Evaluating the effectiveness of a diversity training in an educational organization

Diversity training programs are increasingly being incorporated into organizations as a strategy to meet moral standards and legal challenges. Unfortunately, little research as been conducted to demonstrate the effectiveness of these programs. This study describes an effective diversity training program as one that changes a member of the organization\u27s negative attitude about racial differences toward a positive attitude

Reading instruction in first-grade classrooms: Do basals control teachers?

This study describes first-grade teachers beliefs and practices about reading instruction. Drawing from interview and observational data, 16 teachers from four districts were placed on a continuum from skills-based to literature-based in relationship to their use of the basal. Only 2 teachers were found to rely solely on the basal, while 3 teachers enhanced the basal with literature, and 4 teachers used only literature in their reading instruction. Six teachers enhanced their basal use with additional skills and 1 teacher relied on skills only in her reading instruction. This diversity\u27 of teaching beliefs and practices was corroborated by questionnaire data from a larger sample of teachers. Next, a framework developed by Belenky, Clinchy, Goldberger, and Tarule (1986) was used to categorize teachers\u27 ways of knowing. The findings showed 1 teacher to be a silent knower, 6 were received knowers, 1 was a subjective knower, 7 were procedural knowers, and 1 was a connected knower. Results challenge Shannon\u27s (1987) hypothesis that basals deskill teachers while supporting Sosniak and Stodolskv\u27s (1993) view that teachers are more autonomous in their use of textbook materials

Determinants of General Practitioners' Wages in England

We analyse the determinants of annual net income and wages (annual net income/hours) of general practitioners (GPs) using a unique, anonymised, non-disclosive dataset derived from tax returns for 21,657 GPs in England for the financial year 2002/3. The average GP had a gross income of £189,300, incurred expenses of £115,600, and earned an annual net income of £73,700. The mean wage was £35 per hour. Net income and wages depended on gender, experience, list size, partnership size, whether or not the GP worked in a dispensing practice, whether or not they worked in a Primary Medical Service (PMS) practice, and the characteristics of the local population (limiting long term illness rate, proportion from ethnic minorities, population density, Index of Multiple Deprivation 2000). The findings have implications for discrimination by GP gender and country of qualification, economies of scale by practice size, incentives for competition for patients, compensating differentials for local population characteristics, and the attractiveness of PMS versus General Medical Services contracts.Physician, family. General practitioner. Income. Wages. Contract.

Developing predictive models of health literacy.

IntroductionLow health literacy (LHL) remains a formidable barrier to improving health care quality and outcomes. Given the lack of precision of single demographic characteristics to predict health literacy, and the administrative burden and inability of existing health literacy measures to estimate health literacy at a population level, LHL is largely unaddressed in public health and clinical practice. To help overcome these limitations, we developed two models to estimate health literacy.MethodsWe analyzed data from the 2003 National Assessment of Adult Literacy (NAAL), using linear regression to predict mean health literacy scores and probit regression to predict the probability of an individual having 'above basic' proficiency. Predictors included gender, age, race/ethnicity, educational attainment, poverty status, marital status, language spoken in the home, metropolitan statistical area (MSA) and length of time in U.S.ResultsAll variables except MSA were statistically significant, with lower educational attainment being the strongest predictor. Our linear regression model and the probit model accounted for about 30% and 21% of the variance in health literacy scores, respectively, nearly twice as much as the variance accounted for by either education or poverty alone.ConclusionsMultivariable models permit a more accurate estimation of health literacy than single predictors. Further, such models can be applied to readily available administrative or census data to produce estimates of average health literacy and identify communities that would benefit most from appropriate, targeted interventions in the clinical setting to address poor quality care and outcomes related to LHL

Literature-based reading instruction: Problems, possibilities & polemics in the struggle to change

Concerns are being raised in both professional literature as well as in the popular press regarding certain aspects of the literature-based movement. Here we report on findings from a longitudinal study of a group of first -grade teachers who have been attempting (with varying degrees of success)to introduce literature-based teaching strategies into their classrooms. We inspect the experiences of these teachers in relation to four areas of concern that have been raised regarding literature-based teaching: 1. skills instruction; 2.guided reading strategies; 3. literature selection;and 4. thematic teaching (or curriculum integration). We describe classroom practices and the 9 problems and possibilities associated with teacher change in each of the four areas

Inorganic Polyphosphates Are Important for Cell Survival and Motility of Human Skin Keratinocytes and Play a Role in Wound Healing

Inorganic polyphosphate (polyP) is a simple ancient polymer of linear chains of orthophosphate residues linked by high energy phospho-anhydride bonds ubiquitously found in all organisms. Despite its structural simplicity, it plays diverse functional roles. polyP is involved in myriad of processes including serving as microbial phosphagens, buffer against alkalis, Ca2+ storage, metal-chelating agents, pathogen virulence, cell viability and proliferation, structural component and chemical chaperones, and in the microbial stress response. In mammalian cells, polyP has been implicated in blood coagulation, inflammation, bone differentiation, cell bioenergetics, signal transduction, Ca2+-signaling, neuronal excitability, as a protein-stabilizing scaffold, and in wound healing, among others. This chapter will discuss (1) polyP metabolism and roles of polyP in prokaryotic and eukaryotic cells, (2) the contribution of polyP to survival, cell proliferation, and motility involved in wound healing in human skin keratinocytes, (3) the use of polyP-containing platelet-rich plasma (PRP) to promote wound healing in acute and chronic wounds, including burns, and (4) the use of polyP-containing PRP in excisional wound models to promote faster healing. While polyP shows promise as a therapeutic agent to accelerate healing for acute and chronic wounds, the molecular mechanisms as a potent modulator of the wound healing process remain to be elucidated

Evaluating treatments in health care: The instability of a one-legged stool

<p>Abstract</p> <p>Background</p> <p>Both scientists and the public routinely refer to randomized controlled trials (RCTs) as being the 'gold standard' of scientific evidence. Although there is no question that placebo-controlled RCTs play a significant role in the evaluation of new pharmaceutical treatments, especially when it is important to rule out placebo effects, they have many inherent limitations which constrain their ability to inform medical decision making. The purpose of this paper is to raise questions about <it>over-reliance </it>on RCTs and to point out an additional perspective for evaluating healthcare evidence, as embodied in the Hill criteria. The arguments presented here are generally relevant to all areas of health care, though mental health applications provide the primary context for this essay.</p> <p>Discussion</p> <p>This article first traces the history of RCTs, and then evaluates five of their major limitations: they often lack external validity, they have the potential for increasing health risk in the general population, they are no less likely to overestimate treatment effects than many other methods, they make a relatively weak contribution to clinical practice, and they are excessively expensive (leading to several additional vulnerabilities in the quality of evidence produced). Next, the nine Hill criteria are presented and discussed as a richer approach to the evaluation of health care treatments. Reliance on these multi-faceted criteria requires more analytical thinking than simply examining RCT data, but will also enhance confidence in the evaluation of novel treatments.</p> <p>Summary</p> <p>Excessive reliance on RCTs tends to stifle funding of other types of research, and publication of other forms of evidence. We call upon our research and clinical colleagues to consider additional methods of evaluating data, such as the Hill criteria. Over-reliance on RCTs is similar to resting all of health care evidence on a one-legged stool.</p

In ICU state anxiety is not associated with posttraumatic stress symptoms over six months after ICU discharge: A prospective study

Background: Posttraumatic stress symptoms are common after intensive care treatment. The influence of anxiety during critical illness on the development of posttraumatic stress symptoms needs to be investigated. Objective: To determine the association between anxiety during critical illness (state and trait components) and posttraumatic stress symptoms over six months after ICU discharge. Methods: Prospective study including 141 patients admitted ≥24. h to a closed mixed adult ICU in a tertiary hospital. State anxiety was assessed with the Faces Anxiety Scale during ICU stay. Trait anxiety was measured with the State-Trait Anxiety Inventory Form Y-2. Posttraumatic stress symptoms were measured at three and six months after ICU discharge using the Post-Traumatic Stress Symptoms 10-Question Inventory. Clinical and demographical data were also collected. Mixed effect regression models were used to determine if state and trait anxiety were factors significantly associated with posttraumatic stress symptoms over time. Results: Moderate to severe levels of state anxiety in ICU were reported by 81 (57%) participants. Levels of trait anxiety (median 36 IQR: 29-47) were similar to the Australian population. High levels of posttraumatic stress symptoms occurred at three (n = 19, 19%) and six months (n = 15, 17%). Factors independently associated with posttraumatic stress symptoms were trait anxiety (2.2; 95% CI, 0.3-4.1; p = 0.02), symptoms of anxiety after ICU discharge (0.6; 95% CI, 0.2-1.1; p = 0.005), younger age (-1.4; 95% CI, -2.6 to -0.2; p = 0.02) and evidence of mental health treatment prior to the ICU admission (5.2; 95% CI, 1.5-8.9; p = 0.006). Conclusions: Posttraumatic stress symptoms occurred in a significant proportion of ICU survivors and were significantly associated with higher levels of trait anxiety, younger age, mental health treatment prior to the ICU admission and more symptoms of anxiety after ICU discharge. Early assessment and interventions directed to reduce state and trait anxiety in ICU survivors may be of benefit

The Long-Baseline Neutrino Experiment: Exploring Fundamental Symmetries of the Universe

The preponderance of matter over antimatter in the early Universe, the dynamics of the supernova bursts that produced the heavy elements necessary for life and whether protons eventually decay --- these mysteries at the forefront of particle physics and astrophysics are key to understanding the early evolution of our Universe, its current state and its eventual fate. The Long-Baseline Neutrino Experiment (LBNE) represents an extensively developed plan for a world-class experiment dedicated to addressing these questions. LBNE is conceived around three central components: (1) a new, high-intensity neutrino source generated from a megawatt-class proton accelerator at Fermi National Accelerator Laboratory, (2) a near neutrino detector just downstream of the source, and (3) a massive liquid argon time-projection chamber deployed as a far detector deep underground at the Sanford Underground Research Facility. This facility, located at the site of the former Homestake Mine in Lead, South Dakota, is approximately 1,300 km from the neutrino source at Fermilab -- a distance (baseline) that delivers optimal sensitivity to neutrino charge-parity symmetry violation and mass ordering effects. This ambitious yet cost-effective design incorporates scalability and flexibility and can accommodate a variety of upgrades and contributions. With its exceptional combination of experimental configuration, technical capabilities, and potential for transformative discoveries, LBNE promises to be a vital facility for the field of particle physics worldwide, providing physicists from around the globe with opportunities to collaborate in a twenty to thirty year program of exciting science. In this document we provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess.Comment: Major update of previous version. This is the reference document for LBNE science program and current status. Chapters 1, 3, and 9 provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess. 288 pages, 116 figure