Researching professional practice: The integrated practice perspectives model and continuing education.

The Integrated Practice Perspectives model reframes previous efforts to link education with professional practice by using theories of situated cognition and learning. Reframing allows other variables in professional performance to be identified, performance to be more thoroughly linked to social and cultural contexts, and a more integrative and deeper conceptualization of professional practice and context to be developed

Chemotherapeutic impact on pain and global health-related quality of life in hormone-refractory prostate cancer: Dynamically Modified Outcomes (DYNAMO) analysis of a randomized controlled trial.

PURPOSE: This paper applies the Dynamically Modified Outcomes (DYNAMO) model to a clinical trial of two chemotherapeutic regimens on global health-related quality of life (GHRQL) in hormone-refractory prostate cancer. METHODS: DYNAMO identifies the causal influences operating in a clinical trial and their mediation, moderation, and modulation by uncontrolled variables. The Southwest Oncology Group trial S9916 randomized assignment to mitoxantrone plus prednisone (M + P) versus docetaxel plus estramustine (D + E) treatments. In this application, we examine baseline-adjusted impacts of worst pain (McGill Pain Questionnaire) on GHRQL (EORTC Quality of Life Questionnaire-C30) at 10 weeks. RESULTS: The average treatment levels of pain did not differ, hence, the average mediated effect of treatment on GHRQL was zero. Nonetheless, M + P reduced the impact (the relational outcome) of pain on GHRQL by 54% relative to D + E. Individual variation in the relational outcome (modulation) was of the same magnitude as the average difference between the groups. Performance status moderated the direct effects of treatment, with D + E being more effective in good, but not poor, performance strata. CONCLUSIONS: The DYNAMO approach comprehensively accounted for treatment effects. Rather than a single average effect, there were three distinct treatment effects: one direct effect for each performance status level and a direct effect on the relationship between pain and GHRQL

A History of Louisiana\u27s Rural Electric Cooperatives, 1937-1983.

The Rural Electrification Administration was created by Franklin D. Roosevelt in 1936. There were attempts at rural electrification prior to that date, but FDR\u27s program, as part of the New Deal, was the beginning of the modern system. The REA was put into operation by Morris L. Cooke, and expanded by John Carmody and Harry Slattery through 1944. The Fifties ushered in a conservative presidential administration that opposed organizations such as co-ops, and, consequently, funds were cut. But on the local level, co-ops continued to grow. The Sixties brought with it financial cooperation from Washington, and many co-ops around the country found that there was enough money available to begin generating their own power. In Louisiana, the REA came not as a government organization, but as a generous banker--a lender of low interest money. The co-ops began in Louisiana in late 1937 at Teche Electric, and developed to a total of thirteen individual groups through the late Forties. During the War, the thirteen co-ops in the state organized a statewide association, the purpose of which was to lobby and to promote the idea of rural electrification In the early Fifties they founded a newspaper and threatened to generate their own power in the face of excessive fuel costs from the private power companies in the state. In 1962, prices again rose and the state\u27s co-op leaders, through their statewide organization, began a serious move to generate their own power. After a hard-fought struggle, a loan was finally approved in 1964. But it was not until four years later, after extensive compromise with the private utilities, that the money was finally granted for the construction of the first plant. It was also at this time that the group fought battles over right-of-way regulation and Public Service Commission regulation. Between the completion of the first plant in 1972 and today (1983) Cajun Electric has completed three other plants, all coal

Factors Associated with HIV Discussion and Condom Use with Sexual Partners in an Underserved Community in South Africa

We examined factors associated with discussing HIV and condom use with a sexual partner. Two cross-sectional surveys were conducted in 2004 prior to the implementation of an HIV awareness campaign in a South African community and in 2008 after a three-year education program. Overall, the proportion of individuals who had discussed HIV with a sexual partner increased from 76% in 2004 to 89% in 2008 (p < .001). Among respondents who had sex six months before completing the surveys, condom use significantly increased from 64% in 2004 to 79% in 2008 (p < .05). Respondents who discussed HIV with a sexual partner were more likely to use condoms than respondents who had not discussed HIV with a sexual partner (OR=2.08, 95% CI=1.16, 3.72). These findings indicate the importance of interventions aimed at promoting HIV awareness and discussion of HIV in communities with individuals at risk of acquiring HIV

Postoperative Pain Trajectories in Cardiac Surgery Patients

Poorly controlled postoperative pain is a longstanding and costly problem in medicine. The purposes of this study were to characterize the acute pain trajectories over the first four postoperative days in 83 cardiac surgery patients with a mixed effects model of linear growth to determine whether statistically significant individual differences exist in these pain trajectories, and to compare the quality of measurement by trajectory with conventional pain measurement practices. The data conformed to a linear model that provided slope (rate of change) as a basis for comparing patients. Slopes varied significantly across patients, indicating that the direction and rate of change in pain during the first four days of recovery from surgery differed systematically across individuals. Of the 83 patients, 24 had decreasing pain after surgery, 24 had increasing pain, and the remaining 35 had approximately constant levels of pain over the four postoperative days

An Exploratory Study of the Effects of Mind–Body Interventions Targeting Sleep on Salivary Oxytocin Levels in Cancer Survivors

Cancer survivors experience high levels of distress, associated with a host of negative psychological states, including anxiety, depression, and fear of recurrence, which often lead to sleep problems and reduction in quality of life (QOL) and well-being. As a neuropeptide hormone associated with affiliation, calmness, and well-being, oxytocin may be a useful biological measure of changes in health outcomes in cancer survivors. In this exploratory study, which comprised a subset of participants from a larger study, we evaluated ( a ) the feasibility and reliability of salivary oxytocin (sOT) levels in cancer survivors and ( b ) the effects of 2 sleep-focused mind–body interventions, mind–body bridging (MBB) and mindfulness meditation (MM), compared with a sleep hygiene education (SHE) control, on changes in sOT levels in 30 cancer survivors with self-reported sleep disturbance. Interventions were conducted in 3 sessions, once per week for 3 weeks. Saliva samples were collected at baseline, postintervention (~1 week after the last session), and at the 2-month follow-up. In this cancer survivor group, we found that intra-individual sOT levels were fairly stable across the 3 time points, of about 3 months’ duration, and mean baseline sOT levels did not differ between females and males and were not correlated with age. Correlations between baseline sOT and self-report measures were weak; however, several of these relationships were in the predicted direction, in which sOT levels were negatively associated with sleep problems and depression and positively associated with cancer-related QOL and well-being. Regarding intervention effects on sOT, baseline-subtracted sOT levels were significantly larger at postintervention in the MBB group as compared with those in SHE. In this sample of cancer survivors assessed for sOT, at postintervention, greater reductions in sleep problems were noted for MBB and MM compared with that of SHE, and increases in mindfulness and self-compassion were observed in the MBB group compared with those in SHE. The findings in this exploratory study suggest that sOT may be a reliable biological measure over time that may provide insight into the effects of mind–body interventions on health outcomes in cancer survivors

Comparing and Contrasting a Program versus System Approach to Evaluation: The Example of a Cardiac Care System

This paper focuses on the application of systems thinking concepts to evaluate systems. &nbsp;The terms systems and systems thinking concepts are first defined.&nbsp; The use of systems thinking concepts in program and system evaluation are then highlighted.&nbsp; It is noted that while there are methods available to assist evaluation practitioners in applying systems thinking concepts to program evaluation, there is a need for similar guidance in applying systems thinking concepts to evaluating systems.&nbsp; System Evaluation Theory (SET) is then reviewed as one evaluation theory designed to apply systems thinking concepts to evaluating systems. A case illustration is presented to help teach practitioners how to apply SET’s three steps.&nbsp; The discussion focuses on comparing the differences between evaluation questions answered by applying systems thinking concepts versus those using program logic models

The Effect of Rivals When Firms Emerge from Bankruptcy

Studies on the announcement effects of bankruptcy filings have found that when a firm files for Chapter 11 bankruptcy protection its shareholders suffer significant losses. A recent paper extends these findings by investigating the announcement effect on rival companies, while another examines the equity performance of firms emerging from bankruptcy. We combine these two lines of inquiry by examining the effect on rivals when a firm emerges from the protection of Chapter 11. We find both significant negative stock market returns and significant negative revisions in analysts’ earnings forecasts for rivals of successfully reorganized companies.</jats:p

The Intra-industry Effects of Chapter 11 Filings: Evidence from Analysts’ Earnings Forecast Revisions

Shareholders suffer huge losses when firms they own file Chapter 11. Interestingly, even shareholders of rival companies experience statistically significant losses. We examine how the bad news associated with a bankruptcy filing is transferred to the filing firm’s rivals. Using revisions in analysts’ earnings forecasts as a proxy for changes in expected future cash flows, we find that after a bankruptcy filing the market revises downward its cash flow expectations for rivals. Regression analysis confirms a positive relation between changes in expected cash flow and stock market reactions. These findings are consistent with our hypothesis that bad news associated with bankruptcy filings are transferred to rivals through reductions in expected future cash flows</jats:p