scholarly journals Can Understanding Provider Expectations Improve Provider Adoption of Patient Reported Outcomes?

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0025
Author(s):  
Jeff Houck ◽  
Jillian Santer ◽  
Kostantinos Vasalos ◽  
Judith Baumhauer
Keyword(s):  
High Performance ◽  
Physical Therapist ◽  
Clinical Care ◽  
Improve Patient Care ◽  
Chi Square ◽  
Performance Expectancy ◽  
Orthopedic Rehabilitation ◽  
Patient Reported ◽  
Effort Expectancy ◽  
Chi Square Analysis

Category: Other Introduction/Purpose: New instruments like the Patient Reported Outcome Information System (PROMIS) minimize the burden to patients and providers addressing significant barriers to adoption. Despite these advances provider adoption remains lackluster. Models of technology adoption suggest adoption is more likely to occur when PRO’s directly improve patient care (performance expectancy) and it’s easy to implement (effort expectancy). Problems with effort expectancy are dealt with by training and improving logistics (i.e. eHR presentation, alerts), where performance expectancy is addressed through research (i.e. validation of thresholds). The purposes of this study were to: 1) evaluate the proportion of orthopedic rehabilitation providers who use PRO’s and how they use them; And, 2) to determine if performance expectancy, effort expectancy or provider burnout are related to provider use. Methods: Fifty rehabilitation providers (physical therapist and athletic trainers) anonymously completed the electronic PRO Adoption Survey. Participants were 23.4±5.8 years old and 54% were female. The purpose of the PRO Adoption Survey is to track adoption across health systems. The first section of the PRO Adoption survey includes whether providers use PRO’s and asks them to detail how they use them (Table 1). A factor analysis supported the use of sets of questions to determine performance expectancy and effort expectancy (Table 1). Performance expectancy captures the health benefits the provider expects to experience. Effort expectancy captures the provider’s expectations of how easy it will be to implement PRO tools. The validated Maslach-2 burnout scale (BO) was included as another a factor that may influence adoption. Proportions and chi square tests were used to describe provider use of PRO’s and its relationship with performance expectancy, effort expectancy, and burnout. Results: The profile of PRO use by rehabilitation professionals is that a majority know about PRO’s (86%) however only 34% utilize PRO’s during clinic visits (Table 1). The most common PRO used is PROMIS (83%), followed by generic measures (41%) and disease specific (29%) measures. Type of use indicated the most common use was to make clinical decisions (71%) with relatively few using it for research (12%). Interestingly, 47% of PRO users review data with patients. The average responses for performance expectancy were 3.9 ± 0.1. The average responses for effort expectancy were 3.2 ± 0.2 or “neutral”. The average BO score was 4.6 ± 1.0. Chi square analysis suggested performance expectancy, effort expectancy, and burn out were not significantly associated with provider use. Conclusion: PROMIS scales are currently available in the electronic medical record(eMR) leading to high use (86%) by current PRO users (34%). High performance expectancy scores (~4/5) and low BO suggest providers can be motivated to use PRO’s. However, providers are neutral (~3/5) on how easy PRO’s would be to implement. Also, lower scores for performance expectancy associated with “aggregate” PRO data (only 54% marked “Agree” for this item) suggests training on specific uses of aggregate data are also indicated. These data detail the real issues providers need addressed to effectively capitalize on the benefits of PRO’s to improve clinical care.

scholarly journals Does Identifying Provider Expectations Improve Adoption of Patient Reported Outcomes?

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0025
Author(s):  
Jeff Houck ◽  
Jillian Santer ◽  
Judith Baumhauer
Keyword(s):  
High Performance ◽  
Physical Therapist ◽  
Clinical Care ◽  
Improve Patient Care ◽  
Chi Square ◽  
Performance Expectancy ◽  
Orthopedic Rehabilitation ◽  
Patient Reported ◽  
Effort Expectancy ◽  
Chi Square Analysis

Category: Other Introduction/Purpose: New instruments like the Patient Reported Outcome Information System (PROMIS) minimize the burden to patients and providers addressing significant barriers to adoption. Despite these advances provider adoption remains lackluster. Models of technology adoption suggest adoption is more likely to occur when PRO’s directly improve patient care (performance expectancy) and it’s easy to implement (effort expectancy). Problems with effort expectancy are dealt with by training and improving logistics (i.e. eHR presentation, alerts), where performance expectancy is addressed through research (i.e. validation of thresholds). The purposes of this study were to: 1) evaluate the proportion of orthopedic rehabilitation providers who use PRO’s and how they use them; And, 2) to determine if performance expectancy, effort expectancy or provider burnout are related to provider use. Methods: Fifty rehabilitation providers (physical therapist and athletic trainers) anonymously completed the electronic PRO Adoption Survey. Participants were 23.4±5.8 years old and 54% were female. The purpose of the PRO Adoption Survey is to track adoption across health systems. The first section of the PRO Adoption survey includes whether providers use PRO’s and asks them to detail how they use them (Table 1). A factor analysis supported the use of sets of questions to determine performance expectancy and effort expectancy (Table 1). Performance expectancy captures the health benefits the provider expects to experience. Effort expectancy captures the provider’s expectations of how easy it will be to implement PRO tools. The validated Maslach-2 burnout scale (BO) was included as another a factor that may influence adoption. Proportions and chi square tests were used to describe provider use of PRO’s and its relationship with performance expectancy, effort expectancy, and burnout. Results: The profile of PRO use by rehabilitation professionals is that a majority know about PRO’s (86%) however only 34% utilize PRO’s during clinic visits (Table 1). The most common PRO used is PROMIS (83%), followed by generic measures (41%) and disease specific (29%) measures. Type of use indicated the most common use was to make clinical decisions (71%) with relatively few using it for research (12%). Interestingly, 47% of PRO users review data with patients. The average responses for performance expectancy were 3.9 ± 0.1. The average responses for effort expectancy were 3.2 ± 0.2 or “neutral”. The average Maslach BO score was 4.6 ± 1.0. Chi square analysis suggested performance expectancy, effort expectancy, and burn out were not significantly associated with provider use. Conclusion: PROMIS scales are currently available in the electronic medical record leading to high use (83%) by PRO users(34%). High performance expectancy scores (~4/5) and low BO suggest providers can be motivated to use PRO’s. The survey also suggests that providers are neutral(~3/5) on how easy PRO’s would be to implement. Lower scores for performance expectancy associated with “aggregate” PRO data (only 54% marked “Agree” for this item) suggests training on specific uses of aggregate data are also indicated. These data detail the real issues providers need addressed to effectively capitalize on the benefits of PRO’s to improve clinical care.

scholarly journals Determining Success or Failure After Foot and Ankle Surgery Using Patient Acceptable Symptom State (PASS) and Patient Reported Outcome Information System (PROMIS)

2018 ◽  
Vol 39 (8) ◽  
pp. 894-902 ◽  
Author(s):  
Michael R. Anderson ◽  
Judith F. Baumhauer ◽  
Benedict F. DiGiovanni ◽  
Sam Flemister ◽  
John P. Ketz ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Patient Outcomes ◽  
Roc Analysis ◽  
Patient Reported Outcome ◽  
Foot And Ankle ◽  
Chi Square ◽  
Ankle Surgery ◽  
Patient Reported ◽  
Patient Acceptable Symptom State ◽  
Chi Square Analysis

Background: As the role of generic patient-reported outcomes (PROs) expands, important questions remain about their interpretation. In particular, how the Patient Reported Outcome Measurement Instrumentation System (PROMIS) t score values correlate with the patients’ perception of success or failure (S/F) of their surgery is unknown. The purposes of this study were to characterize the association of PROMIS t scores, the patients’ perception of their symptoms (patient acceptable symptom state [PASS]), and determination of S/F after surgery. Methods: This retrospective cohort study contacted patients after the 4 most common foot and ankle surgeries at a tertiary academic medical center (n = 88). Patient outcome as determined by phone interviews included PASS and patients’ judgment of whether their surgery was a S/F. Assessment also included PROMIS physical function (PF), pain interference (PI), and depression (D) scales. The association between S/F and PASS outcomes was evaluated by chi-square analysis. A 2-way analysis of variance (ANOVA) evaluated the ability of PROMIS to discriminate PASS and/or S/F outcomes. Receiver operator curve (ROC) analysis was used to evaluate the ability of pre- (n = 63) and postoperative (n = 88) PROMIS scores to predict patient outcomes (S/F and PASS). Finally, the proportion of individuals classified by the identified thresholds were evaluated using chi-square analysis. Results: There was a strong association between PASS and S/F after surgery (chi-square <0.01). Two-way ANOVA demonstrated that PROMIS t scores discriminate whether patients experienced positive or negative outcome for PASS ( P < .001) and S/F ( P < .001). The ROC analysis showed significant accuracy (area under the curve > 0.7) for postoperative but not preoperative PROMIS t scores in determining patient outcome for both PASS and S/F. The proportion of patients classified by applying the ROC analysis thresholds using PROMIS varied from 43.0% to 58.8 % for PASS and S/F. Conclusions: Patients who found their symptoms and activity at a satisfactory level (ie, PASS yes) also considered their surgery a success. However, patients who did not consider their symptoms and activity at a satisfactory level did not consistently consider their surgery a failure. PROMIS t scores for physical function and pain demonstrated the ability to discriminate and accurately predict patient outcome after foot and ankle surgery for 43.0% to 58.8% of participants. These data improve the clinical utility of PROMIS scales by suggesting thresholds for positive and negative patient outcomes independent of other factors. Level of Evidence: II, prospective comparative series.

scholarly journals Will the Foot Strike Pattern Change at Different Running Speeds with or without Wearing Shoes?

2020 ◽  
Vol 17 (17) ◽  
pp. 6044
Author(s):  
Ying-Jen Lai ◽  
Willy Chou ◽  
I-Hua Chu ◽  
Yu-Lin Wang ◽  
Yi-Jing Lin ◽  
...  
Keyword(s):  
High Speed ◽  
Physical Therapist ◽  
Random Order ◽  
Heel Strike ◽  
Running Speed ◽  
Chi Square ◽  
Significance Level ◽  
Limb Injuries ◽  
Foot Strike ◽  
Chi Square Analysis

Runners strike their feet with three different patterns during running: forefoot, midfoot, and rearfoot. This study aimed to investigate whether runners maintain consistent patterns while running speed and foot condition change. The foot strike patterns of runners when running on a treadmill at paces ranging from slow to fast were recorded from twenty healthy male regular runners, with and without shoes, in random order. A high-speed camera was used to observe the strike patterns, which were then categorized by an experienced physical therapist. Linear-log and Pearson chi-square analysis with a significance level of α = 0.05 was performed to examine the correlation between foot strike pattern, running speed, and shoe conditions. The results suggest that runners strike with different patterns when running with and without shoes (χ2 = 99.07, p < 0.01); runners preferred to adopt heel strike regardless of running speeds when running with shoes. While running barefoot, only 23.8% of landing strikes were rearfoot, and the strike pattern distribution did not change significantly with the running speed (χ2 = 2.26, p = 0.89). In summary, the foot strike preference of runners is correlated with the foot condition (barefoot or shod) rather than running speed. For runners who intend to change their strike patterns for any reason, we recommend that they consider adjusting their footwear, which may naturally help with the foot strike adjustment. Future studies should attempt to use advanced techniques to observe further foot biomechanics in order to discover if changing strike pattern is directly correlated with lower limb injuries.

scholarly journals Generalizability and Validation of PROMIS Scores to Predict Surgical Success in Foot and Ankle Patients

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000 ◽  
Author(s):  
Judith Baumhauer ◽  
Michael Anderson ◽  
Charles Saltzman ◽  
Man Hung ◽  
Florian Nickisch ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Significant Proportion ◽  
Geographic Area ◽  
Current Data ◽  
Foot And Ankle ◽  
Chi Square ◽  
Data Set ◽  
Post Surgery ◽  
Patient Reported ◽  
Chi Square Analysis

Category: Patient Reported Outcomes Introduction/Purpose: Patient-reported outcomes are advancing clinical care by improving patient satisfaction and engagement. A recent publication reported preoperative PROMIS scores to be highly predictive in selecting patients who would and would not benefit from foot and ankle (F/A) surgery. Although this publication used the data from 5 fellowship trained foot and ankle surgeons at one institution, the generalizability to other patient populations and geographic areas is unknown. This validation study assesses the pre-operative PROMIS physical function (PF) and pain interference (PI) t-scores as a predictor of post-operative success from a separate geographic area. Methods: Prospective consecutive patient visits to a multi-surgeon tertiary F/A clinic were obtained between 1/2014-11/2016 resulting in 18,565 unique visits and 1,408 new patients. Patients undergoing elective operative intervention for F/A were identified by ICD-9/10; CPT code. PROMIS PF and PI were assessed at initial and follow-up visits (minimum 6 months, mean 7.8 months). Two-way ANOVA was used to determine differences in PROMIS PF and PI from pre to post surgery with age and gender as co- variates. The distributive method of estimating a minimal clinical important difference (MCID) was used. Receiver operator curve (ROC) analysis was used to determine cut offs for achieving and failing to achieve MCID. To determine the validity of previously published cut offs, 1) they were compared to cut offs for this data set and 2) the percentage of patients achieving and failing to achieve MCID based on previous cut offs were evaluated using a chi-square analysis. Results: There were significant improvements in PROMIS PF scores (mean=6.0; sd=11.6; p<0.01) and PI scores (mean=-7.0; sd=8.4; p<0.01). The AUC for PROMIS PF (0.77) was significant (p < 0.01) and the cut offs for achieving MCID (current data = <23.8 versus previous study= <29.7) and failing to achieve MCID (current data=>41.1 versus previous study=>42) were comparable (Figure 1). Of the patients identified as unlikely to achieve MCID, a significant proportion (88.9%) failed to achieve an MCID ((Chi square=4.7; p=0.03). Of the patients identified as likely to achieve MCID, a significant proportion (84.2%) achieved MCID ((Chi square=17.8; p<0.01). This validates the prior preoperative PROMIS PF thresholds for patients undergoing F/A surgery who will and will not demonstrate MCID improvement in PROMIS PF. The AUC for PROMIS PI was not significant. Conclusion: PROMIS PF cut offs from published data were successful in classifying patients who would improve in PF with surgery from a different geographic area and academic institution with a broad unique array of surgical procedures, diagnoses, and a diverse patient population. This study provides validation evidence to support using the PROMIS PF as a potential tool for surgical selection to help identify patients who would benefit from surgery as well as those who would not. This can allow for appropriate utilization of healthcare dollars and manpower resources to benefit our patients.

scholarly journals Association of Importance of the Doctoral Degree With Students' Perceptions and Anticipated Activities Reflecting Professionalism

2005 ◽  
Vol 85 (8) ◽  
pp. 766-781 ◽  
Author(s):  
Marie A Johanson
Keyword(s):  
Physical Therapy ◽  
Professional Education ◽  
Physical Therapist ◽  
Doctoral Degree ◽  
Faculty Members ◽  
Chi Square ◽  
Doctor Of Physical Therapy ◽  
Physical Therapist Students ◽  
Chi Square Analysis ◽  
American Physical

Abstract Background and Purpose. The American Physical Therapy Association (APTA) has identified the Doctor of Physical Therapy (DPT) degree as 1 of 6 elements necessary to transition the physical therapy profession to a fully professionalized discipline. However, there have been no data to determine whether physical therapist students who place importance on the DPT degree perceive physical therapy to be more professionalized or anticipate participation in activities reflecting professionalism more than those who do not place importance on the DPT degree. Subjects. The subjects were 919 professional physical therapist students. Methods. Faculty members at 34 physical therapist education programs distributed questionnaires to 1,172 professional physical therapist students and returned 919 questionnaires, for a response rate of 78.4%. The data were statistically analyzed using chi-square analysis and logistic regression. Results. There were few differences between students who place importance on the DPT degree (DPT-I students) and those who do not place importance on the DPT degree (DPT-NI students) regarding how professionalized they perceive physical therapy to be relative to other health care professions or regarding their anticipated participation in activities reflecting professionalism. The one potential distinction found when controlling for other variables was that DPT-I students were more likely than DPT-NI students to anticipate becoming faculty members. Discussion and Conclusion. When beginning their professional education, there are few differences between DPT-I and DPT-NI students' perceptions of the professionalization of physical therapy or anticipation of activities reflecting professionalism.

scholarly journals What Are Typical Outcomes Associated with Physical Therapy for Foot & Ankle Patients?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0010
Author(s):  
Judith F. Baumhauer ◽  
Christopher Neville ◽  
Kostantinos Vasalos ◽  
Chad Condidorio ◽  
Kathleen Fear ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Physical Therapy ◽  
Ankle Sprain ◽  
Patient Reported Outcome ◽  
Published Data ◽  
Foot And Ankle ◽  
Ankle Pain ◽  
Chi Square ◽  
Patient Reported ◽  
Chi Square Analysis

Category: Outcomes Introduction/Purpose: It is unclear whether patients attending physical therapy, post-op or for conservative care, achieve clinically important differences (CID) on the patient reported outcome information system (PROMIS) scales. Key PROMIS outcomes physical function (PF) and pain interference (PI) match well with treatments provided in physical therapy. Physical therapy may also influence depression (Dep). Documentation of PROMIS outcomes associated with physical therapy are useful to help set patient expectations. The purpose of this analysis was to document expected PROMIS PF, PI, and Dep outcomes after physical therapy for foot and ankle diagnoses by 1) reporting average improvement and 2) examining whether severity of symptoms (PROMIS Scales) at the start of physical therapy are associated with a 0.5 standard deviation (CID) improvement at the end of therapy. Methods: PROMIS scales were available at the start and end of physical therapy treatment for 377 patients with foot and ankle ICD10 codes. Clinical categories(>n=20) of patients were identified for 6 groups(n=309): Achilles Rupture(n=24), Fracture(n=34), Ankle Pain(n=105), Foot Pain(n= 50), Ankle Sprain(n=51), and Achilles Non-Rupture(n=45). ANOVA models followed by pairwise comparisons were used to assess differences between start and end scores for all patients (n=377) and across diagnoses (n=309). Minimal CID was defined as improvement of t-score 3-5 and CID as above 5 (0.5 SD) consistent with published data. PROMIS scales were also converted to 0.5 standard deviation(SD) increments to document proportions of patients with symptoms relative to normal of the US population at start and end of physical therapy. Chi-square analysis was used to examine the association of PROMIS symptoms PF and PI at the start and end of care in 0.5 SD increments. Results: Across ALL patients the largest improvements occurred in PF (6.5, p<0.01) followed by PI (3.9, P<0.01) and Dep (2.4, p<0.01). When evaluating diagnostic categories, all categories improved for PI (p<0.01), PF (p<0.05) and for Dep except for Ankle Pain (p=0.22). For PF, improvements ranged from 6.6 for Ankle Sprain to 3.3 for Achilles Non-Rupture. For PI improvements ranged from 11.1 for Achilles rupture to 4.6 for Achilles Non-Rupture. For both PF and PI there was a significant association of starting PF (p<0.01) and PI (p<0.01) score and end PF and PI scores. Patients with worse PF or PI in the midrange (55-65) at the start showed a higher percentage of patients achieving a 0.5 increment improvement at the end of therapy. Conclusion: Although many factors influence these outcomes, physical therapy for foot and ankle patients was associated with strong positive, clinically meaningful outcomes for a majority of patients as assessed during the episode of care. As expected improvements were greater for PF and PI as compared to Dep. Providers should consider more severe symptoms as a possible indication for physical therapy referral.

scholarly journals Is there a Difference in Outcomes between Patients who Received a Double or Triple Arthrodesis for Hindfoot Arthritis?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0025
Author(s):  
Amanda H. Holleran ◽  
Judith F. Baumhauer ◽  
Jeff Houck ◽  
Daniel Homeier ◽  
Adolph S. Flemister ◽  
...  
Keyword(s):  
Physical Function ◽  
Pain Interference ◽  
Foot Deformities ◽  
Triple Arthrodesis ◽  
Chi Square ◽  
Post Surgery ◽  
Increased Risk ◽  
Patient Reported ◽  
Chi Square Analysis

Category: Hindfoot Introduction/Purpose: Triple arthrodesis has historically been considered the standard of treatment for arthritis of the hindfoot with or without deformity. The complications of this surgery including non-union, malunion, nerve injury, infection and wound healing problems can occur at any of the three joints. Double arthrodesis is capable of producing a similar reduction in degrees of motion and correction of foot deformity but may also cause less patient morbidity in regard to these complications due to one less joint being incorporated into the fusion procedure. What is unknown is the patient reported outcomes, specifically physical function (PF) and pain interference (PI) between these two procedures. The purpose of this study is to evaluate the clinical outcomes for hindfoot deformity using a triple compared to a double arthrodesis. Methods: A retrospective medical record review was performed (February 2015-December 2019), of 96 identified cases, 54 had complete data over 4 months post operation for either a double (Age = 58 (11); Body Mass Index (BMI) = 34.4 (6.0); n=24) or triple arthrodesis (Age= 55 (13); BMI = 33.0 (10.0); n = 30). Patient Reported Outcome Measurement Information System (PROMIS) physical function and pain interference were assessed at last available pre-operation and last follow up time points. Medical records were reviewed for complications (yes/no). ANOVA models were used to assess differences pre to post surgery (covariates included age, BMI, and length of follow up). Chi Square analysis was used to assess proportions of patients achieving a minimal clinically important difference (34.5) and complications by group. Results: There were no differences between groups in terms of age (p = 0.51), BMI (p = 0.44), or length of follow up (triple = 540 (334) days versus double = 390 (336) days; p=0.12). There were no significant differences in PROMIS PF (pre-post change 95% CI: triple= 1.2 (-4.1 to 1.6) versus double = 0.2 (-2.5 to 2.0)). The for PROMIS PI both groups experienced lower pain (average 5.1 (1.0) with the greater decrease in pain in the triple group (Figure 1; pre-post change 95% CI: triple= 7.1 (-10.2 to -4.0) versus double = 3 (-5.5 to -0.6)). Chi square analysis showed that a greater proportion of patients undergoing a triple (triple 61.9 % versus double 33.3 %) experienced MCID improvement in PROMIS PI (X2=4.4, p=0.04). There were 4 complications in the double group, and 6 in the triple group. Conclusion: Double arthrodesis can allow for similar correction of foot deformities without the increased risk of wound complication, infection or nonunion/malunion. However, we found that patients who underwent a triple arthrodesis were more likely to have an improvement in minimally important clinical difference (MCID) in the PROMIS pain interference scores than those who underwent a double arthrodesis.

scholarly journals Attitudes, practices, and priority of HIV screening and testing among clinical providers in Transylvania and Moldavia, Romania

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cabiria M. Barbosu ◽  
Amanda Radulescu ◽  
Carmen Manciuc ◽  
Erin Muir ◽  
Brooke A. Levandowski ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Hiv Transmission ◽  
Clinical Care ◽  
Linkage To Care ◽  
People Living With Hiv ◽  
Hiv Screening ◽  
Chi Square ◽  
Aids Epidemic ◽  
Chi Square Analysis ◽  
Hiv Aids

Abstract Screening and linkage to care are core, foundational strategies for HIV transmission prevention and for identifying People Living with HIV (PLHIV). In Romania – with an atypical experience in the HIV/AIDS epidemic – providing care for HIV+ patients identified early is a priority, though screening and testing can pose a challenge in some areas. Methods A survey of 125 clinical providers to explore important dimensions of HIV/ AIDS clinical care was conducted in Transylvania and Moldavia, where clinicians identified poor/ latent screening as a major problem in providing timely care and in preventing the spread of disease. We analyzed determinants of offering HIV screening/testing to patients using Pearson Chi-square analysis and logistic regression. Logistic regression generated Odds Ratios (OR) to reflect the magnitude of association between the relevant variables, with 95% confidence interval (95% CI) indicating statistical range. Results In total, 40.8% of providers did not provide HIV screening/testing to at least one segment of the population. Hospital-based providers were significantly more likely to offer HIV screening/testing to all segments than were non-hospital-based providers (58.1% v. 35.5%, respectively; p < .05). Providers located within institutions with screening/testing policies were more likely to offer such services to their patients (p < .05). Overall, 94.4% of providers indicated interest in more training around HIV screening/testing. Discussion Reaching Romanian and global goals for reducing HIV require more timely screening and action based on positive status. Romanian clinicians are interested in expanding HIV screening/testing and are interested in participating in training that helps them feel more prepared to undertake this work.

PERSEPSI PETERNAK PADA KEPEMIMPINAN PENDAMPING DAN HUBUNGANNYA DENGAN PRODUKTIVITAS USAHA TERNAK DI PAGUYUBAN AL-AWWALIYAH, PASIRWANGI, GARUT, JAWA BARAT

2019 ◽  
Vol 12 (1) ◽  
pp. 42-51
Author(s):  
Dwi Indah Sulistiani ◽  
Ujang Maman ◽  
Junaidi J
Keyword(s):  
Data Analysis ◽  
Secondary Data ◽  
Primary Data ◽  
Leadership Qualities ◽  
Chi Square ◽  
Education Experience ◽  
Spss Software ◽  
Chi Square Analysis ◽  
And Behavior ◽  
The Relationship

Objective of this research; 1) determine the perception of ranchers against the properties and behavior of the leadership of the companion in the Society of Al-Awwaliyah 2) analyze the relationship between productivity breeder with productivity of livestock in the Society of Al-Awwaliyah 3) identify the relationship perceptions of ranchers against the leadership companion with productivity of livestock in the Society of Al-Awwaliyah , The data used in this study are primary and secondary data. Primary data were obtained from questionnaires which stem from ranchers while secondary data sourced from literature in the form of books and articles. Data processing was performed using Chi-square analysis using SPSS software version 21. One of the factors relating to the productivity of ranchers is the perception of ranchers against the leadership of their companion. Leadership companion views of the nature and behavior of which is owned by a companion. Productivity ranchers indirectly related to the productivity of the cattle business. Characteristics breeder visits of age, years of education, experience ranchers, and businesses in addition to ranchers. The results of data analysis showed that there is a significant relationship between business other than ranchers with ranchers productivity. The relationship between the perception of the nature of the companion breeder with productivity ranchers produce Pearson Chi-Square value is 9.751 and Asymp. Sig. (2-sided) of 0.002. This is due to interest ranchers against leadership qualities possessed by a companion who produce prolific ranchers. Ranchers consider that a companion of his leadership qualities are ideal as a companion.

The Effect of Sanctions on Cooperative Behavior: A Study on Medium Trust Individuals in the Context of Corruption

2018 ◽  
Vol 34 (1) ◽  
Author(s):  
Dewi Rosiana ◽  
Achmad Djunaidi ◽  
Indun Lestari Setyono ◽  
Wilis Srisayekti
Keyword(s):  
Logistic Regression ◽  
Public Interest ◽  
Logistic Regression Model ◽  
Cooperative Behavior ◽  
Research Subjects ◽  
Chi Square ◽  
Public Interests ◽  
The Public ◽  
Chi Square Analysis ◽  
Personal Interests

This study aims to describe the effect of sanctions (individual sanctions, collective sanctions, and absence of sanctions) on cooperative behavior of individuals with medium trust in the context of corruption. Both collective sanctions and individual sanctions, are systemic, which means sanctioning behavior is exercised not by each individual but by the system. Cooperative behavior in this context means choosing to obey rules, to reject acts of corruption and to prioritize public interests rather than the personal interests. Conversely, corruption is an uncooperative behavior to the rules, and ignores the public interest and prioritizes personal interests. Research subjects were 62 students. The Chi-Square Analysis was used to see the association between the variables and the logistic regression model was applied to describe the structure of this association. Individual sanction is recommended as punishment to medium trust individuals to promote cooperative behavior in the context of corruption. The results showed that individuals with medium trust had more cooperative behavior.

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