TRial of an Educational intervention on patients' knowledge of Atrial fibrillation and anticoagulant therapy, INR control, and outcome of Treatment with warfarin (TREAT)

Background Atrial fibrillation (AF) patients with a high risk of stroke are recommended anticoagulation with warfarin. However, the benefit of warfarin is dependent upon time spent within the target therapeutic range (TTR) of their international normalised ratio (INR) (2.0 to 3.0). AF patients possess limited knowledge of their disease and warfarin treatment and this can impact on INR control. Education can improve patients' understanding of warfarin therapy and factors which affect INR control. Methods/Design Randomised controlled trial of an intensive educational intervention will consist of group sessions (between 2-8 patients) containing standardised information about the risks and benefits associated with OAC therapy, lifestyle interactions and the importance of monitoring and control of their International Normalised Ratio (INR). Information will be presented within an 'expert-patient' focussed DVD, revised educational booklet and patient worksheets. 200 warfarin-naïve patients who are eligible for warfarin will be randomised to either the intervention or usual care groups. All patients must have ECG-documented AF and be eligible for warfarin (according to the NICE AF guidelines). Exclusion criteria include: aged < 18 years old, contraindication(s) to warfarin, history of warfarin USE, valvular heart disease, cognitive impairment, are unable to speak/read English and disease likely to cause death within 12 months. Primary endpoint is time spent in TTR. Secondary endpoints include measures of quality of life (AF-QoL-18), anxiety and depression (HADS), knowledge of AF and anticoagulation, beliefs about medication (BMQ) and illness representations (IPQ-R). Clinical outcomes, including bleeding, stroke and interruption to anticoagulation will be recorded. All outcome measures will be assessed at baseline and 1, 2, 6 and 12 months post-intervention. Discussion More data is needed on the clinical benefit of educational intervention with AF patients receiving warfarin. Trial registration ISRCTN93952605

Transferring knowledge of manufacturing techniques within a subsidiary of a multi-national corporation

With the growth of the multi-national corporation (MNCs) has come the need to understand how parent companies transfer knowledge to, and manage the operations of, their subsidiaries. This is of particular interest to manufacturing companies transferring their operations overseas. Japanese companies in particular have been pioneering in the development of techniques such as Kaizen, and elements of the Toyota Production System (TPS) such as Kanban, which can be useful tools for transferring the ethos of Japanese manufacturing and maintaining quality and control in overseas subsidiaries. Much has been written about the process of transferring Japanese manufacturing techniques but much less is understood about how the subsidiaries themselves – which are required to make use of such techniques – actually acquire and incorporate them into their operations. This research therefore takes the perspective of the subsidiary in examining how knowledge of manufacturing techniques is transferred from the parent company within its surrounding (subsidiary). There is clearly a need to take a practice-based view to understanding how the local managers and operatives incorporate this knowledge into their working practices. A particularly relevant theme is how subsidiaries both replicate and adapt knowledge from parents and the circumstances in which replication or adaptation occurs. However, it is shown that there is a lack of research which takes an in-depth look at these processes from the perspective of the participants themselves. This is particularly important as much knowledge literature argues that knowledge is best viewed as enacted and learned in practice – and therefore transferred in person – rather than by the transfer of abstract and de-contextualised information. What is needed, therefore, is further research which makes an in-depth examination of what happens at the subsidiary level for this transfer process to occur. There is clearly a need to take a practice-based view to understanding how the local managers and operatives incorporate knowledge about manufacturing techniques into their working practices. In depth qualitative research was, therefore, conducted in the subsidiary of a Japanese multinational, Gambatte Corporation, involving three main manufacturing initiatives (or philosophies), namely 'TPS‘, 'TPM‘ and 'TS‘. The case data were derived from 52 in-depth interviews with project members, moderate-participant observations, and documentations and presented and analysed in episodes format. This study contributes to our understanding of knowledge transfer in relation to the approaches and circumstances of adaptation and replication of knowledge within the subsidiary, how the whole process is developed, and also how 'innovation‘ takes place. This study further understood that the process of knowledge transfer could be explained as a process of Reciprocal Provider-Learner Exchange that can be linked to the Experiential Learning Theory.

Differential effects of value consciousness and coupon proneness on consumers’ persuasion knowledge of pricing tactics

Pricing tactics persuasion knowledge (PTPK) is a relatively new concept that seeks to extend the research on persuasion knowledge to the pricing domain. Pricing tactics persuasion knowledge refers to the persuasion knowledge of consumers about marketers’ pricing tactics. Employing an acquisition–transaction utility theoretic perspective, this study examines the differential effects of value consciousness and coupon proneness on the accuracy, confidence, and calibration of consumers’ pricing tactics persuasion knowledge. The study finds that coupon proneness is negatively related to accuracy, confidence, and calibration of PTPK, while value consciousness is positively related to accuracy, confidence, and calibration of PTPK. The implications of the study are outlined.

Calibration of consumer knowledge of the web

Calibration of consumer knowledge of the web refers to the correspondence between accuracy and confidence in knowledge of the web. Being well-calibrated means that a person is realistic in his or her assessment of the level of knowledge that he or she possesses. This study finds that involvement leads to better calibration and that calibration is higher for procedural knowledge and common knowledge, as compared to declarative knowledge and specialized knowledge. Neither usage, nor experience, has any effect on calibration of knowledge of the web. No difference in calibration is observed between genders. But, in agreement with previous findings, this study also finds that males are more confident in their knowledge of the web. The results point out that calibration could be more a function of knowledge-specific factors and less that of individual-specific factors. The study also identifies flow and frustration with the web as consequences of calibration of knowledge of the web and draws the attention of future researchers to examine these aspects.

Transferring knowledge of manufacturing techniques in multinational corporations:preliminary findings

With the growth of the multinational corporation (MNC) has come the need to understand how parent companies transfer knowledge to, and manage the operations of, their subsidiaries. This is of particular interest to manufacturing companies transferring their operations overseas. Japanese companies in particular have been pioneering in this regard, with techniques such as the Toyota Production System (TPS) for transferring the ethos of Japanese manufacturing and maintaining quality and control in overseas subsidiaries. A great deal has been written about the process of transferring Japanese manufacturing techniques, but much less is understood about how the subsidiaries themselves, which are required to make use of such techniques, actually acquire and incorporate them into their operations. The research on which this paper is based therefore examines how, from the perspective of the subsidiary, knowledge of manufacturing techniques is transferred from the parent company. There is clearly a need to take a practice-based view to understanding how the local managers and operatives incorporate knowledge about manufacturing techniques into their working practices. In-depth qualitative research was, therefore, conducted in the subsidiary of a Japanese multinational, Denso Corporation, involving three main manufacturing initiatives (or philosophies), namely ‘TPS’, ‘TPM’ and ‘TS’. The case data were derived from 52 in-depth interviews with project members, moderate participant observations, and documentations. The aim of this paper is to present the preliminary findings from the case analyses. The research contributes to our understanding of knowledge transfer in relation to the circumstances of the selection between adaptation and replication of knowledge in the subsidiary from its parent. In particular this understanding relates to transfer across different flows and levels in the organisational hierarchy, how the whole process is managed, and also how modification takes place.

An investigation into the effects of the feedback of knowledge of results on operator performance

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Educating the iPod generation:undergraduate attitudes, experiences and knowledge of vodcast and podcast use

There is an increasing pressure on university staff to provide ever more information and resources to students. This study investigated student opinions on (audio) podcasts and (video) vodcasts and how well they met requirements and aided learning processes. Two experiments within the Aston University looked at student opinion on, and usage of, podcasts and vodcasts for a selection of their psychology lectures. Recordings were produced first using a hand-held camcorder, and then using the in-house media department. WebCT was used to distribute the podcasts and vodcasts, attitude questionnaires were then circulated at two time points. Overall students indicated that podcasts and vodcasts were a beneficial addition resource for learning, particularly when used in conjunction with lecturers’ slides and as a tool for revision/assessment. The online material translated into students having increased understanding of the material, which supplemented and enhanced their learning without being a substitute for traditional lectures. There is scope for the provision of portable media files to become standard practice within higher education; integrating distance and online learning with traditional approaches to improve teaching and learning.

An assessment of legal knowledge of preservice teachers completing accredited teacher education programs in South Florida

The purpose of the study was to assess the legal knowledge of preservice teachers completing their educational training at accredited South Florida universities. The population consisted of 372 preservice kindergarten through twelfth grade teachers completing their educational training in any area of public school education.^ The researcher selected areas of school law to assess based on nationwide studies of litigation involving teachers and school boards, the areas most pertinent to the teachers' daily activities and responsibilities. A forty-item instrument was developed and administered to preservice teachers at six South Florida public and private universities. The areas of school law surveyed were tort liability, teachers' rights as instructors and employees, and students' rights. The research questions asked if preservice teachers possess a fundamental knowledge of school law in any of the identified areas and if a significant difference of legal knowledge existed when comparing preservice teachers by university and comparing preservice elementary and preservice secondary teachers. The criteria for a fundamental knowledge of school law was established as scoring 80% or above on the total survey or any area of school law.^ Conclusions. (1) On the overall survey, the preservice teachers did not exhibit a fundamental knowledge of school law. The mean score was 64.2%, with 11.6% of the respondents scoring at or above the 80% level. (2) The preservice teachers did not possess a fundamental knowledge of school law in any of the three areas of school law, though the survey revealed a difference in the preservice teachers' knowledge in the specific areas. The scores were tort liability, 71.9%; teachers' rights, 65%; and students' rights, 52.3%. (3) A significant difference did not exist between elementary and secondary preservice teachers' knowledge of school law. (4) A significant difference did not exist among the preservice teachers' knowledge of school law when compared by university.^ The study suggested a need for increased instruction in these areas of school law to preservice teachers prior to the beginning of their teaching careers. ^

Public school administrators' knowledge of special education law

The purpose of this study was to assess the knowledge of public school administrators with respect to special education (ESE) law. The study used a sample of 220 public school administrators. A survey instrument was developed consisting of 19 demographic questions and 20 situational scenarios. The scenarios were based on ESE issues of discipline, due process (including IEP procedures), identification, evaluation, placement, and related services. The participants had to decide whether a violation of the ESE child's rights had occurred by marking: (a) Yes, (b) No, or (c) Undecided. An analysis of the scores and demographic information was done using a two-way analysis of variance, chi-square, and crosstabs after a 77% survey response rate.^ Research questions addressed the administrators' overall level of knowledge. Comparisons were made between principals and assistant principals and differences between the levels of schooling. Exploratory questions were concerned with ESE issues deemed problematic by administrators, effects of demographic variables on survey scores, and the listing of resources utilized by administrators to access ESE information.^ The study revealed: (a) a significant difference was found when comparing the number of ESE courses taken and the score on the survey, (b) the top five resources of ESE information were the region office, school ESE department chairs, ESE teachers, county workshops, and county inservices, (c) problematic areas included discipline, evaluation procedures, placement issues, and IEP due process concerns, (d) administrators as a group did not exhibit a satisfactory knowledge of ESE law with a mean score of 12 correct and 74% of responding administrators scoring in the unsatisfactory level (below 70%), (e) across school levels, elementary administrators scored significantly higher than high school administrators, and (f) a significant implication that assistant principals consistently scored higher than principals on each scenario with a significant difference at the high school level.^ The study reveals a vital need for administrators to receive additional preparation in order to possess a basic understanding of ESE school law and how it impacts their respective schools and school districts so that they might meet professional obligations and protect the rights of all individuals involved. Recommendations for this additional administrative preparation and further research topics were discussed. ^

General and special education teachers' knowledge of and attitudes toward students with HIV/AIDS

AIDS education is mandated in schools throughout the United States to educate students about the disease. Teachers are expected to assume the major role of disseminating this information; therefore it is reasonable to question how knowledgeable teachers are about HIV/AIDS and where their information is coming from. This study explored the knowledge and attitudes of general and special education teachers toward students with HIV/AIDS and investigated whether a relationship between knowledge and attitudes existed. Information was collected using the AIDS Knowledge and Attitude Survey (AKAS). The sample was limited to certified teachers resulting in 318 participants.^ Research questions were analyzed using descriptive statistics, frequencies, t-tests, one-way analysis of variance (ANOVA), Scheffe post hoc analysis, and Pearson Product-Moment Correlation. Results indicated that general and special education teachers did not have complete knowledge about HIV/AIDS. Participants were knowledgeable regarding modes of transmission which may be the area of greatest concern for teachers, however, deficiencies were present within teachers' knowledge of general statements and facts and pathology. Among the ten demographic variables analyzed, six (gender, race/ethnicity, level of education, certification, instructional level taught, and classroom AIDS instruction) contained statistical significance.^ Analysis of attitudes indicated that general and special education teachers' overall attitudes toward students with HIV/AIDS were generally positive within clusters of Instruction and Fear, but not within Sensitivity and Communication. Among the ten demographic variables used for analysis only three (age, graduate enrollment status, and classroom AIDS instruction) produced statistical significance. Results found statistically significant relationships between Total Knowledge, all knowledge subtests, Fear, and Overall Attitudes. Statistical significance was also located on Total Knowledge, Pathology and Transmission knowledge subtests, and Sensitivity, as well as between Pathology and Instruction, and General Statements and Facts and Communication.^ The only variable determined to have statistical significance on both knowledge and attitudes was classroom AIDS instruction. Participants with previous AIDS instruction showed greater knowledge and possessed more positive attitudes. A review of previous research indicated training to be effective in increasing knowledge and fostering more favorable behavior toward persons with AIDS. Therefore, this study finds AIDS training to be beneficial for all teachers and is recommended during preservice education or through inservices for teachers already in the field. ^

Effect of an inservice on the teachers' knowledge of general school law, Section 504, and the Meta Consent Decree

It is generally assumed by educators that inservice training will make a significant difference in teacher knowledge of topics related to education. This investigation addressed that assumption by examining the effects of various factors, e.g., amount and timing of inservice training, upon teacher knowledge of educational law. Of special interest was teacher knowledge of the law as it pertained to ethnic and other characteristics of students in urban school settings. This study was deliberately designed to determine which factors should be later investigated in a more deterministic form, e.g., an experimental design.^ The investigation built upon that of Ogletree (1985), Osborne (1996) and others who focused on the importance of teacher development as a method to enhance professional abilities. The main question addressed in this study was, "How knowledgeable are teachers of school law, especially with regard to general school law, the Meta Consent Decree and Section 504 of the Rehabilitation Act of 1973."^ The study participants (N = 302) were from the Dade County School System, the fourth largest in the U.S. The survey design (approved by the System), specified participants from all levels and types of schools and geographic representations. A survey instrument was created, pilot tested, revised and approved for use by the district official representatives. After administration of the instrument, the resultant data was treated by several appropriate tests, e.g., multivariate analysis of variance (ANOVA).^ Several findings emerged from the analysis of the data: in general, teachers did not have sufficient knowledge of school law; factors, such as amount and level of education, and status and position were positively correlated with increased knowledge; factors such as years of experience, gender, race and ethnicity were not correlated with higher levels of knowledge. The most significant, however, was that when teachers had participated in several inservice training experiences, typically workshops, and, when combined with other factors noted above, their knowledge of school law was significantly higher. Specific recommendations for future studies were made. ^

Elementary classroom teachers' knowledge of tort liability for negligence

The purpose of this research study was to investigate the legal knowledge of Florida's public elementary classroom teachers in the area of tort liability for negligence. A second purpose of the study was to assess the knowledge of school law in the area of negligence according to specific variables to determine if significant differences in knowledge existed among groups of teachers classified by: years of teaching experience, whether or not teachers took a school law course or inservice, college degree held and whether or not teachers had administrative experience. A validated survey instrument consisting of 22 scenarios based on decided court cases in the United States was utilized. These cases included court decisions ranging from 1938–1994, and represented the categories of duty and standard of care, proper instruction, proper supervision, proper maintenance, field trips, and post-injury treatment. ^ A random sample of 420 elementary classroom teachers were sent the survey instrument to complete, and a total of 309 surveys were returned producing a return rate of 77%. The results of this research study revealed that the overall level of legal knowledge of public elementary classroom teachers in the State of Florida produced a mean percent correct of 53%. The range of scores varied from 18%–82%, with the approximate average of correct answers of 12 out of 22. The category of proper instruction produced the lowest mean percent correct of 35%, and the area of post-injury treatment yielded the highest mean percent correct of 78%. ^ The findings of this study emphasize the necessity of preparing teachers regarding their legal rights, duties and responsibilities. The need for teachers to receive training at the preservice and inservice levels has become clear by this study. ^

The effects of a family-based educational intervention on the prevention of lead poisoning in children

The effects of lead exposure may endure through one's lifetime and can negatively effect educational performance. While the link between the cause and effects of lead poisoning has been identified, the application of lead health education as the mechanism of disease prevention has not. The purpose of this study was to examine whether caregiver participation in a family-based educational intervention can result in decreased lead exposure in low socioeconomic children. ^ Participants (n = 50) were caregivers of children 12 to 36 months of age. They were randomly selected from an urban clinic and randomly assigned to either a treatment or control group. The experimental design of this study involved two clinic visits. Parents in the treatment group were given the educational intervention during the first clinic visit while those in the control group were given the intervention during the second clinic visit. The intervention was reinforced with a lead education brochure coupled with a video on childhood lead poisoning. One instrument was used to test parental knowledge of lead poisoning both pre- and post-intervention. Blood lead levels in pediatric participants were tested using two blood lead screens approximately three to four months apart determined by well-child check-up schedules. ^ Findings from the analysis of variance showed the interaction between the change in blood lead level between the children's first and second clinic visits and the treatment level. This demonstrated a significant interaction between the differences of first and second clinic visits blood lead levels and the presence or absence of the educational intervention. ^ The findings from an analysis of covariance support that caregivers in the treatment group have significantly higher scores on the second clinic visit scores on the CLKT than the caregivers in the control group. These data suggest that the educational treatment is effective in increasing the knowledge of caregivers about the dangers of lead poisoning and the strategies for lead poisoning prevention. ^ Conclusions indicate that the education of adult caregivers can affect blood lead levels of children, the educational treatment increased the knowledge of caregivers, caregivers were able to carry out procedures taught, and caregivers retained knowledge over time. ^

The effectiveness of a conceptually-based health and wellness course in developing health related factors, exercise self-efficacy and knowledge of health issues and exercise performance among diverse college students

The purpose of the study was to investigate the physiological and psychological benefits provided by a self-selected health and wellness course on a racially and ethnically diverse student population. It was designed to determine if students from a 2-year Hispanic serving institution (HIS) from a large metropolitan area would enhance their capacity to perform physical activities, increase their knowledge of health topics and raise their exercise self-efficacy after completing a course that included educational and activity components for a period of 16 weeks. A total of 185 students voluntarily agreed to participate in the study. An experimental group was selected from six sections of a health and wellness course, and a comparison group from students in a student life skills course. All participants were given anthropometric tests of physical fitness, a knowledge test, and an exercise self-efficacy scale was given at the beginning and at the conclusion of the semester. An ANCOVA analyses with the pretest scores being the covariate and the dependent variable being the difference score, indicated a significant improvement of the experimental group in five of the seven anthropometric tests over the comparison group. In addition, the experimental group increased in two of the three sections of the exercise self-efficacy scale indicating greater confidence to participate in physical activities in spite of barriers over the comparison group. The experimental group also increased in knowledge of health related topics over the comparison group at the .05 significance level. Results indicated beneficial outcomes gained by students enrolled in a 16-week health and wellness course. The study has several implications for practitioners, faculty members, educational policy makers and researchers in terms of implementation of strategies to promote healthy behaviors in college students and, to encourage them to engage in regular physical activities throughout their college years.

Toward Prevention of Childhood Sexual Abuse: Preschoolers’ Knowledge of Genital Body Parts

This study examined preschool children’s knowledge of their genital and non-genital body parts. Results indicated that almost all preschool children knew the correct terms for their non-genital body parts, but few knew the correct terminology for their genitals. The importance of this skill in preventing childhood sexual abuse is discussed.