Practice Style Research Articles

Theorizing Style (In Three Sketches)

Style is often saddled to a process of attribution and authorship, where it is deployed to qualify and distinguish between particular genres. Within art and design, these tend to be institutionally coded, such as “Bauhaus” style, or chronologically restricted, as with “Art Deco.” In this paper, I sketch out three ways in which style can be theorized as a transformative force, and not simply a referential schema. The three sketches introduce an understanding of style developed in the philosophical writings of Gilles Deleuze and Anne Sauvagnargues and the design practice of the Russian-French Avant Garde artist Sonia Delaunay. Through them, I develop a specific reading of style as a practice rather than as a genre that characterizes a brand or individual. By understanding style as practice, I seek to foreground an expressive capacity of style that is altogether asignifying, impersonal and transversal, as an injunction for rethinking the style of social-scientific research practice.

Algorithms in Practice: Habitual Application of Defined Steps to Improve Care

Back to table of contents Previous article Next article From the ExpertsFull AccessAlgorithms in Practice: Habitual Application of Defined Steps to Improve CareH. Paul Putman III, M.D.H. Paul Putman IIISearch for more papers by this author, M.D.Published Online:5 Nov 2020https://doi.org/10.1176/appi.pn.2020.11a34AbstractAlgorithms, ubiquitous in today’s increasingly technical culture, are sets of rules or processes to be followed in calculations or problem solving. Underlying the computer program and applications (“apps”) that we use daily, they are really nothing more than equations and step-by-step instructions that humans have always used to achieve goals.As a clinician, what’s the conscious algorithm you utilize to provide the very best patient care?Clinical psychopharmacology is best practiced rationally through a routine process of ongoing, thorough, and complete assessments of our knowledge base, our patients, and the treatment progress. This discipline is attached to conscious application of certain forms of logic in formulating and adjusting diagnoses and treatment plans until they produce outcomes desired by patient and practitioner.An algorithm, a defined set of steps followed habitually, improves overall clinical practice. The elements of an effective algorithm, informed by the therapeutic alliance, are a practitioner’s database, continuous evaluation of a treatment plan, and clinical judgment guided by critical thinking.Understanding and accepting uncertainty and probabilities, clinicians and their patients use randomized, controlled trials (RCTs) to help guide treatment selection.The rational practice of medicine most often utilizes abductive reasoning—using incomplete information to form hypotheses and then testing these hypotheses. Bayesian logic, using prior assumptions corrected with outcome data, is an effective method for modeling and revising, as needed, diagnosis and treatment planning.Many of us accede to the human tendency to not use these skills on a daily basis, to not really understand the study design or statistical analysis in journals, to read non-peer-reviewed articles, and even to fail to ask enough questions to understand our patients. We respond to hearsay, anecdotal evidence, and clinical gossip (partial information that takes on an invalid life of its own). Even in peer-reviewed journals, many studies suffer from inadequate design or analysis, so practitioners need to update and maintain an understanding of the statistical methods used in RCTs and meta-analyses to find the best data. Even the best intentions must overcome many unconscious and potentially conscious barriers to understanding and using only the best knowledge. We must take into account these biases that may distort our interpretation of data and cause us to reject important information that we need in our knowledge base.In contemporary clinical medicine, it is also very easy to get carried away with molecular mechanisms and to use errors in inductive and deductive reasoning across scales to supply an invalid rationale for therapeutic choices. Clinical observation has always preceded the development of underlying theories, and RCTs allow us to use abductive reasoning to predict the results we might obtain from any pharmacological treatment.The best treatment planning targets syndromes over individual symptoms, identifying the smallest number of accurate diagnoses possible that fit the data and fulfill DSM-5 criteria. Adding unnecessary medications to treat isolated symptoms may only confound results.Commitment to a consciously chosen, externally validated, and standardized routine is the beginning of success. A thorough knowledge of medicine, the scientific literature, the history of pharmacological options, supplements that may or may not help, lifestyle issues (such as alcohol, smoking, caffeine use, sleep, diet, exercise), and knowledge of potential adverse events and their management are essential in creating and monitoring effective treatment plans.Follow-up visits, often labeled med checks, may last as little as 15 minutes, but it is entirely possible to cover all the information necessary, make rational decisions about diagnosis and treatment plan changes, answer questions, and write prescriptions in this amount of time. Practitioners must know what information is necessary to obtain from patients and hone their skills for eliciting it. Regularly scheduled follow-up sessions with patients can be designed to efficiently recapitulate much of the initial evaluation, which will then be applied to refining the practitioner’s understanding of the clinical problem and best solutions.Commitment can be made to return to best practices learned from others that may have been forgotten, devalued, or discarded during busy and hectic practice. Identifying weaknesses in practice style and improving them where psychopharmacology is involved is an effort that may not only “do no harm,” but may also be able to do some good.Medicines will come and go, but a consciously and regularly utilized rational algorithm, applied alongside regular literature reviews, should keep a practitioner on the cutting edge for the length of a career. This enables the practitioner to help each patient to the greatest degree possible and contributes to professional satisfaction. ■H. Paul Putman III, M.D., is a distinguished life fellow of the APA and author of Rational Psychopharmacology: A Book of Clinical Skills. APA members may purchase the book at a discount here. ISSUES NewArchived

Dose prediction with deep learning for prostate cancer radiation therapy: Model adaptation to different treatment planning practices

PurposeThis work aims to study the generalizability of a pre-developed deep learning (DL) dose prediction model for volumetric modulated arc therapy (VMAT) for prostate cancer and to adapt the model, via transfer learning with minimal input data, to three different internal treatment planning styles and one external institution planning style. MethodsWe built the source model with planning data from 108 patients previously treated with VMAT for prostate cancer. For the transfer learning, we selected patient cases planned with three different styles, 14–29 cases per style, in the same institution and 20 cases treated in a different institution to adapt the source model to four target models in total. We compared the dose distributions predicted by the source model and the target models with the corresponding clinical plan dose used for patient treatments and quantified the improvement in the prediction quality for the target models over the source model using the Dice similarity coefficients (DSC) of 0% to 100% isodose volumes and the dose-volume-histogram (DVH) parameters of the planning target volume and the organs-at-risk. ResultsThe source model accurately predicts dose distributions for plans generated in the same source style, but performs sub-optimally for the three different internal and one external target styles, with the mean DSC ranging between 0.81–0.94 and 0.82–0.91 for the internal and the external styles, respectively. With transfer learning, the target model predictions improved the mean DSC to 0.88–0.95 and 0.92–0.96 for the internal and the external styles, respectively. Target model predictions significantly improved the accuracy of the DVH parameter predictions to within 1.6%. ConclusionWe demonstrated the problem of model generalizability for DL-based dose prediction and the feasibility of using transfer learning to solve this problem. With 14–29 cases per style, we successfully adapted the source model into several different practice styles. This indicates a realistic way forward to widespread clinical implementation of DL-based dose prediction.

儿旁의 几旁과의 편방 혼동 현상과 관련 한자의 자형 표준화에 대한 提言

In Kaishu style, “人 rén” is transformed to “儿 rén” when it is located below another character. This varied form “儿 rén” is often written as “几 jī” when it is not attached to the part right above it. For this reason, the Chinese characters containing “儿 rén” that is not in contact with the upper part, such as “虎 hǔ”, “微 wēi”, “禿 tū”, “宂 rǒng”, “亮 liàng” and “兜 dōu”, often have a variant form in which “儿 rén” is transformed to “几 jī”.<BR> There are not a few inconsistencies of the forms of components in Chinese character fonts currently used in Korea; more seriously, even the same character has slightly different forms depending on the font. These inconsistencies have been an obstacle that hinders Chinese character education. The same problem is found in the characters that contain “儿 rén”. Therefore, this paper closely examined how neighboring countries in the Chinese character cultural sphere handled this issue for the establishment of standard Chinese character forms. In addition, this paper presents two suggestions that can serve as a reference in dealing with this issue in the process of revising domestic Chinese fonts based on the examples of other East Asian countries. First, based on Shuowenjiezi, for the characters containing “人 rén” in Xiaozhuan style, the forms with “儿 rén” are regarded as a standard in Kaishu style as well. Second, in consideration of the findings of Chinese grammatological studies and the tradition of Kaishu style in actual calligraphic practice, the forms with “几 jī” are regarded as a standard except for “宂 rǒng”, “呪 zhòu” and other characters that have been clearly known to include “儿 rén” for etymological reasons.<BR> The most important point is, whichever of the two is adopted, to improve the systemicity and regularity in the structure of Chinese characters by unifying the different component forms to a fullest extent. As the current issue, that the forms of the same component change slightly depending on the character or the forms of characters vary depending on the font, has a very negative effect on Chinese character education, an improvement is urgently needed.

Over Worked and Under Paid: How Resident Finances Impact Perceived Stress, Career Choices, and Family Life

BackgroundThe magnitude of student debt plaguing our nation is a major topic in political and academic spheres with median medical student debt of $200,000. This is compounded by poor financial health during training. This study evaluates how debt and financial wellness influence resident perceived stress, mental health, career plans, and relationships. MethodsGeneral surgery trainees at an academic institution were surveyed regarding financial parameters, perceived stress, and the impact of finances on their career and family life. A validated stress assessment instrument, the Perceived Stress Scale, was used to evaluate trainee stress. The median perceived stress score was compared for groups using a Wilcoxon rank-sum test. ResultsFifty-eight (61% response rate) residents responded to the survey. The median (range) student loan debt was $200,000-500,000 ($0-750,000) and savings was $5000-10,000 ($0-20,000+). 18 (31%) trainees had monthly credit card debt. Half of the respondents did not have enough liquid assets for an emergency fund, defined as 3 mo of living expenses. The median perceived stress score was 16 (1-30) or moderate stress. Perceived stress score was significantly associated with the trainee’s response to how finances impacted their future career choice, practice style, and relationships (P < 0.005 for all). However, the perceived stress score was not associated with objective measures of financial wellness, such as the overall level of medical school debt, savings, or having an emergency fund. DiscussionThe trainee’s subjective perception of financial wellness, rather than objective financial parameters was associated with higher levels of perceived stress, the strain on relationships, and a greater impact on future practice styles. The majority of surgery residents did not have enough liquid assets for an emergency fund, independent of the level of debt, which emphasizes how financially leveraged residents are during training. Although burnout during surgical training is multifactorial, formal financial education incorporated into graduate medical education programs could increase financial literacy, help to mitigate financial risk, and ultimately decrease some of the perceived stress residents possess.

Modern work patterns of \u201cclassic\u201d versus millennial family doctors and their effect on workforce planning for community-based primary care: a cross-sectional survey

BackgroundThere are ongoing accessibility challenges in primary care in British Columbia, Canada, with 17% of the population not having a regular source of care. Anecdotal evidence suggests that physicians are moving away from a community-based comprehensive practice model, which could contribute to shortages. Thus, we aimed to identify and describe how family physicians are currently organizing their primary care practices in a large health region in British Columbia and to examine differences between newer graduates and more established physicians.MethodsData for this cross-sectional study were drawn from an annual physician privileging survey. N = 1017 physicians were invited to participate. We categorized practice style into five distinct groupings and compared features across respondent groups, including personal and practice location characteristics, hospital and teaching work, payment and appointment characteristics, and scope of practice. We discuss the implications of styles of practice and associated characteristics on health workforce policy and planning.ResultsWe received responses from 525 (51.6%) physicians. Of these, 355 (67.6%) reported doing at least some community-based primary care. However, only 112 (21.3%) provided this care full time. Most respondents supplemented community-based work with part-time hours in focused practice, hospitals, or inpatient facilities. We found diversity in the scope and style of practice across practice models. Compared to established physicians, new graduates (in practice less than 10 years) work more weekly hours (more patient care, and paperwork in particular). However, we found no difference between new and established physicians in the odds of providing any or full-time community-based primary care.ConclusionsDespite a lack of formalized structural reform in British Columbia’s primary care system, most physicians are finding alternative ways to model their practice and shifting away from work at single-location, community-based clinics. This shift challenges assumptions that are relied on for workplace planning that is intended to ensure adequate access to longitudinal, community-based family medicine.

Treatment of mental illness in American adolescents varies widely within and across areas

Many mental health disorders first manifest in adolescence, and early treatment may affect the course of the disease. Using a large national database of insurance claims, this study focuses on variations in the type of care that adolescent patients receive when they are treated for an initial episode of mental illness. We found large variations in the probability that children receive follow-up care and in the type of follow-up care received across zip codes. We also found large variations in the probability that children receive drug treatments that raise a red flag when viewed through the lens of treatment guidelines: Overall, in the first 3 mo after their initial claim for mental illness, 44.85% of children who receive drug treatment receive benzodiazepines, tricyclic antidepressants, or a drug that is not Food and Drug Administration-approved for their age. On average, these children are 12 y old. While the supply of mental health professionals impacts treatment choices, little of the overall variation is explained by supply-side variables, and at least half of the variation in treatment outcomes occurs within zip codes. These results suggest that other factors, such as physician practice style, may play an important role in the types of treatment that children receive.

The relationship of thinking styles and academic performance of students

Introduction. In the conditions of modern Russian education, the emphasis is shifted to the ability of students to carry out non-standard professional duties and to work independently. All this leads to an increase in the number of studies to identify thinking styles in the student age.The aim of the current publication is to present the results of an empirical study focusing on identification of the relationship of thinking styles and academic performance among the students of Astrakhan State University.Methodology and research methods. In order to achieve the aim, the authors used the following research methods: Methods of Thinking Style (by A. K. Belousova), Learning Styles Questionnaire (by P. Honey, A. Mumford), Implicit Theories and Learning Goals Questionnaire (by C. Dweck), Scale of Academic Motivation (by T. O. Gordeeva, O. A. Sychev, E. N. Osin). To process the data, mathematical-statistical methods were employed: the One-Sample Kolmogorov-Smirnov Test, the Independent Samples t Test (Student Test), the Mann-Whitney U Test, the Pearson’s Correlation Coefficient, the Spearman’s Rank Correlation Coefficient. All calculations were performed using the IBM SPSS Statistics 21 computer program.Results. In the course of empirical study, 82 students of five faculties of Astrakhan State University (40 boys and 42 girls aged 20 to 23 years old) were involved. As a result of empirical research, it was revealed that an initiative style of thinking with the variable “enriched personality” has a positive correlation, and critical thinking has a positive correlation with the variable “introjected motivation” and “external motivation”. Managerial and practical thinking styles positively correlate with the variables “achievement motivation”, “growing in telligence”, “enriched personality”, “cognitive motivation”, “adoption of learning goals”.Scientific novelty. The tendency to a reliable connection of thinking styles and academic performance was revealed. A positive correlation between managerial, practical thinking styles and cognitive motivation, achievement motivation is found out. Students with proactive, practical, managerial thinking styles have an above-average academic performance.Practical significance. The materials of the publication are of practical importance for teachers and students, as the study of the stylistic peculiarities of the individuality of students directly contributes to the effectiveness of the process of skills and knowledge development.

33. BARRIERS AND FACILITATORS TO PEDIATRIC RESIDENT EDUCATION IN THE EMERGENCY DEPARTMENT: A QUALITATIVE STUDY UTILIZING FOCUS GROUPS

Background The Accreditation Council for Graduate Medical Education mandates pediatric residency programs provide educational experiences. Local resident evaluations of the Pediatric Emergency Department (ED) declined over the last 5 years. This prompted a literature review showing that resident perspectives on educational experiences are sparse. This study discovers the barriers and facilitators to resident education in the Pediatric ED. Methods This qualitative study utilizing focus groups was completed at a large Pediatric training hospital. Trained facilitators performed semi-structured interviews prompting discussion of resident experiences in the Pediatric ED. One pilot and 6 focus groups (32 pediatric residents) achieved data saturation. Sessions were audio recorded, de-identified and then transcribed by a professional service. Three authors (CJ, JM, SS) analyzed the transcripts independently using line-by-line coding. Following code agreement, authors identified central categories and themes drawing on grounded theory. Results 6 categories emerged: (1) ED environment (2) Consistent goals, expectations, and resources (3) ED workflow (4) Preceptor Accessibility (5) Resident Growth and Development (6) Preconceived Notions of the ED. Residents value a respectful work environment despite the chaotic nature of the ED. They need clear rotation goals and expectations with a strong orientation. Autonomy with open communication and shared decision-making allows residents to feel like members of the team. Residents gravitate toward welcoming, available preceptors who love to teach. More ED environment exposure increases comfort and efficiency and helps develop medical decision-making skills. Lastly, residents admit preconceptions about the ED and personality traits affect performance. Conclusion Residents identified barriers and facilitators to ED education. Educators must provide a safe and open learning environment, clear rotation expectations and goals, consistent attitudes with a teamwork mentality, and allow autonomy to build residents practice styles.

Awareness of Aromatherapy in Healing Stress and Body Pain among Dental Students

Aromatherapy is a style of practice in medicine where essential oils or other scents are used. These are either applied or directly inhaled to attain therapeutic benefit. Also they are used either by distillation with water or steam, or from the epicarp of citrus fruits by a mechanical process or by dry distillation. The mechanism of action in aromatherapy is unknown, but recent studies have shown that aromatherapy is also beneficial for a few health problems. A range of essential oils are found to possess various degrees of antimicrobial activity and are believed to own antiviral, nematicidal, antifungal, insecticidal, and antioxidant properties. Hence this treatment is also known as essential oil therapy. At the current situation of COVID -19 there is a prevalence of stress due to lockdown. This mental stress can adversely affect the physical and mental well-being of each and every individual. In order to overcome this stress this aroma therapy can be used. The main aim of the study is to assess the awareness of the use of aromatherapy in healing stress and body pain. This was a cross sectional study conducted among the dental students through a questionnaire. The questionnaire consisted of 10 questions and was circulated among the student population. The statistical analysis was done with the help of SPSS software version 2.0. The results concludes that most of the participants are aware of aromatherapy and the found it beneficial in healing stress and body pain.

The Frank H. Netter MD School of Medicine at Quinnipiac University.

The Frank H. Netter MD School of Medicine at Quinnipiac University.

What helps and hinders doctors in engaging in continuous professional development? An explanatory sequential design.

Licensure and registration are the traditional approaches to ensure minimally acceptable standards of care for practice. However, due to advances in medical technology and changes in clinical practice, the knowledge and skills obtained from basic education and training may rapidly become out of date. There is no mandated, structured and ongoing mechanism to assess all doctors' competence in Hong Kong. This paper assessed doctors' perceived needs for continuous professional development, and to identify facilitators and barriers that are likely to influence the implementation of compulsory continuous professional development for maintaining professional competence and ensuring patient safety. An explanatory sequential mixed method design with two distinct interactive phases was adopted comprising a postal self-administered questionnaire survey among a random sample of 2,459 of doctors (Phase 1), followed by individual interviews of a stratified sample of 30 questionnaire respondents for the subsequent qualitative analysis (Phase 2). The majority of doctors (over 90%) agreed the importance of continuous professional development to update knowledge and skills. However, just 30.7% of non-specialists compared with 65.4% of specialists agreed it would be desirable for continuous professional development to be a requirement for renewal of licenses. A relatively higher percentage of non-specialists compared with specialists reported barriers to participation such as accessibility, availability and relevance of the content of the programmes. Facilitators for uptake included more convenient schedule and location, relevant content, and incentives for participation such as making this a pre-condition for enrolling in government-funded services. To address the needs of individual doctors, the spheres of practice, personal preferences and learning styles should be considered in deciding the content and processes of continuous professional development. Flexibility is also an important principle. A learning model, incentives for participation and a compliance strategy (instead of deterrence) could be effective strategy for continuous professional development.

Semi-Analytical Path Delay Variation Model With Adjacent Gates Decorrelation for Subthreshold Circuits

The subthreshold circuit is a practical design style for the ultralow-power applications, but its timing estimation is a challenge due to the increasing local variation effects. The delay variation of adjacent gates is not independent because of input slew variation caused by the precedent gate, so their correlation effects are difficult to model and estimate. This article proposes a semi-analytical statistical delay model considering local variation for the subthreshold region, that is, the combination of analytical and simulation-based method. First, it decorrelates the slew influence between adjacent stages by dividing delay and output slew model into fast/slow input cases and dividing delay variation model into process variation and input slew variation. Then, it can be applied into multi-PVT conditions with a one-time SPICE nominal simulation by analyzing the independence of variability and relative variability of step input gate delay variance with output load capacitance and process, voltage, and temperature (PVT). Finally, experiments are carried out for different benchmarks, processes, voltages, and temperatures (BPVTs). The average errors of variance on different BPVTs are 4.8%, 3.1%, 4.0%, and 4.7%. Compared with other analytical works, the accuracies’ improvements of three metrics (variance, variability, and max delay) are $8.3\times $ , $9.6\times $ , and $2.7\times $ by the mean error at all test benchmarks. Compared with industrial method LVF, it has a comparable error in max path delay and runtime, and less three orders of magnitudes than LVF in characterization time and stored data (from TB to GB) at all test benchmarks.

RELATIONSHIP BETWEEN ATTACHMENT PARENTING PRACTICE AND ATTACHMENT STYLES AMONG EARLY CHILDHOOD EDUCATION PUPILS IN KADUNA METROPOLIS, NIGERIA

The study investigated the relationship between attachment parenting practice and attachment styles of pupils in early childhood education in Kaduna metropolis, Nigeria. The study had three objectives; three hypotheses were formulated and tested. The population for the study was 451 early childhood education pupils out of which 83 pupils were studied; 39 males (47%) while 44 females (53 %). Correlation type of survey was employed in the conduct of the research. The instruments used in collecting data were parenting practices and child attachment style checklists. The attachment style checklist was administered by the research assistants on the sampled pupils while the parenting practices checklist was administered to the parents of the sampled pupils. Pearson Product Moment Correlation (PPMC) was the statistical tool used in analyzing the data collected. Results of the analyses indicated significant correlation existed between attachment parenting practice and secure attachment style (p = .003), but there was no significant correlation between attachment parenting practice and ambivalent attachment style (p = .212) as well as between attachment parenting practice and ambivalent attachment style (p =. 081. Based on the findings of this study, it was recommended that parents and caregivers should employ best parenting practices like attachment parenting so that the child grows up in secure environment and develop secure attachment style among others.

Challenges and Opportunities of Evidence Use in Practice in Australian Children’s Development Programs

ABSTRACT This paper explores the role of evidence and its use in a cluster of Australian community-based child development programs. The paper draws on findings from a 2016–2017 study commissioned by a not-for-profit organization to review their programs’ alignment with government evidence-based program expectations. Cunningham and Duffee’s (2009) evidence-based practice style typology is utilized to examine how different purposes of use drive styles of and approaches to evidence sourcing, application, and reporting. Perspectives on what constitutes evidence and how such evidence is valued, used, and reported can vary considerably between individual programs, irrespective of enforced standards and expectations. It is argued that a single-dimensional approach to program evidence-based evaluation and reporting is not appropriate and potentially damaging in contexts where community-based programs have different purposes, structures, cultures, and intentions. Given a program’s particular evidence-use style, evidence-based criteria, processes, and reporting requirements should be matched accordingly.

The Strengths and Difficulties Questionnaire is a usable way to address mental health at well-child visits in general practice - a qualitative study of feasibility

BackgroundMental health problems is frequent among children and psychopathology in early childhood seems to predict mental disorders in adulthood. All Danish children are offered seven free well-child visits at their General Practitioner (GP) during their first 5 years of life. GPs have a unique position to address mental health problems at the well-child visits, but they lack a systematic approach when assessing children’s mental health. The purpose of this study was to investigate if the Strengths and Difficulties Questionnaire (SDQ) is a usable way to address preschool children’s mental health in general practice.MethodsA qualitative study of feasibility. Parents completed an online version of the SDQ at home. At the well-child visit, the GP used the SDQ results as a basis for a talk about the child’s mental health. Afterwards the author JS conducted semistructured interviews with both the parent and the GP over the phone. The interviews were descriptively analyzed using the Framework Approach.ResultsFive primary care centres with 22 general practitioners in both Copenhagen and Region Zealand participated. Twenty four parents completed the SDQ and were interviewed. Participating parents and GPs agreed, that the SDQ introduced mental health as a natural and important part of the well-child visit. Online access had clear advantages: time for reflection at home and preparation, plus a clear result summary for the GP. Some of the GPs were worried that the questionnaire would be too time consuming, and might compromise the individualistic style of general practice. Some parents were worried if children with minor problems would be diagnosed.ConclusionsThe online SDQ was well-accepted and feasible in daily practice. Implementing the SDQ into the well-child visit could strengthen the focus on the child’s mental health. However, before the SDQ can be generally implemented a guideline on how to utilize it in the well-child visit is needed, as well as studies of efficacy in this setting.Trial registrationNot relevant.

An E-Survey of Current Voice Therapy Practices Amongst Speech Language Pathologists (SLPs) in India.

In India, Speech Language Pathologists (SLPs) generally work with ENT surgeons and use a variety of treatment approaches, service delivery methods, feedback modes, and outcome measures in clinical practice while dealing with voice disorders. The practice preferences of the SLPs are based on theoretical and practical exposure during their graduate course, guidance from professional bodies, evidence-based practices, etc. The facilities in the work setting also determine the practice style of the SLP. This study reports information on demographics of the SLPs, nature of patients served, intervention methods, and evidence-based practices followed by the SLPs via an E-survey. Analysis of the survey from 55 SLPs in India, who work in the area of voice revealed that most SLPs had postgraduate (67.27%; n = 37) and doctorate degree (23.63%; n = 13) and worked in medical-related settings (81.81%; n = 45). Therapeutic approaches were practiced as stated in literature by 43.64% (n = 24) of SLPs. Although 56.36% (n = 31) of SLPs modified therapeutic approaches based on the client's needs (75%), literacy (16.66%) and cultural variations (8.33%). Attending Continuing Education Programs and training workshops were required to practice voice. Voice therapy methods (protocols) used by the SLPs were not uniform across India. The development of an indigenous protocol/method for voice therapy is the need of the hour.

Pengaruh Dua Gaya Mengajar Mosston dan Dukungan Motor Ability Mahasiswa Terhadap Hasil Belajar Teknik Dasar Sepak Takraw

This study aims to determine the effect of applying the teaching style of practice and inclusive teaching style on groups of students who have high and low motor abilities in the process of learning the basic techniques of sepak takraw. This research method uses experiments factorial 2x2 with by level design, the population of this study was 82 students of physical education study programs at the Riau Islamic University. The sample of this study was 44 people taken using purposive sampling technique, consisting of 22 people with high motor ability and 22 people with low motor ability. Furthermore the sample was divided into four groups of 11 people each. The data analysis technique used ANAVA with the results of the t-dunnet advanced test. (1) For students who have a high motor ability, the results of the learning of the takraw basic techniques of teaching practice style groups are better than inclusi teaching styles, with t0 = 5.06 ≥ ttable 1.67 then H0 is rejected. (2) Students who have low motor ability, the results of the learning of the basic techniques of takraw group inclusi teaching style is better than the teaching style of practice, with t0 = -1.81 ≤ ttable 1.67 then H0 is rejected. (3) There is an interaction between teaching style and motor ability on the results of the basic takraw learning techniques, with p-value = 0,000 ≤ 0.05 or H0 rejected.

Effect of a multi-component intervention on providers’ HPV vaccine communication

ABSTRACT Objective: To evaluate the effect of a multi-component intervention including communication training on provider beliefs and recommendation practices around the human papillomavirus (HPV) vaccine using both self-reports and audio-recordings of clinical interactions. Methods: We conducted a mixed method study at five family medicine and pediatric practices. Providers self-reported beliefs and practices about HPV vaccination via surveys and qualitative interviews conducted pre- and post-intervention. We also assessed provider recommendation style using audio-recordings of clinical interactions pre- and post-intervention. Content analysis was used to identify themes in qualitative interviews. Matched pre- and post-intervention surveys were analyzed for changes in provider beliefs and attitudes. Pre- and post-intervention audio recordings of clinical interactions were analyzed for observed differences in recommendation styles. Bivariate analyses of quantitative data used Chi-square and Fisher’s exact tests; t-tests were used for continuous variables. Results: Providers reported in interviews that the intervention led to communication changes by increasing their knowledge, reframing the HPV vaccine as a routine vaccination, and providing tools for engaging with parents. Surveys indicated that the proportion of providers reporting that the HPV vaccine is one of the most important adolescent vaccines increased from 71% pre-intervention to 100% post-intervention (p = .03). Audio-recording analysis demonstrated that use of an indicated (presumptive) recommendation style increased from 62.5% pre-intervention to 79.6% post-intervention (p = .047). Conclusions: Educating providers about HPV vaccination and giving them tools to facilitate communication with parents can reframe HPV as a routine adolescent vaccination and motivate providers to routinely use effective recommendation styles in practice.

Recruiting Faculty From Within: Filling The Growing Need For Family Medicine Faculty

The predictions point toward increasing difficulty in recruiting academic faculty in Family Medicine. The 2017 AAMC Final Report, “The Complexities of Physician Supply and Demand: Projections from 2015 to 2030” predicts significant physician shortages by 2025. Changes in practice styles, patient demographics, delivery models, retirement goals, and economic trends make the recruitment of academic faculty more challenging as the physician workforce shrinks.&#x0D; The purpose of this descriptive report is to share how we developed and implemented an academic faculty model that would nurture residents from our program to become members of the Family Medicine faculty, rather than rely on traditional recruiting practices that had proven to be unsuccessful.&#x0D; This process incorporates a faculty /resident needs assessment, development of a customized third-year rotation in academic medicine, completion of faculty development training, a specialized mentorship program and focused orientation. Following this plan, we successfully recruited three new faculty physicians for our residency program.