Use of the DACUM process in the identification and verification of competencies for the medical administrative assistant

Medicine has changed in recent years. Medicare will all of its rules and regulations, worker's compensation laws, managed care and the trend toward more and larger group practices all contributed to the creation of an extremely structured regulatory environment which in turn demanded highly trained medical administrative assistants.^ The researcher noted three primary problems in the identification of competencies for the medical administrative assistant position: A lack of curricula, diverse roles, and a complex environment which has undergone radical change in recent years and will continue to evolve. Therefore, the purposes of the study were to use the DACUM process to develop a relevant list of competencies required by the medical administrative assistant practicing in physicians' offices in South Florida; determine the rank order of importance of each competency using a scale of one to five; cross-validate the DACUM group scores with a second population who did not participate in the DACUM process; and establish a basis for a curriculum framework for an occupational program.^ The DACUM process of curriculum development was selected because it seemed best suited to the need to develop a list of competencies for an occupation for which no programs existed. A panel of expert medical office administrative staff was selected to attend a 2-day workshop to describe their jobs in great detail. The panel, led by a trained facilitator, listed major duties and the respective tasks of their job. Brainstorming techniques were used to develop a consensus.^ Based upon the DACUM workshop, a survey was developed listing the 8 major duties and 71 tasks identified by the panel. The survey was mailed to the DACUM group and a second, larger population who did not participate in the DACUM. The survey results from the two groups were then compared. The non-DACUM group validated all but 3 of the 71 tasks listed by the DACUM panel. Because the three tasks were rated by the second group as at least "somewhat important" and rated "very important" by the DACUM group, the researcher recommended the inclusion of all 71 tasks in program development for this occupation. ^

The Validity of Broad and Narrow Personality Traits For Predicting Job Performance: The Differential Effects of Time

Research into the dynamicity of job performance criteria has found evidence suggesting the presence of rank-order changes to job performance scores across time as well as intraindividual trajectories in job performance scores across time. These findings have influenced a large body of research into (a) the dynamicity of validities of individual differences predictors of job performance and (b) the relationship between individual differences predictors of job performance and intraindividual trajectories of job performance. In the present dissertation, I addressed these issues within the context of the Five Factor Model of personality. The Five Factor Model is arranged hierarchically, with five broad higher-order factors subsuming a number of more narrowly tailored personality facets. Research has debated the relative merits of broad versus narrow traits for predicting job performance, but the entire body of research has addressed the issue from a static perspective -- by examining the relative magnitude of validities of global factors versus their facets. While research along these lines has been enlightening, theoretical perspectives suggest that the validities of global factors versus their facets may differ in their stability across time. Thus, research is needed to not only compare the relative magnitude of validities of global factors versus their facets at a single point in time, but also to compare the relative stability of validities of global factors versus their facets across time. Also necessary to advance cumulative knowledge concerning intraindividual performance trajectories is research into broad vs. narrow traits for predicting such trajectories. In the present dissertation, I addressed these issues using a four-year longitudinal design. The results indicated that the validities of global conscientiousness were stable across time, while the validities of conscientiousness facets were more likely to fluctuate. However, the validities of emotional stability and extraversion facets were no more likely to fluctuate across time than those of the factors. Finally, while some personality factors and facets predicted performance intercepts (i.e., performance at the first measurement occasion), my results failed to indicate a significant effect of any personality variable on performance growth. Implications for research and practice are discussed.

Longitudinal evaluation of quality of life in 288 patients with Neurofibromatosis 2

Advances in molecular biology have resulted in novel therapy for neurofibromatosis 2-related (NF2) tumours, highlighting the need for robust outcome measures. The disease-focused NF2 impact on quality of life (NFTI-QOL) patient questionnaire was assessed as an outcome measure for treatment in a multi-centre study. NFTI-QOL was related to clinician-rated severity (ClinSev) and genetic severity (GenSev) over repeated visits. Data were evaluated for 288 NF2 patients (n = 464 visits) attending the English national NF2 clinics from 2010 to 2012. The male-to-female ratio was equal and the mean age was 42.2 (SD 17.8) years. The analysis included NFTI-QOL eight-item score, ClinSev graded as mild, moderate, or severe, and GenSev as a rank order of the number of NF2 mutations (graded as mild, moderate, severe). The mean (SD) 8.7 (5.4) score for NFTI-QOL for either a first visit or all visits 9.2 (5.4) was similar to the published norm of 9.4 (5.5), with no significant relationships with age or gender. NFTI-QOL internal reliability was good, with a Cronbach’s alpha score of 0.85 and test re-test reliability r = 0.84. NFTI related to ClinSev (r = 0.41, p < 0.001; r = 0.46 for all visits), but weakly to GenSev (r = 0.16, p < 0.05; r = 0.15 for all visits). ClinSev related to GenSev (r = 0.41, p < 0.001; r = 0.42 for all visits). NFTI-QOL showed a good reliability and ability to detect significant longitudinal changes in the QOL of individuals. The moderate relationships of NFTI-QOL with clinician- and genetic-rated severity suggest that NFTI-QOL taps into NF2 patient experiences that are not encompassed by ClinSev rating or genotype.

Usage-Based versus Measure-Based Unit Pricing: Is There a Better Index of Value?

In many product categories, unit prices facilitate price comparisons across brands and package sizes; this enables consumers to identify those products that provide the greatest value. However in other product categories, unit prices may be confusing. This is because there are two types of unit pricing, measure-based and usage-based. Measure-based unit prices are what the name implies; price is expressed in cents or dollars per unit of measure (e.g. ounce). Usage-based unit prices, on the other hand, are expressed in terms of cents or dollars per use (e.g., wash load or serving). The results of this study show that in two different product categories (i.e., laundry detergent and dry breakfast cereal), measure-based unit prices reduced consumers’ ability to identify higher value products, but when a usage-based unit price was provided, their ability to identify product value was increased. When provided with both a measure-based and a usage-based unit price, respondents did not perform as well as when they were provided only a usage-based unit price, additional evidence that the measure-based unit price hindered consumers’ comparisons. Finally, the presence of two potential moderators, education about the meaning of the two measures and having to rank order the options in the choice set in terms of value before choosing, did not eliminate these effects.

Community reintegration and related factors in a Nigerian stroke sample.

Background: The goal of stroke rehabilitation has shifted from mere survival of a victim to how well a survivor can be effectively reintegrated back into the community. Objectives: The present study determined the level of satisfaction with community reintegration (CR) and related factors among Nigerian community-dwelling stroke survivors (CDSS). Methods: This was a cross-sectional survey of 71 volunteering CDSS (35 males, 36 females) from selected South-Eastern Nigerian communities. Reintegration to Normal Living Index was used to assess participants’ CR. Data was analysed using Spearman rank-order correlation, Kruskal-Wallis and Mann-Whitney U tests at p≤0.05. Results: Participants generally had deficits in CR which was either mild/moderate (52.1%) or severe (47.9%). Scores in the CR domains of distance mobility, performance of daily activities, recreational activities and family roles were particularly low (median scores ≤ 4). CR was significantly correlated with and influenced by age (r=-0.35; p=0.00) and presence/absence of diabetes mellitus (u=3.56.50; p=0.01), pre- (k=6.13; p=0.05) and post-stroke employment (k=18.26; p=0.00) status, type of assistive mobility device being used (AMD) (k=25.39; p=0.00) and support from the community (k=7.15; p=0.03) respectively. Conclusion: CR was generally poor for this CDSS sample. Survivors who are older, having diabetes as co-morbidity, using AMD (particularly wheel-chair) and without employment pre- and/or post-stroke may require keener attention. Rehabilitation focus may be targeted at enhancing mobility functions, vocational and social skills.

A Direct Algorithm for the Type Interference in the Rank 2 Fragment of the Second--Order λ-Calculus

We study the problem of type inference for a family of polymorphic type disciplines containing the power of Core-ML. This family comprises all levels of the stratification of the second-order lambda-calculus by "rank" of types. We show that typability is an undecidable problem at every rank k ≥ 3 of this stratification. While it was already known that typability is decidable at rank ≤ 2, no direct and easy-to-implement algorithm was available. To design such an algorithm, we develop a new notion of reduction and show how to use it to reduce the problem of typability at rank 2 to the problem of acyclic semi-unification. A by-product of our analysis is the publication of a simple solution procedure for acyclic semi-unification.

Validation of order rank scales based on compositional data analysis: a proposal

Usually, psychometricians apply classical factorial analysis to evaluate construct validity of order rank scales. Nevertheless, these scales have particular characteristics that must be taken into account: total scores and rank are highly relevant

Stakes and motivation in tournaments : playing when there is nothing to play for but pride

Tournaments are an effective means of incentivising participants to ensure an optimal level of effort. However, situations can occur in tournaments where the final outcome of a given competitor does not depend on his/her future performance. Specifically, we study these specific situations in a data set of the group stages of European football club competitions from 1992 to 2009. We identify situations where teams are already sure to finish either first or last at the penultimate stage in the group. We show that such situations affect team performance in the last match, typically decreasing the performance of a team sure to finish first and increasing the performance of a team sure to finish last. The first finding is in line with the economic predictions yet provides interesting implications, namely that the schedule of the match order plays a significant role in the overall performance of the team. The second, counter-intuitive, finding is not well accommodated into the existing economics framework and thus we discuss two alternative explanations, one based on social pressure and the other on pride.

A framework for a dense matching algorithm : Results using matching metrics and order statistic filters

An algorithm for computing dense correspondences between images of a stereo pair or image sequence is presented. The algorithm can make use of both standard matching metrics and the rank and census filters, two filters based on order statistics which have been applied to the image matching problem. Their advantages include robustness to radiometric distortion and amenability to hardware implementation. Results obtained using both real stereo pairs and a synthetic stereo pair with ground truth were compared. The rank and census filters were shown to significantly improve performance in the case of radiometric distortion. In all cases, the results obtained were comparable to, if not better than, those obtained using standard matching metrics. Furthermore, the rank and census have the additional advantage that their computational overhead is less than these metrics. For all techniques tested, the difference between the results obtained for the synthetic stereo pair, and the ground truth results was small.

Order statistic filters for image matching

The rank and census are two filters based on order statistics which have been applied to the image matching problem for stereo pairs. Advantages of these filters include their robustness to radiometric distortion and small amounts of random noise, and their amenability to hardware implementation. In this paper, a new matching algorithm is presented, which provides an overall framework for matching, and is used to compare the rank and census techniques with standard matching metrics. The algorithm was tested using both real stereo pairs and a synthetic pair with ground truth. The rank and census filters were shown to significantly improve performance in the case of radiometric distortion. In all cases, the results obtained were comparable to, if not better than, those obtained using standard matching metrics. Furthermore, the rank and census have the additional advantage that their computational overhead is less than these metrics. For all techniques tested, the difference between the results obtained for the synthetic stereo pair, and the ground truth results was small.

Application of higher-order spectra for automated grading of diabetic maculopathy

Diabetic macular edema (DME) is one of the most common causes of visual loss among diabetes mellitus patients. Early detection and successive treatment may improve the visual acuity. DME is mainly graded into non-clinically significant macular edema (NCSME) and clinically significant macular edema according to the location of hard exudates in the macula region. DME can be identified by manual examination of fundus images. It is laborious and resource intensive. Hence, in this work, automated grading of DME is proposed using higher-order spectra (HOS) of Radon transform projections of the fundus images. We have used third-order cumulants and bispectrum magnitude, in this work, as features, and compared their performance. They can capture subtle changes in the fundus image. Spectral regression discriminant analysis (SRDA) reduces feature dimension, and minimum redundancy maximum relevance method is used to rank the significant SRDA components. Ranked features are fed to various supervised classifiers, viz. Naive Bayes, AdaBoost and support vector machine, to discriminate No DME, NCSME and clinically significant macular edema classes. The performance of our system is evaluated using the publicly available MESSIDOR dataset (300 images) and also verified with a local dataset (300 images). Our results show that HOS cumulants and bispectrum magnitude obtained an average accuracy of 95.56 and 94.39 % for MESSIDOR dataset and 95.93 and 93.33 % for local dataset, respectively.

Molecular orientational order of nitroxide radicals in liquid crystalline media

The orientational distribution of a set of stable nitroxide radicals in aligned liquid crystals 5CB (nematic) and 8CB (smectic A) was studied in detail by numerical simulation of EPR spectra. The order parameters up to the 10th rank were measured. The directions of the principal orientation axes of the radicals were determined. It was shown that the ordering of the probe molecules is controlled by their interaction with the matrix molecules more than the inherent geometry of the probes themselves. The rigid fused phenanthrene-based (A5) and 2-azaphenalene (A4) nitroxides as well as the rigid core elongated C11 and 5α-cholestane (CLS) nitroxides were found to be most sensitive to the orientation of the liquid crystal matrixes.

Rank regression analysis of correlated water quality data from South East Queensland

With growing population and fast urbanization in Australia, it is a challenging task to maintain our water quality. It is essential to develop an appropriate statistical methodology in analyzing water quality data in order to draw valid conclusions and hence provide useful advices in water management. This paper is to develop robust rank-based procedures for analyzing nonnormally distributed data collected over time at different sites. To take account of temporal correlations of the observations within sites, we consider the optimally combined estimating functions proposed by Wang and Zhu (Biometrika, 93:459-464, 2006) which leads to more efficient parameter estimation. Furthermore, we apply the induced smoothing method to reduce the computational burden. Smoothing leads to easy calculation of the parameter estimates and their variance-covariance matrix. Analysis of water quality data from Total Iron and Total Cyanophytes shows the differences between the traditional generalized linear mixed models and rank regression models. Our analysis also demonstrates the advantages of the rank regression models for analyzing nonnormal data.

Standard errors and covariance matrices for smoothed rank estimators

A 'pseudo-Bayesian' interpretation of standard errors yields a natural induced smoothing of statistical estimating functions. When applied to rank estimation, the lack of smoothness which prevents standard error estimation is remedied. Efficiency and robustness are preserved, while the smoothed estimation has excellent computational properties. In particular, convergence of the iterative equation for standard error is fast, and standard error calculation becomes asymptotically a one-step procedure. This property also extends to covariance matrix calculation for rank estimates in multi-parameter problems. Examples, and some simple explanations, are given.