Effectiveness of a Multifaceted Intervention for Potentially Inappropriate Prescribing in Older Patients in Primary Care: A Cluster-Randomized Controlled Trial (OPTI-SCRIPT Study)

PURPOSE Potentially inappropriate prescribing (PIP) is common in older people and can result in increased morbidity, adverse drug events, and hospitalizations. The OPTI-SCRIPT study (Optimizing Prescribing for Older People in Primary Care, a cluster-randomized controlled trial) tested the effectiveness of a multifaceted intervention for reducing PIP in primary care.

METHODS We conducted a cluster-randomized controlled trial among 21 general practitioner practices and 196 patients with PIP. Intervention participants received a complex, multifaceted intervention incorporating academic detailing; review of medicines with web-based pharmaceutical treatment algorithms that provide recommended alternative-treatment options; and tailored patient information leaflets. Control practices delivered usual care and received simple, patient-level PIP feedback. Primary outcomes were the proportion of patients with PIP and the mean number of potentially inappropriate prescriptions. We performed intention-to-treat analysis using random-effects regression.

RESULTS All 21 practices and 190 patients were followed. At intervention completion, patients in the intervention group had significantly lower odds of having PIP than patients in the control group (adjusted odds ratio = 0.32; 95% CI, 0.15–0.70; P = .02). The mean number of PIP drugs in the intervention group was 0.70, compared with 1.18 in the control group (P = .02). The intervention group was almost one-third less likely than the control group to have PIP drugs at intervention completion, but this difference was not significant (incidence rate ratio = 0.71; 95% CI, 0.50–1.02; P = .49). The intervention was effective in reducing proton pump inhibitor prescribing (adjusted odds ratio = 0.30; 95% CI, 0.14–0.68; P = .04).

CONCLUSIONS The OPTI-SCRIPT intervention incorporating academic detailing with a pharmacist, and a review of medicines with web-based pharmaceutical treatment algorithms, was effective in reducing PIP, particularly in modifying prescribing of proton pump inhibitors, the most commonly occurring PIP drugs nationally.

Aprendizagem baseada em projetos na consolidação de conceitos de programação de linguagens SCRIPT

Relatório da prática de ensino supervisionada, Mestrado em Ensino de Informática, Universidade de Lisboa, 2014

Television script for Corn Girl

Television script for commercial "Corn Girl" featuring the song "Mellow Yellow"

1980 Big Mac Attack script

1980 script for Attack a Big Mac

Rough draft of the script for "The Swimmer"

A draft with handwritten notes of "The Swimmer" script for use in the 1984 nutrition campaign.

"Gallagher" commercial script

This script is dated 1996, but may have been reused from a commercial used in 1983.

Le test de concordance de script (TCS) explore-t-il des processus de raisonnement clinique différents de ceux du QCM à contexte riche (basés sur des cas cliniques) ? : et si oui, quels sont-ils ?

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

L’évaluation du raisonnement clinique des résidents en hématologie par l’approche de concordance de script

La pratique de l’hématologie, comme celle de toute profession, implique l’acquisition d’un raisonnement adéquat. Se basant sur une théorie de psychologie cognitive, le test de concordance de script (TCS) a été développé et validé comme un instrument permettant d’évaluer le raisonnement clinique dans diverses spécialités médicales. Le but de cette étude était d’examiner l’utilité et les paramètres psychométriques d’un TCS en hématologie. Nous avons construit un TCS composé de 60 questions que nous avons administré à 15 résidents juniors (R1 à R3 en médecine interne), 46 résidents séniors (R4, R5 et R6 en hématologie) et 17 hématologues à travers le Canada. Après optimisation, le TCS comptait 51 questions. Sa consistance interne mesurée par le coefficient de Cronbach alpha était 0.83. Le test était en mesure de discriminer entre les résidents selon leur niveau de formation. Les questions contenant des images (n=10) semblaient avoir un potentiel discriminatoire plus élevé. Les scores obtenus par les résidents séniors corrélaient modéremment avec ceux obtenus à un test conventionnel d’hématologie composé de questions à choix multiples et à courte réponse (r de Pearson = 0.42; p=0.02). Le TCS a été complété en 36 minutes en moyenne et a été bien reçu par les participants. Le TCS est un instrument d’évaluation utile et valide en hématologie. Il peut être utilisé à des fins formatives en aidant au suivi de la progression des résidents. Il pourrait aussi être combiné à d’autres instruments d’évaluation à des fins sanctionnelles, ou encore, en éducation médicale continue.

An Online Character Recognition System to Convert Grantha Script to Malayalam

This paper presents a novel approach to recognize Grantha, an ancient script in South India and converting it to Malayalam, a prevalent language in South India using online character recognition mechanism. The motivation behind this work owes its credit to (i) developing a mechanism to recognize Grantha script in this modern world and (ii) affirming the strong connection among Grantha and Malayalam. A framework for the recognition of Grantha script using online character recognition is designed and implemented. The features extracted from the Grantha script comprises mainly of time-domain features based on writing direction and curvature. The recognized characters are mapped to corresponding Malayalam characters. The framework was tested on a bed of medium length manuscripts containing 9-12 sample lines and printed pages of a book titled Soundarya Lahari writtenin Grantha by Sri Adi Shankara to recognize the words and sentences. The manuscript recognition rates with the system are for Grantha as 92.11%, Old Malayalam 90.82% and for new Malayalam script 89.56%. The recognition rates of pages of the printed book are for Grantha as 96.16%, Old Malayalam script 95.22% and new Malayalam script as 92.32% respectively. These results show the efficiency of the developed system

A System for Offline Recognition of Handwritten Characters in Malayalam Script

In this paper, we propose a handwritten character recognition system for Malayalam language. The feature extraction phase consists of gradient and curvature calculation and dimensionality reduction using Principal Component Analysis. Directional information from the arc tangent of gradient is used as gradient feature. Strength of gradient in curvature direction is used as the curvature feature. The proposed system uses a combination of gradient and curvature feature in reduced dimension as the feature vector. For classification, discriminative power of Support Vector Machine (SVM) is evaluated. The results reveal that SVM with Radial Basis Function (RBF) kernel yield the best performance with 96.28% and 97.96% of accuracy in two different datasets. This is the highest accuracy ever reported on these datasets

Southampton Chemistry Twilight Practical Script

The full script and worksheet for the 6th form outreach event where the practical extraction of trimyristin is undertaken.The PDF also contains a detailed NMR spectrum

Twilight chemistry script

The script used in the 2015 January Twilight sessions for chemistry.

Letterforms for handwriting and reading: print script and sanserifs in early twentieth-century England

This essay is about letterforms and typography in reading books for young children and how they were influenced by the teaching of handwriting in the early decades of the twentieth century. I examine the contributions made by infant teachers to typography and book design and draw particular attention to the print script movement and the gradual introduction of sanserif typefaces in reading books. I suggest that the use of sanserifs in reading books for young children is one of their first appearances for continuous text. Although the influence of print script on the teaching of handwriting may have had some undesirable effects, I suggest that it indirectly contributed to some innovations in book design.