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Fisher K.G.,Carolina Headache Institute | Calhoun A.H.,Carolina Headache Institute | Calhoun A.H.,University of North Carolina at Chapel Hill | Ford S.,Carolina Headache Institute | And 5 more authors.
Postgraduate Medicine

Objective: To identify characteristics of patients who frequently initiate contact with a headache specialty clinic outside of scheduled appointments. Materials and Methods: We scanned records of all telephone calls received during 1 calendar year at an academic headache clinic to identify frequent callers. High-frequency (HF) callers were defined as established patients who initiated calls on ≥ 20 days during the year. We compared these patients with a cohort of established low-frequency (LF) callers who initiated no telephone calls during the same year. Clinic records were analyzed for demographic characteristics, diagnoses, and medication use. Additionally, we administered a questionnaire to clinic physicians and administrative staffquerying their perception of each patient's demands on clinic resources. Results: High-frequency (n = 26) and LF (n = 18) callers did not differ significantly in marital status, ethnicity, diagnosis, or age. There was a trend toward female gender among HF callers and toward being outside of a body mass index range of 19 to 30 kg/m2. The groups were similar in their use of triptans and botulinum toxin treatments, but HF callers were more likely to be opioid users (96% vs 11.1%) and more likely to be taking multiple opioids in substantially higher potency, dosage, and quantity (154.4 mg vs 1.4 mg morphine equivalents/day). More than 80% of each group were migraineurs, but HF callers were more likely to have comorbid psychiatric disorders (P < 0.05). High-frequency callers were also more likely to be rated by administrative staffand physicians as demanding and time-consuming. Conclusions: In this university-based headache specialty clinic, HF callers were more likely to be opioid users on high morphine-equivalent doses. Compared with LF callers, HF callers placed a greater burden on health care resources as perceived by staffand physicians. © Postgraduate Medicine. Source

Niemi D.,Kaplan Inc. | Gitin E.,Kaplan University
IADIS International Conference on Cognition and Exploratory Learning in Digital Age, CELDA 2012

An underlying theme of this paper is that it can be easier and more efficient to conduct valid and effective research studies in online environments than in traditional classrooms. Taking advantage of the "big data" available in an online university, we conducted a study in which a massive online database was used to predict student successes and failures. We found that a pattern of declining performance over time is a good predictor of the likelihood of dropping out, and that having dependents or being married or in the military reduces the risk of dropping out. The risk of dropping out was higher for older students, females, and students with previous college education or transfer credits. These results provide a foundation for testing interventions to help students who are at risk and will also help to inform the development of a "research pipeline" that will enable rapid experimental studies of new tools and strategies. Source

Mahgoub S.O.,Kaplan University | Sabone M.,University of Botswana | Jackson J.,University of Botswana
South African Journal of Clinical Nutrition

Objectives: Data on the glycaemic index (GI) of foods commonly consumed in Botswana are lacking. The present study aimed to evaluate the GI of some of the staple carbohydrate-rich foods eaten in Botswana. Design, setting and subjects: Fifty university student volunteers were divided into five groups. Members of each group consumed different test foods based on wheat, maize, sorghum, millet and morama beans to supply 50 g of available carbohydrate after 10-12 hours of overnight fasting. GI was determined using a standard method with white bread. Outcome measures: The GI values were calculated after measuring blood glucose levels before and after ingestion at 0, 15, 30, 45, 60, 90 and 120 minutes. Results: The results showed a clear variation in the GI values for the same food when consumed by different individuals. In addition, variations were observed in the GI values of test foods based on the same material. On average, wheat-based foods exhibited the highest GI values (103.1), followed by millet-based foods (95.3), sorghum-based foods (92.5), maize-based foods (9.1) and morama-based foods (86.4). Of the tested food, mapakiwa (wheat-based) had the highest GI (110.6) whereas roasted morama had the lowest GI (82.8). Conclusion: These results could form the basis of dietary advice to consumers, and particularly patients with diabetes. Further studies are needed on more of the commonly consumed foods in Botswana. © SAJCN. Source

Knapp S.,Kaplan University
International Journal of Health Care Quality Assurance

Purpose – The purpose of this paper is to examine the relationship between four organizational cultural types defined by the Competing Values Framework and three Lean Six Sigma implementation components – management involvement, use of Lean Six Sigma methods and Lean Six Sigma infrastructure. Design/methodology/approach – The study involved surveying 446 human resource and quality managers from 223 hospitals located in Maine, New Hampshire, Vermont, Massachusetts and Rhode Island using the Organizational Culture Assessment Instrument. Findings – In total, 104 completed responses were received and analyzed using multivariate analysis of variance. Follow-up analysis of variances showed management support was significant, F(3, 100)=4.89, p<0.01, η2=1.28; infrastructure was not significant, F(3, 100)=1.55, p=0.21, η2=0.05; and using Lean Six Sigma methods was also not significant, F(3, 100)=1.34, p=0.26, η2=0.04. Post hoc analysis identified group and development cultures having significant interactions with management support. Practical implications – The relationship between organizational culture and Lean Six Sigma in hospitals provides information on how specific cultural characteristics impact the Lean Six Sigma initiative key components. This information assists hospital staff who are considering implementing quality initiatives by providing an understanding of what cultural values correspond to effective Lean Six Sigma implementation. Originality/value – Managers understanding the quality initiative cultural underpinnings, are attentive to the culture-shared values and norm’s influence can utilize strategies to better implement Lean Six Sigma. © 2015, Emerald Group Publishing Limited. Source

Ferebee S.,Kaplan University | Davis J.,University of Phoenix
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)

An increasing body of information is being assembled to understand how persuasive technology can be applied to develop successful persuasive health systems. Both technology and human issues contribute to reduced success of some persuasive systems. Neuroscience research has opened the door to improved understanding of how humans process information during attitude formation, attitude change, and during persuasion attempts. This article presents the Neural Persuasion Model, which delves more deeply into the human component of persuasion. The model draws on current neuroscience research and theories of neural readiness and neural organization to suggest ways in which understanding the neural activity of the brain might close the gap between persuasive technology design and behavioral outcomes, particularly for addiction recovery and other circumstances where neural disorder exists. © 2012 Springer-Verlag. Source

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