff, Anna; Nietschke, Yung

    2008-01-01

    In 2003, the International Conflict Resolution Centre at the University of Melbourne, Australia, produced a primary school teaching manual for UNESCO Vietnam. The finished manual included lesson plans and materials for a five year, 50 lesson peace education course. The manual is one of the first examples of a systematic core national curriculum in…

  5. The Effects of an Individualised ICT-Based Music Education Programme on Primary School Students' Musical Competence and Grades

    ERIC Educational Resources Information Center

    Hernández-Bravo, Juan R.; Cardona-Moltó, M. Cristina; Hernández-Bravo, José A.

    2016-01-01

    The purpose of this study was to examine the effect of an information and communications technology (ICT)-based individualised music education programme on primary students' musical competence. A 2 × 3 aptitude treatment interaction factorial design was used to assess the impact of the programme as a function of students' musical aptitude (MA)…

  6. "If Michael Owen Drinks It, Why Can't I? "--9 and 10 Year Olds' Perceptions of Physical Activity and Healthy Eating

    ERIC Educational Resources Information Center

    Gosling, Rachael; Stanistreet, Debbi; Swami, Viren

    2008-01-01

    Objective: To explore the perceptions of physical activity and healthy eating among children from two north west of England primary schools, with the ultimate aim of improving healthy lifestyle choices. Design: A qualitative study in which each child participated in two focus groups. Setting: Two primary schools in a deprived ward of Warrington,…

  7. Using Blended Learning to Facilitate the Mathematical thought Processes of Primary School Learners in a Computer Laboratory: A Case Study in Calculating Simple Areas

    ERIC Educational Resources Information Center

    Naidoo, N.; Naidoo, R.

    2007-01-01

    Primary school learners' first encounters with mathematics in a traditional learning environment often create lifelong "math phobia."(Papert 1980) The situation in a country emerging from an oppressive education system designed to educationally disempower the majority of the population is much worse. The typical scenario in a previously…

  8. Examination of the Mathematical Problem-Solving Beliefs and Success Levels of Primary School Teacher Candidates through the Variables of Mathematical Success and Gender

    ERIC Educational Resources Information Center

    Bal, Ayten Pinar

    2015-01-01

    The aim of this study is to examine the mathematical problem-solving beliefs and problem-solving success levels of primary school teacher candidates through the variables of academic success and gender. The research was designed according to the mixed methods technique in which qualitative and quantitative methods are used together. The working…

  9. Understanding the Primary School Students' Van Hiele Levels of Geometry Thinking in Learning Shapes and Spaces: A Q-Methodology

    ERIC Educational Resources Information Center

    Hock, Tan Tong; Tarmizi, Rohani Ahmad; Yunus, Aida Suraya Md.; Ayub, Ahmad Fauzi

    2015-01-01

    This study was conducted using a new hybrid method of research which combined qualitative and quantitative designs to investigate the viewpoints of primary school students' conceptual understanding in learning geometry from the aspect of shapes and spaces according to van Hiele theory. Q-methodology is used in this research to find out what…

  10. Nuclear density evaluation on asphaltic concrete: final report.

    DOT National Transportation Integrated Search

    1967-04-01

    This study was one of two studies designated as Research Project 62-1SB to evaluate the use of nuclear devices in highway construction. (1) The primary objective of this study was to evaluate a nuclear density device for obtaining densities on asphal...

  11. Influence of Drilling Speed on Stability of Tapered Dental Implants: An Ex Vivo Experimental Study.

    PubMed

    Almeida, Karen P; Delgado-Ruiz, Rafael; Carneiro, Leandro G; Leiva, Alberto Bordonaba; Calvo-Guirado, Jose Luis; Gómez-Moreno, Gerardo; Malmström, Hans; Romanos, Georgios E

    2016-01-01

    The aim of this study was to evaluate whether the drilling speed used during implant site preparation influences primary stability. Eighty tapered designed implants (3.8 × 10 mm) were inserted following osteotomies created in solid rigid polyurethane foam (simulating bone type II) and cellular rigid polyurethane foam (simulating bone type IV). Half were prepared using drilling speeds of 800 rpm (low speed), and the other half were prepared using speeds of 1,500 rpm (high speed). Following insertion, implant primary stability was measured using Periotest and Osstell (resonance frequency analysis [RFA]) devices. Two-way analysis of variance (ANOVA) used for this study found that the drilling speed used to create the osteotomies appeared to have no significant impact on primary stability. The bone quality and not the osteotomy drilling speed seems to influence the implant primary stability.

  12. "Greenlight study": a controlled trial of low-literacy, early childhood obesity prevention.

    PubMed

    Sanders, Lee M; Perrin, Eliana M; Yin, H Shonna; Bronaugh, Andrea; Rothman, Russell L

    2014-06-01

    Children who become overweight by age 2 years have significantly greater risks of long-term health problems, and children in low-income communities, where rates of low adult literacy are highest, are at increased risk of developing obesity. The objective of the Greenlight Intervention Study is to assess the effectiveness of a low-literacy, primary-care intervention on the reduction of early childhood obesity. At 4 primary-care pediatric residency training sites across the US, 865 infant-parent dyads were enrolled at the 2-month well-child checkup and are being followed through the 24-month well-child checkup. Two sites were randomly assigned to the intervention, and the other sites were assigned to an attention-control arm, implementing the American Academy of Pediatrics' The Injury Prevention Program. The intervention consists of an interactive educational toolkit, including low-literacy materials designed for use during well-child visits, and a clinician-centered curriculum for providing low-literacy guidance on obesity prevention. The study is powered to detect a 10% difference in the number of children overweight (BMI > 85%) at 24 months. Other outcome measures include observed physician-parent communication, as well as parent-reported information on child dietary intake, physical activity, and injury-prevention behaviors. The study is designed to inform evidence-based standards for early childhood obesity prevention, and more generally to inform optimal approaches for low-literacy messages and health literacy training in primary preventive care. This article describes the conceptual model, study design, intervention content, and baseline characteristics of the study population. Copyright © 2014 by the American Academy of Pediatrics.

  13. ART/Ada design project, phase 1. Task 2 report: Detailed design

    NASA Technical Reports Server (NTRS)

    Allen, Bradley P.

    1988-01-01

    Various issues are studied in the context of the design of an Ada based expert system building tool. Using an existing successful design as a starting point, the impact is analyzed of the Ada language and Ada development methodologies on that design, the Ada system is redesigned, and its performance is analyzed using both complexity-theoretic and empirical techniques. The algorithms specified in the overall design are refined, resolving and documenting any open design issues, identifying each system module, documenting the internal architecture and control logic, and describing the primary data structures involved in the module.

  14. Comparative Effectiveness of Motivation Phase Intervention Components for Use with Smokers Unwilling to Quit: A Factorial Screening Experiment

    PubMed Central

    Cook, Jessica W.; Collins, Linda M.; Fiore, Michael C.; Smith, Stevens S.; Fraser, David; Bolt, Daniel M.; Baker, Timothy B.; Piper, Megan E.; Schlam, Tanya R.; Jorenby, Douglas; Loh, Wei-Yin; Mermelstein, Robin

    2015-01-01

    Aims To screen promising intervention components designed to reduce smoking and promote abstinence in smokers initially unwilling to quit. Design A balanced, 4-factor, randomized factorial experiment. Setting Eleven primary care clinics in southern Wisconsin, USA. Participants 517 adult smokers (63% women, 91% White) recruited during primary care visits who were willing to reduce their smoking but not quit. Interventions Four factors contrasted intervention components designed to reduce smoking and promote abstinence: 1) nicotine patch vs. none; 2) nicotine gum vs. none; 3) motivational interviewing (MI) vs. none; and 4) behavioral reduction counseling (BR) vs. none. Participants could request cessation treatment at any point during the study. Measurements The primary outcome was percent change in cigarettes smoked per day at 26 weeks post-study enrollment; the secondary outcomes were percent change at 12 weeks and point-prevalence abstinence at 12 and 26 weeks post-study enrollment. Findings There were few main effects, but a significant 4-way interaction at 26-weeks post-study enrollment (p=.01, β = .12) revealed relatively large smoking reductions by two component combinations: nicotine gum combined with BR and BR combined with MI. Further, BR improved 12-week abstinence rates (p=.04), and nicotine gum, when used without MI, increased abstinence after a subsequent aided quit attempt (p=.01). Conclusions Motivation-phase nicotine gum and behavioral reduction counseling are promising intervention components for smokers who are initially unwilling to quit. PMID:26582140

  15. Retention of the posterior cruciate ligament versus the posterior stabilized design in total knee arthroplasty: a prospective randomized controlled clinical trial

    PubMed Central

    van den Boom, Lennard GH; Brouwer, Reinoud W; van den Akker-Scheek, Inge; Bulstra, Sjoerd K; van Raaij, Jos JAM

    2009-01-01

    Background Prosthetic design for the use in primary total knee arthroplasty has evolved into designs that preserve the posterior cruciate ligament (PCL) and those in which the ligament is routinely sacrificed (posterior stabilized). In patients with a functional PCL the decision which design is chosen depends largely on the favour and training of the surgeon. The objective of this study is to determine whether the patient's perceived outcome and speed of recovery differs between a posterior cruciate retaining total knee arthroplasty and a posterior stabilized total knee arthroplasty. Methods/Design A randomized controlled trial will be conducted. Patients who are admitted for primary unilateral TKA due to primary osteoarthrosis are included when the following inclusion criteria are met: non-fixed fixed varus or valgus deformity less than 10 degrees, age between 55 and 85 years, body mass index less than 35 kg/m2 and ASA score (American Society of Anaesthesiologists) I or II. Patients are randomized in 2 groups. Patients in the posterior cruciate retaining group will receive a prosthesis with a posterior cut-out for the posterior cruciate ligament and relatively flat topography. In patients allocated to the posterior stabilized group, in which the posterior cruciate ligament is excised, the design may substitute for this function by an intercondylar tibial prominence that articulates with the femur in flexion. Measurements will take place preoperatively and 6 weeks, 3 months, 6 months and 1 year postoperatively. At all measurement points patient's perceived outcome will be assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcome measures are quality of life (SF-36) and physician reported functional status and range of motion as determined with the Knee Society Clinical Rating System (KSS). Discussion In the current practice both posterior cruciate retaining and posterior stabilized designs for total knee arthroplasty are being used. To date no studies have been performed determining whether there is a difference in patient's perceived outcome between the two designs. Additionally, there is a lack of studies determining the speed of recovery in both designs as most studies only determine the final outcome. This randomised controlled study has been designed to determine whether the patient's perceived outcome and speed of recovery differs between a posterior cruciate retaining total knee arthroplasty and a posterior stabilized total knee arthroplasty. Trial Registration The trial is registered in the Netherlands Trial Registry (NTR1673). PMID:19793397

  16. Dissociated emergent-response system and fine-processing system in human neural network and a heuristic neural architecture for autonomous humanoid robots.

    PubMed

    Yan, Xiaodan

    2010-01-01

    The current study investigated the functional connectivity of the primary sensory system with resting state fMRI and applied such knowledge into the design of the neural architecture of autonomous humanoid robots. Correlation and Granger causality analyses were utilized to reveal the functional connectivity patterns. Dissociation was within the primary sensory system, in that the olfactory cortex and the somatosensory cortex were strongly connected to the amygdala whereas the visual cortex and the auditory cortex were strongly connected with the frontal cortex. The posterior cingulate cortex (PCC) and the anterior cingulate cortex (ACC) were found to maintain constant communication with the primary sensory system, the frontal cortex, and the amygdala. Such neural architecture inspired the design of dissociated emergent-response system and fine-processing system in autonomous humanoid robots, with separate processing units and another consolidation center to coordinate the two systems. Such design can help autonomous robots to detect and respond quickly to danger, so as to maintain their sustainability and independence.

  17. Substitution of Hospital Care with Primary Care: Defining the Conditions of Primary Care Plus

    PubMed Central

    Kroese, Mariëlle Elisabeth Aafje Lydia; Spreeuwenberg, Marieke Dingena; Elissen, Arianne Mathilda Josephus; Meerlo, Ronald Johan; Hanraets, Monique Margaretha Henriëtte; Ruwaard, Dirk

    2016-01-01

    Objective: To analyse barriers and facilitators in substituting hospital care with primary care to define preconditions for successful implementation. Methods: A descriptive feasibility study was performed to collect information on the feasibility of substituting hospital care with primary care. General practitioners were able to refer patients, about whom they had doubts regarding diagnosis, treatment and/or the need to refer to hospital care, to medical specialists who performed low-complex consultations at general practitioner practices. Qualitative data were collected through interviews with general practitioners and medical specialists, focus groups and notes from meetings in the Netherlands between April 2013 and January 2014. Data were analysed using a conventional content analysis which resulted in categorised barriers, facilitators and policy adjustments, after which preconditions were formulated. Results: The most important preconditions were make arrangements on governmental level, arrange a collective integrated IT-system, determine the appropriate profile for medical specialists, design a referral protocol for eligible patients, arrange deliberation possibilities for general practitioners and medical specialists and formulate a diagnostic protocol. Conclusions: The barriers, facilitators and formulated preconditions provided relevant input to change the design of substituting hospital care with primary care. PMID:27616956

  18. An innovative acupuncture treatment for primary dysmenorrhea: a randomized cross-over pilot study

    PubMed Central

    Wade, Christine M.; Abercrombie, Priscilla D.; Gomolak, Denise

    2013-01-01

    Background/Objective Dysmenorrhea is highly prevalent among adolescent women and a major cause of activity restriction. Standard pharmaceuticals used to treat dysmenorrhea are not effective for all women and have side effects that limit their use. Our study objective was to examine feasibility, acceptability, and preliminary effects of acupuncture point injection of vitamin K1 as an alternative treatment for primary dysmenorrhea among US women. Methods/Design We conducted a pilot study using a crossover trial design. Women with primary dysmenorrhea were randomized to receive vitamin K1 injection in the Spleen-6 acupuncture point at the start of menstruation followed by saline in a non-acupuncture point after two months, or the reverse order of treatments. Setting/Participants The study was conducted in the San Francisco Bay Area among women 18 and 25 years of age diagnosed with primary dysmenorrhea; fourteen women completed all study visits. Primary Outcome Measure Dysmenorrhea pain intensity was measured using a 0–10 numeric rating scale before and after injections. Results Women had an average 2.5 point decrease in pain after vitamin K1 injection in Spleen-6 (p < 0.001) compared with a 1.8 point decrease after saline (p < 0.001). Change scores of vitamin K1 compared with saline injection approached statistical significance (p < 0.10). Intensity and duration of menstrual symptoms measured by the Cox Retrospective Symptom Score also decreased following injections. After participating, 94% would still agree to go through with the injection therapy and 77% reported they would come every month were the treatment available. Conclusions Findings suggest high acceptability of acupuncture point injection of vitamin K1 as treatment for primary dysmenorrhea among young women in San Francisco. Pain decreased with both treatments, with a trend toward greater pain reduction for vitamin K1/Spleen-6 injection. This is consistent with outcomes from the Obstetrics & Gynecology Hospital in Shanghai, China, where the protocol was developed. PMID:24445356

  19. Patients' experiences of a computerised self-help program for treating depression - a qualitative study of Internet mediated cognitive behavioural therapy in primary care.

    PubMed

    Holst, Anna; Nejati, Shabnam; Björkelund, Cecilia; Eriksson, Maria C M; Hange, Dominique; Kivi, Marie; Wikberg, Carl; Petersson, Eva-Lisa

    2017-03-01

    The objective of this study was to explore primary care patients' experiences of Internet mediated cognitive behavioural therapy (iCBT) depression treatment. Qualitative study. Data were collected from focus group discussions and individual interviews. Primary care. Data were analysed by systematic text condensation by Malterud. Thirteen patients having received iCBT for depression within the PRIM-NET study. Analysis presented different aspects of patients' experiences of iCBT. The informants described a need for face-to-face meetings with a therapist. A therapist who performed check-ups and supported the iCBT process seemed important. iCBT implies that a responsibility for the treatment is taken by the patient, and some patients felt left alone, while others felt well and secure. This was a way to work in privacy and freedom with a smoothly working technology although there was a lack of confidence and a feeling of risk regarding iCBT. iCBT is an attractive alternative to some patients with depression in primary care, but not to all. An individual treatment design seems to be preferred, and elements of iCBT could be included as a complement when treating depression in primary care. Such a procedure could relieve the overall treatment burden of depression. Key points Internet mediated cognitive behavioural therapy (iCBT) can be effective in treating depression in primary care, but patients' experiences of iCBT are rarely studied • Most patients express a need for human contact, real-time interaction, dialogue and guidance when treated for depression. • The patient's opportunity to influence the practical circumstances about iCBT is a success factor, though this freedom brings a large responsibility upon the receiver. • An individual treatment design seems to be crucial, and elements of iCBT could be included as a complement to face-to-face meetings.

  20. A preliminary study of solar powdered aircraft and associated power trains

    NASA Technical Reports Server (NTRS)

    Hall, D. W.; Fortenbach, C. D.; Dimiceli, E. V.; Parks, R. W.

    1983-01-01

    The feasibility of regeneratively powered solar high altitude powered platform (HAPP) remotely piloted vehicles was assessed. Those technologies which must be pursued to make long duration solar HAPPs feasible are recommended. A methodology which involved characterization and parametric analysis of roughly two dozen variables to determine vehicles capable of fulfilling the primary mission are defined. One of these vehicles was then conceptually designed. Variations of each major design parameter were investigated along with state-of-the-art changes in power train component capabilities. The midlatitude mission studied would be attainable by a solar HAPP if fuel cell, electrolyzer and photovoltaic technologies are pursued. Vehicles will be very large and have very lightweight structures in order to attain the combinations of altitude and duration required by the primary mission.

  1. Use of mobile devices in nursing student-nurse teacher cooperation during the clinical practicum: an integrative review.

    PubMed

    Strandell-Laine, Camilla; Stolt, Minna; Leino-Kilpi, Helena; Saarikoski, Mikko

    2015-03-01

    To identify and appraise study findings on the use of mobile devices, in particular for what purposes and how, in nursing student-nurse teacher cooperation during the clinical practicum. A systematic literature search was conducted using the PubMed/Medline, CINAHL, PsycINFO and ERIC for primary empirical studies published in English. An integrative literature review was undertaken. Quality appraisal of the included studies was conducted using design-specific standardized checklists. Studies were thematically analyzed. Based on the inclusion and exclusion criteria, eleven studies were included in the review. Weaknesses in designs, samples, questionnaires and results, compromised comparison and/or generalization of the findings of the studies. Three main themes were identified: (1) features of mobile devices (2) utility of mobile devices and (3) barriers to the use of mobile devices. Problems of connectivity were the main challenges reported in the use of mobile devices. Participants used mobile devices primarily as reference tools, but less frequently as tools for reflection, assessment or cooperation during the clinical practicum. Interest in mobile device use during the clinical practicum was reported, but training and ongoing support are needed. As only a small number of eligible primary empirical studies were found, it is not possible to draw firm conclusions on the results. In the future, rigorous primary empirical studies are needed to explore the potential of mobile devices in providing a supplementary pedagogical method in nursing student-nurse teacher cooperation during the clinical practicum. Robust study designs, including experimental ones, are clearly needed to assess the effectiveness of mobile devices in nursing student-nurse teacher cooperation during the clinical practicum. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. FLUORESCENT TRACER EVALUATION OF PROTECTIVE CLOTHING PERFORMANCE

    EPA Science Inventory

    Field studies evaluating chemical protective clothing (CPC), which is often employed as a primary control option to reduce occupational exposures during pesticide applications, are limited. This study, supported by the U.S. Environmental Protection Agency (EPA), was designed to...

  3. 40 CFR 60.170 - Applicability and designation of affected facility.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Performance for Primary Zinc Smelters § 60.170 Applicability and designation of affected facility. (a) The provisions of this subpart are applicable to the following affected facilities in primary zinc smelters...

  4. Time for Textiles in the Primary Classroom.

    ERIC Educational Resources Information Center

    Paige, Kathy

    1999-01-01

    Outlines how a group of primary teachers developed a range of design briefs using textiles, and describes how students were taught explicit skills which enabled them to successfully solve the design tasks. (WRM)

  5. A multi-center, randomized, double blind placebo-controlled trial of estrogens to prevent Alzheimer’s disease and loss of memory in women: design and baseline characteristics

    PubMed Central

    Sano, Mary; Jacobs, Diane; Andrews, Howard; Bell, Karen; Graff-Radford, Neill; Lucas, John; Rabins, Peter; Bolla, Karen; Tsai, Wei-Yan; Cross, Peter; Andrews, Karen; Costa, Rosann; Luo, Xiaodong

    2012-01-01

    Background Observational studies and small clinical trials suggested that hormone replacement therapy (HRT) decreases risk of cognitive loss and Alzheimer’s disease (AD) in postmenopausal women and may have value in primary prevention. Purpose A clinical trial was designed to determine if HRT delays AD or memory loss. This report describes the rationale and original design of the trial and details extensive modifications that were required to respond to unanticipated findings that emerged from other studies during the course of the trial. Methods The trial was designed as a multi-center, placebo-controlled primary prevention trial for women 65 years of age or older with a family history of dementia. Recruitment from local sites was supplemented by centralized efforts to use names of Medicare beneficiaries. Inclusion criteria included good general health and intact memory functioning. Participants were randomized to HRT or placebo in a 1:1 ratio. Assignment was stratified by hysterectomy status and site. The primary outcomes were incident AD and memory decline on neuropsychological testing. Results Enrollment began in March 1998. In response to the Women’s Health Initiative (WHI) May 2002 report of increased incidence of heart disease, stroke, pulmonary embolism, and breast cancer among women randomized to HRT, participants were re-consented with a revised consent form. Procedural modifications, including discontinuation of study medication and a modification of the planned primary outcome based on a final enrollment below the target enrollment (N = 477), were enacted in response to the subsequent WHI Memory Study report of increased risk of dementia and poorer cognitive function with HRT. The mean length of treatment exposure prior to discontinuation was 2.14 years. Participants’ mean age at baseline was 72.8; mean education was 14.2 years. Minority participation was 19% and 34% had a hysterectomy. The study continues to follow these participants for a total of 5 years blind to the original medication assignment. Limitations Results reported from the WHI during the course of this study mandated extensive procedural modifications, including discontinuing recruitment before completion and halting study medication. Alternative strategies for study redesign that were considered are discussed. PMID:18827045

  6. A trial like ALIC4E: why design a platform, response-adaptive, open, randomised controlled trial of antivirals for influenza-like illness?

    PubMed Central

    Butler, Christopher C.; Coenen, Samuel; Saville, Benjamin R.; Cook, Johanna; van der Velden, Alike; Homes, Jane; de Jong, Menno; Little, Paul; Goossens, Herman; Ieven, Margareta; Francis, Nick; Moons, Pieter; Bongard, Emily; Verheij, Theo

    2018-01-01

    ALIC4E is the first publicly funded, multicountry, pragmatic study determining whether antivirals should be routinely prescribed for influenza-like illness in primary care. The trial aims to go beyond determining the average treatment effect in a population to determining effects in patients with combinations of participant characteristics (age, symptom duration, illness severity, and comorbidities). It is one of the first platform, response-adaptive, open trial designs implemented in primary care, and this article aims to provide an accessible description of key aspects of the study design. 1) The platform design allows the study to remain relevant to evolving circumstances, with the ability to add treatment arms. 2) Response adaptation allows the proportion of participants with key characteristics allocated to study arms to be altered during the course of the trial according to emerging outcome data, so that participants' information will be most useful, and increasing their chances of receiving the trial intervention that will be most effective for them. 3) Because the possibility of taking placebos influences participant expectations about their treatment, and determining effects of the interventions on patient help seeking and adherence behaviour in real-world care is critical to estimates of cost-effectiveness, ALIC4E is an open-label trial. PMID:29761108

  7. Feasibility of using a knowledge-based system concept for in-flight primary flight display research

    NASA Technical Reports Server (NTRS)

    Ricks, Wendell R.

    1991-01-01

    A study was conducted to determine the feasibility of using knowledge-based systems architectures for inflight research of primary flight display information management issues. The feasibility relied on the ability to integrate knowledge-based systems with existing onboard aircraft systems. And, given the hardware and software platforms available, the feasibility also depended on the ability to use interpreted LISP software with the real time operation of the primary flight display. In addition to evaluating these feasibility issues, the study determined whether the software engineering advantages of knowledge-based systems found for this application in the earlier workstation study extended to the inflight research environment. To study these issues, two integrated knowledge-based systems were designed to control the primary flight display according to pre-existing specifications of an ongoing primary flight display information management research effort. These two systems were implemented to assess the feasibility and software engineering issues listed. Flight test results were successful in showing the feasibility of using knowledge-based systems inflight with actual aircraft data.

  8. Design and Development of the Solar Dynamics Observatory (SDO) Electrical Power System

    NASA Technical Reports Server (NTRS)

    Denney, Keys; Burns, Michael; Kercheval, Bradford

    2009-01-01

    The SDO spacecraft was designed to help us understand the Sun's influence on Earth and Near-Earth space by studying the solar atmosphere on small scales of space and time and in many wavelengths simultaneously. It will perform its operations in a geosynchronous orbit of the earth. This paper will present background on the SDO mission, an overview of the design and development activities associated specifically with the SDO electrical power system (EPS), as well as the major driving requirements behind the mission design. The primary coverage of the paper will be devoted to some of the challenges faced during the design and development phase. This will include the challenges associated with development of a compatible CompactPCI (cPCI) interface within the Power System Electronics (PSE) in order to utilize a "common" processor card, implementation of new solid state power controllers (SSPC) for primary load distribution switching and over current protection in the PSE, and the design approach adopted to meet single fault tolerance requirements for all of the SDO EPS functions.

  9. Physical models and primary design of reactor based slow positron source at CMRR

    NASA Astrophysics Data System (ADS)

    Wang, Guanbo; Li, Rundong; Qian, Dazhi; Yang, Xin

    2018-07-01

    Slow positron facilities are widely used in material science. A high intensity slow positron source is now at the design stage based on the China Mianyang Research Reactor (CMRR). This paper describes the physical models and our primary design. We use different computer programs or mathematical formula to simulate different physical process, and validate them by proper experiments. Considering the feasibility, we propose a primary design, containing a cadmium shield, a honeycomb arranged W tubes assembly, electrical lenses, and a solenoid. It is planned to be vertically inserted in the Si-doping channel. And the beam intensity is expected to be 5 ×109

  10. Progress in the development of an H{sup −} ion source for cyclotrons

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

    Etoh, H., E-mail: Hrh-Etoh@shi.co.jp; Aoki, Y.; Mitsubori, H.

    2015-04-08

    A multi-cusp DC H{sup −} ion source has been developed for cyclotrons in medical use. Beam optics of the H{sup −} ion beam is studied using a 2D beam trajectory code. The simulation results are compared with the experimental results obtained in the Mark I source, which has produced up to 16 mA H{sup −} ion beams. The optimum extraction voltages show good agreement between the calculation and the experimental results. A new ion source, Mark II source, is designed to achieve the next goal of producing an H{sup −} beam of 20 mA. The magnetic field configurations and the plasma electrodemore » design are optimized for Cs-seeded operation. Primary electron trajectory simulation shows that primary electrons are confined well and the magnetic filter prevents the primary electrons from entering into the extraction region.« less

  11. Opto-mechanical design and gravity-deformation analysis on optical telescope in laser communication system

    NASA Astrophysics Data System (ADS)

    Fu, Sen; Du, Jindan; Song, Yiwei; Gao, Tianyu; Zhang, Daqing; Wang, Yongzhi

    2017-11-01

    In space laser communication, optical antennas are one of the main components and the precision of optical antennas is very high. In this paper, it is based on the R-C telescope and it is carried out that the design and simulation of optical lens and supporting truss, according to the parameters of the systems. And a finite element method (FEM) was used to analyze the deformation of the optical lens. Finally, the Zernike polynomial was introduced to fit the primary mirror with a diameter of 250mm. The objective of this study is to determine whether the wave-front aberration of the primary mirror can meet the imaging quality. The results show that the deterioration of the imaging quality caused by the gravity deformation of primary and secondary mirrors. At the same time, the optical deviation of optical antenna increase with the diameter of the pupil.

  12. Computational design of high efficiency release targets for use at ISOL facilities

    NASA Astrophysics Data System (ADS)

    Liu, Y.; Alton, G. D.; Middleton, J. W.

    1999-06-01

    This report describes efforts made at the Oak Ridge National Laboratory to design high-efficiency-release targets that simultaneously incorporate the short diffusion lengths, high permeabilities, controllable temperatures, and heat removal properties required for the generation of useful radioactive ion beam (RIB) intensities for nuclear physics and astrophysics research using the isotope separation on-line (ISOL) technique. Short diffusion lengths are achieved either by using thin fibrous target materials or by coating thin layers of selected target material onto low-density carbon fibers such as reticulated vitreous carbon fiber (RVCF) or carbon-bonded-carbon-fiber (CBCF) to form highly permeable composite target matrices. Computational studies which simulate the generation and removal of primary beam deposited heat from target materials have been conducted to optimize the design of target/heat-sink systems for generating RIBs. The results derived from diffusion release-rate simulation studies for selected targets and thermal analyses of temperature distributions within a prototype target/heat-sink system subjected to primary ion beam irradiation will be presented in this report.

  13. High-efficiency-release targets for use at ISOL facilities: computational design

    NASA Astrophysics Data System (ADS)

    Liu, Y.; Alton, G. D.

    1999-12-01

    This report describes efforts made at the Oak Ridge National Laboratory to design high-efficiency-release targets that simultaneously incorporate the short diffusion lengths, high permeabilities, controllable temperatures, and heat-removal properties required for the generation of useful radioactive ion beam (RIB) intensities for nuclear physics and astrophysics research using the isotope separation on-line (ISOL) technique. Short diffusion lengths are achieved either by using thin fibrous target materials or by coating thin layers of selected target material onto low-density carbon fibers such as reticulated-vitreous-carbon fiber (RVCF) or carbon-bonded-carbon fiber (CBCF) to form highly permeable composite target matrices. Computational studies that simulate the generation and removal of primary beam deposited heat from target materials have been conducted to optimize the design of target/heat-sink systems for generating RIBs. The results derived from diffusion release-rate simulation studies for selected targets and thermal analyses of temperature distributions within a prototype target/heat-sink system subjected to primary ion beam irradiation are presented in this report.

  14. 30 CFR 585.707 - What are the CVA's primary duties for facility design review?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 2 2014-07-01 2014-07-01 false What are the CVA's primary duties for facility design review? 585.707 Section 585.707 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF...; (5) Stress analyses; (6) Material designations; (7) Soil and foundation conditions; (8) Safety...

  15. 30 CFR 585.707 - What are the CVA's primary duties for facility design review?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 2 2012-07-01 2012-07-01 false What are the CVA's primary duties for facility design review? 585.707 Section 585.707 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF...; (5) Stress analyses; (6) Material designations; (7) Soil and foundation conditions; (8) Safety...

  16. 30 CFR 585.707 - What are the CVA's primary duties for facility design review?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 2 2013-07-01 2013-07-01 false What are the CVA's primary duties for facility design review? 585.707 Section 585.707 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF...; (5) Stress analyses; (6) Material designations; (7) Soil and foundation conditions; (8) Safety...

  17. 30 CFR 285.707 - What are the CVA's primary duties for facility design review?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false What are the CVA's primary duties for facility design review? 285.707 Section 285.707 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, REGULATION... data; (4) Load determinations; (5) Stress analyses; (6) Material designations; (7) Soil and foundation...

  18. 30 CFR 250.916 - What are the CVA's primary duties during the design phase?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false What are the CVA's primary duties during the design phase? 250.916 Section 250.916 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, REGULATION... data; (iv) Load determinations; (v) Stress analyses; (vi) Material designations; (vii) Soil and...

  19. Turbomachinery design considerations for the nuclear HTGR-GT power plant

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

    McDonald, C.F.; Smith, M.J.

    1979-11-01

    For several years, design studies have been under way in the USA on a nuclear closed-cycle gas turbine plant (HTGR-GT). Design aspects of the helium turbomachine portion of these studies are presented. Gas dynamic and mechanical design considerations are presented for helium turbomachines in the 400-MW(e) (non-intercooled) and 600-MW(e) (intercooled) power range. Design of the turbomachine is a key element in the overall power plant program effort, which is currently directed toward the selection of a reference HTGR-GT commercial plant configuration for the US utility market. A conservative design approach has been emphasized to provide maximum safety and durability. Themore » studies presented for the integrated plant concept outline the necessary close working relationship between the reactor primary system and turbomachine designers.« less

  20. Progress on SOFIA primary mirror

    NASA Astrophysics Data System (ADS)

    Geyl, Roland; Tarreau, Michel

    2000-06-01

    REOSC, SAGEM Group, has a significant contribution to the SOFIA project with the design and fabrication of the 2.7-m primary mirror and its fixtures as well as the M3 mirror tower assembly. This paper will primarily report the progress made on the primary mirror design and the first important manufacturing step: its lightweighting by machining pockets from the rear side of the blank.

  1. Rationale and design of the 'F.I.R.E.' study. A multicenter, double-blind, randomized, placebo-controlled study to measure the effect of FX06 (a fibrin-derived peptide Bbeta(15-42)) on ischemia-reperfusion injury in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.

    PubMed

    Atar, Dan; Huber, Kurt; Rupprecht, Hans-Jürgen; Kopecky, Stephen L; Schwitter, Jürg; Theek, Carmen; Brandl, Katherine; Henning, Rainer; Geudelin, Bernard

    2007-01-01

    Immediate reopening of acutely occluded coronary arteries via primary percutaneous coronary intervention (PCI) is the treatment of choice to salvage the ischemic myocardium in the setting of ST-segment elevation myocardial infarction (STEMI). However, the sudden re-initiation of blood flow achieved with PCI can lead to a local acute inflammatory response with further endothelial and myocardial damage. This phenomenon, described as 'reperfusion injury', has been recognized for several decades, yet no pharmacologic intervention has so far succeeded in reducing myocardial damage linked to reperfusion. FX06 is a naturally occurring peptide derived from the neo-N-terminus of fibrin (Bbeta(15-42)). It prevents leukocyte migration through the gap junctions of endothelial cells. Experimental studies have shown that FX06 inhibits the binding of the proinflammatory fibrin E1 fragment to VE-cadherin expressed in the adherence junction. It represents a novel approach to reducing local and systemic inflammation, including myocardial reperfusion injury, in the adherens junction. The present multicenter, double-blind, randomized, placebo-controlled study is designed to test the hypothesis that FX06 injection during and immediately after primary PCI can reduce infarct size in patients with STEMI. The primary outcome measure of efficacy in this study is the degree of myocardial salvage calculated as the difference between the perfusion defect before and after PCI, determined by myocardial perfusion scintigraphy during rest. Further, infarct size at the end of the index hospitalization, as well as at 4 months, will be measured by cardiac magnetic resonance imaging. The present position paper describes the rationale, design and the methods utilized in this trial. 2007 S. Karger AG, Basel

  2. Tobacco use disorder treatment in primary care

    PubMed Central

    Kunyk, Diane; Els, Charl; Papadakis, Sophia; Selby, Peter

    2014-01-01

    Abstract Objective To test a team-based, site-specific, multicomponent clinical system pathway designed for enhancing tobacco use disorder treatment by primary care physicians. Design A prospective cohort study. Setting Sixty primary care sites in Alberta. Participants A convenience sample of 198 primary care physicians from the population of 2857. Main outcome measures Data collection occurred between September 2010 and February 2012 on 3 distinct measures. Twenty-four weeks after the intervention, audits of the primary care practices assessed the adoption and sustainability of 10 tobacco clinical system pathway components, a survey measured changes in physicians’ treatment intentions, and patient chart reviews examined changes in physicians’ consistency with the treatment algorithm. Results The completion rate by physicians was 89.4%. An intention-to-treat approach was undertaken for statistical analysis. Intervention uptake was demonstrated by positive changes at 4 weeks in how many of the 10 clinical system measures were performed (mean [SD] = 4.22 [1.60] vs 8.57 [1.46]; P < .001). Physicians demonstrated significant favourable changes in 9 of the 12 measures of treatment intention (P < .05). The 18 282 chart reviews documented significant increases in 6 of the 8 algorithm components. Conclusion Our findings suggest that the provision of a tobacco clinical system pathway that incorporates other members of the health care team and builds on existing office infrastructures will support positive and sustainable changes in tobacco use disorder treatment by physicians in primary care. This study reaffirms the substantive and important role of supporting how treatment is delivered in physicians’ practices. PMID:25022640

  3. Screening for increased cardiometabolic risk in primary care: a systematic review

    PubMed Central

    den Engelsen, Corine; Koekkoek, Paula S; Godefrooij, Merijn B; Spigt, Mark G; Rutten, Guy E

    2014-01-01

    Background Many programmes to detect and prevent cardiovascular disease (CVD) have been performed, but the optimal strategy is not yet clear. Aim To present a systematic review of cardiometabolic screening programmes performed among apparently healthy people (not yet known to have CVD, diabetes, or cardiometabolic risk factors) and mixed populations (apparently healthy people and people diagnosed with risk factor or disease) to define the optimal screening strategy. Design and setting Systematic review of studies performed in primary care in Western countries. Method MEDLINE, Embase, and CINAHL databases were searched for studies screening for increased cardiometabolic risk. Exclusion criteria were studies designed to assess prevalence of risk factors without follow-up or treatment; without involving a GP; when fewer than two risk factors were considered as the primary outcome; and studies constrained to ethnic minorities. Results The search strategy yielded 11 445 hits; 26 met the inclusion criteria. Five studies (1995–2012) were conducted in apparently healthy populations: three used a stepwise method. Response rates varied from 24% to 79%. Twenty-one studies (1967–2012) were performed in mixed populations; one used a stepwise method. Response rates varied from 50% to 75%. Prevalence rates could not be compared because of heterogeneity of used thresholds and eligible populations. Observed time trends were a shift from mixed to apparently healthy populations, increasing use of risk scores, and increasing use of stepwise screening methods. Conclusion The optimal screening strategy in primary care is likely stepwise, in apparently healthy people, with the use of risk scores. Increasing public awareness and actively involving GPs might facilitate screening efficiency and uptake. PMID:25267047

  4. Stepped Care to Optimize Pain care Effectiveness (SCOPE) trial study design and sample characteristics.

    PubMed

    Kroenke, Kurt; Krebs, Erin; Wu, Jingwei; Bair, Matthew J; Damush, Teresa; Chumbler, Neale; York, Tish; Weitlauf, Sharon; McCalley, Stephanie; Evans, Erica; Barnd, Jeffrey; Yu, Zhangsheng

    2013-03-01

    Pain is the most common physical symptom in primary care, accounting for an enormous burden in terms of patient suffering, quality of life, work and social disability, and health care and societal costs. Although collaborative care interventions are well-established for conditions such as depression, fewer systems-based interventions have been tested for chronic pain. This paper describes the study design and baseline characteristics of the enrolled sample for the Stepped Care to Optimize Pain care Effectiveness (SCOPE) study, a randomized clinical effectiveness trial conducted in five primary care clinics. SCOPE has enrolled 250 primary care veterans with persistent (3 months or longer) musculoskeletal pain of moderate severity and randomized them to either the stepped care intervention or usual care control group. Using a telemedicine collaborative care approach, the intervention couples automated symptom monitoring with a telephone-based, nurse care manager/physician pain specialist team to treat pain. The goal is to optimize analgesic management using a stepped care approach to drug selection, symptom monitoring, dose adjustment, and switching or adding medications. All subjects undergo comprehensive outcome assessments at baseline, 1, 3, 6 and 12 months by interviewers blinded to treatment group. The primary outcome is pain severity/disability, and secondary outcomes include pain beliefs and behaviors, psychological functioning, health-related quality of life and treatment satisfaction. Innovations of SCOPE include optimized analgesic management (including a stepped care approach, opioid risk stratification, and criteria-based medication adjustment), automated monitoring, and centralized care management that can cover multiple primary care practices. Published by Elsevier Inc.

  5. “Greenlight Study”: A Controlled Trial of Low-Literacy, Early Childhood Obesity Prevention

    PubMed Central

    Perrin, Eliana M.; Yin, H. Shonna; Bronaugh, Andrea; Rothman, Russell L.

    2014-01-01

    Children who become overweight by age 2 years have significantly greater risks of long-term health problems, and children in low-income communities, where rates of low adult literacy are highest, are at increased risk of developing obesity. The objective of the Greenlight Intervention Study is to assess the effectiveness of a low-literacy, primary-care intervention on the reduction of early childhood obesity. At 4 primary-care pediatric residency training sites across the US, 865 infant-parent dyads were enrolled at the 2-month well-child checkup and are being followed through the 24-month well-child checkup. Two sites were randomly assigned to the intervention, and the other sites were assigned to an attention-control arm, implementing the American Academy of Pediatrics' The Injury Prevention Program. The intervention consists of an interactive educational toolkit, including low-literacy materials designed for use during well-child visits, and a clinician-centered curriculum for providing low-literacy guidance on obesity prevention. The study is powered to detect a 10% difference in the number of children overweight (BMI > 85%) at 24 months. Other outcome measures include observed physician–parent communication, as well as parent-reported information on child dietary intake, physical activity, and injury-prevention behaviors. The study is designed to inform evidence-based standards for early childhood obesity prevention, and more generally to inform optimal approaches for low-literacy messages and health literacy training in primary preventive care. This article describes the conceptual model, study design, intervention content, and baseline characteristics of the study population. PMID:24819570

  6. Partnership disengagement from primary community care networks (PCCNs): A qualitative study for a national demonstration project

    PubMed Central

    2010-01-01

    Background The Primary Community Care Network (PCCN) Demonstration Project, launched by the Bureau of National Health Insurance (BNHI) in 2003, is still in progress. Partnership structures in PCCNs represent both contractual clinic-to-clinic and clinic-to-hospital member relationships of organizational aspects. The partnership structures are the formal relationships between individuals and the total network. Their organizational design aims to ensure effective communication, coordination, and integration across the total network. Previous studies have focused largely on how contractual integration among the partnerships works and on its effects. Few studies, however, have tried to understand partnership disengagement in PCCNs. This study explores why some partnerships in PCCNs disengage. Methods This study used a qualitative methodology with semi-structured questions for in-depth interviews. The semi-structured questions were pre-designed to explore the factors driving partnership disengagement. Thirty-seven clinic members who had withdrawn from their PCCNs were identified from the 2003-2005 Taiwan Primary Community Care Network Lists. Results Organization/participant factors (extra working time spend and facility competency), network factors (partner collaboration), and community factors (health policy design incompatibility, patient-physician relationship, and effectiveness) are reasons for clinic physicians to withdraw or change their partnerships within the PCCNs. Conclusions To strengthen partnership relationships, several suggestions are made, including to establish clinic and hospital member relationships, and to reduce administrative work. In addition, both educating the public about the concept of family doctors and ensuring well-organized national health policies could help health care providers improve the integration processes. PMID:20359369

  7. Children's Perceptions of Illness and Health: An Analysis of Drawings

    ERIC Educational Resources Information Center

    Mouratidi, Paraskevi-Stavroula; Bonoti, Fotini; Leondari, Angeliki

    2016-01-01

    Objective: The purpose of this study was to explore possible age differences in children's perceptions of illness and health and to what extent these differ from adults' perceptions. Design: Cross-sectional design. Setting: Selected nursery and primary schools in Greece. Method: The sample consisted of 347 children aged 5-11 years and 114…

  8. Content and Language Integrated Learning through an Online Game in Primary School: A Case Study

    ERIC Educational Resources Information Center

    Dourda, Kyriaki; Bratitsis, Tharrenos; Griva, Eleni; Papadopoulou, Penelope

    2014-01-01

    In this paper an educational design proposal is presented which combines two well established teaching approaches, that of Game-based Learning (GBL) and Content and Language Integrated Learning (CLIL). The context of the proposal was the design of an educational geography computer game, utilizing QR Codes and Google Earth for teaching English…

  9. Greenhouse Affect: The Relationship between the Sustainable Design of Schools and Children's Environmental Attitudes

    ERIC Educational Resources Information Center

    Izadpanahi, Parisa; Elkadi, Hisham; Tucker, Richard

    2017-01-01

    This study aims to determine if primary school children's environmental attitudes can be predicted by whether their school had been designed or adapted for sustainability. A New Ecological Paradigm ("NEP") scale for children was adopted to measure attitudes, with supplementary questions added to align this scale to the Australian context…

  10. HEALTHY study rationale, design and methods: Moderating risk of type 2 diabetes in multi-ethnic middle school students

    USDA-ARS?s Scientific Manuscript database

    The HEALTHY primary prevention trial was designed and implemented in response to the growing numbers of children and adolescents being diagnosed with type 2 diabetes. The objective was to moderate risk factors for type 2 diabetes. Modifiable risk factors measured were indicators of adiposity and gly...

  11. Web Consulting for Non-Academic Educational Missions: How Instructional Design Offers a Competitive Advantage

    ERIC Educational Resources Information Center

    Cates, Ward Mitchell; Mattke, Paige Hawkins

    2013-01-01

    Based on a recently completed study of education directors at science museums, this article addresses how design-and-development consultants might use those findings to enhance the way in which they propose and deliver Website services to non-academic organizations with either primary or complementary educational missions. After a very brief…

  12. Determinants of Preventive Health Behavior in Relation to Cervical Cancer Screening among the Female Population of Belgrade

    ERIC Educational Resources Information Center

    Matejic, Bojana; Vukovic, Dejana; Pekmezovic, Tatjana; Kesic, Vesna; Markovic, Milica

    2011-01-01

    Identifying the factors that deter or stimulate the women to participate in screening activities is very important in order to design effective education and motivation strategies, particularly in the countries without an organized system. The study employed a case-control design. The participants were recruited in four primary health care…

  13. The Use of Genre Analysis in the Design of Electronic Meeting Systems

    ERIC Educational Resources Information Center

    Antunes, Pedro; Costa, Carlos J.; Pino, José A.

    2006-01-01

    Introduction: Genre analysis is an approach to study communication patterns and thus it can be applied to the specific context of meetings. This research investigates the use of genre analysis in the design of electronic meeting systems. Background: The primary goal of genre analysis is to understand how virtual communities use digital…

  14. Results from an Exploratory Study of Sun Protection Practice: Implications for the Design of Health Promotion Messages

    ERIC Educational Resources Information Center

    Eadie, Douglas; MacAskill, Susan

    2007-01-01

    Purpose: The primary aim of the research reported here is to provide strategic guidance for the development of a national communication strategy to improve sun protection practice amongst young people. Design/methodology/approach: The research adopted an exploratory approach, employing qualitative focus groups to represent three population groups,…

  15. An experiment to study the nuclear component of primary cosmic rays

    NASA Technical Reports Server (NTRS)

    Paul, J. M.; Verma, S. D.

    1971-01-01

    An apparatus has been designed and is being fabricated to study the charge composition, fluxes, and energy spectra of light nuclei in the energy region from 1 GeV to 100 GeV. The apparatus essentially consists of an array of a large number of particle detectors operated in coincidence and serving as a charged particle telescope. A mosaic silicon semiconductor detector, a plastic scintillation counter and a lucite Cerenkov detector are used to measure the charges of the incident nuclei. Two one-inch thick CsI detectors are used to study low energy particles. An ionization spectrometer is utilized to measure primary energies in the 1 to 100 GeV energy interval. A gas Cerenkov counter is being designed to distinguish between electrons and protons. It is planned to calibrate the apparatus at an accelerator using particles of known energy.

  16. Feasibility and effectiveness of the implementation of a primary prevention programme for type 2 diabetes in routine primary care practice: a phase IV cluster randomised clinical trial

    PubMed Central

    2012-01-01

    Background The objective of this study is to perform an independent evaluation of the feasibility and effectiveness of an educational programme for the primary prevention of type 2 diabetes (DM2) in high risk populations in primary care settings, implanted within the Basque Health Service - Osakidetza. Methods/design This is a prospective phase IV cluster clinical trial conducted under routine conditions in 14 primary health care centres of Osakidetza, randomly assigned to an intervention or control group. We will recruit a total sample of 1089 individuals, aged between 45 and 70 years old, without diabetes but at high risk of developing the condition (Finnish Diabetes Risk Score, FINDRISC ≥ 14) and follow them up for 2 years. Primary health care nursing teams of the intervention centres will implement DE-PLAN, a structured educational intervention program focused on changing healthy lifestyles (diet and physical activity); while the patients in the control centres will receive the usual care for the prevention and treatment of DM2 currently provided in Osakidetza. The effectiveness attributable to the programme will be assessed by comparing the changes observed in patients exposed to the intervention and those in the control group, with respect to the risk of developing DM2 and lifestyle habits. In terms of feasibility, we will assess indicators of population coverage and programme implementation. Discussion The aim of this study is to provide the scientific basis for disseminate the programme to the remaining primary health centres in Osakidetza, as a novel way of addressing prevention of DM2. The study design will enable us to gather information on the effectiveness of the intervention as well as the feasibility of implementing it in routine practice. Trial registration ClinicalTrials.gov NCT01365013 PMID:23158830

  17. [The Jena Anxiety Monitoring List (JAMoL) - a tool for the evidence-based treatment of panic disorder with or without agoraphobia in primary care].

    PubMed

    Hiller, Thomas Stephan; Freytag, Antje; Breitbart, Jörg; Teismann, Tobias; Schöne, Elisabeth; Blank, Wolfgang; Schelle, Mercedes; Vollmar, Horst Christian; Margraf, Jürgen; Gensichen, Jochen

    2018-04-01

    Behavior therapy-oriented methods are recommended for treating anxiety disorders in primary care. The treatment of patients with long-term conditions can be improved by case management and structured clinical monitoring. The present paper describes the rationale, design and application of the 'Jena Anxiety Monitoring List' (JAMoL), a monitoring tool for the treatment of patients with panic disorder, with or without agoraphobia, in primary care. JAMoL's design was based on established clinical measures, the rationale of exposure-based anxiety treatment, and research on family practice-based case management. After piloting, the JAMoL was used in the clinical study 'Jena-PARADISE' (ISRCTN64669297), where non-physician practice staff monitored patients with panic disorder by telephone. Using semi-structured interviews in concomitant studies, study participants were asked about the instrument's functionality. The JAMoL assesses the severity of anxiety symptoms (6 items) as well as the patient's adherence to therapy (4 items) and fosters the case management-related information exchange (3 items). An integrated traffic light scheme facilitates the evaluation of monitoring results. Within the clinical study, non-physician practice staff carried out a total of 1,525 JAMoL-supported monitoring calls on 177 patients from 30 primary care practices (median calls per patient: 10 [interquartile range, 9-10]). Qualitative analyses revealed that most practice teams and patients rated the JAMoL as a practicable and treatment-relevant tool. The JAMoL enables primary care practice teams to continuously monitor anxiety symptoms and treatment adherence in patients with panic disorder with or without agoraphobia. Within the behavior therapy-oriented treatment program 'Jena-PARADISE', the JAMoL constitutes an important case management tool. Copyright © 2018. Published by Elsevier GmbH.

  18. Evaluation of the National Assessment of Educational Progress. Study Reports

    ERIC Educational Resources Information Center

    Buckendahl, Chad W.; Davis, Susan L.; Plake, Barbara S.; Sireci, Stephen G.; Hambleton, Ronald K.; Zenisky, April L.; Wells, Craig S.

    2009-01-01

    The "Evaluation of the National Assessment of Educational Progress: Study Reports" describes the special studies that comprised the design of the evaluation. In the Final Report, the authors presented a practical discussion of the evaluation studies to its primary, intended audience, namely policymakers. On this accompanying CD, readers…

  19. The 6th Grade Primary History Book and the Reactions of the Greek and Cypriot Educational Communities and Societies

    ERIC Educational Resources Information Center

    Kimitris, Petros N.

    2017-01-01

    The present study was designed to explore the role of Rebousi et al's primary 6th grade history school book in evaluating the experience of a nation but also to examine the causes behind the reactions of political parties, historians and the wider public. History books and politics have very deep roots that reflect on old responsibilities,…

  20. Designing and Using an Organisational Culture Inquiry Tool to Glimpse the Relational Nature of Leadership and Organisational Culture within a South Australian Primary School

    ERIC Educational Resources Information Center

    Giles, David; Bills, Andrew

    2017-01-01

    This case study research found that the relational leadership and organisational culture at a public primary school situated in a high poverty location in South Australia was built upon the strength of the inter-relationships between the teachers, teachers and leadership, and between teachers and students. Supported by what we called "dynamic…

  1. The effect of financial incentives on the quality of health care provided by primary care physicians.

    PubMed

    Scott, Anthony; Sivey, Peter; Ait Ouakrim, Driss; Willenberg, Lisa; Naccarella, Lucio; Furler, John; Young, Doris

    2011-09-07

    The use of blended payment schemes in primary care, including the use of financial incentives to directly reward 'performance' and 'quality' is increasing in a number of countries. There are many examples in the US, and the Quality and Outcomes Framework (QoF) for general practitioners (GPs) in the UK is an example of a major system-wide reform. Despite the popularity of these schemes, there is currently little rigorous evidence of their success in improving the quality of primary health care, or of whether such an approach is cost-effective relative to other ways to improve the quality of care. The aim of this review is to examine the effect of changes in the method and level of payment on the quality of care provided by primary care physicians (PCPs) and to identify:i) the different types of financial incentives that have improved quality;ii) the characteristics of patient populations for whom quality of care has been improved by financial incentives; andiii) the characteristics of PCPs who have responded to financial incentives. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of Systematic Reviews (CDSR) (The Cochrane Library), MEDLINE, HealthSTAR, EMBASE, CINAHL, PsychLIT, and ECONLIT. Searches of Internet-based economics and health economics working paper collections were also conducted. Finally, studies were identified through the reference lists of retrieved articles, websites of key organisations, and from direct contact with key authors in the field. Articles were included if they were published from 2000 to August 2009. Randomised controlled trials (RCT), controlled before and after studies (CBA), and interrupted time series analyses (ITS) evaluating the impact of different financial interventions on the quality of care delivered by primary healthcare physicians (PCPs). Quality of care was defined as patient reported outcome measures, clinical behaviours, and intermediate clinical and physiological measures. Two review authors independently extracted data and assessed study quality, in consultation with two other review authors where there was disagreement. For each included study, we reported the estimated effect sizes and confidence intervals. Seven studies were included in this review. Three of the studies evaluated single-threshold target payments, one examined a fixed fee per patient achieving a specified outcome, one study evaluated payments based on the relative ranking of medical groups' performance (tournament-based pay), one study examined a mix of tournament-based pay and threshold payments, and one study evaluated changing from a blended payments scheme to salaried payment. Three cluster RCTs examined smoking cessation; one CBA examined patients' assessment of the quality of care; one CBA examined cervical screening, mammography screening, and HbA1c; one ITS focused on four outcomes in diabetes; and one controlled ITS (a difference-in-difference design) examined cervical screening, mammography screening, HbA1c, childhood immunisation, chlamydia screening, and appropriate asthma medication. Six of the seven studies showed positive but modest effects on quality of care for some primary outcome measures, but not all. One study found no effect on quality of care. Poor study design led to substantial risk of bias in most studies. In particular, none of the studies addressed issues of selection bias as a result of the ability of primary care physicians to select into or out of the incentive scheme or health plan. The use of financial incentives to reward PCPs for improving the quality of primary healthcare services is growing. However, there is insufficient evidence to support or not support the use of financial incentives to improve the quality of primary health care. Implementation should proceed with caution and incentive schemes should be more carefully designed before implementation. In addition to basing incentive design more on theory, there is a large literature discussing experiences with these schemes that can be used to draw out a number of lessons that can be learned and that could be used to influence or modify the design of incentive schemes. More rigorous study designs need to be used to account for the selection of physicians into incentive schemes. The use of instrumental variable techniques should be considered to assist with the identification of treatment effects in the presence of selection bias and other sources of unobserved heterogeneity. In randomised trials, care must be taken in using the correct unit of analysis and more attention should be paid to blinding. Studies should also examine the potential unintended consequences of incentive schemes by having a stronger theoretical basis, including a broader range of outcomes, and conducting more extensive subgroup analysis. Studies should more consistently describe i) the type of payment scheme at baseline or in the control group, ii) how payments to medical groups were used and distributed within the groups, and iii) the size of the new payments as a percentage of total revenue. Further research comparing the relative costs and effects of financial incentives with other behaviour change interventions is also required.

  2. Louisiana (LA) Health: Design and Methods for a Childhood Obesity Prevention Program in Rural Schools

    PubMed Central

    Williamson, Donald A.; Champagne, Catherine M.; Harsha, David; Han, Hongmei; Martin, Corby K.; Newton, Robert; Stewart, Tiffany M.; Ryan, Donna H.

    2008-01-01

    There is a worldwide epidemic of obesity with far-reaching consequences for the health of our nation. Prevention of obesity, especially in children, has been deemed by public health policy makers to be one of the most important objectives for our country. This prevention project, called Louisiana (LA) Health, will test whether modification of environmental and behavioral factors can prevent inappropriate weight gain in children from rural parishes of Louisiana who are enrolled in the fourth to sixth grades during Year 1. The primary aim of the LA Health project is to test the efficacy of two school-based approaches for obesity prevention: primary prevention alone and a combination of primary and secondary prevention which will be compared to a no-intervention control group using a cluster randomization research design, with 17 school clusters randomly assigned to the three treatment arms. The study will span three years and will provide critical tests of strategies that: 1) modify the child’s environment as a primary prevention strategy and 2) provide health behavior modification via classroom instruction and internet counseling as a secondary prevention strategy. The study will also recruit a similar sample of students to measure changes in body weight relative to height, gender, and age over the same three-year period. PMID:18448393

  3. Pelvic floor muscle training versus watchful waiting or pessary treatment for pelvic organ prolapse (POPPS): design and participant baseline characteristics of two parallel pragmatic randomized controlled trials in primary care.

    PubMed

    Wiegersma, Marian; Panman, Chantal M C R; Kollen, Boudewijn J; Vermeulen, Karin M; Schram, Aaltje J; Messelink, Embert J; Berger, Marjolein Y; Lisman-Van Leeuwen, Yvonne; Dekker, Janny H

    2014-02-01

    Pelvic floor muscle training (PFMT) and pessaries are commonly used in the conservative treatment of pelvic organ prolapse (POP). Because there is a lack of evidence regarding the optimal choice between these two interventions, we designed the "Pelvic Organ prolapse in primary care: effects of Pelvic floor muscle training and Pessary treatment Study" (POPPS). POPPS consists of two parallel open label randomized controlled trials performed in primary care, in women aged ≥55 years, recruited through a postal questionnaire. In POPPS trial 1, women with mild POP receive either PFMT or watchful waiting. In POPPS trial 2, women with advanced POP receive either PFMT or pessary treatment. Patient recruitment started in 2009 and was finished in December 2012. Primary outcome of both POPPS trials is improvement in POP-related symptoms. Secondary outcomes are quality of life, sexual function, POP-Q stage, pelvic floor muscle function, post-void residual volume, patients' perception of improvement, and costs. All outcomes are measured 3, 12, and 24 months after the start of treatment. Cost-effectiveness will be calculated based on societal costs, using the PFDI-20 and the EQ-5D as outcomes. In this paper the POPPS design, the encountered challenges and our solutions, and participant baseline characteristics are presented. For both trials the target numbers of patients in each treatment group are achieved, giving this study sufficient power to lead to promising results. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Follow-up of cancer in primary care versus secondary care: systematic review

    PubMed Central

    Lewis, Ruth A; Neal, Richard D; Williams, Nefyn H; France, Barbara; Hendry, Maggie; Russell, Daphne; Hughes, Dyfrig A; Russell, Ian; Stuart, Nicholas SA; Weller, David; Wilkinson, Clare

    2009-01-01

    Background Cancer follow-up has traditionally been undertaken in secondary care, but there are increasing calls to deliver it in primary care. Aim To compare the effectiveness and cost-effectiveness of primary versus secondary care follow-up of cancer patients, determine the effectiveness of the integration of primary care in routine hospital follow-up, and evaluate the impact of patient-initiated follow-up on primary care. Design of study Systematic review. Setting Primary and secondary care settings. Method A search was carried out of 19 electronic databases, online trial registries, conference proceedings, and bibliographies of included studies. The review included comparative studies or economic evaluations of primary versus secondary care follow-up, hospital follow-up with formal primary care involvement versus conventional hospital follow-up, and hospital follow-up versus patient-initiated or minimal follow-up if the study reported the impact on primary care. Results There was no statistically significant difference for patient wellbeing, recurrence rate, survival, recurrence-related serious clinical events, diagnostic delay, or patient satisfaction. GP-led breast cancer follow-up was cheaper than hospital follow-up. Intensified primary health care resulted in increased home-care nurse contact, and improved discharge summary led to increased GP contact. Evaluation of patient-initiated or minimal follow-up found no statistically significant impact on the number of GP consultations or cancer-related referrals. Conclusion Weak evidence suggests that breast cancer follow-up in primary care is effective. Interventions improving communication between primary and secondary care could lead to greater GP involvement. Discontinuation of formal follow-up may not increase GP workload. However, the quality of the data in general was poor, and no firm conclusions can be reached. PMID:19566990

  5. Studies on the Validity of the Hydraulic Analogy to Supersonic Flow. Parts 1 and 2

    DTIC Science & Technology

    1950-05-01

    project supervisor for the Division of Industrial Cooperation of the Massachusetts Inrtitute of Technology. The design and construction phase@ were...ABSTRACT The primary concern of Part I of this research prbgram is the design , construction, adjustment and calibration of a superoritical flow channel...superoritical flow and on the hydraulio analogy was prepared in order that the design of the ohannel might bene- fit from past experieno. The

  6. Rapid lead discovery through iterative screening of one bead one compound libraries.

    PubMed

    Gao, Yu; Amar, Sabrina; Pahwa, Sonia; Fields, Gregg; Kodadek, Thomas

    2015-01-12

    Primary hits that arise from screening one bead one compound (OBOC) libraries against a target of interest rarely have high potency. However, there has been little work focused on the development of an efficient workflow for primary hit improvement. In this study, we show that by characterizing the binding constants for all of the hits that arise from a screen, structure-activity relationship (SAR) data can be obtained to inform the design of "derivative libraries" of a primary hit that can then be screened under more demanding conditions to obtain improved compounds. Here, we demonstrate the rapid improvement of a primary hit against matrix metalloproteinase-14 using this approach.

  7. Conceptual studies for a mercury target circuit

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

    Sigg, B.

    1996-06-01

    For the now favored target design of the European Spallation Source project, i.e. the version using mercury as target material, a basic concept of the primary system has been worked out. It does not include a detailed design of the various components of the target circuit, but tries to outline a feasible solution for the system. Besides the removal of the thermal power of about 3MW produced in the target by the proton beam, the primary system has to satisfy a number of other requirements related to processing, safety, and operation. The basic proposal uses an electromagnetic pump and amore » mercury-water intermediate heat excanger, but other alternatives are also being discussed. Basic safety requirements, i.e. protection against radiation and toxic mercury vapours, are satisfied by a design using an air-tight primary system containment, double-walled tubes in the intermediate heat exchanger, a fail-safe system for decay heat removal, and a remote handling facility for the active part of the system. Much engineering work has still to be done, because many details of the design of the mercury and gas processing systems remain to be clarified, the thermal-hydraulic components need further optimisation, the system for control and instrumentation is only known in outline and a through safety analysis will be required.« less

  8. Intervention to improve social and family support for caregivers of dependent patients: ICIAS study protocol

    PubMed Central

    2014-01-01

    Background Despite the existence of formal professional support services, informal support (mainly family members) continues to be the main source of eldercare, especially for those who are dependent or disabled. Professionals on the primary health care are the ideal choice to educate, provide psychological support, and help to mobilize social resources available to the informal caregiver. Controversy remains concerning the efficiency of multiple interventions, taking a holistic approach to both the patient and caregiver, and optimum utilization of the available community resources. .For this reason our goal is to assess whether an intervention designed to improve the social support for caregivers effectively decreases caregivers burden and improves their quality of life. Methods/design Design: Controlled, multicentre, community intervention trial, with patients and their caregivers randomized to the intervention or control group according to their assigned Primary Health Care Team (PHCT). Study area: Primary Health Care network (9 PHCTs). Study participants: Primary informal caregivers of patients receiving home health care from participating PHCTs. Sample: Required sample size is 282 caregivers (141 from PHCTs randomized to the intervention group and 141 from PHCTs randomized to the control group. Intervention: a) PHCT professionals: standardized training to implement caregivers intervention. b) Caregivers: 1 individualized counselling session, 1 family session, and 4 educational group sessions conducted by participating PHCT professionals; in addition to usual home health care visits, periodic telephone follow-up contact and unlimited telephone support. Control: Caregivers and dependent patients: usual home health care, consisting of bimonthly scheduled visits, follow-up as needed, and additional attention upon request. Data analysis Dependent variables: Caregiver burden (short-form Zarit test), caregivers’ social support (Medical Outcomes Study), and caregivers’ reported quality of life (SF-12) Independent variables: a) Caregiver: sociodemographic data, Goldberg Scale, Apgar family questionnaire, Holmes and Rahe Psychosocial Stress Scale, number of chronic diseases. b) Dependent patient: sociodemographic data, level of dependency (Barthel Index), cognitive impairment (Pfeiffer test). Discussion If the intervention intended to improve social and family support is effective in reducing the burden on primary informal caregivers of dependent patients, this model can be readily applied throughout usual PHCT clinical practice. Trial registration Clinical trials registrar: NCT02065427 PMID:24666438

  9. Feasibility study of a clinical decision support system for the management of multimorbid seniors in primary care: study protocol.

    PubMed

    Weltermann, Birgitta; Kersting, Christine

    2016-01-01

    Care for seniors is complex because patients often have more than one disease, one medication, and one physician. It is a key challenge for primary care physicians to structure the various aspects of each patient's care, to integrate each patient's preferences, and to maintain a long-term overview. This article describes the design for the development and feasibility testing of the clinical decision support system (CDSS) eCare*Seniors© which is electronic health record (EHR)-based allowing for a long-term, comprehensive, evidence-based, and patient preference-oriented management of multimorbid seniors. This mixed-methods study is designed in three steps. First, focus groups and practice observations will be conducted to develop criteria for software design from a physicians' and practice assistants' perspective. Second, based on these criteria, a CDSS prototype will be developed. Third, the prototype's feasibility will be tested by five primary care practices in the care of 30 multimorbid seniors. Primary outcome is the usability of the software measured by the validated system usability scale (SUS) after 3 months. Secondary outcomes are the (a) willingness to routinely use the CDSS, (b) degree of utilization of the CDSS, (c) acceptance of the CDSS, (d) willingness of the physicians to purchase the CDSS, and (e) willingness of the practice assistants to use the CDSS in the long term. These outcomes will be measured using semi-structured interviews and software usage data. If the SUS score reaches ≥70 %, feasibility testing will be judged successful. Otherwise, the CDSS prototype will be refined according to the users' needs and retested by the physicians and practice assistants until it is fully adapted to their requirements and reaches a usability score ≥70 %. The study will support the development of a CDSS which is primary care-defined, user-friendly, easy-to-comprehend, workflow-oriented, and comprehensive. The software will assist physicians and practices in their long-term, individualized care for multimorbid seniors. German Clinical Trials Register, DRKS00008777.

  10. Inquiry-based science education: towards a pedagogical framework for primary school teachers

    NASA Astrophysics Data System (ADS)

    van Uum, Martina S. J.; Verhoeff, Roald P.; Peeters, Marieke

    2016-02-01

    Inquiry-based science education (IBSE) has been promoted as an inspiring way of learning science by engaging pupils in designing and conducting their own scientific investigations. For primary school teachers, the open nature of IBSE poses challenges as they often lack experience in supporting their pupils during the different phases of an open IBSE project, such as formulating a research question and designing and conducting an investigation. The current study aims to meet these challenges by presenting a pedagogical framework in which four domains of scientific knowledge are addressed in seven phases of inquiry. The framework is based on video analyses of pedagogical interventions by primary school teachers participating in open IBSE projects. Our results show that teachers can guide their pupils successfully through the process of open inquiry by explicitly addressing the conceptual, epistemic, social and/or procedural domain of scientific knowledge in the subsequent phases of inquiry. The paper concludes by suggesting further research to validate our framework and to develop a pedagogy for primary school teachers to guide their pupils through the different phases of open inquiry.

  11. A preliminary report of an educational intervention in practice management

    PubMed Central

    Crites, Gerald E; Schuster, Richard J

    2004-01-01

    Background Practice management education continues to evolve, and little information exists regarding its curriculum design and effectiveness for resident education. We report the results of an exploratory study of a practice management curriculum for primary care residents. Methods After performing a needs assessment with a group of primary care residents at Wright State University, we designed a monthly seminar series covering twelve practice management topics. The curriculum consisted of interactive lectures and practice-based application, whenever possible. We descriptively evaluated two cognitive components (practice management knowledge and skills) and the residents' evaluation of the curriculum. Results The mean correct on the knowledge test for this group of residents was 74% (n = 12) and 91% (n = 12) before and after the curriculum, respectively. The mean scores for the practice management skill assessments were 2.62 before (n = 12), and 3.65 after (n = 12) the curriculum (modified Likert, 1 = strongly disagree, 5 = strongly agree). The residents rated the curriculum consistently high. Conclusions This exploratory study suggests that this curriculum may be useful in developing knowledge and skills in practice management for primary care residents. This study suggests further research into evaluation of this curriculum may be informative for practice-based education. PMID:15380023

  12. Effectiveness, immunogenicity and safety of 23-valent pneumococcal polysaccharide vaccine revaccinations in the elderly: a systematic review.

    PubMed

    Remschmidt, Cornelius; Harder, Thomas; Wichmann, Ole; Bogdan, Christian; Falkenhorst, Gerhard

    2016-11-25

    In many industrialized countries routine vaccination with the 23-valent pneumococcal polysaccharide vaccine (PPSV-23) is recommended to prevent pneumococcal disease in the elderly. However, vaccine-induced immunity wanes after a few years, and there are controversies around revaccination with PPSV-23. Here, we systematically assessed the effectiveness and safety of PPSV-23 revaccination. We conducted a systematic literature review in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from inception to June 2015. We included all study types that compared effectiveness, immunogenicity and/or safety of PPSV-23 as a primary vs. a revaccination dose in persons aged 50 years and older. With respect to immunogenicity, we calculated the ratio of geometric mean antibody concentrations and opsonophagocytic indexes at identical time-points after primary and revaccination. Additionally, we compared rates and severity of adverse events (AEs) after primary and revaccination. We included 14 observational studies. 10 studies had a prospective design and analysed data on (i) the same individuals after a first and a second dose of PPSV-23 given 1 to 10 years later (n = 5) or (ii) two groups consisting of participants receiving PPSV-23 who were either vaccine-naïve or had received a first PPSV-23 dose 3 to 13 years earlier (n = 5). Three studies used electronic data bases to compare AEs after primary vs. revaccination doses of PPSV-23 after 1 to 10 years and one study had a cross-sectional design. Number of participants in the non-register-based and register-based studies ranged from 29 to 1414 and 360 to 316,000, respectively. 11 out of 14 included studies were at high risk of bias, three studies had an unclear risk of bias. None of the studies reported data on clinical effectiveness. Immunogenicity studies revealed that during the first two months antibody levels tended to be lower after revaccination as compared to primary vaccination. Thereafter, no obvious differences in antibody levels were observed. Compared to primary vaccination, revaccination was associated with an increased risk of local and systemic AEs, which, however, were usually mild and self-limiting. The risk and severity of AEs appeared to decrease with longer intervals between primary and revaccination. Data comparing the effectiveness of primary vs. revaccination with PPSV-23 are still lacking, because there are no studies with clinical endpoints. Data from observational studies indicates that revaccination with PPSV-23 is likely to induce long-term antibody levels that are comparable to those after primary vaccination. Given the high disease burden and the waning of vaccine-induced immunity, revaccination with PPSV-23 could be considered in the elderly. The increased risk of local and systemic AEs can likely be mitigated when giving revaccination at least five years after the primary dose. Adequately powered randomized controlled trials using clinical endpoints are urgently needed.

  13. Structural synthesis: Precursor and catalyst

    NASA Technical Reports Server (NTRS)

    Schmit, L. A.

    1984-01-01

    More than twenty five years have elapsed since it was recognized that a rather general class of structural design optimization tasks could be properly posed as an inequality constrained minimization problem. It is suggested that, independent of primary discipline area, it will be useful to think about: (1) posing design problems in terms of an objective function and inequality constraints; (2) generating design oriented approximate analysis methods (giving special attention to behavior sensitivity analysis); (3) distinguishing between decisions that lead to an analysis model and those that lead to a design model; (4) finding ways to generate a sequence of approximate design optimization problems that capture the essential characteristics of the primary problem, while still having an explicit algebraic form that is matched to one or more of the established optimization algorithms; (5) examining the potential of optimum design sensitivity analysis to facilitate quantitative trade-off studies as well as participation in multilevel design activities. It should be kept in mind that multilevel methods are inherently well suited to a parallel mode of operation in computer terms or to a division of labor between task groups in organizational terms. Based on structural experience with multilevel methods general guidelines are suggested.

  14. Professional Readiness Level of Candidate Teachers: A Qualitative Evaluation

    ERIC Educational Resources Information Center

    Yildirim, Nail

    2016-01-01

    The study investigates novice teachers? self-perceptions of their professional readiness. The study has a qualitative research design, adopting the phenomenology pattern. The study group comprised subject matter teachers employed at different educational stages (primary, secondary and high schools). The participants were selected according to the…

  15. Young Tanzanians and the Cinema: A Study of the Effects of Selected Basic Motion Picture Elements and Population Characteristics on Filmic Comprehension of Tanzanian Adolescent Primary School Children.

    ERIC Educational Resources Information Center

    Giltrow, David Roger

    A study was conducted of Tanzanian adolescent school children's responses to filmic elements. The design included a very large sample in a complicated factorial design, varying such factors as color, type of action, background and sound of the film, and the demographic characteristics of the subjects. Results showed that of these variables,…

  16. Design of a phase III multicenter trial to evaluate the efficacy of the RTS,S/AS01 malaria vaccine in children across diverse transmission settings in Africa

    PubMed Central

    2011-01-01

    Background GlaxoSmithKline Biologicals and the PATH Malaria Vaccine Initiative are working in partnership to develop a malaria vaccine to protect infants and children living in malaria endemic regions of sub-Saharan Africa, which can be delivered through the Expanded Programme on Immunization. The RTS,S/AS candidate vaccine has been evaluated in multiple phase I/II studies and shown to have a favourable safety profile and to be well-tolerated in both adults and children. This paper details the design of the phase III multicentre efficacy trial of the RTS,S/AS01 malaria vaccine candidate, which is pivotal for licensure and policy decision-making. Methods The phase III trial is a randomized, controlled, multicentre, participant- and observer-blind study on-going in 11 centres associated with different malaria transmission settings in seven countries in sub-Saharan Africa. A minimum of 6,000 children in each of two age categories (6-12 weeks, 5-17 months) have been enrolled. Children were randomized 1:1:1 to one of three study groups: (1) primary vaccination with RTS,S/AS01 and booster dose of RTS,S/AS01; (2) primary vaccination with RTS,S/AS01 and a control vaccine at time of booster; (3) primary vaccination with control vaccine and a control vaccine at time of booster. Primary vaccination comprises three doses at monthly intervals; the booster dose is administered at 18 months post-primary course. Subjects will be followed to study month 32. The co-primary objectives are the evaluation of efficacy over one year post-dose 3 against clinical malaria when primary immunization is delivered at: (1) 6-12 weeks of age, with co-administration of DTPwHepB/Hib antigens and OPV; (2) 5-17 months of age. Secondary objectives include evaluation of vaccine efficacy against severe malaria, anaemia, malaria hospitalization, fatal malaria, all-cause mortality and other serious illnesses including sepsis and pneumonia. Efficacy of the vaccine against clinical malaria under different transmission settings, the evolution of efficacy over time and the potential benefit of a booster will be evaluated. In addition, the effect of RTS,S/AS01 vaccination on growth, and the safety and immunogenicity in HIV-infected and malnourished children will be assessed. Safety of the primary course of immunization and the booster dose will be documented in both age categories. Conclusions This pivotal phase III study of the RTS,S/AS01 candidate malaria vaccine in African children was designed and implemented by the Clinical Trials Partnership Committee. The study will provide efficacy and safety data to fulfil regulatory requirements, together with data on a broad range of endpoints that will facilitate the evaluation of the public health impact of the vaccine and will aid policy and implementation decisions. Trial registration Clinicaltrials.gov NCT00866619 PMID:21816029

  17. 77 FR 71323 - Reconsideration of Certain New Source and Startup/Shutdown Issues: National Emission Standards...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-30

    ... units designed for the coal >= 8300 Btu/lb (non- low rank virgin coal) subcategory. Some petitioners...-fired EGU would have the opportunity to design the primary PM control device to meet the new source... the opportunity to design the primary PM control device to meet the new source emission limit, we can...

  18. Project Help. An Elementary Curriculum Guide Designed to Help Students Help Themselves.

    ERIC Educational Resources Information Center

    Cranston School Dept., RI.

    This two-part curriculum is designed to teach elementary students basic life skills that will enable them to assume greater responsibility for themselves. Part 1, the primary curriculum, is designed for grades 3 and 4. Five units of instruction are included in the primary curriculum: home management, foods, personal cleanliness, sewing, and…

  19. 75 FR 34953 - Existence of Proposed Airworthiness Design Standards for Acceptance Under the Primary Category...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-21

    ... the proposed airworthiness design standards for acceptance of the OHA, Inc., Models Cessna 172I, 172K... Airworthiness Design Standards for Acceptance Under the Primary Category Rule; Orlando Helicopter Airways (OHA), Inc., Models Cessna 172I, 172K, 172L, and 172M AGENCY: Federal Aviation Administration (FAA), DOT...

  20. Designing primary health care teams for developing countries.

    PubMed Central

    Reisman, A; Duran, L

    1983-01-01

    A time-honored industrial engineering technique, job evaluation, which was developed to set rates for manual labor, was used in the design of new teams for delivering primary health care in Latin America. The technique was used both in writing job descriptions for new allied health personnel and in designing the curriculums needed to train the personnel. PMID:6856744

  1. The CUPCIG (CAM-Use in Primary Care in Germany) Study:Part I-Pain. Study Protocol of a Pilot-trial to Assess Feasibility, Acceptability and Perceived Effectiveness of CAM in Pain Disorders in Primary Care.

    PubMed

    Schencking, Martin; Sönnichsen, Andreas; Bassüner, Susanne; Redaelli, Marcus

    2015-01-01

    There is limited valid data available on CAM procedures for chronic joint and neuropathic pain in primary care in Germany. Indiviual CAM qualifications of the general practitioners (GPs) and the potential of cost reduction through CAM treatment are almost unknown. The aim of this pilot trial preceding the main study is to examine the survey mode, to estimate the response rate by GPs with or without an additional qualification for CAM, and to identify the status quo in therapeutic approaches for chronic pain disorders in primary care. This is a cross-sectional study with an ex post facto design among German GPs consisting of 2 parts: In a first step, a pilot trial precedes the main study targeting 200 GPs with and 200 GPs without additional qualification in CAM in a selected region. The results of the CUPCIG study comprise the distribution of pain types treated in primary care practices, the GPs' attitude toward complementary pain therapy, pharmacological or CAM treatment, the estimate of cost reduction through CAM treatment of pain, the application of diverse CAM procedures, and biographical data. The CUPCIG study serves to compile pain therapy approaches in primary care in Germany with respect to the individual CAM expertise of the GPs. © 2015 S. Karger GmbH, Freiburg.

  2. Developing a Decision Support System for Tobacco Use Counseling Using Primary Care Physicians

    PubMed Central

    Marcy, Theodore W.; Kaplan, Bonnie; Connolly, Scott W.; Michel, George; Shiffman, Richard N.; Flynn, Brian S.

    2009-01-01

    Background Clinical decision support systems (CDSS) have the potential to improve adherence to guidelines, but only if they are designed to work in the complex environment of ambulatory clinics as otherwise physicians may not use them. Objective To gain input from primary care physicians in designing a CDSS for smoking cessation to ensure that the design is appropriate to a clinical environment before attempts to test this CDSS in a clinical trial. This approach is of general interest to those designing similar systems. Design and Approach We employed an iterative ethnographic process that used multiple evaluation methods to understand physician preferences and workflow integration. Using results from our prior survey of physicians and clinic managers, we developed a prototype CDSS, validated content and design with an expert panel, and then subjected it to usability testing by physicians, followed by iterative design changes based on their feedback. We then performed clinical testing with individual patients, and conducted field tests of the CDSS in two primary care clinics during which four physicians used it for routine patient visits. Results The CDSS prototype was substantially modified through these cycles of usability and clinical testing, including removing a potentially fatal design flaw. During field tests in primary care clinics, physicians incorporated the final CDSS prototype into their workflow, and used it to assist in smoking cessation interventions up to eight times daily. Conclusions A multi-method evaluation process utilizing primary care physicians proved useful for developing a CDSS that was acceptable to physicians and patients, and feasible to use in their clinical environment. PMID:18713526

  3. Rationale of a novel study design for the BIOFLOW V study, a prospective, randomized multicenter study to assess the safety and efficacy of the Orsiro sirolimus-eluting coronary stent system using a Bayesian approach.

    PubMed

    Doros, Gheorghe; Massaro, Joseph M; Kandzari, David E; Waksman, Ron; Koolen, Jacques J; Cutlip, Donald E; Mauri, Laura

    2017-11-01

    Traditional study design submitted to the Food and Drug Administration to test newer drug-eluting stents (DES) for marketing approval is the prospective randomized controlled trial. However, several DES have extensive clinical data from trials conducted outside the United States that have led to utilization of a novel design using the Bayesian approach. This design was proposed for testing DES with bioresorbable polymer compared with DES most commonly in use today that use durable polymers for drug elution. This prospective, multicenter, randomized, controlled trial is designed to assess the safety and efficacy of the Orsiro bioresorbable polymer sirolimus-eluting stent (BP SES). Up to 1,334 subjects with up to 3 de novo or restenotic coronary artery lesions who qualify for percutaneous coronary intervention with stenting will be randomized 2:1 to the BP SES versus the Xience durable polymer everolimus-eluting stent (DP EES). Data from this trial will be combined with data from 2 similarly designed trials that also randomize subjects to BP SES and DP EES (BIOFLOW II, N=452 and BIOFLOW IV, N=579) by using a Bayesian approach. The primary end point is target lesion failure at 12 months post index procedure, defined as cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization, and the primary analysis is a test of noninferiority of the BP SES versus DP EES on the primary end point according to a noninferiority delta of 3.85%. Secondary end points include stent thrombosis and the individual components of target lesion failure. Subjects will be followed for 5 years after randomization. The BIOFLOW V trial offers an opportunity to assess clinical outcomes in patients treated with coronary revascularization using the Orsiro BP SES relative to a commonly used DP EES. The use of a Bayesian analysis combines a large randomized cohort of patients 2 two smaller contributing randomized trials to augment the efficiency of the comparison. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Layered water Cherenkov detector for the study of ultra high energy cosmic rays

    NASA Astrophysics Data System (ADS)

    Letessier-Selvon, Antoine; Billoir, Pierre; Blanco, Miguel; Mariş, Ioana C.; Settimo, Mariangela

    2014-12-01

    We present a new design for the water Cherenkov detectors that are in use in various cosmic ray observatories. This novel design can provide a significant improvement in the independent measurement of the muonic and electromagnetic component of extensive air showers. From such multi-component data an event by event classification of the primary cosmic ray mass becomes possible. According to popular hadronic interaction models, such as EPOS-LHC or QGSJetII-04, the discriminating power between iron and hydrogen primaries reaches Fisher values of 2 or above for energies in excess of 1019 eV with a detector array layout similar to that of the Pierre Auger Observatory.

  5. Community participation to design rural primary healthcare services.

    PubMed

    Farmer, Jane; Nimegeer, Amy

    2014-03-21

    This paper explores how community participation can be used in designing rural primary healthcare services by describing a study of Scottish communities. Community participation is extolled in healthcare policy as useful in planning services and is understood as particularly relevant in rural settings, partly due to high social capital. Literature describes many community participation methods, but lacks discussion of outcomes relevant to health system reconfiguration. There is a spectrum of ideas in the literature on how to design services, from top-down standard models to contextual plans arising from population health planning that incorporates community participation. This paper addresses an evidence gap about the outcomes of using community participation in (re)designing rural community health services. Community-based participatory action research was applied in four Scottish case study communities in 2008-10. Data were collected from four workshops held in each community (total 16) and attended by community members. Workshops were intended to produce hypothetical designs for future service provision. Themes, rankings and selections from workshops are presented. Community members identified consistent health priorities, including local practitioners, emergency triage, anticipatory care, wellbeing improvement and health volunteering. Communities designed different service models to address health priorities. One community did not design a service model and another replicated the current model despite initial enthusiasm for innovation. Communities differ in their receptiveness to engaging in innovative service design, but some will create new models that fit in a given budget. Design diversity indicates that context influences local healthcare planning, suggesting community participation impacts on design outcomes, but standard service models maybe useful as part of the evidence in community participation discussions.

  6. A nuclear electric propulsion vehicle for planetary exploration

    NASA Technical Reports Server (NTRS)

    Pawlik, E. V.; Phillips, W. M.

    1976-01-01

    A study is currently underway at JPL to design a nuclear electric-propulsion vehicle capable of performing detailed exploration of the outer planets. Evaluation of the design indicates that it is also applicable to orbit raising. Primary emphasis is on the power subsystem. Work on the design of the power system, the mission rationale, and preliminary spacecraft design are summarized. A propulsion system at a 400-kWe power level with a specific weight goal of no more than 25-kg/kW was selected for this study. The results indicate that this goal can be realized along with compatibility with the shuttle launch-vehicle constraints.

  7. Postmarketing studies for novel drugs approved by both the FDA and EMA between 2005 and 2010: a cross-sectional study

    PubMed Central

    Zeitoun, Jean-David; Ross, Joseph S; Atal, Ignacio; Vivot, Alexandre; Downing, Nicholas S; Baron, Gabriel; Ravaud, Philippe

    2017-01-01

    Objectives To characterise postmarketing studies for drugs that were newly approved by the US Food and Drug Administration and the European Medicines Agency. Design and setting Cross-sectional analysis of postmarketing studies registered in ClinicalTrials.gov until September 2014 for all novel drugs approved by both regulators between 2005 and 2010. Regulatory documents from both agencies were used. Primary and secondary outcome measures All identified postmarketing studies were classified according to planned enrolment, funding, status and geographical location, and we determined whether studies studied the originally approved indication. Results Overall, 69 novel drugs approved between 2005 and 2010 were eligible for inclusion. A total of 6679 relevant postmarketing studies were identified; 5972 were interventional (89.4%). The median number of studies per drug was 55 (IQR 33–119) and median number of patients to be enrolled per study was 60 (IQR 28–183). Industry was the primary sponsor of 2713 studies (40.6%) and was a primary or secondary sponsor in 4176 studies (62.5%). In all, 2901 studies (43.4%) were completed, 487 (7.3%) terminated, 1013 (15.2%) active yet not recruiting, 1895 (28.4%) recruiting and 319 (4.8%) not yet recruiting. A total of 80% of studies were conducted in only one country and 84.4% took place in Europe and/or North America; 2441 (36.5%) studied another indication than the originally approved indication. Studies designed in the originally approved indication were found to be more industry-sponsored than others 68.7%vs53.7%; P<0.0001. Conclusions Postmarketing pharmaceutical research was highly variable and predominantly located in North America and Europe. Postmarketing studies were frequently designed to study indications other than the originally approved one. Although some findings were reassuring, others question the lack of coordination of postmarketing research. PMID:29273664

  8. STUDY DESIGN FOR A PILOT STUDY OF CHILDREN'S TOTAL EXPOSURE TO PERSISTENT PESTICIDES AND OTHER PERSISTENT ORGANIC PESTICIDES "CTEPP"

    EPA Science Inventory

    The Children's Total Exposure to Persistent Pesticides and Other Persistent Pollutant (CTEPP) study is one of the largest aggregate exposure studies of young children in the United States. The CTEPP study examines the exposures of about 260 preschool children and their primary ad...

  9. Measurements Methods for the analysis of Nuclear Reactors Thermal Hydraulic in Water Scaled Facilities

    NASA Astrophysics Data System (ADS)

    Spaccapaniccia, C.; Planquart, P.; Buchlin, J. M. AB(; ), AC(; )

    2018-01-01

    The Belgian nuclear research institute (SCK•CEN) is developing MYRRHA. MYRRHA is a flexible fast spectrum research reactor, conceived as an accelerator driven system (ADS). The configuration of the primary loop is pool-type: the primary coolant and all the primary system components (core and heat exchangers) are contained within the reactor vessel, while the secondary fluid is circulating in the heat exchangers. The primary coolant is Lead Bismuth Eutectic (LBE). The recent nuclear accident of Fukushima in 2011 changed the requirements for the design of new reactors, which should include the possibility to remove the residual decay heat through passive primary and secondary systems, i.e. natural convection (NC). After the reactor shut down, in the unlucky event of propeller failures, the primary and secondary loops should be able to remove the decay heat in passive way (Natural Convection). The present study analyses the flow and the temperature distribution in the upper plenum by applying laser imaging techniques in a laboratory scaled water model. A parametric study is proposed to study stratification mitigation strategies by varying the geometry of the buffer tank simulating the upper plenum.

  10. Study protocol: a multi-professional team intervention of physical activity referrals in primary care patients with cardiovascular risk factors—the Dalby lifestyle intervention cohort (DALICO) study

    PubMed Central

    2012-01-01

    Background The present study protocol describes the trial design of a primary care intervention cohort study, which examines whether an extended, multi-professional physical activity referral (PAR) intervention is more effective in enhancing and maintaining self-reported physical activity than physical activity prescription in usual care. The study targets patients with newly diagnosed hypertension and/or type 2 diabetes. Secondary outcomes include: need of pharmacological therapy; blood pressure/plasma glucose; physical fitness and anthropometric variables; mental health; health related quality of life; and cost-effectiveness. Methods/Design The study is designed as a long-term intervention. Three primary care centres are involved in the study, each constituting one of three treatment groups: 1) Intervention group (IG): multi-professional team intervention with PAR, 2) Control group A (CA): physical activity prescription in usual care and 3) Control group B: treatment as usual (retrospective data collection). The intervention is based on self-determination theory and follows the principles of motivational interviewing. The primary outcome, physical activity, is measured with the International Physical Activity Questionnaire (IPAQ) and expressed as metabolic equivalent of task (MET)-minutes per week. Physical fitness is estimated with the 6-minute walk test in IG only. Variables such as health behaviours; health-related quality of life; motivation to change; mental health; demographics and socioeconomic characteristics are assessed with an electronic study questionnaire that submits all data to a patient database, which automatically provides feed-back to the health-care providers on the patients’ health status. Cost-effectiveness of the intervention is evaluated continuously and the intermediate outcomes of the intervention are extrapolated by economic modelling. Discussions By helping patients to overcome practical, social and cultural obstacles and increase their internal motivation for physical activity we aim to improve their physical health in a long-term perspective. The targeted patients belong to a patient category that is supposed to benefit from increased physical activity in terms of improved physiological values, mental status and quality of life, decreased risk of complications and maybe a decreased need of medication. PMID:22726659

  11. A school-based comprehensive lifestyle intervention among chinese kids against obesity (CLICK-Obesity): rationale, design and methodology of a randomized controlled trial in Nanjing city, China.

    PubMed

    Xu, Fei; Ware, Robert S; Tse, Lap Ah; Wang, Zhiyong; Hong, Xin; Song, Aiju; Li, Jiequan; Wang, Youfa

    2012-06-15

    The prevalence of childhood obesity among adolescents has been rapidly rising in Mainland China in recent decades, especially in urban and rich areas. There is an urgent need to develop effective interventions to prevent childhood obesity. Limited data regarding adolescent overweight prevention in China are available. Thus, we developed a school-based intervention with the aim of reducing excess body weight in children. This report described the study design. We designed a cluster randomized controlled trial in 8 randomly selected urban primary schools between May 2010 and December 2013. Each school was randomly assigned to either the intervention or control group (four schools in each group). Participants were the 4th graders in each participating school. The multi-component program was implemented within the intervention group, while students in the control group followed their usual health and physical education curriculum with no additional intervention program. The intervention consisted of four components: a) classroom curriculum, (including physical education and healthy diet education), b) school environment support, c) family involvement, and d) fun programs/events. The primary study outcome was body composition, and secondary outcomes were behaviour and behavioural determinants. The intervention was designed with due consideration of Chinese cultural and familial tradition, social convention, and current primary education and exam system in Mainland China. We did our best to gain good support from educational authorities, school administrators, teachers and parents, and to integrate intervention components into schools' regular academic programs. The results of and lesson learned from this study will help guide future school-based childhood obesity prevention programs in Mainland China. ChiCTR-ERC-11001819.

  12. Implementing collaborative care for depression treatment in primary care: A cluster randomized evaluation of a quality improvement practice redesign

    PubMed Central

    2011-01-01

    Background Meta-analyses show collaborative care models (CCMs) with nurse care management are effective for improving primary care for depression. This study aimed to develop CCM approaches that could be sustained and spread within Veterans Affairs (VA). Evidence-based quality improvement (EBQI) uses QI approaches within a research/clinical partnership to redesign care. The study used EBQI methods for CCM redesign, tested the effectiveness of the locally adapted model as implemented, and assessed the contextual factors shaping intervention effectiveness. Methods The study intervention is EBQI as applied to CCM implementation. The study uses a cluster randomized design as a formative evaluation tool to test and improve the effectiveness of the redesign process, with seven intervention and three non-intervention VA primary care practices in five different states. The primary study outcome is patient antidepressant use. The context evaluation is descriptive and uses subgroup analysis. The primary context evaluation measure is naturalistic primary care clinician (PCC) predilection to adopt CCM. For the randomized evaluation, trained telephone research interviewers enrolled consecutive primary care patients with major depression in the evaluation, referred enrolled patients in intervention practices to the implemented CCM, and re-surveyed at seven months. Results Interviewers enrolled 288 CCM site and 258 non-CCM site patients. Enrolled intervention site patients were more likely to receive appropriate antidepressant care (66% versus 43%, p = 0.01), but showed no significant difference in symptom improvement compared to usual care. In terms of context, only 40% of enrolled patients received complete care management per protocol. PCC predilection to adopt CCM had substantial effects on patient participation, with patients belonging to early adopter clinicians completing adequate care manager follow-up significantly more often than patients of clinicians with low predilection to adopt CCM (74% versus 48%%, p = 0.003). Conclusions Depression CCM designed and implemented by primary care practices using EBQI improved antidepressant initiation. Combining QI methods with a randomized evaluation proved challenging, but enabled new insights into the process of translating research-based CCM into practice. Future research on the effects of PCC attitudes and skills on CCM results, as well as on enhancing the link between improved antidepressant use and symptom outcomes, is needed. Trial Registration ClinicalTrials.gov: NCT00105820 PMID:22032247

  13. An 8 Meter Monolithic UV/Optical Space Telescope

    NASA Technical Reports Server (NTRS)

    Stahl, H. Philip; Postman, Marc

    2008-01-01

    The planned Ares V launch vehicle with its 10 meter fairing and at least 55,600 kg capacity to Earth Sun L2 enables entirely new classes of space telescopes. A consortium from NASA, Space Telescope Science Institute, and aerospace industry are studying an 8-meter monolithic primary mirror UV/optical/NIR space telescope to enable new astrophysical research that is not feasible with existing or near-term missions, either space or ground. This paper briefly reviews the science case for such a mission and presents the results of an on-going technical feasibility study, including: optical design; structural design/analysis including primary mirror support structure, sun shade and secondary mirror support structure; thermal analysis; launch vehicle performance and trajectory; spacecraft including structure, propulsion, GN&C, avionics, power systems and reaction wheels; operations & servicing; mass budget and cost.

  14. Nonimaging concentrators for photovoltaic arrays in space

    NASA Technical Reports Server (NTRS)

    Winston, R.; Greenman, P.; Rockey, D.

    1981-01-01

    Two stage concentrators are studied in order to design an optimum concentrator for photovoltaic arrays in space. The study is directed at designs with two-dimensional geometries because they are better suited to moderate concentrations of about 10 X to 50 X, and because the instantaneous flux distribution is more uniform. It is found that with an f/0.5 primary, where f is the focal length of the primary, the flux distribution is very smooth regardless of the angle of incidence of the radiation. As the focal ratio is increased, peaks in the distribution begin to appear. The nonuniformities can be reduced by introducing small, closely spaced distortions into the reflecting surfaces, and practical arrays can achieve a concentration of 10 when the acceptance half angle is 4.25 deg or 50 when the acceptance half angle is + or - 1 deg.

  15. Physician Interactions with Electronic Health Records in Primary Care

    PubMed Central

    Montague, Enid; Asan, Onur

    2013-01-01

    Objective It is essential to design technologies and systems that promote appropriate interactions between physicians and patients. This study explored how physicians interact with Electronic Health Records (EHRs) to understand the qualities of the interaction between the physician and the EHR that may contribute to positive physician-patient interactions. Study Design Video-taped observations of 100 medical consultations were used to evaluate interaction patterns between physicians and EHRs. Quantified observational methods were used to contribute to ecological validity. Methods Ten primary care physicians and 100 patients from five clinics participated in the study. Clinical encounters were recorded with video cameras and coded using a validated objective coding methodology in order to examine how physicians interact with electronic health records. Results Three distinct styles were identified that characterize physician interactions with the EHR: technology-centered, human-centered, and mixed. Physicians who used a technology-centered style spent more time typing and gazing at the computer during the visit. Physicians who used a mixed style shifted their attention and body language between their patients and the technology throughout the visit. Physicians who used the human-centered style spent the least amount of time typing and focused more on the patient. Conclusion A variety of EHR interaction styles may be effective in facilitating patient-centered care. However, potential drawbacks of each style exist and are discussed. Future research on this topic and design strategies for effective health information technology in primary care are also discussed. PMID:24009982

  16. Impact of hospital care on incidence of bloodstream infection: the evaluation of processes and indicators in infection control study.

    PubMed Central

    Kritchevsky, S. B.; Braun, B. I.; Wong, E. S.; Solomon, S. L.; Steele, L.; Richards, C.; Simmons, B. P.

    2001-01-01

    The Evaluation of Processes and Indicators in Infection Control (EPIC) study assesses the relationship between hospital care and rates of central venous catheter-associated primary bacteremia in 54 intensive-care units (ICUs) in the United States and 14 other countries. Using ICU rather than the patient as the primary unit of statistical analysis permits evaluation of factors that vary at the ICU level. The design of EPIC can serve as a template for studies investigating the relationship between process and event rates across health-care institutions. PMID:11294704

  17. Application study of filamentary composites in a commercial jet aircraft fuselage

    NASA Technical Reports Server (NTRS)

    Johnson, R. W.; June, R. R.

    1972-01-01

    A study of applications of filamentary composite materials to aircraft fuselage structure was performed. General design criteria were established and material studies conducted using the 727-200 forebody as the primary structural component. Three design approaches to the use of composites were investigated: uniaxial reinforcement of metal structure, uniaxial and biaxial reinforcement of metal structure, and an all-composite design. Materials application studies for all three concepts were conducted on fuselage shell panels, keel beam, floor beams, floor panels, body frames, fail-safe straps, and window frames. Cost benefit studies were conducted and developmental program costs estimated. On the basis of weight savings, cost effectiveness, developmental program costs, and potential for early application on commercial aircraft, the unaxial design is recommended for a 5-year flight service evaluation program.

  18. Using discrete event simulation to compare the performance of family health unit and primary health care centre organizational models in Portugal.

    PubMed

    Fialho, André S; Oliveira, Mónica D; Sá, Armando B

    2011-10-15

    Recent reforms in Portugal aimed at strengthening the role of the primary care system, in order to improve the quality of the health care system. Since 2006 new policies aiming to change the organization, incentive structures and funding of the primary health care sector were designed, promoting the evolution of traditional primary health care centres (PHCCs) into a new type of organizational unit--family health units (FHUs). This study aimed to compare performances of PHCC and FHU organizational models and to assess the potential gains from converting PHCCs into FHUs. Stochastic discrete event simulation models for the two types of organizational models were designed and implemented using Simul8 software. These models were applied to data from nineteen primary care units in three municipalities of the Greater Lisbon area. The conversion of PHCCs into FHUs seems to have the potential to generate substantial improvements in productivity and accessibility, while not having a significant impact on costs. This conversion might entail a 45% reduction in the average number of days required to obtain a medical appointment and a 7% and 9% increase in the average number of medical and nursing consultations, respectively. Reorganization of PHCC into FHUs might increase accessibility of patients to services and efficiency in the provision of primary care services.

  19. Absorption of nickel, chromium, and iron by the root surface of primary molars covered with stainless steel crowns.

    PubMed

    Keinan, David; Mass, Eliyahu; Zilberman, Uri

    2010-01-01

    Objective. The purpose of this study was to analyze the absorption of metal ions released from stainless steel crowns by root surface of primary molars. Study Design. Laboratory research: The study included 34 primary molars, exfoliated or extracted during routine dental treatment. 17 molars were covered with stainless-steel crowns for more than two years and compared to 17 intact primary molars. Chemical content of the mesial or distal root surface, 1 mm apically to the crown or the cemento-enamel junction (CEJ), was analyzed. An energy dispersive X-ray spectrometer (EDS) was used for chemical analysis. Results. Higher amounts of nickel, chromium, and iron (5-6 times) were found in the cementum of molars covered with stainless-steel crowns compared to intact molars. The differences between groups were highly significant (P < .001). Significance. Stainless-steel crowns release nickel, chromium, and iron in oral environment, and the ions are absorbed by the primary molars roots. The additional burden of allergenic metals should be reduced if possible.

  20. The Primary Prevention of PTSD in Firefighters: Preliminary Results of an RCT with 12-Month Follow-Up

    PubMed Central

    Rees, Clare S.; Mazzucchelli, Trevor G.; Kane, Robert T.

    2016-01-01

    Aim To develop and evaluate an evidence-based and theory driven program for the primary prevention of Post-traumatic Stress Disorder (PTSD). Design A pre-intervention / post-intervention / follow up control group design with clustered random allocation of participants to groups was used. The “control” group received “Training as Usual” (TAU). Method Participants were 45 career recruits within the recruit school at the Department of Fire and Emergency Services (DFES) in Western Australia. The intervention group received a four-hour resilience training intervention (Mental Agility and Psychological Strength training) as part of their recruit training school curriculum. Data was collected at baseline and at 6- and 12-months post intervention. Results We found no evidence that the intervention was effective in the primary prevention of mental health issues, nor did we find any significant impact of MAPS training on social support or coping strategies. A significant difference across conditions in trauma knowledge is indicative of some impact of the MAPS program. Conclusion While the key hypotheses were not supported, this study is the first randomised control trial investigating the primary prevention of PTSD. Practical barriers around the implementation of this program, including constraints within the recruit school, may inform the design and implementation of similar programs in the future. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12615001362583 PMID:27382968

  1. Primary studies of Chinese spaceborne SAR

    NASA Technical Reports Server (NTRS)

    Wang, Zhen-Song; Wu, Guo-Xiang; Guo, Hua-Dong; Wei, Zhong-Quan; Zhu, Min-Hui

    1993-01-01

    The primary studies on spaceborne synthetic aperture radar (SAR) in China are discussed. The SAR will be launched aboard a Chinese satellite and operated at L-band with HH polarization. The purpose of the mission in consideration is dedicated to resources and environment uses, especially to natural disaster monitoring. The ground resolution is designed as 25 m x 25 m for detailed mode and 100 m x 100 m for wide scan-SAR mode. The off-nadir angle can be varied from 20 to 40 deg. The key system concepts are introduced.

  2. Prospective cohort studies of newly marketed medications: using covariate data to inform the design of large-scale studies.

    PubMed

    Franklin, Jessica M; Rassen, Jeremy A; Bartels, Dorothee B; Schneeweiss, Sebastian

    2014-01-01

    Nonrandomized safety and effectiveness studies are often initiated immediately after the approval of a new medication, but patients prescribed the new medication during this period may be substantially different from those receiving an existing comparator treatment. Restricting the study to comparable patients after data have been collected is inefficient in prospective studies with primary collection of outcomes. We discuss design and methods for evaluating covariate data to assess the comparability of treatment groups, identify patient subgroups that are not comparable, and decide when to transition to a large-scale comparative study. We demonstrate methods in an example study comparing Cox-2 inhibitors during their postmarketing period (1999-2005) with nonselective nonsteroidal anti-inflammatory drugs (NSAIDs). Graphical checks of propensity score distributions in each treatment group showed substantial problems with overlap in the initial cohorts. In the first half of 1999, >40% of patients were in the region of nonoverlap on the propensity score, and across the study period this fraction never dropped below 10% (the a priori decision threshold for transitioning to the large-scale study). After restricting to patients with no prior NSAID use, <1% of patients were in the region of nonoverlap, indicating that a large-scale study could be initiated in this subgroup and few patients would need to be trimmed from analysis. A sequential study design that uses pilot data to evaluate treatment selection can guide the efficient design of large-scale outcome studies with primary data collection by focusing on comparable patients.

  3. Evaluation of Emotional Literacy Activities: A Phenomenological Study

    ERIC Educational Resources Information Center

    Oksuz, Yucel

    2016-01-01

    The present study aims to evaluate impact of the emotional literacy activities through participant student's experiences. Emotional literacy activities, including social-emotional skills Goleman's emotional intelligence and Fapuel's emotional literacy model designed and conducted for 2 months on primary school students, who study in 4th grade. The…

  4. (PRESENTED NAQC SAN FRANCISCO, CA) COARSE PM METHODS STUDY: STUDY DESIGN AND RESULTS

    EPA Science Inventory

    Comprehensive field studies were conducted to evaluate the performance of sampling methods for measuring the coarse fraction of PM10 in ambient air. Five separate sampling approaches were evaluated at each of three sampling sites. As the primary basis of comparison, a discrete ...

  5. Implementing change in primary care practices using electronic medical records: a conceptual framework.

    PubMed

    Nemeth, Lynne S; Feifer, Chris; Stuart, Gail W; Ornstein, Steven M

    2008-01-16

    Implementing change in primary care is difficult, and little practical guidance is available to assist small primary care practices. Methods to structure care and develop new roles are often needed to implement an evidence-based practice that improves care. This study explored the process of change used to implement clinical guidelines for primary and secondary prevention of cardiovascular disease in primary care practices that used a common electronic medical record (EMR). Multiple conceptual frameworks informed the design of this study designed to explain the complex phenomena of implementing change in primary care practice. Qualitative methods were used to examine the processes of change that practice members used to implement the guidelines. Purposive sampling in eight primary care practices within the Practice Partner Research Network-Translating Researching into Practice (PPRNet-TRIP II) clinical trial yielded 28 staff members and clinicians who were interviewed regarding how change in practice occurred while implementing clinical guidelines for primary and secondary prevention of cardiovascular disease and strokes. A conceptual framework for implementing clinical guidelines into primary care practice was developed through this research. Seven concepts and their relationships were modelled within this framework: leaders setting a vision with clear goals for staff to embrace; involving the team to enable the goals and vision for the practice to be achieved; enhancing communication systems to reinforce goals for patient care; developing the team to enable the staff to contribute toward practice improvement; taking small steps, encouraging practices' tests of small changes in practice; assimilating the electronic medical record to maximize clinical effectiveness, enhancing practices' use of the electronic tool they have invested in for patient care improvement; and providing feedback within a culture of improvement, leading to an iterative cycle of goal setting by leaders. This conceptual framework provides a mental model which can serve as a guide for practice leaders implementing clinical guidelines in primary care practice using electronic medical records. Using the concepts as implementation and evaluation criteria, program developers and teams can stimulate improvements in their practice settings. Investing in collaborative team development of clinicians and staff may enable the practice environment to be more adaptive to change and improvement.

  6. Effective recruitment strategies in primary care research: a systematic review.

    PubMed

    Ngune, Irene; Jiwa, Moyez; Dadich, Ann; Lotriet, Jaco; Sriram, Deepa

    2012-01-01

    Patient recruitment in primary care research is often a protracted and frustrating process, affecting project timeframes, budget and the dissemination of research findings. Yet, clear guidance on patient recruitment strategies in primary care research is limited. This paper addresses this issue through a systematic review. Articles were sourced from five academic databases - AustHealth, CINAHL, the Cochrane Methodology Group, EMBASE and PubMed/Medline; grey literature was also sourced from an academic library and the Primary Healthcare Research & Information Service (PHCRIS) website. Two reviewers independently screened the articles using the following criteria: (1) published in English, (2) reported empirical research, (3) focused on interventions designed to increase patient recruitment in primary care settings, and (4) reported patient recruitment in primary care settings. Sixty-six articles met the inclusion criteria. Of these, 23 specifically focused on recruitment strategies and included randomised trials (n = 7), systematic reviews (n = 8) and qualitative studies (n = 8). Of the remaining articles, 30 evaluated recruitment strategies, while 13 addressed the value of recruitment strategies using descriptive statistics and/or qualitative data. Among the 66 articles, primary care chiefly included general practice (n = 30); nursing and allied health services, multiple settings, as well as other community settings (n = 30); and pharmacy (n = 6). Effective recruitment strategies included the involvement of a discipline champion, simple patient eligibility criteria, patient incentives and organisational strategies that reduce practitioner workload. The most effective recruitment in primary care research requires practitioner involvement. The active participation of primary care practitioners in both the design and conduct of research helps to identify strategies that are congruent with the context in which patient care is delivered. This is reported to be the optimal recruitment strategy.

  7. Barriers and facilitators to implementing electronic prescription: a systematic review of user groups' perceptions.

    PubMed

    Gagnon, Marie-Pierre; Nsangou, Édith-Romy; Payne-Gagnon, Julie; Grenier, Sonya; Sicotte, Claude

    2014-01-01

    We conducted a systematic review identifying users groups' perceptions of barriers and facilitators to implementing electronic prescription (e-prescribing) in primary care. We included studies following these criteria: presence of an empirical design, focus on the users' experience of e-prescribing implementation, conducted in primary care, and providing data on barriers and facilitators to e-prescribing implementation. We used the Donabedian logical model of healthcare quality (adapted by Barber et al) to analyze our findings. We found 34 publications (related to 28 individual studies) eligible to be included in this review. These studies identified a total of 594 elements as barriers or facilitators to e-prescribing implementation. Most user groups perceived that e-prescribing was facilitated by design and technical concerns, interoperability, content appropriate for the users, attitude towards e-prescribing, productivity, and available resources. This review highlights the importance of technical and organizational support for the successful implementation of e-prescribing systems. It also shows that the same factor can be seen as a barrier or a facilitator depending on the project's own circumstances. Moreover, a factor can change in nature, from a barrier to a facilitator and vice versa, in the process of e-prescribing implementation. This review summarizes current knowledge on factors related to e-prescribing implementation in primary care that could support decision makers in their design of effective implementation strategies. Finally, future studies should emphasize on the perceptions of other user groups, such as pharmacists, managers, vendors, and patients, who remain neglected in the literature.

  8. Field verification process for open-graded HMAC mixes : final report.

    DOT National Transportation Integrated Search

    2002-07-01

    The State of Oregon uses significant amounts of open-graded HMAC mixes as primary wearing courses on state highways. The primary materials design system for these mixes relies heavily on laboratory draindown to select the design asphalt content. Subs...

  9. ClinicalTrials.gov registration can supplement information in abstracts for systematic reviews: a comparison study.

    PubMed

    Scherer, Roberta W; Huynh, Lynn; Ervin, Ann-Margret; Taylor, Jakeisha; Dickersin, Kay

    2013-06-18

    The inclusion of randomized controlled trials (RCTs) reported in conference abstracts in systematic reviews is controversial, partly because study design information and risk of bias is often not fully reported in the abstract. The Association for Research in Vision and Ophthalmology (ARVO) requires trial registration of abstracts submitted for their annual conference as of 2007. Our goal was to assess the feasibility of obtaining study design information critical to systematic reviews, but not typically included in conference abstracts, from the trial registration record. We reviewed all conference abstracts presented at the ARVO meetings from 2007 through 2009, and identified 496 RCTs; 154 had a single matching registration record in ClinicalTrials.gov. Two individuals independently extracted information from the abstract and the ClinicalTrials.gov record, including study design, sample size, inclusion criteria, masking, interventions, outcomes, funder, and investigator name and contact information. Discrepancies were resolved by consensus. We assessed the frequencies of reporting variables appearing in the abstract and the trial register and assessed agreement of information reported in both sources. We found a substantial amount of study design information in the ClinicalTrials.gov record that was unavailable in the corresponding conference abstract, including eligibility criteria associated with gender (83%; 128/154); masking or blinding of study participants (53%, 82/154), persons administering treatment (30%, 46/154), and persons measuring the outcomes (40%, 61/154)); and number of study centers (58%; 90/154). Only 34% (52/154) of abstracts explicitly described a primary outcome, but a primary outcome was included in the "Primary Outcome" field in the ClinicalTrials.gov record for 82% (126/154) of studies. One or more study interventions were reported in each abstract, but agreed exactly with those reported in ClinicalTrials.gov only slightly more than half the time (88/154, 56%). We found no contact information for study investigators in the abstract, but this information was available in less than one quarter of ClinicalTrial.gov records (17%; 26/154). RCT design information not reported in conference abstracts is often available in the corresponding ClinicalTrials.gov registration record. Sometimes there is conflicting information reported in the two sources and further contact with the trial investigators may still be required.

  10. ClinicalTrials.gov registration can supplement information in abstracts for systematic reviews: a comparison study

    PubMed Central

    2013-01-01

    Background The inclusion of randomized controlled trials (RCTs) reported in conference abstracts in systematic reviews is controversial, partly because study design information and risk of bias is often not fully reported in the abstract. The Association for Research in Vision and Ophthalmology (ARVO) requires trial registration of abstracts submitted for their annual conference as of 2007. Our goal was to assess the feasibility of obtaining study design information critical to systematic reviews, but not typically included in conference abstracts, from the trial registration record. Methods We reviewed all conference abstracts presented at the ARVO meetings from 2007 through 2009, and identified 496 RCTs; 154 had a single matching registration record in ClinicalTrials.gov. Two individuals independently extracted information from the abstract and the ClinicalTrials.gov record, including study design, sample size, inclusion criteria, masking, interventions, outcomes, funder, and investigator name and contact information. Discrepancies were resolved by consensus. We assessed the frequencies of reporting variables appearing in the abstract and the trial register and assessed agreement of information reported in both sources. Results We found a substantial amount of study design information in the ClinicalTrials.gov record that was unavailable in the corresponding conference abstract, including eligibility criteria associated with gender (83%; 128/154); masking or blinding of study participants (53%, 82/154), persons administering treatment (30%, 46/154), and persons measuring the outcomes (40%, 61/154)); and number of study centers (58%; 90/154). Only 34% (52/154) of abstracts explicitly described a primary outcome, but a primary outcome was included in the “Primary Outcome” field in the ClinicalTrials.gov record for 82% (126/154) of studies. One or more study interventions were reported in each abstract, but agreed exactly with those reported in ClinicalTrials.gov only slightly more than half the time (88/154, 56%). We found no contact information for study investigators in the abstract, but this information was available in less than one quarter of ClinicalTrial.gov records (17%; 26/154). Conclusion RCT design information not reported in conference abstracts is often available in the corresponding ClinicalTrials.gov registration record. Sometimes there is conflicting information reported in the two sources and further contact with the trial investigators may still be required. PMID:23773868

  11. Demand for Agricultural Extension Services among Small-Scale Maize Farmers: Micro-Level Evidence from Kenya

    ERIC Educational Resources Information Center

    Gido, Eric O.; Sibiko, Kenneth W.; Ayuya, Oscar I.; Mwangi, Joseph K.

    2015-01-01

    Purpose: The objective of the study was to determine the level and determinants of demand for extension services among small-scale maize farmers in Kenya. Design/methodology/approach: Based on an exploratory research design, primary data were collected from a sample of 352 households through face-to-face interviews. Focus group discussions were…

  12. The Feasibility of Using Nature-Based Settings for Physical Activity Programming: Views from Urban Youth and Program Providers

    ERIC Educational Resources Information Center

    Blanton, Jedediah E.; Oregon, Evelyn M.; Flett, M. Ryan; Gould, Daniel R.; Pfeiffer, Karin A.

    2013-01-01

    Background and Purpose: Given the urgency to design programs to increase physical activity, especially to combat obesity in children, the primary purpose of this study was to investigate perceptions and opinions of a nature-based physical activity intervention designed for low-income urban adolescents. Methods: Four focus groups of adolescents,…

  13. Incorporating Beliefs, Values and Local Wisdom of Betawi Culture in a Character-Based Education through a Design-Based Research

    ERIC Educational Resources Information Center

    Suswandari

    2017-01-01

    This design-based research is part of three-year national projects examining the incorporation of local wisdom in a character-based education in primary school contexts. Specifically, the present study addresses two research questions: 1) what are local wisdoms of Betawi ethnic feasible to be incorporated in character based curriculum in primary…

  14. Cutting-Edge Panacea of the Twenty-First Century: Workplace Spirituality for Higher Education Human Resources

    ERIC Educational Resources Information Center

    Khasawneh, Samer

    2011-01-01

    Purpose: The primary purpose of this study is to determine the level of spirituality in the workplace for faculty members at public universities in Jordan. Design/methodology/approach: The paper uses a survey design as the basis for the research. Findings: The results indicate that participants perceived an overall moderate-to-high level of…

  15. The Effect of the Thinking-Aloud Strategy on the Reading Comprehension Skills of 4th Grade Primary School Students

    ERIC Educational Resources Information Center

    Sönmez, Yasemin; Sulak, Süleyman Erkam

    2018-01-01

    The purpose of this study, which is designed in quasi-experimental model, is to examine the effect of the thinking aloud strategy on the reading comprehension skills of the 4th grade primary school students. For this purpose, in the second semester of 2016-2017 academic year, the reading comprehension levels of 26 students in the 4th grade at a…

  16. What Makes My School a Good Training Ground for Leadership Development?: The Perceptions of Heads, Middle Leaders and Classroom Teachers from 70 Contextually Different Primary and Secondary Schools in England

    ERIC Educational Resources Information Center

    Rhodes, Christopher; Brundrett, Mark

    2008-01-01

    This article reports on outcomes from a study funded by the National College for School Leadership designed to explore leadership talent identification, development, succession and retention in contextually different primary and secondary schools in England. It draws upon this larger project and offers evidence not seen before elsewhere. It deals…

  17. Patients' and practitioners' views on health behaviour change: a qualitative study.

    PubMed

    Elwell, Laura; Povey, Rachel; Grogan, Sarah; Allen, Candia; Prestwich, Andrew

    2013-01-01

    This study was designed to examine patients' and health professionals' perspectives on lifestyle behaviour change and to inform the development of a lifestyle behaviour change intervention to be used in primary care. Focus groups were conducted with seven patients and 13 health professionals where they were asked to discuss lifestyle behaviour change in relation to the design and development phase of a tailored lifestyle behaviour change intervention package. An inductive thematic analysis of transcripts suggested a range of issues that are relevant to the development and implementation of lifestyle change interventions such as time, lack of resources and starting interventions too late, as well as personal circumstances and the continuous effort that behaviour change requires. They were interpreted as two superordinate themes of 'internal and external influences on behaviour change' and 'behaviour change initiation and maintenance'. The results are discussed in relation to the implications they may have for researchers and health service commissioners designing interventions and practitioners implementing lifestyle change interventions in primary care. Many factors are involved in patients' and health care professionals' understanding of interventions and lifestyle behaviour change. These should be taken into consideration when designing interventions based on behaviour change theories.

  18. Primary care physicians' perceived barriers and facilitators to conservative care for older adults with chronic kidney disease: design of a mixed methods study.

    PubMed

    Tam-Tham, Helen; Hemmelgarn, Brenda; Campbell, David; Thomas, Chandra; Quinn, Robert; Fruetel, Karen; King-Shier, Kathryn

    2016-01-01

    Guideline committees have identified the need for research to inform the provision of conservative care for older adults with stage 5 chronic kidney disease (CKD) who have a high burden of comorbidity or functional impairment. We will use both qualitative and quantitative methodologies to provide a comprehensive understanding of barriers and facilitators to care for these patients in primary care. Our objectives are to (1) interview primary care physicians to determine their perspectives of conservative care for older adults with stage 5 CKD and (2) survey primary care physicians to determine the prevalence of key barriers and facilitators to provision of conservative care for older adults with stage 5 CKD. A sequential exploratory mixed methods design was adopted for this study. The first phase of the study will involve fundamental qualitative description and the second phase will be a cross-sectional population-based survey. The research is conducted in Alberta, Canada. The participants are primary care physicians with experience in providing care for older adults with stage 5 CKD not planning on initiating dialysis. The first objective will be achieved by undertaking interviews with primary care physicians from southern Alberta. Participants will be selected purposively to include physicians with a range of characteristics (e.g., age, gender, and location of clinical practice). Interviews will be recorded, transcribed verbatim, and analyzed using conventional content analysis to generate themes. The second objective will be achieved by undertaking a population-based survey of primary care physicians in Alberta. The questionnaire will be developed based on the findings from the qualitative interviews and pilot tested for face and content validity. Physicians will be provided multiple options to complete the questionnaire including mail, fax, and online methods. Descriptive statistics and associations between demographic factors and barriers and facilitators to care will be analyzed using regression models. A potential limitation of this mixed methods study is its cross-sectional nature. This work will inform development of clinical resources and tools for care of older adults with stage 5 CKD, to address barriers and enable facilitators to community-based conservative care.

  19. Engaging Primary Children and Pre-Service Teachers in a Whole School "Design and Make Day": The Evaluation of a Creative Science and Technology Collaboration

    ERIC Educational Resources Information Center

    Pressick-Kilborn, Kimberley; Prescott, Anne

    2017-01-01

    A pedagogical innovation was collaboratively designed, implemented and evaluated in the context of a school-university partnership. The innovation had a dual purpose: 1) to provide an opportunity for primary pre-service teachers to develop their understanding and experience of teaching "design and produce" processes (working…

  20. Designing a Primary Science Curriculum in a Globalizing World: How Do Social Constructivism and Vietnamese Culture Meet?

    ERIC Educational Resources Information Center

    H?ng, Ngô Vu Thu; Meijer, Marijn Roland; Bulte, Astrid M. W.; Pilot, Albert

    2017-01-01

    The implementation of social constructivist approaches to learning science in primary education in Vietnamese culture as an example of Confucian heritage culture remains challenging and problematic. This theoretical paper focuses on the initial phase of a design-based research approach; that is, the description of the design of a formal, written…

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