Lessons learned in practice-based research: Studying preschool language interventions in the real world

Abstract Background and aims: Practice-based research holds potential as a promising solution to closing the research-practice gap, because it addresses research questions based on problems that arise in clinical practice and tests whether systems and interventions are effective and sustainable in a clinical setting. One type of practice-based research involves capturing practice by collecting evidence within clinical settings to evaluate the effectiveness of current practices. Here, we describe our collaboration between researchers and clinicians that sought to answer clinician-driven questions about community-based language interventions for young children (Are our interventions effective? What predicts response to our interventions?) and to address questions about the characteristics, strengths, and challenges of engaging in practice-based research. Methods: We performed a retrospective chart review of 59 young children who had participated in three group language interventions at one publicly funded community clinic between 2012 and 2017. Change on the Focus on the Outcomes of Communication Under Six (FOCUS), a government mandated communicative participation measure, was extracted as the main outcome measure. Potential predictors of growth during intervention were also extracted from the charts, including type of intervention received, attendance, age at the start of intervention, functional communication ability pre-intervention, and time between pre- and post-intervention FOCUS scores. Results: Overall, 49% of children demonstrated meaningful clinical change on the FOCUS after their participation in the language groups. Only 3% of participants showed possibly meaningful clinical change, while the remaining 46% of participants demonstrated not likely meaningful clinical change. There were no significant predictors of communicative participation growth during intervention. Conclusions: Using a practice-based research approach aimed at capturing current practice, we were able to answer questions about the effectiveness of interventions delivered in real-world settings and learn about factors that do not appear to influence growth during these interventions. We also learned about benefits associated with engaging in practice-based research, including high clinical motivation, high external validity, and minimal time/cost investment. Challenges identified were helpful in informing our future efforts to examine other possible predictors through development of a new, clinically feasible checklist, and to pursue methods for improving collection of outcome data in the clinical setting. Implications: Clinicians and researchers can successfully collaborate to answer clinically informed research questions while considering realistic clinical practice and using research-informed methods and principles. Practice-based research partnerships between researchers and clinicians are both valuable and feasible

The Best Practices of Mcdonald’s Malaysia: A Case Study of the National Dual Training System

The National Dual Training System (NDTS) was officially launched in February 2018 and there are five NDTS-approved McDonald’s practical training locations at the early implementation of the NDTS. By 2025, 450 McDonald’s Malaysia restaurants are expected to expand, adding 10,000 jobs to the current workforce of 12,000 employees. Based on the increasing number of employees and positive implementation of the NDTS program in McDonald’s Malaysia, this study aimed to explore the best practices of McDonald’s Malaysia in the context of NDTS. Methodologically, a qualitative approach was employed in this study by conducting a group discussion with the McDonald’s personnel, document analysis (such as news, annual reports, and websites) and a literature review. From the thematic analysis, the findings highlight the best practices of McDonald’s Malaysia and the positive implications of the NDTS implementation. A review of McDonald's training and skill development around the world provides additional support for the findings. Significantly, this study contributes to promote the best practices of McDonald’s Malaysia, the positive image of McDonald's Malaysia and the positive implications of NDTS in supporting skills development in Malaysia

Impact of COVID-19 on a Free Clinic Patient Population

The Robert R. Frank Student Run Free Clinic at WSUSOM, surveyed patients to determine the impact of the COVID-19 pandemic on its patient population. The study examined any challenges faced in food, financial status, transportation, and healthcare. A Qualtrics survey was administered with ethnicity, age, and gender as controls, while testing patient responses to social factors using the Likert scale. The survey was targeted to a portion of the clinic’s patient pool (n=33) over a span of three months and responses were analyzed using SPSS 26 regression analysis, ANOVA, and paired sample T-tests. Significant responses were across demographics, categories of impact, and pre/post COVID-19. Results show that access to fresh foods was severely impacted by COVID-19 (t = -3.19, p\u3c 0.05). Linear regression models show a correlation between difficulty accessing healthcare and medications, before and after COVID-19, indicating that the pandemic may have exacerbated pre-existing barriers to treatment (correlation = 0.810). Financial status has been the most affected with many patients indicating changes in employment or income status. 55% of the participants noted a greater use of savings or retirement money to make ends meet. A moderate correlation (0.471) was found between the use of public transportation prior to the pandemic and transportation barriers during the pandemic. We have decided to compile resources to address the needs based on the study results. Future research includes a longitudinal, follow-up survey to gauge any changes. Limitations include the study sample size and participation bias among the patient population

Development and Validation of the Behavioral Tendencies Questionnaire

At a fundamental level, taxonomy of behavior and behavioral tendencies can be described in terms of approach, avoid, or equivocate (i.e., neither approach nor avoid). While there are numerous theories of personality, temperament, and character, few seem to take advantage of parsimonious taxonomy. The present study sought to implement this taxonomy by creating a questionnaire based on a categorization of behavioral temperaments/tendencies first identified in Buddhist accounts over fifteen hundred years ago. Items were developed using historical and contemporary texts of the behavioral temperaments, described as “Greedy/Faithful”, “Aversive/Discerning”, and “Deluded/Speculative”. To both maintain this categorical typology and benefit from the advantageous properties of forced-choice response format (e.g., reduction of response biases), binary pairwise preferences for items were modeled using Latent Class Analysis (LCA). One sample (n1 = 394) was used to estimate the item parameters, and the second sample (n2 = 504) was used to classify the participants using the established parameters and cross-validate the classification against multiple other measures. The cross-validated measure exhibited good nomothetic span (construct-consistent relationships with related measures) that seemed to corroborate the ideas present in the original Buddhist source documents. The final 13-block questionnaire created from the best performing items (the Behavioral Tendencies Questionnaire or BTQ) is a psychometrically valid questionnaire that is historically consistent, based in behavioral tendencies, and promises practical and clinical utility particularly in settings that teach and study meditation practices such as Mindfulness Based Stress Reduction (MBSR)

Lifshitz black holes in Brans-Dicke theory

We present an exact asymptotically Lifshitz black hole solution in Brans-Dicke theory of gravity in arbitrary $n(\ge 3)$ dimensions in presence of a power-law potential. In this solution, the dynamical exponent $z$ is determined in terms of the Brans-Dicke parameter $\omega$ and $n$. Asymptotic Lifshitz condition at infinity requires $z>1$, which corresponds to $-(n-1)/(n-2) \le \omega < -n/(n-1)$. On the other hand, the no-ghost condition for the scalar field in the Einstein frame requires $0<z \le 2(n-2)/(n-3)$. We compute the Hawking temperature of the black hole solution and discuss the problems encountered and the proposals in defining its thermodynamic properties. A generalized solution charged under the Maxwell field is also presented.Comment: 32 pages, no figure. v2: revised version. Section 3.1 and Appendix B improved. The argument in Appendix A clarified. v3: References added. v4: analysis on the black hole thermodynamical properties corrected. Final version to appear in JHE

Impact of Montmorillonite Clay on Polysulfone Mixed Matrix Membrane for Heavy Metal Adsorption

Exposure to high levels of heavy metals exerts serious health hazards to humankind. It is, hence, imperative to limit exposure to heavy metals by avoiding their consumption, direct or indirect, and by appropriately disposing of items that may contain heavy metals. To explore heavy metals removal efficacy, montmorillonite (MMT), a type of clay, was prepared at varying dosages (0.5, 1.0, and 1.5 wt%) to fabricate polysulfone mixed matrix membranes for treating aqueous solution contaminated with cadmium and lead. The mixed matrix membranes are characterized by scanning electron microscope (SEM), Fourier transforms infrared (FTIR), energy dispersive X-rays (EDX), water uptake test, pure water flux calculation, and heavy metal adsorption test. The particle size distribution of MMT is first measured covering the range of 1 to 42 μm. The FTIR spectra of MMT and MMT filled membranes indicate that the silica functional group dominates the MMT elemental composition. It is revealed that the modified design improves water uptake by 83% compared to the pristine membrane. The pure water flux of the 1.5 MMM membrane is the fastest among the membrane at ~2500 L/m2·h and is the most porous membrane with a porosity of 10%. Heavy metal rejection measurement shows that the modified membrane can remove cadmium and lead by 3% and 14%, respectively. Furthermore, all prepared membranes show solute water flux of more than 500 L/m2·h. The incorporation of MMT has successfully altered the polysulfone mixed matrix membrane to become a high-fux membrane capable of treating cadmium- and lead-rich water. Further study is needed to utilize the membrane to treat heavy metal wastewater

Intellectual Property Rights and the Ascent of Proprietary Innovation in Agriculture

Biological innovations in agriculture did not enjoy protection by formal intellectual property rights (IPRs) for a long time, but the recent trend has been one of considerable broadening and strengthening of these rights. We document the nature of these IPRs and their evolution, and provide an assessment of their impacts on innovation. We integrate elements of the institutional history of plant IPRs with a discussion of the relevant economic theory and a review of applicable empirical evidence. Throughout, we highlight how the experience of biological innovation mirrors, or differs from, the broader literature on IPRs and innovation. We conclude with some considerations on the relation between IPRs and market structure and the pricing of proprietary inputs in agricultur

Snout Shape in Extant Ruminants

Copyright: © 2014 Tennant, MacLeod. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. [4.0 license]. The attached file is the published version of the article

The positive impact of a facilitated peer mentoring program on academic skills of women faculty

<p>Abstract</p> <p>Background</p> <p>In academic medicine, women physicians lag behind their male counterparts in advancement and promotion to leadership positions. Lack of mentoring, among other factors, has been reported to contribute to this disparity. Peer mentoring has been reported as a successful alternative to the dyadic mentoring model for women interested in improving their academic productivity. We describe a facilitated peer mentoring program in our institution's department of medicine.</p> <p>Methods</p> <p>Nineteen women enrolled in the program were divided into 5 groups. Each group had an assigned facilitator. Members of the respective groups met together with their facilitators at regular intervals during the 12 months of the project. A pre- and post-program evaluation consisting of a 25-item self-assessment of academic skills, self-efficacy, and academic career satisfaction was administered to each participant.</p> <p>Results</p> <p>At the end of 12 months, a total of 9 manuscripts were submitted to peer-reviewed journals, 6 of which are in press or have been published, and another 2 of which have been invited to be revised and resubmitted. At the end of the program, participants reported an increase in their satisfaction with academic achievement (mean score increase, 2.32 to 3.63; <it>P </it>= 0.0001), improvement in skills necessary to effectively search the medical literature (mean score increase, 3.32 to 4.05; <it>P </it>= 0.0009), an improvement in their ability to write a comprehensive review article (mean score increase, 2.89 to 3.63; <it>P </it>= 0.0017), and an improvement in their ability to critically evaluate the medical literature (mean score increased from 3.11 to 3.89; <it>P </it>= 0.0008).</p> <p>Conclusions</p> <p>This facilitated peer mentoring program demonstrated a positive impact on the academic skills and manuscript writing for junior women faculty. This 1-year program required minimal institutional resources, and suggests a need for further study of this and other mentoring programs for women faculty.</p