Information Presentation Features and Comprehensibility of Hospital Report Cards: Design Analysis and Online Survey Among Users

Background: Improving the transparency of information about the quality of health care providers is one way to improve health care quality. It is assumed that Internet information steers patients toward better-performing health care providers and will motivate providers to improve quality. However, the effect of public reporting on hospital quality is still small. One of the reasons is that users find it difficult to understand the formats in which information is presented. Objective: We analyzed the presentation of risk-adjusted mortality rate (RAMR) for coronary angiography in the 10 most commonly used German public report cards to analyze the impact of information presentation features on their comprehensibility. We wanted to determine which information presentation features were utilized, were preferred by users, led to better comprehension, and had similar effects to those reported in evidence-based recommendations described in the literature. Methods: The study consisted of 5 steps: (1) identification of best-practice evidence about the presentation of information on hospital report cards; (2) selection of a single risk-adjusted quality indicator; (3) selection of a sample of designs adopted by German public report cards; (4) identification of the information presentation elements used in public reporting initiatives in Germany; and (5) an online panel completed an online questionnaire that was conducted to determine if respondents were able to identify the hospital with the lowest RAMR and if respondents’ hospital choices were associated with particular information design elements. Results: Evidence-based recommendations were made relating to the following information presentation features relevant to report cards: evaluative table with symbols, tables without symbols, bar charts, bar charts without symbols, bar charts with symbols, symbols, evaluative word labels, highlighting, order of providers, high values to indicate good performance, explicit statements of whether high or low values indicate good performance, and incomplete data (“N/A” as a value). When investigating the RAMR in a sample of 10 hospitals’ report cards, 7 of these information presentation features were identified. Of these, 5 information presentation features improved comprehensibility in a manner reported previously in literature. Conclusions: To our knowledge, this is the first study to systematically analyze the most commonly used public reporting card designs used in Germany. Best-practice evidence identified in international literature was in agreement with 5 findings about German report card designs: (1) avoid tables without symbols, (2) include bar charts with symbols, (3) state explicitly whether high or low values indicate good performance or provide a “good quality” range, (4) avoid incomplete data (N/A given as a value), and (5) rank hospitals by performance. However, these findings are preliminary and should be subject of further evaluation. The implementation of 4 of these recommendations should not present insurmountable obstacles. However, ranking hospitals by performance may present substantial difficulties.

Telefone celular como recurso didático no ensino de física

Currently, there are several factors that suggest the need for the school to review their teaching practices: 1) the speed with which information and communication technologies - ICT are spread throughout society and in particular the increasing use of mobile phone by groups in school age;2) the scope and power of integrating ICT convergence of these technological resources, that can be used as teaching resources; 3) the fact that nowadays students grow up in a technological world and make their thought patterns operating in accordance with this reality, etc... In contrast, there are educators unrelated to the appropriation of ICT, presenting, in many cases, resistance to them. There is a incongruity between how individuals use mobile phones, for example, inside and outside the school. There are also educators, schools, public educational departments claiming to be against mobile phones usage; bills and laws regulating their use in educational space, etc... For these controversial aspects we have investigated whether cell phone use as a teaching resource practices mediator in Physics teaching. For this purpose, we developed an applied research with qualitative and exploratory approach about the objectives, adopting participant and the technical procedures. A documental and bibliographical research was taken. First of all, data were collected by e-mail, through a multiple choice questionnaire applied to private school teachers in southern Brazil, to identify the researched reality and develop teaching practices likely to be applied in the studied corpus. Then, such practices were applied in workshops located in Curitiba and Ponta Grossa cities, in Paraná state. During the application, data was collected by the researcher's field notes. Then, we recorded chats about the workshops from an instant message software (msn messenger), and we took photographic records. Data analysis was performed by triangulation. The results showed the need to enhance continuing education courses for teachers and the production of national academic literature, such as articles, dissertations, theses and books that explore the theme of the cell phone and its functionality in educational spaces as an educational resource mediator in the practices of teaching Physics. They are available in the dissertation defended in 2012, and now are also systematized in this book, organized as a final product of research conducted by the Graduate Program in Science Education and Technology UTFPR, Campus Ponta Grossa-PR.

Study and investigation of the various reactions of Mazandaran Province shoreline against wind waves

Determining of beach states and study of manner sediment transmission in beach profile, involves the evaluating the actions of hydrodynamic forces dominated over the beaches, in this research through determining the beach states by the help of Hanson and short method, different reactions of Mazandaran’s shoreline against wind waves was studied and investigated. For this reason, First, the kind of hydrodynamic forces dominated over the beaches of this province was studied and beaches of the this province was distinguished as wave–dominated beaches, afterwards eight stations are chosen throughout the shoreline and the waves qualities and the sediments regarding to different depth was evaluated in these stations by using software and laboratory actions. In this way the parameter of dimensionless fall velocity each station was calculated and the beach states and their changes according to time was studied. Finally, the gained information is located in the software area of Arc GIS, and the waves dynamics and the way of erosion and accretion was evaluated in each station. In this research by study of air photographs during a thirty years period we found that was no remarkable changes at shoreline in western and central parts and each type of change depends upon the delta, while eastern part of coast at the location of breakwaters in neighbouring of Farahabad Station, accretion features is quiet evident. In the main results of this research, it became obvious that the beach state in the stations Neca, Farahabad, Larim, Naftchal, Mazandaran university, Babolsar, Noor is dissipative and the beach in Nashtarood station is in intermediate (ridge and runnel) state to the extend that in the dissipation beaches from east to west, the degree of dissipation of the beaches is decreased continuously.

Essays on Information Frictions, Prices and Unemployment

I investigate the effects of information frictions in price setting decisions. I show that firms' output prices and wages are less sensitive to aggregate economic conditions when firms and workers cannot perfectly understand (or know) the aggregate state of the economy. Prices and wages respond with a lag to aggregate innovations because agents learn slowly about those changes, and this delayed adjustment in prices makes output and unemployment more sensitive to aggregate shocks. In the first chapter of this dissertation, I show that workers' noisy information about the state of the economy help us to explain why real wages are sluggish. In the context of a search and matching model, wages do not immediately respond to a positive aggregate shock because workers do not (yet) have enough information to demand higher wages. This increases firms' incentives to post more vacancies, and it makes unemployment volatile and sensitive to aggregate shocks. This mechanism is robust to two major criticisms of existing theories of sluggish wages and volatile unemployment: the flexibility of wages for new hires and the cyclicality of the opportunity cost of employment. Calibrated to U.S. data, the model explains 60% of the overall unemployment volatility. Consistent with empirical evidence, the response of unemployment to TFP shocks predicted by my model is large, hump-shaped, and peaks one year after the TFP shock, while the response of the aggregate wage is weak and delayed, peaking after two years. In the second chapter of this dissertation, I study the role of information frictions and inventories in firms' price setting decisions in the context of a monetary model. In this model, intermediate goods firms accumulate output inventories, observe aggregate variables with one period lag, and observe their nominal input prices and demand at all times. Firms face idiosyncratic shocks and cannot perfectly infer the state of nature. After a contractionary nominal shock, nominal input prices go down, and firms accumulate inventories because they perceive some positive probability that the nominal price decline is due to a good productivity shock. This prevents firms' prices from decreasing and makes current profits, households' income, and aggregate demand go down. According to my model simulations, a 1% decrease in the money growth rate causes output to decline 0.17% in the first quarter and 0.38% in the second followed by a slow recovery to the steady state. Contractionary nominal shocks also have significant effects on total investment, which remains 1% below the steady state for the first 6 quarters.

Assessment of a data-limited, multi-species shark fishery in the Great Barrier Reef Marine Park and south-east Queensland

The status of five species of commercially exploited sharks within the Great Barrier Reef Marine Park (GBRMP) and south-east Queensland was assessed using a data-limited approach. Annual harvest rate, U, estimated empirically from tagging between 2011 and 2013, was compared with an analytically-derived proxy for optimal equilibrium harvest rate, UMSY Lim. Median estimates of U for three principal retained species, Australian blacktip shark, Carcharhinus tilstoni, spot-tail shark, Carcharhinus sorrah, and spinner shark, Carcharhinus brevipinna, were 0.10, 0.06 and 0.07 year-1, respectively. Median U for two retained, non-target species, pigeye shark, Carcharhinus amboinensis and Australian sharpnose shark, Rhizoprionodon taylori, were 0.27 and 0.01 year-1, respectively. For all species except the Australian blacktip the median ratio of U/UMSY Lim was <1. The high vulnerability of this species to fishing combined with life history characteristics meant UMSY Lim was low (0.04-0.07 year-1) and that U/UMSY Lim was likely to be > 1. Harvest of the Australian blacktip shark above UMSY could place this species at a greater risk of localised depletion in parts of the GBRMP. Results of the study indicated that much higher catches, and presumably higher U, during the early 2000s were likely unsustainable. The unexpectedly high level of U on the pigeye shark indicated that output-based management controls may not have been effective in reducing harvest levels on all species, particularly those caught incidentally by other fishing sectors including the recreational sector. © 2016 Elsevier B.V.

Field study and numerical simulation of developing red tide in the northern Strait of Hormuz

The catastrophic event of red tide has happened in the Strait of Hormuz, the Persian Gulf and Gulf of Oman from late summer 2008 to spring 2009. With its devastating effects, the phenomenon shocked all the countries located in the margin of the Persian Gulf and the Gulf of Oman and caused considerable losses to fishery industries, tourism, and tourist and trade economy of the region. In the maritime cruise carried out by the Persian Gulf and Gulf of Oman Ecological Research Institute, field data, including temperature, salinity, chlorophyll-a, dissolved oxygen and algal density were obtained for this research. Satellite information was received from MODIS and MERIS and SeaWiFS sensors. Temperature and surface chlorophyll images were obtained and compared with the field data and data of PROBE model. The results obtained from the present research indicated that with the occurrence of harmful algal blooms (HAB), the Chlorophyll-a and the dissolved oxygen contents increased in the surface water. Maximum algal density was seen in the northern coasts of the Strait of Hormuz. Less concentration of algal density was detected in deep and surface offshore water. Our results show that the occurred algal bloom was the result of seawater temperature drop, water circulation and the adverse environmental pollutions caused by industrial and urban sewages entering the coastal waters in this region of the Persian Gulf ,This red tide phenomenon was started in the Strait of Hormuz and eventually covered about 140,000 km2 of the Persian Gulf and total area of Strait of Hormuz and it survived for 10 months which is a record amongst the occurred algal blooms across the world. Temperature and chlorophyll satellite images were proportionate to the measured values obtained by the field method. This indicates that satellite measurements have acceptable precisions and they can be used in sea monitoring and modeling.

Anticancer and antibacterial secondary metabolites from the endophytic fungus Penicillium sp. CAM64 against multi-drug resistant Gram-negative bacteria.

Background: The emergence of multiple-drug resistance bacteria has become a major threat and thus calls for an urgent need to search for new effective and safe anti-bacterial agents. Objectives: This study aims to evaluate the anticancer and antibacterial activities of secondary metabolites from Penicillium sp. , an endophytic fungus associated with leaves of Garcinia nobilis . Methods: The culture filtrate from the fermentation of Penicillium sp. was extracted and analyzed by liquid chromatography– mass spectrometry, and the major metabolites were isolated and identified by spectroscopic analyses and by comparison with published data. The antibacterial activity of the compounds was assessed by broth microdilution method while the anticancer activity was determined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Results: The fractionation of the crude extract afforded penialidin A-C (1-3), citromycetin (4), p-hydroxyphenylglyoxalaldoxime (5) and brefelfin A (6). All of the compounds tested here showed antibacterial activity (MIC = 0.50 – 128 μg/mL) against Gramnegative multi-drug resistance bacteria, Vibrio cholerae (causative agent of dreadful disease cholera) and Shigella flexneri (causative agent of shigellosis), as well as the significant anticancer activity (LC50 = 0.88 – 9.21 μg/mL) against HeLa cells. Conclusion: The results obtained indicate that compounds 1-6 showed good antibacterial and anticancer activities with no toxicity to human red blood cells and normal Vero cells.

The Relationship of Culturally Responsive Instruction and the Reading Comprehension and Attitude of Struggling Urban Adolescent Readers

Culturally responsive instruction refers to the identification of relevant cultural aspects of students’ lives and infusion of these into the curriculum. This instructional approach assumes that a culturally appropriate curriculum can potentially motivate, engage, and lead students to higher rates of achievement. This quasi-experimental study (N=44) investigated the relationship of culturally responsive instruction and the reading comprehension and attitude of struggling urban adolescent readers. The study incorporated the use of culturally responsive instruction using culturally relevant literature (CRL), the Bluford Series Novels, as authentic texts of instruction. Participants were seventh grade reading students at a Title I middle school in South Florida. After a baseline period, two different classes were taught for 8 weeks using different methods. One class formed the experimental group (n=22) and the other class formed the comparison group (n=22). The CRI curriculum for the experimental group embraced the socio-cultural perspective through the use of small discussion groups in which students read and constructed meaning with peers through interaction with the Bluford Series Novels; gave written responses to multiple strategies according to SCRAP – Summarize, Connect, Reflect, Ask Questions, Predict; responded to literal and inferential questions, while at the same time validating their responses through evidence from the text. The Read XL (basal reader) curriculum of the comparison group utilized a traditional form of instruction which incorporated the reading of passages followed by responses to comprehension questions, and teacher-led whole group discussion. The main sources of data were collected from the Gates-MacGinitie Reading Tests, the Florida Assessments for Instruction in Reading (FAIR), and the Rhody Secondary Reading Attitude Assessment. Statistical analyses were performed using Repeated Measures ANOVAs. Findings from the study revealed that the experimental participants’ reading attitudes and FAIR comprehension scores increased when compared to the comparison group. Overall, the results from the study revealed that culturally responsive instruction can potentially foster reading comprehension and a more positive attitude towards reading. However, a replication of this study in other settings with a larger, more randomized sample size and a greater ethnic variation is needed in order to make full generalizations.

Teaching-learning process and teaching methodology in Portuguese for the deaf under the perspective of inclusive education

For years, the discrepancies faced by deaf students in the teaching of the Portuguese language were due to the lack of hearing. Recently, these failures have been attributed to the use of inadequate teaching methodologies and to the lack of communication through Libras between the deaf and the hearers. This article aims at reporting a research study that analyzed the teaching-learning processes from the point of view of a deaf elementary student in Viçosa/MG. The project was primarily developed by a qualitative approach, by utilizing the bibliographical review, the participant observation and the field diary. Results showed the communicative interactions were restrained, since teachers and hearing students were not fluent in Libras, and there was no interpreter available. The methodology was mostly expositive, with a predominance of oral resources. The findings demonstrated the challenges faced by the deaf students are numerous, since the school does not offer the structure to meet their needs, and the teachers do not have the required education to work in an inclusive school environment. This article reports some methodological proposals for the teaching of Portuguese that were elaborated and applied within an inclusive context, all following PCN orientations. It reinforces the need to invest in teacher training to meet the demands of inclusive education to improve the quality of the classes offered to the deaf in regards to the teaching-learning process for Portuguese.

BELIEFS ABOUT ENGLISH LEARNING AND TEACHING IN A TECHNICAL SCHOOL IN THE CITY OF PONTA PORÃ/MS

Abstract: This study is part of my master research, which aimed to investigate the beliefs about  English learning and teaching of students entering to a High School Course integrated to Computer Technician at a Federal High School in the city Ponta Pora / MS , located at the  border  with Paraguay . In the context , great part of the students coming from public schools in the region  had not studied English as a foreign language in elementary school , once it is located  in a region of the border with Paraguay , it offers only Spanish as a foreign language. The interest for this research came up as of conflicting situations between the teacher way of teaching and students ways of learning, especially of those who had not studied English in elementary school. Thus we tried to study the beliefs of these students, analyzing how they process in that context in order to promote reflection of the teacher  to perform actions of intervention in order to reduce the mismatches between the ways of teaching and the ways that the students believe to be the right to learn. Keywords: Beliefs; English Teaching and Learning; Context

LINGUISTICS AND TEACHING: PORTUGUESE LANGUAGE TEACHERS’ TRAINING

This paper aims at investigating how and which theoretical aspects of linguistics are effective for implementing a Letters course directed across the educations of Portuguese language teachers. This study is anchored to a theoretical-methodological perspective of the French discourse analysis which dialogues with the History of Linguistic Ideas. Our analysis is carried out through a documental investigation of a corpus of analysis containing accounts on the Letters course, specifically at UNOCHAPECÓ-SC.