140 research outputs found
A Hub Website of Online German Learning and Teaching: Resources for the Development of 21st Century Skills
Rapid technological developments and relaxed international trade agreements have created increased global competition in the job market (Committee for Economic, 2006). In this global society and economy, a new set of skills will be required of the United States workforce. These 21st century skills include autonomous learning skills, communication skills, and technological literacy (Partnership, 2008). In order to support the development and instruction of these skills in the high school German classroom, a hub website of online resources for German teachers and students has been created. The resources available on the hub website include teacher resources, reference resources, instructional websites, practice tools, and websites for enrichment and exploration
Comprehensive Assessment: Interventions and Coping Strategies Professionals use to Increase Adaptation of a Sibling with an Ill Brother or Sister
No abstract provided
Comprehensive Assessment: Interventions and Coping Strategies Professionals use to Increase Adaptation of a Sibling with an Ill Brother or Sister
No abstract provided
Factors influencing the retention of women faculty in STEM disciplines.
Low numbers of women faculty in STEM (science, technology, engineering and mathematics) disciplines continues to be a concern in higher education. Even though completion of STEM degrees by women has increased in many disciplines, increases in the number of women faculty have not been seen. Additionally, women continue to leave faculty positions at twice the rate of men. In order to remain globally competitive, the US needs to retain a diverse STEM professoriate. This dissertation examined the factors influencing the retention of women faculty in STEM disciplines and their over-representation in non-research intensive institutions. The analysis was broken into two parts. Using the 2013 HERI Faculty Survey, the constructs faculty stress, job satisfaction, and intent to leave were first examined for faculty group differences based upon gender, discipline, and institution type using EFA and MIMIC analyses. In the second part, I examined the structural relationship between these three constructs using SEM techniques. Women faculty were found to be more stressed, less satisfied, and had greater intent to leave. Faculty stress had both direct and indirect effects on intent to leave with greater indirect effects occurring due to the mediation of job satisfaction. Ultimately, women faculty in STEM were more likely to have intent to leave due to high levels of stress reducing their job satisfaction. In order to retain women faculty in STEM disciplines, institutions will need to examine their practices and policies to ensure women faculty are not being disadvantaged or discriminated based on their biology. By enabling women faculty to achieve a better work-life balance will not only increase their retention but will strengthen the entire professoriate
The effect of simulated narratives that leverage EMR data on shared decision-making: a pilot study
BACKGROUND: Shared decision-making can improve patient satisfaction and outcomes. To participate in shared decision-making, patients need information about the potential risks and benefits of treatment options. Our team has developed a novel prototype tool for shared decision-making called hearts like mine (HLM) that leverages EHR data to provide personalized information to patients regarding potential outcomes of different treatments. These potential outcomes are presented through an Icon array and/or simulated narratives for each âpersonâ in the display. In this pilot project we sought to determine whether the inclusion of simulated narratives in the display affects individualsâ decision-making. Thirty subjects participated in this block-randomized study in which they used a version of HLM with simulated narratives and a version without (or in the opposite order) to make a hypothetical therapeutic decision. After each decision, participants completed a questionnaire that measured decisional confidence. We used Chi square tests to compare decisions across conditions and MannâWhitney U tests to examine the effects of narratives on decisional confidence. Finally, we calculated the mean of subjectsâ post-experiment rating of whether narratives were helpful in their decision-making. RESULTS: In this study, there was no effect of simulated narratives on treatment decisions (decision 1: Chi squared = 0, p = 1.0; decision 2: Chi squared = 0.574, p = 0.44) or Decisional confidence (decision 1, w = 105.5, p = 0.78; decision 2, w = 86.5, p = 0.28). Post-experiment, participants reported that narratives helped them to make decisions (mean = 3.3/4). CONCLUSIONS: We found that simulated narratives had no measurable effect on decisional confidence or decisions and most participants felt that the narratives were helpful to them in making therapeutic decisions. The use of simulated stories holds promise for promoting shared decision-making while minimizing their potential biasing effect
Doodle Health: A Crowdsourcing Game for the Co-design and Testing of Pictographs to Reduce Disparities in Healthcare Communication
Supplementing patient education content with pictographs can improve the comprehension and recall of information, especially patients with low health literacy. Pictograph design and testing, however, are costly and time consuming. We created a Web-based game, Doodle Health, for crowdsourcing the drawing and validation of pictographs. The objective of this pilot study was to test the usability of the game and its appeal to healthcare consumers. The chief purpose of the game is to involve a diverse population in the co-design and evaluation of pictographs. We conducted a community-based focus group to inform the game design. Game designers, health sciences librarians, informatics researchers, clinicians, and community members participated in two Design Box meetings. The results of the meetings were used to create the Doodle Health crowdsourcing game. The game was presented and tested at two public fairs. Initial testing indicates crowdsourcing is a promising approach to pictograph development and testing for relevancy and comprehension. Over 596 drawings were collected and 1,758 guesses were performed to date with 70-90% accuracies, which are satisfactorily high
Caribbean Corals in Crisis: Record Thermal Stress, Bleaching, and Mortality in 2005
BACKGROUND The rising temperature of the world's oceans has become a major threat to coral reefs globally as the severity and frequency of mass coral bleaching and mortality events increase. In 2005, high ocean temperatures in the tropical Atlantic and Caribbean resulted in the most severe bleaching event ever recorded in the basin. METHODOLOGY/PRINCIPAL FINDINGS Satellite-based tools provided warnings for coral reef managers and scientists, guiding both the timing and location of researchers' field observations as anomalously warm conditions developed and spread across the greater Caribbean region from June to October 2005. Field surveys of bleaching and mortality exceeded prior efforts in detail and extent, and provided a new standard for documenting the effects of bleaching and for testing nowcast and forecast products. Collaborators from 22 countries undertook the most comprehensive documentation of basin-scale bleaching to date and found that over 80% of corals bleached and over 40% died at many sites. The most severe bleaching coincided with waters nearest a western Atlantic warm pool that was centered off the northern end of the Lesser Antilles. CONCLUSIONS/SIGNIFICANCE Thermal stress during the 2005 event exceeded any observed from the Caribbean in the prior 20 years, and regionally-averaged temperatures were the warmest in over 150 years. Comparison of satellite data against field surveys demonstrated a significant predictive relationship between accumulated heat stress (measured using NOAA Coral Reef Watch's Degree Heating Weeks) and bleaching intensity. This severe, widespread bleaching and mortality will undoubtedly have long-term consequences for reef ecosystems and suggests a troubled future for tropical marine ecosystems under a warming climate.This work was partially supported by salaries from the NOAA Coral Reef Conservation Program to the NOAA Coral Reef Conservation Program authors. NOAA provided funding to Caribbean ReefCheck investigators to undertake surveys of bleaching and mortality. Otherwise, no funding from outside authors' institutions was necessary for the undertaking of this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Gambling and problem gambling in Canada in 2018: prevalence and changes since 2002
Permission to archive accepted author manuscript. Reuse is restricted to non-commercial and no derivative uses.Objective The purpose of this study was to provide an updated profile of gambling and problem gambling in Canada and to examine how the rates and pattern of participation compare to 2002.
Method An assessment of gambling and problem gambling was included in the 2018 Canadian Community Health Survey and administered to 24,982 individuals aged 15 and older. The present analyses selected for adults (18+).
Results A total of 66.2% of people reported engaging in some type of gambling in 2018, primarily lottery and/or raffle tickets, the only type in which the majority of Canadians participate. There are some significant inter-provincial differences, with perhaps the most important one being the higher rate of electronic gambling machine (EGM) participation in Manitoba and Saskatchewan The overall pattern of gambling in 2018 is very similar to 2002, although participation is generally much lower in 2018, particularly for EGMs and bingo. Only 0.6% of the population were identified as problem gamblers in 2018, with an additional 2.7% being at-risk gamblers. There is no significant inter-provincial variation in problem gambling rates. The inter-provincial pattern of problem gambling in 2018 is also very similar to what was found in 2002 with the main difference being a 45% decrease in the overall prevalence of problem gambling.
Conclusions Gambling and problem gambling have both decreased in Canada from 2002 to 2018, although the provincial patterns are quite similar between the two time periods. Several mechanisms have likely collectively contributed to these declines. Decreases have also been reported in several other western countries in recent years and have occurred despite the expansion of legal gambling opportunities, suggesting a degree of inoculation or adaptation in the population.Ye
Apicoplast isoprenoid precursor synthesis and the molecular basis of fosmidomycin resistance in Toxoplasma gondii
Expression of a bacterial transporter protein in Toxoplasma gondii results in parasite susceptibility to Formidomycin, a drug targeting isoprenoid precursor synthesis
Cost-effectiveness of non-invasive methods for assessment and monitoring of liver fibrosis and cirrhosis in patients with chronic liver disease: systematic review and economic evaluation
BACKGROUND: Liver biopsy is the reference standard for diagnosing the extent of fibrosis in chronic liver disease; however, it is invasive, with the potential for serious complications. Alternatives to biopsy include non-invasive liver tests (NILTs); however, the cost-effectiveness of these needs to be established. OBJECTIVE: To assess the diagnostic accuracy and cost-effectiveness of NILTs in patients with chronic liver disease. DATA SOURCES: We searched various databases from 1998 to April 2012, recent conference proceedings and reference lists. METHODS: We included studies that assessed the diagnostic accuracy of NILTs using liver biopsy as the reference standard. Diagnostic studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Meta-analysis was conducted using the bivariate random-effects model with correlation between sensitivity and specificity (whenever possible). Decision models were used to evaluate the cost-effectiveness of the NILTs. Expected costs were estimated using a NHS perspective and health outcomes were measured as quality-adjusted life-years (QALYs). Markov models were developed to estimate long-term costs and QALYs following testing, and antiviral treatment where indicated, for chronic hepatitis B (HBV) and chronic hepatitis C (HCV). NILTs were compared with each other, sequential testing strategies, biopsy and strategies including no testing. For alcoholic liver disease (ALD), we assessed the cost-effectiveness of NILTs in the context of potentially increasing abstinence from alcohol. Owing to a lack of data and treatments specifically for fibrosis in patients with non-alcoholic fatty liver disease (NAFLD), the analysis was limited to an incremental cost per correct diagnosis. An analysis of NILTs to identify patients with cirrhosis for increased monitoring was also conducted. RESULTS: Given a cost-effectiveness threshold of ÂŁ20,000 per QALY, treating everyone with HCV without prior testing was cost-effective with an incremental cost-effectiveness ratio (ICER) of ÂŁ9204. This was robust in most sensitivity analyses but sensitive to the extent of treatment benefit for patients with mild fibrosis. For HBV [hepatitis B e antigen (HBeAg)-negative)] this strategy had an ICER of ÂŁ28,137, which was cost-effective only if the upper bound of the standard UK cost-effectiveness threshold range (ÂŁ30,000) is acceptable. For HBeAg-positive disease, two NILTs applied sequentially (hyaluronic acid and magnetic resonance elastography) were cost-effective at a ÂŁ20,000 threshold (ICER: ÂŁ19,612); however, the results were highly uncertain, with several test strategies having similar expected outcomes and costs. For patients with ALD, liver biopsy was the cost-effective strategy, with an ICER of ÂŁ822. LIMITATIONS: A substantial number of tests had only one study from which diagnostic accuracy was derived; therefore, there is a high risk of bias. Most NILTs did not have validated cut-offs for diagnosis of specific fibrosis stages. The findings of the ALD model were dependent on assuptions about abstinence rates assumptions and the modelling approach for NAFLD was hindered by the lack of evidence on clinically effective treatments. CONCLUSIONS: Treating everyone without NILTs is cost-effective for patients with HCV, but only for HBeAg-negative if the higher cost-effectiveness threshold is appropriate. For HBeAg-positive, two NILTs applied sequentially were cost-effective but highly uncertain. Further evidence for treatment effectiveness is required for ALD and NAFLD. STUDY REGISTRATION: This study is registered as PROSPERO CRD42011001561. FUNDING: The National Institute for Health Research Health Technology Assessment programme
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