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Medication adherence and its relationship to the therapeutic alliance: Results from an innovative pilot study within a community pharmacy MTM practice
Janice Pringle, PhD.,Michael Melczak, PhD,Arnie Aldridge, MS,Margie Snyder, PharmD, MPH
INNOVATIONS in Pharmacy , 2011,
Abstract: Objectives: To determine whether patients who received Medication Therapy Management (MTM) from community pharmacists using a brief scale to measure Therapeutic Alliance (i.e., MTM + TA) would show better medication adherence than patients whoreceived MTM without use of the TA scale (MTM only). Design: Quasi-experimental, using a direct intervention group (MTM + TA) and a comparison group of randomly selected claims records from patients who received only the MTM service (MTM only). We used a doubly robust propensity score approach to estimate the average effect of therapeutic alliance on medication adherence. The analysis was limited to the following broad medication categories: antihypertensives, antidiabetic agents, and antihyperlipidemics. Setting: The direct intervention group included patients receiving MTM services from pharmacists in a community pharmacy chain setting. Participants: After matching with claims data, the direct intervention group was n=117, with an average age of 76.4. The comparison group was n=146, with an average age of 76.2. Intervention: Administration of two brief scales designed to measure general health outcomes and TA within the context of MTM (with focus on TA scale administration). Main Outcome MeasuresProportion of Days Covered (PDC) and PDC80. Results: Using the therapeutic alliance scales in the context of community pharmacistprovided MTM was associated with a 3.1 percentage point increase in patients’ overall PDC (p<.001) and an increase of 4.6 percentage points in PDC80 (p=.02) as compared to patients receiving MTM without use of the therapeutic alliance scales. Conclusion: Measuring therapeutic alliance in the context of MTM is associated with improved medication adherence and represents one strategy for enhancing the effectiveness of MTM encounters. Furthermore, administration of the therapeutic alliance scales used very little time; therefore it is likely feasible for pharmacists to routinely use the scales in their practice.
An Initial Assessment of the Philippines Preparedness for E-Learning
Arnie Trinidad
Kasarinlan : Philippine Journal of Third World Studies , 2002,
Abstract: Any attempt to institutionalize e-learning will prove futile without first attaining its vital requisites. An initial assessment of the Philippines’ e-learning stature both depicts a glooming and changing scenario. Three crucial domains need further reinvigoration: technology and infrastructure, educational standards and literacy, and government-private sector teamwork. Access to phone lines, computers and the internet cannot substitute to the greater need to develop the academic well-being of Filipino students. E-learning requires higher-order skills and analytical thinking. Raising the quality of training of teachers and students is a must to maximize the promises of Internet technology. The apparent lackluster performance of the Department of Education (DepEd) in providing the basic needs of primary and secondary high schools and the low standard of education seems to be steps backward to this end. Emphasis should be given on raising students’ English language proficiency and ‘digital fluency’. The public sector cannot carry the burden of forming an e-learning society alone. The government’s collaboration with the private sector in programs such as PREGINET, Fit-Ed programs and the ASTI- and PLDT-sponsored project testifies to this truth.
Controlling the cell cycle clock
Susan Aldridge
Genome Biology , 2001, DOI: 10.1186/gb-spotlight-20011017-01
Abstract: The regulation of cell division by the co-ordinated control of the cell cycle clock through its various stages is essential to the healthy functioning of all organisms - from bacteria to humans. Loss of cell cycle control plays an important role in cancer, and its restoration is currently the target of potential new therapeutics.Many of the proteins involved in cell cycle control are already known; in humans, for instance, the cyclin dependent kinases (CDKs) regulate different phases of the cell cycle through reversible phosphorylation that is, in itself, controlled by another group of proteins, known as cyclins. But what has not previously been well understood is how the regulators of the cell cycle are themselves transcriptionally regulated - so the map of the cell cycle has been incomplete.The Whitehead team studied nine cell cycle transcription activators in yeast, each of which was known to be involved in turning on genes needed for specific stages of the cycle. What they found - somewhat to their surprise - was that each of the activators also acted as a bridge to the next stage, turning on transcription of the corresponding regulator involved in the next stage of the cycle. This means that the cell cycle regulators - the 'master switches' - form their own closed circuit ensuring smooth running of the cell cycle clock. The challenge now is to construct a complete map of the cell cycle, including all the levels of control.The current study made use of a new technique for studying DNA-protein binding called genome-wide location analysis, which was developed in Young's lab. This involves fixing DNA-binding proteins to their binding sites in vivo, using chemical cross-linking, and then fishing out protein-bound DNA fragments with antibody-linked magnetic beads following cell cleavage. After unhooking the proteins, the DNA fragments that were bound to the transcription activators were identified by hybridization against a yeast library in an array."We think a key a
Sanger Institute looks to the future
Susan Aldridge
Genome Biology , 2001, DOI: 10.1186/gb-spotlight-20011106-02
Abstract: Funded by the Wellcome Trust - the World's largest biomedical charity - the Institute is a leading player in the Human Genome Project Consortium and was responsible for unravelling one third of the human genome. A 'working draft' of the genome was published earlier this year, but the work goes on - with the finished sequence expected by 2003. The Sanger Institute will build on the genome investment with new research on gene function and control. In the coming year, one third of the Institute's £63.3 million funding is earmarked for new projects. "The funding is a very strong commitment to our work by the Trust," said Deputy Director Richard Durbin. "We believe we can continue to play a major role in the post-genomic era, moving from pure DNA studies to protein. A lot of what we're looking at will retain a strong genetic element, however. We also want to see more projects with the other organisations on the Wellcome campus, such as Ensembl - our project with the European Bioinformatics Institute - which is the only public domain gene database."A major focus will be on cancer genomics, with a search for genetic mutations in the most common cancers - breast, lung, colorectal, ovary and prostate. In the first phase of this research, more than 80 genome abnormalities in cancer cells have been identified; this is expected to lead to the discovery of many new cancer genes, including tumor suppressor genes.Other research will identify genes on the X chromosome, using techniques employed in the Cancer Genome Project. Initially, this will uncover genes involved in X-linked mental retardation, which is one of the most common genetic disorders. Another project will look into the basis of common multiple gene disorders such as diabetes, asthma and other allergies, by analysis of single nucleotide polymorphisms (SNPs) on the human genome map. Many SNPs are linked to disease susceptibility, so this approach should allow researchers to uncover the genetic basis of these conditions.
New era for the European Bioinformatics Institute
Susan Aldridge
Genome Biology , 2001, DOI: 10.1186/gb-spotlight-20010919-01
Abstract: The EBI is located at the Wellcome Trust Genome Campus at Hinxton, Cambridgeshire, a site shared by the Sanger Centre and the UK Medical Research Council Human Genome Mapping Project Resource Centre. It is part of the European Molecular Biology Laboratory (EMBL), an international network of research institutes funded by EU countries, Switzerland and Israel and headquartered in Heidelberg, Germany. In 1980, EMBL established the world's first nucleotide database; EBI has built on this work, creating and maintaining a number of public domain databases covering gene and protein sequences, biological macromolecular structures and, more recently, gene expression data."I see the research being built around these core resources and interacting with them. For example, my own research is very much to do with protein structures, but it goes into sequences and into genomes too. It will make a difference being here with the people developing these resources, who understand what's in them," said Thornton who has been seconded for five years to EBI from her current job as Head of the Birkbeck/UCL Joint Research Bloomsbury Centre for Structural Biology.She also wants to see groups - some headed by researchers with outside funding - in new areas, such as gene expression, transcriptome and proteomics data, as well as evolutionary and phylogenetic aspects. "I am also interested in the link between bioinformatics and chemoinformatics - the small molecules - since biology is not just about the big molecules. At the moment bioinformatics has dealt mostly with single molecules and single genes but the future is clearly about looking at networks of interactions and modelling whole systems and whole animals. The problem of going from genotype to phenotype is one of understanding how all these different things interact and that's the push I think we have to make." She also believes that links with experimental biologists will be critical for taking areas such as functional genomics further.T
Review: Michael Huberman & Matthew B. Miles (Hrsg.) (2002). The Qualitative Researcher's Companion Review: Michael Huberman & Matthew B. Miles (Eds.) (2002). The Qualitative Researcher's Companion Rese a: Michael Huberman & Matthew B. Miles (Eds.) (2002). The Qualitative Researcher's Companion
David Aldridge
Forum : Qualitative Social Research , 2002,
Abstract: Mittlerweile verfügt die qualitative Sozialforschung über ein derart gro es Fundament an Prim rliteratur, dass auch ein stetiges Anwachsen der Sekund rliteratur zu beobachten ist. In diese Kategorie f llt auch – wie der im englischen Titel enthaltene Begriff Companion signalisiert – das hier besprochene Buch. Das Sammelwerk enth lt eine Auswahl wichtiger Beitr ge zu sozialwissenschaftlichen Ans tzen in der qualitativen Forschung. Die Auswahl der einbezogenen Kapitel wurde auf der Basis der beeindruckenden Anzahl von eintausend relevanten Titeln vorgenommen. Das Buch ist in drei Teile gegliedert: Im ersten Teil wird der Frage nachgegangen, wie wir Konzepte konstruieren und Theorien entwickeln, die wiederum das Forschungsdesign beeinflussen. Der zweite Teil besch ftigt sich mit methodologischen Fragen, u.a. mit dem Aufbauen von Glaubwürdigkeit, der Vermeidung von Voreingenommenheit und der Generalisierbarkeit von Forschungsergebnissen im Kontext kleiner Studien. Im dritten Teil werden sechs empirische Studien vorgestellt, denen jeweils verschiedene qualitative Ans tze zugrunde liegen, und die als exemplarisch für eine gute Forschungspraxis gelten k nnen. Das Buch liefert bei einer hohen Qualit t des Schreibstils wertvolle Ressourcen und einige angemessene Beispiele für qualitatives Forschungsdenken und -handeln. URN: urn:nbn:de:0114-fqs0204367 A companion is traditionally a secondary piece of work that accompanies the main texts of a discipline. Qualitative research now has such a foundation of work that we can begin to see the production of secondary literature. This book contains a selection of important writings from the broad literature relating to social science research as it is applied in qualitative research. The selection of included chapters was made from a possible battery of one thousand titles! There are three main sections to the book. Section one is concerned with looking at how we weave concepts together and develop theories that, in turn, influence research design. Section two addresses itself directly to methodological issues focusing, among other matters, on establishing credibility, avoiding bias and generalizing from small-scale studies. Section three takes six empirical studies from varying qualitative approaches and presents them as examples of how to do a qualitative study well. This is a valuable resource book providing some pertinent examples of research thinking and practice. The quality of writing is high. URN: urn:nbn:de:0114-fqs0204367 La investigación social cualitativa posee una gran base de literatura primaria, y se puede o
Adaptive group testing as channel coding with feedback
Matthew Aldridge
Mathematics , 2012, DOI: 10.1109/ISIT.2012.6283596
Abstract: Group testing is the combinatorial problem of identifying the defective items in a population by grouping items into test pools. Recently, nonadaptive group testing - where all the test pools must be decided on at the start - has been studied from an information theory point of view. Using techniques from channel coding, upper and lower bounds have been given on the number of tests required to accurately recover the defective set, even when the test outcomes can be noisy. In this paper, we give the first information theoretic result on adaptive group testing - where the outcome of previous tests can influence the makeup of future tests. We show that adaptive testing does not help much, as the number of tests required obeys the same lower bound as nonadaptive testing. Our proof uses similar techniques to the proof that feedback does not improve channel capacity.
Interference Mitigation in Large Random Wireless Networks
Matthew Aldridge
Mathematics , 2011,
Abstract: A central problem in the operation of large wireless networks is how to deal with interference -- the unwanted signals being sent by transmitters that a receiver is not interested in. This thesis looks at ways of combating such interference. In Chapters 1 and 2, we outline the necessary information and communication theory background, including the concept of capacity. We also include an overview of a new set of schemes for dealing with interference known as interference alignment, paying special attention to a channel-state-based strategy called ergodic interference alignment. In Chapter 3, we consider the operation of large regular and random networks by treating interference as background noise. We consider the local performance of a single node, and the global performance of a very large network. In Chapter 4, we use ergodic interference alignment to derive the asymptotic sum-capacity of large random dense networks. These networks are derived from a physical model of node placement where signal strength decays over the distance between transmitters and receivers. (See also arXiv:1002.0235 and arXiv:0907.5165.) In Chapter 5, we look at methods of reducing the long time delays incurred by ergodic interference alignment. We analyse the tradeoff between reducing delay and lowering the communication rate. (See also arXiv:1004.0208.) In Chapter 6, we outline a problem that is equivalent to the problem of pooled group testing for defective items. We then present some new work that uses information theoretic techniques to attack group testing. We introduce for the first time the concept of the group testing channel, which allows for modelling of a wide range of statistical error models for testing. We derive new results on the number of tests required to accurately detect defective items, including when using sequential `adaptive' tests.
The capacity of Bernoulli nonadaptive group testing
Matthew Aldridge
Statistics , 2015,
Abstract: We consider nonadaptive group testing with Bernoulli tests, where each item is placed in each test independently with some fixed probability. We give a tight threshold on the maximum number of tests required to find the defective set under optimal Bernoulli testing. Achievability is given by a result of Scarlett and Cevher; here we give a converse bound showing that this result is best possible. Our new converse requires three parts: a typicality bound generalising the trivial counting bound, a converse on the COMP algorithm of Chan et al, and a bound on the SSS algorithm similar to that given by Aldridge, Baldassini, and Johnson. Our result has a number of important corollaries, in particular that, in denser cases, Bernoulli nonadaptive group testing is strictly worse than the best adaptive strategies.
Review of: Organizational Spirituality: Commitment, Awareness, Readiness and Engagement (C.A.R.E.) for Organization Development and Transformation: A Case Study of ABC co., Ltd
David Barrett ALDRIDGE
Social Research Reports , 2011,
Abstract: Conducted in Thailand against a backdrop of unique Thai cultural influences and significant demographic, technological as well as political changes, the research and findings provided the peer reviewer with an understanding of organizational spirituality and its importance to a cohesive, high performing organization and also provided insights into the enabling elements of organizational spirituality that the reviewer believes are important for business leaders to understand before undergoing any type of organizational transformation. The reviewer finds this research to be relevant to businesses that are contemplating changes or where leaders which to have a deeper understanding and insight into their organizations.
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