Implementing electronic lab order entry management in hospitals: Incremental strategies lead to better productivity outcomes

This paper evaluates the impact of varying implementation of electronic lab order entry management (eLAB) system strategies on hospitals’ productivity in the short run. Using the American Hospital Association's Annual Surveys for 2005–2008, we developed hospital productivity measures to assess facilities’ relative performances upon implementing eLAB systems. The results indicate that different eLAB system implementation strategies were systematically related to changes in hospitals’ relative productivity levels over the years studied. Hospitals that partially implemented an eLAB system without completing the roll-out experienced negative impacts on productivity. The greatest loss in short-term productivity was experienced by facilities that moved from having no eLAB system to a complete implantation in one year—a strategy called the “Big Bang”. The hybrid approach of a limited introduction in one period followed by complete roll-out in the next year was the only eLAB system implementation strategy associated with significant productivity gains. Our findings support a very specific strategy for eLAB system implementation where facilities began with a one-year pilot program immediately followed by an organization-wide implementation effort in the next period.     

Life and Honorary Members

Abstract

The relative importance of body size, body composition, cardiovascular-respiratory capacity, and running speed in determining individual differences in performance on 600-yd run and mile run tests was investigated using data on 196 children, ages 7 to 12 years. A multivariate, multistage path model was developed in which height, % fat, [Vdot]O₂ max (ml/kg FFW · min) and the 50-yd dash time were postulated as determinants of individual differences on the two distance-running tests. These four independent variables accounted for 71% and 66% of the variance in the 600-yd run and mile run, respectively. All four independent variables had significant associations with the two distance runs when the influence of the other independent variables was taken into account. The 50-yd dash time and % fat were found to be the most important determinants of both distance runs. It was concluded that determinants of the 600-yd run and mile run in elementary-school-age children are complex and that individual differences on these tests reflect a number of attributes in addition to cardiovascular-respiratory capacity.     

Effects of sensory-level high-volt pulsed electrical current ondelayed-onset muscle soreness

Abstract

Ten healthy males and ten healthy females aged 21.5 ± 3.2 years (mean ± s) participated in the study, which was designed to evaluate the effectiveness of sensory level-high volt pulsed electrical current (HVPC) on delayed-onset muscle soreness (DOMS). Arm discomfort, elbow extension range of motion and isometric elbow flexion strength were obtained as baseline measurements. Delayed-onset muscle soreness was induced in the participants' dominant or non-dominant arm using two sets of 20 maximal eccentric elbow flexion contractions. After the induction of DOMS, the participants were randomly divided into an experimental condition (HVPC) or a placebo condition. The experimental condition consisted of 20 min of HVPC immediately after the induction of DOMS, and 20 min every 24 h for three consecutive days thereafter. The participants in the placebo condition received an intervention similar in design; however, no electrical current was administered. Baseline measurements were reevaluated at 24, 48, 72 and 96 h after the induction of DOMS. Three weeks later, the participants returned and the protocol was repeated on the contralateral limb, using the opposite intervention (HVPC or placebo). Repeated-measures analysis of variance revealed a significant increase in overall arm discomfort, decrease in elbow extension and decrease in isometric strength for both conditions over time. No significant main effect of treatment, or time-by-treatment interaction, was found for the HVPC condition when compared with the placebo condition for any variable. Sensory-level HVPC, as utilized in our application, was ineffective in reducing the measured variables associated with DOMS.     

Participant Perceptions of Exercise Programs for Overweight Women

Abstract

Eighteen women participated in a research project involving two phases: (a) an interview regarding weight history and exercise patterns, and (b) a series of exercise sessions followed by discussions of participants' reactions to them. The data were analyzed using inductive analysis techniques, and results of the analysis were discussed with participants for collaborative validation of the interpretation. Profiles of selected participants and themes that emerged are described. The participants varied in age and body size and had diverse backgrounds, interests, and abilities, but their shared experience of social disapproval based on body size was shown to affect their perceptions of exercise programs and their decisions about participation.     

Reliability of a 5-m multiple shuttle test

The aim of the present study was to determine the reliability of a modified 5-m multiple shuttle test. The ‘matchrelated fitness’ of 23 female hockey players was assessed on four occasions within 4 weeks. The results of each test session and each shuttle were analysed using analysis of variance with repeated measures to determine the reliability of the test. The mean distance for each of the six shuttles decreased (121.2 ? 7.5, 114.5 ? 7.5, 112.2 ? 7.5, 109.9 ? 7.9, 108.4 ? 8.1 and 108.7 ? 8.3 m for shuttles 1-6, respectively; P < 0.001) similarly for each of the four sessions (P = 0.99). The total and peak distances covered during the tests were not significantly different (P = 0.99 and P = 0.12, respectively). The intra-class correlation coefficient (R) for these variables was 0.98 and 0.86, respectively. The delta distance and the fatigue index calculated post-test were significantly different (P = 0.001 and P = 0.006, respectively) between the four sessions. The intra-class correlation coefficient for both these variables was 0.74. Heart rate and rating of perceived exertion (RPE) were not significantly different between sessions (P = 0.42 and P = 0.095, respectively). The intra-class correlation coefficient for heart rate ranged from 0.65 to 0.97 and that for RPE from 0.85 to 0.91. We conclude that the 5-m multiple shuttle run test is a reliable measure of total and peak distances, heart rate and RPE response and is sufficiently reliabile to track changes in fitness over a season. The delta distance and fatigue index are not as reliable and should be interpreted with caution.     

Variance and Invariance in Expert and Novice Triple Junipers

Abstract

The purpose of this study was to examine relative timing, relative distance, and effector independence characteristics of the triple jump. We videotaped expert and novice triple jumpers using standing and running starts. On some trials, the triple jumpers were required to take off from their nondominant leg. Gentner's (1987) interaction test was used to assess the proportional duration model in describing the timing of the component submovements. For both experts and novices, the proportional durations varied with the type of start. For experts, the relative timing of the jump components was independent of the take-off leg. The findings were mixed for the novices. Similar results were obtained when relative distance was examined. These results are discussed with respect to constructs related to variability in skilled performance.     

An explanation of reading comprehension across development using models from Cattell–Horn–Carroll theory: Support for integrative models of reading

The purpose of this research was to investigate the cognitive abilities that explain reading comprehension across childhood and early adulthood. Drawing from the standardization sample of the Woodcock–Johnson III, analyses were conducted with large samples at age levels spanning early childhood to early adulthood: 5 to 6 (n = 639), 7 to 8 (n = 720), 9 to 13 (n = 1,995), 14 to 19 (n = 1,615), and 20 to 39 (n = 1,409). Using a model including factors representing general intelligence, Cattell–Horn–Carroll broad abilities, and reading decoding skills, results revealed significant direct effects for reading decoding skills and Crystallized Intelligence on reading comprehension across all age levels. Memory‐related abilities, processing speed, and auditory processing demonstrated indirect effects on reading comprehension through reading decoding skills. The magnitude of direct and indirect effects varied as a function of age. The results provide support for integrative models of reading that include both direct and indirect effects of cognitive abilities on reading comprehension and for consideration of developmental differences in the cognitive aptitudes predicting reading comprehension. © 2012 Wiley Periodicals, Inc.     

Reaching the non-traditional stopout population: a segmentation approach

An estimated 21% of 25–34-year-olds in the United States, about eight million individuals, have attended college and quit before completing a degree. These non-traditional students may or may not return to college. Those who return to college are referred to as stopouts, whereas those who do not return are referred to as stayouts. In the face of declining pools of traditional students, colleges and universities have attempted to induce these students to return to higher education. Regrettably, little is known about the intentions and attitudes of these young adults after they have left higher education. This paper uses segmentation and targeting to identify those students who intend to return to college and those who do not. Using demographic and psychographic variables, five unique segments are identified. The study recommends strategies for reaching those segments which are most likely to return to higher education.     

Cross-Cultural Field Experiences in Alaska Native Villages: Implications for Culturally Responsive Teacher Education

The purpose of this article was to examine a cross-cultural field experience initiative that placed preservice teacher candidates in Alaska Native Village schools. The qualitative study explored 53 candidates' experiences and perceptions of schooling to construct a portrait of the sociocultural context of education in Alaska Native Villages and consider implications for designing a culturally responsive teacher education program. Findings revealed two major themes: (1) schools were spaces for teaching Alaska Native cultural traditions and languages and (2) schools were sites of separation where many White teachers were separated from the communities, applied a deficit orientation to student learning, and implemented curriculum disconnected from the local culture. Based on these findings, three key components for designing a culturally responsive teacher education curriculum were identified: (1) culturally responsive conceptual framework, (2) critical sociocultural consciousness, and (3) engagement with culturally relevant epistemology and knowledge.     

Alignment as a Teacher Variable

Essay scores generated by machine and by human raters are generally comparable; that is, they can produce scores with similar means and standard deviations, and machine scores generally correlate as highly with human scores as scores from one human correlate with scores from another human. Although human and machine essay scores are highly related on average, this does not eliminate the possibility that machine and human scores may differ significantly for certain gender, ethnic, or country groups. Such differences were explored with essay data from two large-scale high-stakes testing programs: the Test of English as a Foreign Language and the Graduate Record Examination. Human and machine scores were very similar across most subgroups, but there were some notable exceptions. Policies were developed so that any differences between humans and machines would have a minimal impact on final reported scores.