Home About us Contact
|
Home About us Contact | ||
|
|
||
Randomized Design (randomized + design)
Selected AbstractsUsing Screen-Based Simulation to Improve Performance During Pediatric ResuscitationACADEMIC EMERGENCY MEDICINE, Issue 2009Kevin J. Biese MD Abstract Objectives:, To assess the ability of a screen-based simulation-training program to improve emergency medicine and pediatric resident performance in critical pediatric resuscitation knowledge, confidence, and skills. Methods:, A pre,post, interventional design was used. Three measures of performance were created and assessed before and after intervention: a written pre-course knowledge examination, a self,efficacy confidence score, and a skills-based high-fidelity simulation code scenario. For the high-fidelity skills assessment, independent physician raters recorded and reviewed subject performance. The intervention consisted of eight screen-based pediatric resuscitation scenarios that subjects had 4 weeks to complete. Upon completion of the scenarios, all three measures were repeated. For the confidence assessment, summary pre- and post-test summary confidence scores were compared using a t-test, and for the skills assessment, pre-scores were compared with post-test measures for each individual using McNemar's chi-square test for paired samples. Results:, Twenty-six of 35 (71.3%) enrolled subjects completed the institutional review board,approved study. Increases were observed in written test scores, confidence, and some critical interventions in high-fidelity simulation. The mean improvement in cumulative confidence scores for all residents was 10.1 (SD ±4.9; range 0,19; p < 0.001), with no resident feeling less confident after the intervention. Although overall performance in simulated codes did not change significantly, with average scores of 6.65 (±1.76) to 7.04 (±1.37) out of 9 possible points (p = 0.58), improvement was seen in the administering of appropriate amounts of IV fluids (59,89%, p = 0.03). Conclusions:, In this study, improvements in resident knowledge, confidence, and performance of certain skills in simulated pediatric cardiac arrest scenarios suggest that screen-based simulations may be an effective way to enhance resuscitation skills of pediatric providers. These results should be confirmed using a randomized design with an appropriate control group. [source] A study on feeding hazelnut kernel oil meal as a protein source for broiler chickensANIMAL SCIENCE JOURNAL, Issue 3 2009Guray ERENER ABSTRACT An experiment was conducted to evaluate the effect of substituting different levels of hazelnut kernel oil meal (HKM) for soybean meal (SBM) in diets for broiler. A total of 450 one-day-old female Ross 308 broiler chicks were allocated randomly to three treatment groups of 150 birds each in a randomized design. Each treatment group consisted of five replicates each of 30 chicks. All diets (in mash form) were formulated to meet nutrient concentrations recommended for broilers. The experiment lasted for six weeks. In the experiment, an SBM control (SBM) diet was compared to two HKM diets, replacing 50 (50HKM) and 100% (HKM) of SBM protein, respectively. Body weight gain, feed intake and feed conversion ratio of broilers were adversely affected (P < 0.05) by the HKM diets at 42 days of age. Broilers fed 50HKM and HKM had growth performances similar (P > 0.05). The carcass yield and abdominal fat pads of birds fed diets with SBM were higher (P < 0.05) than those of chicks fed the 50HKM and HKM diets. The edible inner organ weight of chicks fed diets with HKM was the heaviest (P < 0.05). It is concluded that SBM cannot be replaced even up to 50% with HKM in commercial broiler diet. [source] Brown propolis extract in feed as a growth promoter of Nile tilapia (Oreochromis niloticus, Linnaeus 1758) fingerlingsAQUACULTURE RESEARCH, Issue 5 2009Fábio Meurer Abstract This study assessed the use of increasing levels of brown propolis extract (BPE) as a growth promoter in Nile tilapia fingerling feeds. In a complete randomized design, 75 Nile tilapia fingerlings with 60 days on average and weighing 4.1±0.1 g were assigned to 25 aquaria (60 L) and subjected to 5 treatments in 5 repetitions for 30 days. Propolis from Serra do Araripe, Cariri Region, South Ceará State , Brazil was used to produce the BPE. The treatments involved the addition of BPE to feed samples (0.91, 1.83, 2.74 and 3.65 g kg,1) and feed control (without BPE). The final mean weight and the percentage of weight gain varied quadratically with the increase in BPE (P<0.01), with a maximum of 2.22 g kg,1. The other evaluated parameters were not affected by the treatments (P>0.05). The level of best performance parameters was 2.22 g kg,1, between the levels of 1.83 and 2.74 g BPE kg,1 feed inclusion. These results indicate the potential to use the brown propolis extract as a growth promoter to Nile tilapia fingerlings. [source] Factors that influence physicians' detection of distress in patients with cancer,CANCER, Issue 2 2005Can a communication skills training program improve physicians' detection? Abstract BACKGROUND No study to date has assessed the impact of skills acquisition after a communication skills training program on physicians' ability to detect distress in patients with cancer. METHODS First, the authors used a randomized design to assess the impact, on physicians' ability to detect patients' distress, of a 1-hour theoretical information course followed by 2 communication skills training programs: a 2.5-day basic training program and the same training program consolidated by 6 3-hour consolidation workshops. Then, theinvestigate contextual, patient, and communication variables or factors associated with physicians' detection of patients' distress were investigated. After they attended the basic communication skills training program, physicians were assigned randomly to consolidation workshops or to a waiting list. Interviews with a cancer patient were recorded before training, after consolidation workshops for the group that attended consolidation workshops, and , 5 months after basic training for the group that attended basic training without the consolidation workshops. Patient distress was recorded with the Hospital Anxiety and Depression Scale before the interviews. Physicians rated their patients' distress on a visual analog scale after the interviews. Physicians' ability to detect patients' distress was measured through computing differences between physicians' ratings of patients' distress and patients' self-reported distress. Communication skills were analyzed according to the Cancer Research Campaign Workshop Evaluation Manual. RESULTS Fifty-eight physicians were evaluable. Repeated-measures analysis of variance showed no statistically significant changes over time and between groups in physicians' ability to assess patient distress. Mixed-effects modeling showed that physicians' detection of patients' distress was associated negatively with patients' educational level (P = 0.042) and with patients' self-reported distress (P < 0.000). Mixed-effects modeling also showed that physicians' detection of patient distress was associated positively with physicians breaking bad news (P = 0.022) and using assessment skills (P = 0.015) and supportive skills (P = 0.045). CONCLUSIONS Contrary to what was expected, no change was observed in physicians' ability to detect distress in patients with cancer after a communication skills training programs, regardless of whether physicians attended the basic training program or the basic training program followed by the consolidation workshops. The results indicated a need for further improvements in physicians' detection skills through specific training modules, including theoretical information about factors that interfere with physicians' detection and through role-playing exercises that focus on assessment and supportive skills that facilitate detection. Cancer 2005. © 2005 American Cancer Society. [source] Prediction variance and G-criterion location for split-plot designsQUALITY AND RELIABILITY ENGINEERING INTERNATIONAL, Issue 4 2009Wayne R. Wesley Abstract Prediction variance properties for completely randomized designs (CRD) are fairly well covered in the response surface literature for both spherical and cuboidal designs. This paper evaluates the impact of changes in the variance ratio on the prediction properties of second-order split-plot designs (SPD). It is shown that the variance ratio not only influences the value of the G-criterion but also its location, in contrast with the G-criterion tendencies in CRD. An analytical method, rather than a heuristic optimization algorithm, is used to compute the prediction variance properties, which include the maximum, minimum and integrated variances for second-order SPD. The analytical equations are functions of the design parameters, radius and variance ratio. As a result, the exact values for these quantities are reported along with the location of the maximum prediction variance used in the G-criterion. The two design spaces of the whole plot and the subplot are studied and as a result, relative efficiency values for these distinct spaces are suggested. Copyright © 2008 John Wiley & Sons, Ltd. [source] | ||||||||||